title: Meta-analysis of neuropsychological measures of executive functioning in children and adolescents with high-functioning autism spectrum disorder.
abstract: Existing literature on the profile of executive dysfunction in autism spectrum disorder showed inconsistent results. Age, comorbid attention-deficit/hyperactivity disorder (ADHD) and cognitive abilities appeared to play a role in confounding the picture. Previous meta-analyses have focused on a few components of executive functions. This meta-analysis attempted to delineate the profile of deficit in several components of executive functioning in children and adolescents with high-functioning autism spectrum disorder (HFASD). Ninety-eight English published case-control studies comparing children and adolescents with HFASD with typically developing controls using well-known neuropsychological measures to assess executive functions were included. Results showed that children and adolescents with HFASD were moderately impaired in verbal working memory (g = 0.67), spatial working memory (g = 0.58), flexibility (g = 0.59), planning (g = 0.62), and generativity (g = 0.60) except for inhibition (g = 0.41). Subgroup analysis showed that impairments were still significant for flexibility (g = 0.57-0.61), generativity (g = 0.52-0.68), and working memory (g = 0.49-0.56) in a sample of autism spectrum disorder (ASD) subjects without comorbid ADHD or when the cognitive abilities of the ASD group and the control group were comparable. This meta-analysis confirmed the presence of executive dysfunction in children and adolescents with HFASD. These deficits are not solely accounted for by the effect of comorbid ADHD and the general cognitive abilities. Our results support the executive dysfunction hypothesis and contribute to the clinical understanding and possible development of interventions to alleviate these deficits in children and adolescents with HFASD. Autism Res 2017, 10: 911-939. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.
authors.affiliation: Castle Peak Hospital, Tuen Mun, Hong Kong.
authors.forename: Chun Lun Eric
authors.initials: CLE
authors.lastname: Lai
authors.affiliation: Castle Peak Hospital, Tuen Mun, Hong Kong.
authors.forename: Zoe
authors.initials: Z
authors.lastname: Lau
authors.affiliation: Castle Peak Hospital, Tuen Mun, Hong Kong.
authors.forename: Simon S Y
authors.initials: SSY
authors.lastname: Lui
authors.affiliation: Castle Peak Hospital, Tuen Mun, Hong Kong.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Lok
authors.affiliation: Castle Peak Hospital, Tuen Mun, Hong Kong.
authors.forename: Venus
authors.initials: V
authors.lastname: Tam
authors.affiliation: Castle Peak Hospital, Tuen Mun, Hong Kong.
authors.forename: Quinney
authors.initials: Q
authors.lastname: Chan
authors.affiliation: Castle Peak Hospital, Tuen Mun, Hong Kong.
authors.forename: Koi Man
authors.initials: KM
authors.lastname: Cheng
authors.affiliation: Castle Peak Hospital, Tuen Mun, Hong Kong.
authors.forename: Siu Man
authors.initials: SM
authors.lastname: Lam
authors.affiliation: Castle Peak Hospital, Tuen Mun, Hong Kong.
authors.forename: Eric F C
authors.initials: EFC
authors.lastname: Cheung
mesh_terms: D000293:Adolescent; D000067877:Autism Spectrum Disorder / Q000503:physiopathology* / Q000523:psychology*; D016022:Case-Control Studies; D002648:Child; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*
keywords: Asperger's syndrome; executive function; high-functioning autism spectrum disorder; meta-analysis