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Poster #48 - Emotional problems, behaviors, and executive functioning in autism: The role of cognitive flexibility

Fri, March 22, 9:45 to 11:00am, Baltimore Convention Center, Floor: Level 1, Exhibit Hall B

Integrative Statement

Background: Emotion problems and behaviors such as anxiety and self-injury are commonly observed comorbidities in children with Autism Spectrum Disorder (ASD; Magnuson & Constantino, 2011). It has been proposed that individuals with ASD have a different cognitive profile including altered executive functioning (EF; Kenworthy et al., 2008) and altered brain topographies (Voelbel et al., 2006). EFs are neurocognitive processes that sustain problem-solving in order to achieve a later goal and include skills such as cognitive flexibility, planning, and inhibition. Previous studies have found that anxiety is mediated by parent-reported cognitive inflexibility in children with ASD (Lawson et al., 2015). However, no studies have investigated the direct relationship between EF deficits, as assessed through validated, researcher administered measures and other emotional and behavioral problems.
Objectives: This study examines the relationship between EF, as measured by the NIH-Toolbox Cognition Battery (NIH-TCB), and anxiety, lethargy, and self-injurious behavior as measured by parent-report.
Methods: ASD children ages 3-17 years and typically developing (TD) children matched on age are currently being recruited. Data from 134 children and adolescents with ASD (mean age = 9 years; SD= 4 years) and 92 TD controls (mean age = 8 years 5 months; SD = 3 years) is included in this preliminary analysis. TD children demonstrated a significantly higher intelligent quotient (IQ) as indexed via the Stanford-Binet Intelligence Test, Fifth Edition (SB-5; TD mean IQ = 111.6; ASD mean IQ = 91.93; p=.01), therefore the analysis controlled for IQ. Parents completed the Parent Anxiety Checklist-ASD to assess current levels of anxiety; the Repetitive Behavior Scales-Revised (RBS-R), to assess child self-injurious behavior; and the Aberrant Behavior Checklist (ABC), to assess child lethargy. Children completed the NIH Toolbox Dimensional Change Card Sort (DCCS) assessment. ASD level was classified into mild, moderate, and high based on Autism Diagnostic Observation Scales (ADOS) comparative scores. A path analysis was conducted to test the following hypothesized mediation model: ASD status -> cognitive Inflexibility -> anxiety.
Results: The hypothesized mediation model presented non-significant differences between groups (p=.78). Both direct effects (ASD severity -> outcome variable) and indirect effects were tested (ASD severity -> cognitive inflexibility -> outcome variable) for the following outcome variables (with indirect statistics reported): anxiety (low ASD B=0.62, SE=2.10, p=0.77; mild ASD B=0.812, SE =2.72, p=0.77; high ASD B=0.37, SE=1.27, and p-0.77), self-injurious behavior (low ASD B=-0.13, SE=0.37, p=0.73; mild ASD B=-0.17, SE=0.48, p=0.72; high ASD B=-0.77, SE=0.22, and p=0.73), and lethargy (low ASD B=-0.02 SE=0.63, p=0.97; mild ASD B=-0.03, SE =0.83, p=0.97; high ASD B=-0.01, SE=0.38, and p=0.97). All models demonstrated significant direct effects (p<.01) and indirect effects (p<.01), and provided acceptable fit indices (RMSEA<.1).
Conclusions: These preliminary findings replicate previously observed pathways between cognitive flexibility and anxiety in children with ASD using performance-based measures, while also extending these findings to emotional and behavior problems. The results of this analysis further suggest that deficits in executive functioning partly explain the effect of ASD diagnosis on emotional problems and behaviors.

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