In this paper, we consider the domain of executive functions (EFs) and their possible role in developmental psychopathologies. We first consider general theoretical and measurement issues involved in studying EFs and then review studies of EFs in four developmental psychopathologies: attention deficit hyperactivity disorder (ADHD), conduct disorder (CD), autism, and Tourette syndrome (TS). Our review reveals that EF deficits are consistently found in both ADHD and autism but not in CD (without ADHD) or in TS. Moreover, both the severity and profile of EF deficits appears to differ across ADHD and autism. Molar EF deficits are more severe in the latter than the former. In the few studies of more specific EF tasks, there are impairments in motor inhibition in ADHD but not in autism, whereas there are impairments in verbal working memory in autism but not ADHD. We close with a discussion of implications for future research.

Executive Functions and Developmental Psychopathology

Background: Manifestations of core social deficits in autism are more pronounced in everyday settings than in explicit experimental tasks. To bring experimental measures in line with clinical observation, we report a novel method of quantifying atypical strategies of social monitoring in a setting that simulates the demands of daily experience. Enhanced ecological validity was intended to maximize between-group effect sizes and assess the predictive utility of experimental variables relative to outcome measures of social competence. Methods: While viewing social scenes, eye-tracking technology measured visual fixations in 15 cognitively able males with autism and 15 age-, sex-, and verbal IQ– matched control subjects. We reliably coded fixations on 4 regions: mouth, eyes, body, and objects. Statistical analyses compared fixation time on regions of interest between groups and correlation of fixation time with outcome measures of social competence (ie, standardized measures of daily social adjustment and degree of autistic social symptoms). Results: Significant between-group differences were obtained for all 4 regions. The best predictor of autism was reduced eye region fixation time. Fixation on mouths and objects was significantly correlated with social functioning: increased focus on mouths predicted improved social adjustment and less autistic social impairment, whereas more time on objects predicted the opposite relationship. Conclusions: When viewing naturalistic social situations, individuals with autism demonstrate abnormal patterns of social visual pursuit consistent with reduced salience of eyes and increased salience of mouths, bodies, and objects. Fixation times on mouths and objects but not on eyes are strong predictors of degree of social competence. Arch Gen Psychiatry. 2002;59:809-816

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Visual fixation patterns during viewing of naturalistic social situations as predictors of social competence in individuals with autism.

Part two of this three-part series commences with anomalous dominance and special talents. Part one appears in a previous issue of theArchives. 1 ANOMALOUS DOMINANCE AND SPECIAL TALENTS According to our hypothesis, slowed growth within certain zones of the left hemisphere is likely to result in enlargement of other cortical regions, in particular, the homologous contralateral area, but also adjacent unfaffected regions. The influences that favor anomalous dominance may thus favor talents associated with superior development of certain regions either in the right hemisphere or in adjacent parts of the left hemisphere. Even with excessive retardation of growth and the resultant migration abnormalities and learning disorders (LD), high talents may exist as a result of compensatory enlargement of other cortical regions. Several types of data are in concordance with these conclusions. Several studies have claimed that the average level of spatial talents is higher in male subiects. 2 Hier

https://jamanetwork.com/journals/jamaneurology/articlepdf/584161/archneur_42_5_008.pdf

Cerebral lateralization. Biological mechanisms, associations, and pathology: II. A hypothesis and a program for research.

Motor development and cognitive development may be fundamentally interrelated. Contrary to popular notions that motor development begins and ends early, whereas cognitive development begins and ends later, both motor and cognitive development display equally protracted developmental timetables. When cognitive development is perturbed, as in a neurodevelopmental disorder, motor development is often adversely affected. While it has long been known that the striatum functions as part of a circuit with dorsolateral prefrontal cortex, it is suggested here that the same is true for the cerebellum and that the cerebellum may be important for cognitive as well as motor functions. Like prefrontal cortex, the cerebellum reaches maturity late. Many cognitive tasks that require prefrontal cortex also require the cerebellum. To make these points, evidence is summarized of the close co-activation of the neocerebellum and dorsolateral prefrontal cortex in functional neuroimaging, of similarities in the cognitive sequelae of damage to dorsolateral prefrontal cortex and the neocerebellum, of motor deficits in "cognitive" developmental disorders, and of abnormalities in the cerebellum and in prefrontal cortex in the same developmental disorders.

https://www.jstor.org/stable/info/1132216

Close interrelation of motor development and cognitive development and of the cerebellum and prefrontal cortex.

The visual scanpaths of five high-functioning adult autistic males and five adult male controls were recorded using an infrared corneal reflection technique as they viewed photographs of human faces. Analyses of the scanpath data revealed marked differences in the scanpaths of the two groups. The autistic participants viewed nonfeature areas of the faces significantly more often and core feature areas of the faces (i.e., eyes, nose, and mouth) significantly less often than did control participants. Across both groups of participants, scanpaths generally did not differ as a function of the instructions given to the participants (i.e., “Please look at the faces in any manner you wish.” vs. “Please identify the emotions portrayed in these faces.”). Autistic participants showed a deficit in emotion recognition, but this effect was driven primarily by deficits in the recognition of fear. Collectively, these results indicate disorganized processing of face stimuli in autistic individuals and suggest a mechanism that may subserve the social information processing deficits that characterize autism spectrum disorders.

Visual Scanning of Faces in Autism

Two experiments were carried out assessing autistic children's recognition, discrimination, and fixation of unfamiliar faces and unfamiliar buildings. The experiments showed that (i) unfamiliar face recognition is impaired relative to normal peers, non-verbal ability matched and verbal ability matched controls. Relative to verbal ability matched controls (ii) recognition of buildings is normal; (iii) there is an enhanced discrepancy between face discrimination and buildings discrimination, in favour of buildings; and (iv) fixation is normal. Analysis of the results suggests that impaired face recognition does not result from impaired attention or discrimination.

Unfamiliar face recognition in relatively able autistic children.

Background: Structural language anomalies or impairments in autistic spectrum disorder (ASD) are theoretically and practically important, although underrecognised as such. This review aims to highlight the ubiquitousness of structural language anomalies and impairments in ASD, and to stimulate investigation of their immediate causes and implications for intervention.

Method:  Studies of structural language in ASD are reviewed (based on a search of the literature and selected as meeting defined inclusion criteria), and explanatory hypotheses are discussed.

Results:  Some individuals with ASD never acquire language. Amongst those who do, language abilities range from clinically normal (ALN) to various degrees of impairment (ALI). Developmental trajectories and individual profiles are diverse, and minority subgroups have been identified. Specifically: language is commonly but not always delayed and delayed early language is always characterised by impaired comprehension and odd utterances, and sometimes by deviant articulation and grammar. Nevertheless, by school age an ‘ASD-typical’ language profile emerges from group studies, with articulation and syntax least affected, and comprehension, semantics and certain facets of morphology most affected. Thus, even individuals with ALN have poor comprehension relative to expressive language; also semantic-processing anomalies and idiosyncratic word usage. It is argued that impaired socio-emotional-communicative relating, atypical sensory-perceptual processing, and uneven memory/learning abilities may underlie shared language anomalies across the spectrum; and that varying combinations of low nonverbal intelligence, semantic memory impairment and comorbidities including specific language impairment (SLI), hearing impairment, and certain medical syndromes underlie ALI and variation in individual profiles.

Conclusions:  Structural language is universally affected in ASD, due to a complex of shared and unshared causal factors. There is an urgent need for more research especially into the characteristics and causes of clinically significant language impairments.

Research review: structural language in autistic spectrum disorder - characteristics and causes

Autistic children were compared with control children on tasks in which retention was tested by different methods. In three tests of recall, using named pictures, written words and spoken words as test stimuli, autistic children were impaired in comparison with age-matched normal children and with controls matched for verbal and non-verbal ability. In one test of forced-choice recognition of pictures, autistic children were impaired in comparison with ability-matched controls. In three tests of cued recall, using named pictures, written words and spoken words as test stimuli, and acoustic, graphemic and semantic cues, autistic children were not impaired in comparison with normal age-matched controls. In one test of paired-associate learning using non-related word pairs as test stimuli autistic children were not impaired in comparison with normal age-matched controls. These experimental paradigms were similar to some that have been used to investigate the amnesic syndrome in man. Thus findings on paired-associate learning differ in autistic and amnesic subjects, but findings on recall, recognition and cued recall are comparable. A possible parallel between autism and amnesia is discussed.

Memory deficits in early infantile autism: some similarities to the amnesic syndrome.

Experimental research into the symbolic play of autistic children is reviewed in an attempt to outline the nature of their deficit in this area. While many studies can be criticized on methodological grounds, there is good evidence for an impairment in the spontaneous symbolic play of autistic children, an impairment that appears to extend to cover spontaneous functional play also. However studies that have investigated elicited and instructed play have indicated that autistic children may have a capacity for symbolic play that they do not spontaneously exhibit. The implications of these findings for various hypotheses concerning a symbolic play deficit in autism are considered and directions for future research are outlined.

Symbolic Play in Autism: A Review.

It has been suggested that language impairment in autism is behaviorally, neurobiologically, and etiologically related to specific language impairment (SLI). In this article, the authors review evidence at each level and argue that the vast majority of data does not support the view that language impairment in autism can be explained in terms of comorbid SLI. The authors make recommendations for how this debate might be resolved and suggest a shift in research focus. They recommend that researchers concentrate on those aspects of language impairment that predominate in each disorder rather than on those comparatively small areas of potential overlap.

/pdf/language-in-autism-and-specific-language-impairment-where-4ob4cbo8f6.pdf

Jill Boucher

Papers

Unfamiliar face recognition in relatively able autistic children.

Research review: structural language in autistic spectrum disorder - characteristics and causes

Memory deficits in early infantile autism: some similarities to the amnesic syndrome.

Symbolic Play in Autism: A Review.

Language in autism and specific language impairment: where are the links?