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Semin Speech Lang 2019; 40(04): 291-304
DOI: 10.1055/s-0039-1692964
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A Review of Language, Executive Function, and Intervention in Autism Spectrum Disorder

Laura Friedman
1   Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, Wisconsin
,
Audra Sterling
1   Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, Wisconsin
› Author Affiliations
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Publication History

Publication Date:
16 July 2019 (online)

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Abstract

Difficulties with both executive functions and language skills are common but variable in autism spectrum disorder (ASD). Executive functions and language skills are related to one another, such that vocabulary, syntax, and pragmatics are related to domains of working memory, shifting, and inhibition in ASD, although the directionality of these relationships remains unclear. Moreover, interventions that target pragmatic ability have been found to improve executive function skills, and conversely, executive function interventions are linked with improvements in social skills in children with ASD. We review the literature on executive functions, language skills, and their relationship in ASD; discuss factors that may be driving inconsistent findings; and explore clinical applications from the research thus far.

Keywords

autism spectrum disorder - executive function - language - intervention

Disclosures

Financial: This work was supported in part by a training grant from the National Institute on Deafness and Other Communication Disorders (T32 DC05359; PI: Susan Ellis Weismer), as well as a core grant to the Waisman Center from the National Institute of Child Health and Human Development (U54 HD090256, PI: Qiang Chang).


Nonfinancial: No relevant relationships exist


 

  • References

  • 1 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 2013
    PubMedGoogle Scholar
  • 2 Baio J, Wiggins L, Christensen DL. , et al. Prevalence of autism spectrum disorder among children aged 8 years - Autism and Developmental Disabilities Monitoring Network, 11 sites, United States, 2014. MMWR Surveill Summ 2018; 67 (06) 1-23
    CrossrefPubMedGoogle Scholar
  • 3 Pellicano E. The development of executive function in autism. Autism Res Treat 2012; 2012: 146132
    PubMedGoogle Scholar
  • 4 Craig F, Margari F, Legrottaglie AR, Palumbi R, de Giambattista C, Margari L. A review of executive function deficits in autism spectrum disorder and attention-deficit/hyperactivity disorder. Neuropsychiatr Dis Treat 2016; 12: 1191-1202
    PubMedGoogle Scholar
  • 5 Leung RC, Zakzanis KK. Brief report: cognitive flexibility in autism spectrum disorders: a quantitative review. J Autism Dev Disord 2014; 44 (10) 2628-2645
    CrossrefPubMedGoogle Scholar
  • 6 Hill EL. Executive dysfunction in autism. Trends Cogn Sci 2004; 8 (01) 26-32
    CrossrefPubMedGoogle Scholar
  • 7 Kenworthy L, Yerys BE, Anthony LG, Wallace GL. Understanding executive control in autism spectrum disorders in the lab and in the real world. Neuropsychol Rev 2008; 18 (04) 320-338
    CrossrefPubMedGoogle Scholar
  • 8 Kaushanskaya M, Park JS, Gangopadhyay I, Davidson MM, Weismer SE. The relationship between executive functions and language abilities in children: a latent variables approach. J Speech Lang Hear Res 2017; 60 (04) 912-923
    CrossrefPubMedGoogle Scholar
  • 9 Miyake A, Friedman NP, Emerson MJ, Witzki AH, Howerter A, Wager TD. The unity and diversity of executive functions and their contributions to complex “Frontal Lobe” tasks: a latent variable analysis. Cognit Psychol 2000; 41 (01) 49-100
    CrossrefPubMedGoogle Scholar
  • 10 Zelazo PD, Craik FIM, Booth L. Executive function across the life span. Acta Psychol (Amst) 2004; 115 (2-3): 167-183
    CrossrefPubMedGoogle Scholar
  • 11 Akbar M, Loomis R, Paul R. The interplay of language on executive functions in children with ASD. Res Autism Spectr Disord 2013; 7 (03) 494-501
    CrossrefPubMedGoogle Scholar
  • 12 Gruber O, Goschke T. Executive control emerging from dynamic interactions between brain systems mediating language, working memory and attentional processes. Acta Psychol (Amst) 2004; 115 (2-3): 105-121
    CrossrefPubMedGoogle Scholar
  • 13 Gilotty L, Kenworthy L, Sirian L, Black DO, Wagner AE. Adaptive skills and executive function in autism spectrum disorders. Child Neuropsychol 2002; 8 (04) 241-248
    CrossrefPubMedGoogle Scholar
  • 14 St Clair-Thompson HL, Gathercole SE. Executive functions and achievements in school: shifting, updating, inhibition, and working memory. Q J Exp Psychol (Hove) 2006; 59 (04) 745-759
    CrossrefPubMedGoogle Scholar
  • 15 Kloosterman PH, Kelley EA, Parker JDA, Craig WM. Executive functioning as a predictor of peer victimization in adolescents with and without an autism spectrum disorder. Res Autism Spectr Disord 2014; 8 (03) 244-254
    CrossrefPubMedGoogle Scholar
  • 16 Whitehouse AJO, Watt HJ, Line EA, Bishop DVM. Adult psychosocial outcomes of children with specific language impairment, pragmatic language impairment and autism. Int J Lang Commun Disord 2009; 44 (04) 511-528
    CrossrefPubMedGoogle Scholar
  • 17 Long MR, Horton WS, Rohde H, Sorace A. Individual differences in switching and inhibition predict perspective-taking across the lifespan. Cognition 2018; 170 (April): 25-30
    CrossrefPubMedGoogle Scholar
  • 18 Marcovitch S, Zelazo PD. A hierarchical competing systems model of the emergence and early development of executive function. Dev Sci 2009; 12 (01) 1-18
    CrossrefPubMedGoogle Scholar
  • 19 Hale CM, Tager-Flusberg H. Social communication in children with autism: the relationship between theory of mind and discourse development. Autism 2005; 9 (02) 157-178
    CrossrefPubMedGoogle Scholar
  • 20 Capps L, Kehres J, Sigman M. Conversational abilities among children with Autism and children with developmental delays. Autism 1998; 2 (04) 325-344
    CrossrefPubMedGoogle Scholar
  • 21 McEvoy RE, Rogers SJ, Pennington BF. Executive function and social communication deficits in young autistic children. J Child Psychol Psychiatry 1993; 34 (04) 563-578
    CrossrefPubMedGoogle Scholar
  • 22 Kissine M. Pragmatics, cognitive flexibility and autism spectrum disorders. Mind Lang 2012; 27 (01) 1-28
    CrossrefPubMedGoogle Scholar
  • 23 Eigsti I, De Marchena AB, Schuh JM, Kelley E. Language acquisition in autism spectrum disorders : a developmental review. Res Autism Spectr Disord 2011; 5: 681-691
    CrossrefPubMedGoogle Scholar
  • 24 Arnold JE, Bennetto L, Diehl JJ. Reference production in young speakers with and without autism: effects of discourse status and processing constraints. Cognition 2009; 110 (02) 131-146
    CrossrefPubMedGoogle Scholar
  • 25 Adams C, Green J, Gilchrist A, Cox A. Conversational behaviour of children with Asperger syndrome and conduct disorder. J Child Psychol Psychiatry 2002; 43 (05) 679-690
    CrossrefPubMedGoogle Scholar
  • 26 Kover ST, McDuffie AS, Hagerman RJ, Abbeduto L. Receptive vocabulary in boys with autism spectrum disorder: cross-sectional developmental trajectories. J Autism Dev Disord 2013; 43 (11) 2696-2709
    CrossrefPubMedGoogle Scholar
  • 27 Hudry K, Leadbitter K, Temple K. , et al; PACT Consortium. Preschoolers with autism show greater impairment in receptive compared with expressive language abilities. Int J Lang Commun Disord 2010; 45 (06) 681-690
    CrossrefPubMedGoogle Scholar
  • 28 Ellis Weismer S, Lord C, Esler A. Early language patterns of toddlers on the autism spectrum compared to toddlers with developmental delay. J Autism Dev Disord 2010; 40 (10) 1259-1273
    CrossrefPubMedGoogle Scholar
  • 29 Jarrold C, Boucher J, Russell J. Language profiles in children with autism. Autism 1997; 1: 57-76
    CrossrefPubMedGoogle Scholar
  • 30 Volden J, Smith IM, Szatmari P. , et al. Using the Preschool Language Scale, Fourth Edition to characterize language in preschoolers with autism spectrum disorders. Am J Speech-Language Pathol 2011; 20: 200-208
    PubMedGoogle Scholar
  • 31 Hobson RP, Lee A, Hobson JA. Personal pronouns and communicative engagement in autism. J Autism Dev Disord 2010; 40 (06) 653-664
    CrossrefPubMedGoogle Scholar
  • 32 Durrleman S, Delage H. Autism spectrum disorder and specific language impairment: overlaps in syntactic profiles. Lang Acquis 2016; 23 (04) 361-386
    CrossrefPubMedGoogle Scholar
  • 33 De Mulder H. Developing communicative competence: a longitudinal study of the acquisition of mental state terms and indirect requests. J Child Lang 2015; 42 (05) 969-1005
    CrossrefPubMedGoogle Scholar
  • 34 Pierce S, Bartolucci G. A syntactic investigation of verbal autistic, mentally retarded, and normal children. J Autism Child Schizophr 1977; 7 (02) 121-134
    CrossrefPubMedGoogle Scholar
  • 35 Park CJ, Yelland GW, Taffe JR, Gray KM. Morphological and syntactic skills in language samples of pre school aged children with autism: atypical development?. Int J Speech-Language Pathol 2012; 14 (02) 95-108
    PubMedGoogle Scholar
  • 36 Eigsti IM, Bennetto L, Dadlani MB. Beyond pragmatics: morphosyntactic development in autism. J Autism Dev Disord 2007; 37 (06) 1007-1023
    CrossrefPubMedGoogle Scholar
  • 37 Ambridge B, Bannard C, Jackson GH. Is grammar spared in autism spectrum disorder? Data from judgments of verb argument structure overgeneralization errors. J Autism Dev Disord 2015; 45 (10) 3288-3296
    CrossrefPubMedGoogle Scholar
  • 38 Modyanova N, Perovic A, Wexler K. Grammar is differentially impaired in subgroups of autism spectrum disorders: evidence from an investigation of tense marking and morphosyntax. Front Psychol 2017; 8: 320
    CrossrefPubMedGoogle Scholar
  • 39 Kjelgaard MM, Tager-Flusberg H. An investigation of language impairment in autism: implications for genetic subgroups. Lang Cogn Process 2001; 16 (2-3): 287-308
    CrossrefPubMedGoogle Scholar
  • 40 Roberts JA, Rice ML, Tager-Flusberg H. Tense marking in children with autism. Appl Psycholinguist 2004; 25 (03) 429-448
    CrossrefPubMedGoogle Scholar
  • 41 Joseph RM, McGrath LM, Tager-Flusberg H. Executive dysfunction and its relation to language ability in verbal school-age children with autism. Dev Neuropsychol 2005; 27 (03) 361-378
    CrossrefPubMedGoogle Scholar
  • 42 Corbett BA, Constantine LJ, Hendren R, Rocke D, Ozonoff S. Examining executive functioning in children with autism spectrum disorder, attention deficit hyperactivity disorder and typical development. Psychiatry Res 2009; 166 (2-3): 210-222
    CrossrefPubMedGoogle Scholar
  • 43 Kado Y, Sanada S, Yanagihara M. , et al. Executive function in children with pervasive developmental disorder and attention-deficit/hyperactivity disorder assessed by the Keio version of the Wisconsin card sorting test. Brain Dev 2012; 34 (05) 354-359
    CrossrefPubMedGoogle Scholar
  • 44 Yang J, Zhou S, Yao S, Su L, McWhinnie C. The relationship between theory of mind and executive function in a sample of children from mainland China. Child Psychiatry Hum Dev 2009; 40 (02) 169-182
    CrossrefPubMedGoogle Scholar
  • 45 Pellicano E. Individual differences in executive function and central coherence predict developmental changes in theory of mind in autism. Dev Psychol 2010; 46 (02) 530-544
    CrossrefPubMedGoogle Scholar
  • 46 Liss M, Fein D, Allen D. , et al. Executive functioning in high-functioning children with autism. J Child Psychol Psychiatry 2001; 42 (02) 261-270
    CrossrefPubMedGoogle Scholar
  • 47 Kimhi Y, Shoam-Kugelmas D, Agam Ben-Artzi G, Ben-Moshe I, Bauminger-Zviely N. Theory of mind and executive function in preschoolers with typical development versus intellectually able preschoolers with autism spectrum disorder. J Autism Dev Disord 2014; 44 (09) 2341-2354
    CrossrefPubMedGoogle Scholar
  • 48 Roelofs RL, Visser EM, Berger HJC, Prins JB, Van Schrojenstein Lantman-De Valk HMJ, Teunisse JP. Executive functioning in individuals with intellectual disabilities and autism spectrum disorders. J Intellect Disabil Res 2015; 59 (02) 125-137
    CrossrefPubMedGoogle Scholar
  • 49 Heaton R, Chelune G, Talley J, Kay G, Curtis G. Wisconsin Card Sorting Test (WCST) Manual Revised and Expanded. Odessa, FL: Psychological Assessment Resources; 1993
    Google Scholar
  • 50 Ozonoff S, Jensen J. Brief report: specific executive function profiles in three neurodevelopmental disorders. J Autism Dev Disord 1999; 29 (02) 171-177
    CrossrefPubMedGoogle Scholar
  • 51 Gioia GA, Isquith PK, Guy SC, Kenworthy L. Behavior Rating of Executive Function. Lutz, FL: Psychological Assessment Resources; 2000
    Google Scholar
  • 52 Roth RM, Isquith PK, Gioia GA. Behavior Rating Inventory of Executive Function - Adult Version. Lutz, FL: Psychological Assessment Resources; 2005
    Google Scholar
  • 53 Durrleman S, Franck J. Exploring links between language and cognition in autism spectrum disorders: complement sentences, false belief, and executive functioning. J Commun Disord 2015; 54: 15-31
    CrossrefPubMedGoogle Scholar
  • 54 Golden CJ. Stroop Color and Word Test: A Manual for Clinical and Experimental Uses. 1978
    PubMedGoogle Scholar
  • 55 Johnston K, Madden AK, Bramham J, Russell AJ. Response inhibition in adults with autism spectrum disorder compared to attention deficit/hyperactivity disorder. J Autism Dev Disord 2011; 41 (07) 903-912
    CrossrefPubMedGoogle Scholar
  • 56 Burgess PW, Shallice T. The Hayling and Brixton Tests. Bury St Edmonds: Thames Valley Test Company; 1997
    Google Scholar
  • 57 Kashima H, Kato M. Wisconsin Card Sorting Test (Keio Version) (KWCST) [in Japanese]. Brain Sci Ment Disord 1995; 6: 209-2016
    PubMedGoogle Scholar
  • 58 Hill AP, van Santen J, Gorman K, Langhorst BH, Fombonne E. Memory in language-impaired children with and without autism. J Neurodev Disord 2015; 7 (01) 19
    CrossrefPubMedGoogle Scholar
  • 59 Ozonoff S, McEvoy RE. A longitudinal study of executive function and theory of mind development in autism. Dev Psychopathol 1994; 6 (03) 415-431
    CrossrefPubMedGoogle Scholar
  • 60 Cascia J, Barr JJ. Associations among vocabulary, executive function skills and empathy in individuals with autism spectrum disorder. J Appl Res Intellect Disabil 2017; 30 (04) 627-637
    CrossrefPubMedGoogle Scholar
  • 61 Haebig E, Kaushanskaya M, Ellis Weismer S. Lexical processing in school-age children with autism spectrum disorder and children with specific language impairment: the role of semantics. J Autism Dev Disord 2015; 45 (12) 4109-4123
    CrossrefPubMedGoogle Scholar
  • 62 Semel E, Wiig EH, Secord WA. Clinical Evaluation of Language Fundamentals - 4. San Antonio, TX: The Psychological Corporation; 2003
    Google Scholar
  • 63 Bishop DVM. The Children's Communication Checklist Second Edition (CCC-2). London: The Psychological Corporation; 2003
    Google Scholar
  • 64 Delis DC, Kaplan E, Kramer JH. The Delis-Kaplan Executive Function System: Examiner's Manual. San Antonio, TX: The Psychological Corporation; 2001
    Google Scholar
  • 65 Korkman M, Kirk U, Kemp SL. NEPSY-II. San Antonio, TX: The Psychological Corporation; 2007
    Google Scholar
  • 66 Wechsler D. Wechsler Abbreviated Scale of Intelligence - Second Edition. San Antonio, TX: NCS Pearson; 2011
    Google Scholar
  • 67 Ellis Weismer S, Kaushanskaya M, Larson C, Mathée J, Bolt D. Executive function skills in school-age children with autism spectrum disorder: association with language abilities. J Speech Lang Hear Res 2018; 61 (11) 2641-2658
    CrossrefPubMedGoogle Scholar
  • 68 Carrow-Woolfolk E. Comprehensive Assessment of Spoken Language (CASL). Circle Pines, MN: American Guidance Service; 1999
    Google Scholar
  • 69 Seibert JM, Hogan AE, Mundy PC. Assessing social communication skills in infancy. Top Early Child Spec Educ 1987; 7: 32-48
    PubMedGoogle Scholar
  • 70 Pugliese CE, Anthony L, Strang JF, Dudley K, Wallace GL, Kenworthy L. Increasing adaptive behavior skill deficits from childhood to adolescence in autism spectrum disorder: role of executive function. J Autism Dev Disord 2015; 45 (06) 1579-1587
    CrossrefPubMedGoogle Scholar
  • 71 Sparrow SS, Cicchetti DV, Balla DA. Vineland Adaptive Behavior Scales: Survey Form (2nd ed.). Circle Pines, MN: American Guidance Service; 2005
    Google Scholar
  • 72 Stichter JP, Herzog MJ, Visovsky K. , et al. Social competence intervention for youth with Asperger Syndrome and high-functioning autism: an initial investigation. J Autism Dev Disord 2010; 40 (09) 1067-1079
    CrossrefPubMedGoogle Scholar
  • 73 Constantino JN, Gruber C. The Social Responsiveness Scale. Los Angeles, CA: Western Psychological Services; 2005
    Google Scholar
  • 74 Stichter JP, O'Connor KV, Herzog MJ, Lierheimer K, McGhee SD. Social competence intervention for elementary students with Asperger's syndrome and high functioning autism. J Autism Dev Disord 2012; 42 (03) 354-366
    CrossrefPubMedGoogle Scholar
  • 75 Prizant BM, Wetherby AM, Rubin E, Laurent AC, Rydell JP. The SCERTS model: Volume I Assessment; Volume II Program Planning and Intervention. Baltimore, MD: Brookes Publishing; 2006
    Google Scholar
  • 76 Morgan L, Hooker JL, Sparapani N, Reinhardt VP, Schatschneider C, Wetherby AM. Cluster randomized trial of the classroom SCERTS intervention for elementary students with autism spectrum disorder. J Consult Clin Psychol 2018; 86 (07) 631-644
    CrossrefPubMedGoogle Scholar
  • 77 Kenworthy L, Anthony LG, Naiman DQ. , et al. Randomized controlled effectiveness trial of executive function intervention for children on the autism spectrum. J Child Psychol Psychiatry 2014; 55 (04) 374-383
    CrossrefPubMedGoogle Scholar