Executive Functioning and Emotion Regulation in Children with Autism Spectrum Disorder: Understanding Heterogeneity in Presentation and Interventions

Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder characterized by social communication deficits and restricted patterns of behaviours and interest. Children with ASD present with a wide range of neurocognitive abilities, including challenges in emotion regulation (ER: ability to identify and modulate one’s own emotional response to situations) and executive functions (EF: cognitive processes involved in self-regulation, goal-directed behaviours, and higher order thinking). Given that ER and EF skills are essential in everyday functioning, gaining a better understanding of the presentation of these cognitive processes in children with ASD and how they can be targeted in interventions could have important implications. The current manuscript aimed to: (1) understand the broad presentation of everyday EF and ER skills in children with ASD by using a person-centered approach analysis (Study 1), and (2) examine the evidence and existing support for targeted interventions in these areas by conducting a systematic review of the literature (Study 2). Results from Study 1 indicated that individuals with ASD present with heterogeneous EF and ER abilities, ranging from impaired to developing as expected, as assessed through an informant-based measure. The latent profile analyses revealed three profiles: broadly affected, narrowly affected, and intact EF and ER skills, demonstrating that being on the autism spectrum is not sufficient to infer challenges in EF or ER. Results from Study 2 identified 22 studies assessing interventions targeting ER and/or EF skills in children with ASD. Three types of interventions were identified as showing promising results: (1) cognitive behavioural interventions targeting ER specifically, (2) mindfulness-based interventions, and (3) group-based martial arts interventions. However, more research is required before these are considered evidence-based practices. Additionally, most interventions were assessed on a narrow range of children with ASD, primarily school-age males with no significant cognitive delays, thus limiting the generalizability of results across the entire autism spectrum. Taking a person-centered approach when working with this population is extremely important. It is hoped that information from this manuscript can be used to inform future research in EF and ER in ASD and the development of targeted intervention programs specific to this clinical group.