Skip to main content
SpringerLink
Log in

The Triple I Hypothesis: Taking Another(’s) Perspective on Executive Dysfunction in Autism

Journal of Autism and Developmental Disorders volume 43, pages 114–121 (2013)Cite this article

Abstract

The executive dysfunction theory attempts to explain not only the repetitive behaviours but also the socio-communicative difficulties in autism. While it is clear that some individuals with autism perform poorly on certain executive function tasks, it remains unclear what underlies these impairments. The most consistent and striking difficulties are seen on tasks that are open-ended in structure, lack explicit instructions and involve arbitrary rules. I propose that impairment on such tasks is not due to executive dysfunction; instead, poor performance results from difficulties forming an implicit understanding of the experimenter’s expectations for the task, resulting in egocentric and idiosyncratic behaviour. These difficulties in taking another’s perspective may be explained parsimoniously by the mentalising difficulties robustly demonstrated to exist in autism.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Fig. 1

Notes

  1. While the Triple I hypothesis proposes that executive ability is relatively unimpaired in autism, this does not preclude the possibility that some cases of autism may involve executive dysfunction for reasons unrelated to the core autistic symptoms.

References

  • Adams, N. C., & Jarrold, C. (2009). Inhibition and the validity of the stroop task for children with autism. Journal of Autism and Developmental Disorders, 39, 1112–1121.

    Article  PubMed  Google Scholar 

  • Agam, Y., Joseph, R. M., Barton, J. J., & Manoach, D. S. (2010). Reduced cognitive control of response inhibition by the anterior cingulate cortex in autism spectrum disorders. Neuroimage, 52, 336–347.

    Article  PubMed  Google Scholar 

  • Ambery, F. Z., Russell, A. J., Perry, K., Morris, R., & Murphy, D. G. (2006). Neuropsychological functioning in adults with Asperger syndrome. Autism, 10, 551–664.

    Article  PubMed  Google Scholar 

  • Barnard, L., Muldoon, K., Hasan, R., O’Brien, G., & Stewart, M. (2008). Profiling executive dysfunction in adults with autism and comorbid learning disability. Autism, 12, 125–141.

    Article  PubMed  Google Scholar 

  • Bigham, S. (2010). Impaired competence for pretense in children with autism: Exploring potential cognitive predictors. Journal of Autism and Developmental Disorders, 40, 30–38.

    Article  PubMed  Google Scholar 

  • Bishop, D. V., & Norbury, C. F. (2005). Executive functions in children with communication impairments, in relation to autistic symptomatology. 2: Response inhibition. Autism, 9, 29–43.

    Article  PubMed  Google Scholar 

  • Bogte, H., Flamma, B., van der Meere, J., & van Engeland, H. (2008). Cognitive flexibility in adults with high functioning autism. Journal of Clinical and Experimental Neuropsychology, 30, 33–41.

    Article  PubMed  Google Scholar 

  • Boucher, J., Cowell, P., Howard, M., Broks, P., Farrant, A., Roberts, N., et al. (2005). A combined clinical, neuropsychological, and neuroanatomical study of adults with high functioning autism. Cognitive Neuropsychiatry, 10, 165–213.

    Article  PubMed  Google Scholar 

  • Cederlund, M., Hagberg, B., & Gillberg, C. (2010). Asperger syndrome in adolescent and young adult males. Interview, self- and parent assessment of social, emotional, and cognitive problems. Research in Developmental Disabilities, 31, 287–298.

    Article  PubMed  Google Scholar 

  • Chan, A. S., Cheung, M. C., Han, Y. M., Sze, S. L., Leung, W. W., Man, H. S., et al. (2009). Executive function deficits and neural discordance in children with autism spectrum disorders. Clinical Neurophysiology, 120, 1107–1115.

    Article  PubMed  Google Scholar 

  • Colvert, E., Custance, D., & Swettenham, J. (2002). Rule-based reasoning and theory of mind in autism: A commentary on the work of Zelazo, Jacques, Burack and Frye. Infant and Child Development, 11, 197–200.

    Article  Google Scholar 

  • Corbett, B. A., Constantine, L. J., Hendren, R., Rocke, D., & Ozonoff, S. (2009). Examining executive functioning in children with autism spectrum disorder, attention deficit hyperactivity disorder and typical development. Psychiatry Research, 166, 210–222.

    Article  PubMed  Google Scholar 

  • Dichter, G. S., & Belger, A. (2007). Social stimuli interfere with cognitive control in autism. Neuroimage, 35, 1219–1230.

    Article  PubMed  Google Scholar 

  • Dichter, G. S., Radonovich, K. J., Turner-Brown, L. M., Lam, K. S., Holtzclaw, T. N., & Bodfish, J. W. (2010). Performance of children with autism spectrum disorders on the dimension-change card sort task. Journal of Autism and Developmental Disorders, 40, 448–456.

    Article  PubMed  Google Scholar 

  • Edgin, J. O., & Pennington, B. F. (2005). Spatial cognition in autism spectrum disorders: superior, impaired, or just intact? Journal of Autism and Developmental Disorders, 35, 729–745.

    Article  PubMed  Google Scholar 

  • Fournier-Vicente, S., Larigauderie, P., & Gaonac’h, D. (2008). More dissociations and interactions within central executive functioning: A comprehensive latent-variable analysis. Acta Psychologia, 129, 32–48.

    Article  Google Scholar 

  • Gaigg, S. B., Gardiner, J. M., & Bowler, D. M. (2008). Free recall in autism spectrum disorder: The role of relational and item-specific encoding. Neuropsychologia, 46, 983–992.

    Article  PubMed  Google Scholar 

  • Geurts, H. M., Corbett, B., & Solomon, M. (2009). The paradox of cognitive flexibility in autism. Trends in Cognitive Sciences, 13, 74–82.

    Article  PubMed  Google Scholar 

  • Geurts, H. M., Verte, S., Oosterlaan, J., Roeyers, H., & Sergeant, J. A. (2004). How specific are executive functioning deficits in attention deficit hyperactivity disorder and autism? Journal of Child Psychology and Psychiatry, 45, 836–854.

    Article  PubMed  Google Scholar 

  • Gioia, G. A., Isquith, P. K., Kenworthy, L., & Barton, R. M. (2002). Profiles of everyday executive function in acquired and developmental disorders. Child Neuropsychology, 8, 121–137.

    Article  PubMed  Google Scholar 

  • Goldberg, M. C., Mostofsky, S. H., Cutting, L. E., Mahone, E. M., Astor, B. C., Denckla, M. B., et al. (2005). Subtle executive impairment in children with autism and children with ADHD. Journal of Autism and Developmental Disorders, 35, 279–293.

    Article  PubMed  Google Scholar 

  • Griebling, J., Minshew, N. J., Bodner, K., Libove, R., Bansal, R., Konasale, P., et al. (2010). Dorsolateral prefrontal cortex magnetic resonance imaging measurements and cognitive performance in autism. Journal of Child Neurology, 25, 856–863.

    Article  PubMed  Google Scholar 

  • Hadjikhani, N., Joseph, R. M., Snyder, J., Chabris, C. F., Clark, J., Steele, S., et al. (2004). Activation of the fusiform gyrus when individuals with autism spectrum disorder view faces. Neuroimage, 22, 1141–1150.

    Article  PubMed  Google Scholar 

  • Happé, F., Booth, R., Charlton, R., & Hughes, C. (2006). Executive function deficits in autism spectrum disorders and attention-deficit/hyperactivity disorder: Examining profiles across domains and ages. Brain and Cognition, 61, 25–39.

    Article  PubMed  Google Scholar 

  • Hill, E. L. (2004). Evaluating the theory of executive dysfunction in autism. Developmental Review, 24, 189–233.

    Article  Google Scholar 

  • Hill, E. L., & Bird, C. M. (2006). Executive processes in Asperger syndrome: Patterns of performance in a multiple case series. Neuropsychologia, 44, 2822–2835.

    Article  PubMed  Google Scholar 

  • Joseph, R. M., McGrath, L. M., & Tager-Flusberg, H. (2005). Executive dysfunction and its relation to language ability in verbal school-age children with autism. Developmental Neuropsychology, 27, 361–378.

    Article  PubMed  Google Scholar 

  • Joseph, R. M., & Tager-Flusberg, H. (2004). The relationship of theory of mind and executive functions to symptom type and severity in children with autism. Development and Psychopathology, 16, 137–155.

    Article  PubMed  Google Scholar 

  • Kaland, N., Smith, L., & Mortensen, E. L. (2008). Brief report: Cognitive flexibility and focused attention in children and adolescents with Asperger syndrome or high-functioning autism as measured on the computerized version of the Wisconsin Card Sorting Test. Journal of Autism and Developmental Disorders, 38, 1161–1165.

    Article  PubMed  Google Scholar 

  • Kalbfleisch, M.L., & Loughan, A.R., (2012). Impact of IQ discrepancy on executive function in high-functioning autism: Insight into Twice Exceptionality. Journal of Autism and Developmental Disorders, 42, 390–400.

    Google Scholar 

  • Kana, R. K., Keller, T. A., Minshew, N. J., & Just, M. A. (2007). Inhibitory control in high-functioning autism: Decreased activation and underconnectivity in inhibition networks. Biological Psychiatry, 62, 198–206.

    Article  PubMed  Google Scholar 

  • Keary, C. J., Minshew, N. J., Bansal, R., Goradia, D., Fedorov, S., Keshavan, M. S., et al. (2009). Corpus callosum volume and neurocognition in autism. Journal of Autism and Developmental Disorders, 39, 834–841.

    Article  PubMed  Google Scholar 

  • Kenworthy, L., Yerys, B. E., Anthony, L. G., & Wallace, G. L. (2008). Understanding executive control in autism spectrum disorders in the lab and in the real world. Neuropsychology Review, 18, 320–338.

    Article  PubMed  Google Scholar 

  • Kleinhans, N., Akshoomoff, N., & Delis, D. C. (2005). Executive functions in autism and Asperger’s disorder: Flexibility, fluency, and inhibition. Developmental Neuropsychology, 27, 379–401.

    Article  PubMed  Google Scholar 

  • Landa, R. J., & Goldberg, M. C. (2005). Language, social, and executive functions in high functioning autism: a continuum of performance. Journal of Autism and Developmental Disorders, 35, 557–573.

    Article  PubMed  Google Scholar 

  • Lee, P. S., Yerys, B. E., Della Rosa, A., Foss-Feig, J., Barnes, K. A., James, J. D., et al. (2009). Functional connectivity of the inferior frontal cortex changes with age in children with autism spectrum disorders: A fcMRI study of response inhibition. Cerebral Cortex, 19, 1787–1794.

    Article  PubMed  Google Scholar 

  • Lopez, B. R., Lincoln, A. J., Ozonoff, S., & Lai, Z. (2005). Examining the relationship between executive functions and restricted, repetitive symptoms of autistic disorder. Journal of Autism and Developmental Disorders, 35, 445–460.

    Article  PubMed  Google Scholar 

  • Low, J., Goddard, E., & Melser, J. (2009). Generativity and imagination in autism spectrum disorder: Evidence from individual differences in children’s impossible entity drawings. British Journal of Developmental Psychology, 27, 425–444.

    Article  PubMed  Google Scholar 

  • Luna, B., Doll, S. K., Hegedus, S. J., Minshew, N. J., & Sweeney, J. A. (2007). Maturation of executive function in autism. Biological Psychiatry, 61, 474–481.

    Article  PubMed  Google Scholar 

  • Mackinlay, R., Charman, T., & Karmiloff-Smith, A. (2006). High functioning children with autism spectrum disorder: A novel test of multitasking. Brain and Cognition, 61, 14–24.

    Article  PubMed  Google Scholar 

  • Miyake, A., Friedman, N. P., Emerson, M. J., Witzki, A. H., Howerter, A., & Wager, T. D. (2000). The unity and diversity of executive functions and their contributions to complex “frontal lobe” tasks: A latent variable analysis. Cognitive Psychology, 41, 49–100.

    Article  PubMed  Google Scholar 

  • Morton, J., & Frith, U. (1995). Causal modeling: a structural approach to developmental psychopathology. In D. Cichetti & D. J. Cohen (Eds.), Manual of developmental psychopathology. New York: Wiley.

    Google Scholar 

  • Mosconi, M. W., Kay, M., D’Cruz, A. M., Seidenfeld, A., Guter, S., Stanford, L. D., et al. (2009). Impaired inhibitory control is associated with higher-order repetitive behaviors in autism spectrum disorders. Psychological Medicine, 39, 1559–1566.

    Article  PubMed  Google Scholar 

  • Nakahachi, T., Iwase, M., Takahashi, H., Honaga, E., Sekiyama, R., Ukai, S., et al. (2006). Discrepancy of performance among working memory-related tasks in autism spectrum disorders was caused by task characteristics, apart from working memory, which could interfere with task execution. Psychiatry and Clinical Neurosciences, 60, 312–318.

    Article  PubMed  Google Scholar 

  • Ozonoff, S. (1995). Reliability and validity of the wisconsin card sorting test in studies of autism. Neuropsychology, 9, 491–500.

    Article  Google Scholar 

  • Ozonoff, S., Cook, I., Coon, H., Dawson, G., Joseph, R. M., Klin, A., et al. (2004). Performance on Cambridge Neuropsychological Test Automated Battery subtests sensitive to frontal lobe function in people with autistic disorder: Evidence from the collaborative programs of excellence in autism network. Journal of Autism and Developmental Disorders, 34, 139–150.

    Article  PubMed  Google Scholar 

  • Ozonoff, S., Pennington, B. F., & Rogers, S. J. (1991). Executive function deficits in high- functioning autistic individuals: relationship to theory of mind. Journal of Child Psychology and Psychiatry, 32, 1081–1105.

    Article  PubMed  Google Scholar 

  • Pellicano, E. (2007). Links between theory of mind and executive function in young children with autism: Clues to developmental primacy. Developmental Psychology, 43, 974–990.

    Article  PubMed  Google Scholar 

  • Pellicano, E. (2010). The development of core cognitive skills in autism: A 3 year prospective study. Child Development, 81, 1400.

    Article  PubMed  Google Scholar 

  • Pellicano, E., Maybery, M., Durkin, K., & Maley, A. (2006). Multiple cognitive capabilities/deficits in children with an autism spectrum disorder: “Weak” central coherence and its relationship to theory of mind and executive control. Development and Psychopathology, 18, 77–98.

    Article  PubMed  Google Scholar 

  • Perner, J., & Lang, B. (1999). Development of theory of mind and executive control. Trends in Cognitive Sciences, 3, 337–344.

    Article  PubMed  Google Scholar 

  • Phelan, H. L., Filliter, J. H., & Johnson, S. A. (2010). Brief report: memory performance on the California verbal learning test–children’s version in Autism spectrum disorder. Journal of Autism and Developmental Disorders, 41, 518–523.

    Article  Google Scholar 

  • Pierce, K., Müller, R. A., Ambrose, J., Allen, G., & Courchesne, E. (2001). Face processing occurs outside the fusiform ‘face area’ in autism: Evidence from functional MRI. Brain, 124, 2059–2073.

    Article  PubMed  Google Scholar 

  • Poljac, E., Simon, S., Ringlever, L., Kalcik, D., Groen, W. B., Buitelaar, J. K., et al. (2010). Impaired task switching performance in children with dyslexia but not in children with autism. Quarterly Journal of Experimental Psychology, 63, 401–416.

    Article  Google Scholar 

  • Robinson, S., Goddard, L., Dritschel, B., Wisley, M., & Howlin, P. (2009). Executive functions in children with autism spectrum disorders. Brain and Cognition, 71, 362–368.

    Article  PubMed  Google Scholar 

  • Russell, J. (1997). How executive disorders can bring about an inadequate “theory of mind”. In J. Russell (Ed.), Autism as an executive disorder. Oxford: Oxford University Press.

    Google Scholar 

  • Russo, N., Flanagan, T., Iarocci, G., Berringer, D., Zelazo, P. D., & Burack, J. A. (2007). Deconstructing executive deficits among persons with autism: Implications for cognitive neuroscience. Brain and Cognition, 65, 77–86.

    Article  PubMed  Google Scholar 

  • Schmitz, N., Rubia, K., Daly, E., Smith, A., Williams, S., & Murphy, D. G. (2006). Neural correlates of executive function in autistic spectrum disorders. Biological Psychiatry, 59, 7–16.

    Article  PubMed  Google Scholar 

  • Semrud-Clikeman, M., Walkowiak, J., Wilkinson, A., & Butcher, B. (2010). Executive functioning in children with Asperger syndrome, ADHD-combined type, ADHD-predominately inattentive type, and controls. Journal of Autism and Developmental Disorders, 40, 1017–1027.

    Article  PubMed  Google Scholar 

  • Senju, A., Southgate, V., White, S. J., & Frith, U. (2009). Mindblind eyes: an absence of spontaneous theory of mind in Asperger syndrome. Science, 325, 883–885.

    Article  PubMed  Google Scholar 

  • Sinzig, J., Morsch, D., Bruning, N., Schmidt, M. H., & Lehmkuhl, G. (2008). Inhibition, flexibility, working memory and planning in autism spectrum disorders with and without comorbid ADHD-symptoms. Child and Adolescent Psychiatry and Mental Health, 2, 4.

    Article  Google Scholar 

  • Towgood, K. J., Meuwese, J. D., Gilbert, S. J., Turner, M. S., & Burgess, P. W. (2009). Advantages of the multiple case series approach to the study of cognitive deficits in autism spectrum disorder. Neuropsychologia, 47, 2981–2988.

    Article  PubMed  Google Scholar 

  • Verte, S., Geurts, H. M., Roeyers, H., Oosterlaan, J., & Sergeant, J. A. (2005). Executive functioning in children with autism and Tourette syndrome. Development and Psychopathology, 17, 415–445.

    Article  PubMed  Google Scholar 

  • Voelbel, G. T., Bates, M. E., Buckman, J. F., Pandina, G., & Hendren, R. L. (2006). Caudate nucleus volume and cognitive performance: are they related in childhood psychopathology? Biological Psychiatry, 60, 942–950.

    Article  PubMed  Google Scholar 

  • White, S. J., Burgess, P. W., & Hill, E. L. (2009). Impairments on “open-ended” executive function tests in autism. Autism Research, 2, 138–147.

    Article  PubMed  Google Scholar 

  • Wilson, B. A., Alderman, N., Burgess, P. W., Emslie, H. C., & Evans, J. J. (1996). The behavioural assessment of the dysexecutive syndrome. Flempton, Bury St. EdmundsThames : Valley Test Company.

    Google Scholar 

  • Wimmer, H. (1989). Common-Sense Mentalismus und Emotion: entwicklungspsychologische Implikationen: I. In E. Roth (Ed.), Denken und Fühlen. Berlin: Springer-Verlag.

    Google Scholar 

  • Yerys, B. E., Hepburn, S. L., Pennington, B. F., & Rogers, S. J. (2007). Executive function in preschoolers with autism: Evidence consistent with a secondary deficit. Journal of Autism and Developmental Disorders, 37, 1068–1079.

    Article  PubMed  Google Scholar 

  • Yerys, B. E., Wallace, G. L., Harrison, B., Celano, M. J., Giedd, J. N., & Kenworthy, L. E. (2009). Set-shifting in children with autism spectrum disorders: Reversal shifting deficits on the Intradimensional/Extradimensional Shift Test correlate with repetitive behaviors. Autism, 13, 523–538.

    PubMed  Google Scholar 

  • Zinke, K., Fries, E., Altgassen, M., Kirschbaum, C., Dettenborn, L., & Kliegel, M. (2010). Visuospatial short-term memory explains deficits in tower task planning in high-functioning children with autism spectrum disorder. Child Neuropsychology, 16, 229–241.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The author wishes to thank John Morton and Uta Frith for helpful conversation and lively discussion whilst writing this paper and over a number of years. This work was supported by a British Academy Fellowship PDF/2009/213.

Author information

Authors and Affiliations

  1. Institute of Cognitive Neuroscience, University College London, 17 Queen Square, London, WC1N 3AR, UK

    Sarah J. White

Authors
  1. Sarah J. White
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sarah J. White.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

White, S.J. The Triple I Hypothesis: Taking Another(’s) Perspective on Executive Dysfunction in Autism. J Autism Dev Disord 43, 114–121 (2013). https://doi.org/10.1007/s10803-012-1550-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-012-1550-8

Keywords

search

Navigation