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.
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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.
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.
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.
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.
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.
Bigham, S. (2010). Impaired competence for pretense in children with autism: Exploring potential cognitive predictors. Journal of Autism and Developmental Disorders, 40, 30–38.
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.
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.
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.
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.
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.
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.
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.
Dichter, G. S., & Belger, A. (2007). Social stimuli interfere with cognitive control in autism. Neuroimage, 35, 1219–1230.
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.
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.
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.
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.
Geurts, H. M., Corbett, B., & Solomon, M. (2009). The paradox of cognitive flexibility in autism. Trends in Cognitive Sciences, 13, 74–82.
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.
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.
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.
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.
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.
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.
Hill, E. L. (2004). Evaluating the theory of executive dysfunction in autism. Developmental Review, 24, 189–233.
Hill, E. L., & Bird, C. M. (2006). Executive processes in Asperger syndrome: Patterns of performance in a multiple case series. Neuropsychologia, 44, 2822–2835.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Ozonoff, S. (1995). Reliability and validity of the wisconsin card sorting test in studies of autism. Neuropsychology, 9, 491–500.
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.
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.
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.
Pellicano, E. (2010). The development of core cognitive skills in autism: A 3 year prospective study. Child Development, 81, 1400.
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.
Perner, J., & Lang, B. (1999). Development of theory of mind and executive control. Trends in Cognitive Sciences, 3, 337–344.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
White, S. J., Burgess, P. W., & Hill, E. L. (2009). Impairments on “open-ended” executive function tests in autism. Autism Research, 2, 138–147.
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.
Wimmer, H. (1989). Common-Sense Mentalismus und Emotion: entwicklungspsychologische Implikationen: I. In E. Roth (Ed.), Denken und Fühlen. Berlin: Springer-Verlag.
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.
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.
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.
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.
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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
- Executive function
- Theory of mind