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Pilot Study of an Attention and Executive Function Cognitive Intervention in Children with Autism Spectrum Disorders


This pilot study investigated the efficacy of a game-based cognitive training program (Caribbean Quest; CQ) for improving attention and executive function (EF) in school-aged children with Autism Spectrum Disorder (ASD). CQ is a ‘serious game’ that uses a hybrid process-specific/compensatory approach to remediate attention and EF abilities through repetitive, hierarchically graded exercises delivered in an adaptive format. Game-play is accompanied by instruction in metacognitive strategies delivered by an adult trainer. Twenty children diagnosed with ASD (ages 6–12 years) completed 12 h of intervention in schools over 8–10 weeks that was facilitated by a trained Research Assistant. Pre-post testing indicated near transfer gains for visual working memory and selective attention and far transfer effects for math fluency. Exit interviews with parents and school staff indicated anecdotal gains in attention, EF, emotion-regulation, flexibility, communication, and social skills. Overall, this study provides preliminary support for the feasibility and potential efficacy of the CQ when delivered in schools to children with ASD.

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This research was supported by a grant from Kids Brain Health Network (previously NeuroDevNet), which is a member of the Networks of Centres of Excellence program of Canada.

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SJM designed/directed this study, supervised the analysis, and co-wrote the manuscript. IS and BB supported data analysis and manuscript preparation. AS delivered the intervention. JS was involved with manuscript preparation and editing.

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Correspondence to Sarah J. Macoun.

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No financial interest or other benefit has arisen from the direct applications of this research.

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This research was conducted with the approval of the University of Victoria Human Ethics Board and in accordance with Tri-Council Human Ethics guidelines.

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Macoun, S.J., Schneider, I., Bedir, B. et al. Pilot Study of an Attention and Executive Function Cognitive Intervention in Children with Autism Spectrum Disorders. J Autism Dev Disord 51, 2600–2610 (2021).

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