Abstract
Social communication and executive functioning challenges as well as co-occurring anxiety/depression may make acquiring the skills needed to manage daily life tasks difficult for diploma-track autistic youth, thus limiting their participation in adult roles. This study describes the associations between executive function, social communication skills, and internalizing behaviors on task management in academically capable autistic adolescents (n = 46) using multiple regression with mediator analysis. The three predictors and youth age explained a moderate amount of variance in task management. Metacognition mediated the effect of social communication skills and internalizing behaviors on task management. Relations between underlying factors that influence self-management of daily life tasks are complex, supporting the need for multifaceted assessment and intervention approaches for academically capable autistic youth.
Similar content being viewed by others
Notes
Identity first language used per Kenny et al. (2016)
References
AAIDD. (2010). Intellectual disability: Definition, classification, and systems of supports (11th ed.). American Association on Intellectual and Developmental Disabilities.
Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA school-age forms & profiles. University of Vermont, Research Center for Children, Youth, & Families.
Achenbach, T. M., & Rescorla, L. A. (2003). Manual for the ASEBA adult forms & profiles. University of Vermont, Research Center for Children, Youth, & Families.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). American Psychiatric Association.
Andersen, P. N., Skogli, E. W., Hovik, K. T., Egeland, J., & Øie, M. (2015). Associations among symptoms of autism, symptoms of depression and executive functions in children with high-functioning autism: A 2 year follow-up study. Journal of Autism and Developmental Disorders, 45(8), 2497–2507. https://doi.org/10.1007/s10803-015-2415-8
Anderson, K., Sosnowy, C., Kuo, A. A., & Shattuck, P. T. (2018). Transition of individuals with autism to adulthood: A review of qualitative studies. Pediatrics, 141, S318–S327. https://doi.org/10.1542/peds.2016-4300I
Bal, V. H., Kim, S.-H., Cheong, D., & Lord, C. (2015). Daily living skills in individuals with autism spectrum disorder from 2 to 21 years of age. Autism, 19(7), 774–784. https://doi.org/10.1177/1362361315575840
Bandura, A., & Walters, R. H. (1977). Social learning theory (Vol. 1). Prentice Hall.
Baraka, M., El-Dessouky, H. M., El-Wahed, E. E., & Allam Amer, S. S. (2019). Theory of mind: Its development and its relation to communication disorders: A systematic review. Menoufia Medical Journal, 32, 25–30. https://doi.org/10.4103/mmj.mmj
Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182.
Bauminger, N., Solomon, M., & Rogers, S. J. (2010). Externalizing and internalizing behaviors in ASD. Autism Research, 3(3), 101–112. https://doi.org/10.1002/aur.131
Bertollo, J. R., Strang, J. F., Anthony, L. G., Kenworthy, L., Wallace, G. L., & Yerys, B. E. (2020). Adaptive behavior in youth with autism spectrum disorder: The role of flexibility. Journal of Autism and Developmental Disorders, 50(1), 42–50. https://doi.org/10.1007/s10803-019-04220-9
Cannon, L., Kenworthy, L., Alexander, K. C., Werner, M. A., & Anthony, L. G. (2011). Unstuck and on target!: An executive function curriculum to improve flexibility for children with autism spectrum disorders. Paul H. Brookes.
Coster, W. J. (2013). Making the best match: Selecting outcome measures for clinical trials and outcome studies. The American Journal of Occupational Therapy, 67(2), 162–170. https://doi.org/10.5014/ajot.2013.006015
Diamond, A. (2013). Executive functions. Annual Review of Psychology, 64(1), 135–168. https://doi.org/10.1146/annurev-psych-113011-143750
Drahota, A., Wood, J. J., Sze, K. M., & Van Dyke, M. (2011). Effects of cognitive behavioral therapy on daily living skills in children with high-functioning autism and concurrent anxiety disorders. Journal of Autism and Developmental Disorders, 41(3), 257–265. https://doi.org/10.1007/s10803-010-1037-4
Duncan, A. W., & Bishop, S. L. (2015). Understanding the gap between cognitive abilities and daily living skills in adolescents with autism spectrum disorders with average intelligence. Autism, 19(1), 64–72. https://doi.org/10.1177/1362361313510068
Dunn, L., Coster, W. J., Orsmond, G. I., & Cohn, E. S. (2009). Household task participation of children with and without attentional problems. Physical and Occupational Therapy in Pediatrics, 29(3), 258–273. https://doi.org/10.1080/01942630903008350
Eysenck, M. W., Derakshan, N., Santos, R., & Calvo, M. G. (2007). Anxiety and cognitive performance: Attentional control theory. Emotion, 7(2), 336–353. https://doi.org/10.1037/1528-3542.7.2.336
First, J., Cheak-Zamora, N. C., & Teti, M. (2016). A qualitative study of stress and coping when transitioning to adulthood with autism spectrum disorder. Journal of Family Social Work, 19(3), 220–236. https://doi.org/10.1080/10522158.2016.1185074
Gardiner, E., & Iarocci, G. (2018). Everyday executive function predicts adaptive and internalizing behavior among children with and without autism spectrum disorder. Autism Research, 11(2), 284–295. https://doi.org/10.1002/aur.1877
Gilotty, L., Kenworthy, L., Sirian, L., Black, D. O., & Wagner, A. E. (2002). Adaptive skills and executive function in autism spectrum disorders. Child Neuropsychology, 8(4), 241–248.
Gioia, G. A., Isquith, P. K., Guy, S. C., & Kenworthy, L. (2000). Behavior rating inventory of executive function. Psychological Assessment Resources.
Gioia, G. A., Isquith, P. K., Guy, S. C., & Kenworthy, L. (2015). Behavior rating inventory of executive function, Second Edition (BRIEF2). WPS Publishing.
Gleason, K., & Coster, W. (2012). An ICF-CY-based content analysis of the Vineland Adaptive Behavior Scales-II. Journal of Intellectual and Developmental Disability, 37(4), 285–293. https://doi.org/10.3109/13668250.2012.720675
Goldstein, S., Naglieri, J. A., Princiotta, D., & Otero, T. M. (2014). Introduction: A history of EF as a theoretical and clinical construct. In S Goldstein & J. A. Naglieri (Eds.), Handbook of executive functioning (pp. 1–12). Springer. https://doi.org/10.1007/978-1-4614-8106-5
Gotham, K., Brunwasser, S. M., & Lord, C. (2015). Depressive and anxiety symptom trajectories from school age through young adulthood in samples with autism spectrum disorder and developmental delay. Journal of the American Academy of Child & Adolescent Psychiatry, 54(5), 369–376.
Granader, Y., Wallace, G. L., Hardy, K. K., Yerys, B. E., Lawson, R. A., Rosenthal, M., Wills, M. C., Dixon, E., Pandey, J., Penna, R., Schultz, R. T., & Kenworthy, L. (2014). Characterizing the factor structure of parent reported executive function in autism spectrum disorders: The impact of cognitive inflexibility. Journal of Autism and Developmental Disorders, 44(12), 3056–3062. https://doi.org/10.1007/s10803-014-2169-8
Haley, S. M., Coster, W. J., Dumas, H. M., Fragala-Pinkham, M. A., Kramer, J., Ni, P., Tian, F., Kao, Y. -C., Moed, R., & Ludlow, L. H. (2011). Accuracy and precision of the Pediatric Evaluation of Disability Inventory computer-adaptive tests (PEDI-CAT). Developmental Medicine and Child Neurology, 53(12), 1100–1106. https://doi.org/10.1111/j.1469-8749.2011.04107.x
Haley, S. M., Coster, W. J., Dumas, H. M., Fragala-Pinkham, M. A., & Moed, R. (2012). PEDI-CAT: Development, standardization, and administration manual. CRECare.
Hayes, A. F. (2012). PROCESS: A versatile computational tool for observed variable mediation, moderation, and conditional process modeling 1.
Hill, E. L. (2004). Executive dysfunction in autism. Trends in Cognitive Sciences, 8(1), 26–32. https://doi.org/10.1016/j.tics.2003.11.003
Hill, T. L., Gray, S. A. O., Kamps, J. L., & Varela, R. E. (2015). Age and adaptive functioning in children and adolescents with ASD: The effects of intellectual functioning and ASD symptom severity. Journal of Autism and Developmental Disorders, 45(12), 4074–4083. https://doi.org/10.1007/s10803-015-2522-6
Hollocks, M. J., Jones, C. R. G., Pickles, A., Baird, G., Happé, F., Charman, T., & Simonoff, E. (2014). The association between social cognition and executive functioning and symptoms of anxiety and depression in adolescents with autism spectrum disorders. Autism Research, 7(2), 216–228. https://doi.org/10.1002/aur.1361
Howlin, P., & Magiati, I. (2017). Autism spectrum disorder: Outcomes in adulthood. Current Opinion in Psychiatry, 30(2), 69–76. https://doi.org/10.1097/YCO.0000000000000308
Hughes, C., & Leekam, S. (2004). What are the links between theory of mind and social relations? Social Development, 13(4), 590–619.
Hume, K., Boyd, B. A., Hamm, J. V., & Kucharczyk, S. (2014). Supporting independence in adolescents on the autism spectrum. Remedial and Special Education, 35(2), 102–113. https://doi.org/10.1177/0741932513514617
IBM Corp. (2020). IBM SPSS statistics for windows, Version 27.0. IBM Corp.
Individuals with Disabilities Education Act, Pub. L. No. 1400 (2004). 20 U.S.C.
Kao, Y.-C., Coster, W. J., Cohn, E. S., & Orsmond, G. I. (2021). Preparation for adulthood: Shifting responsibility for management of daily tasks from parents to their children. American Journal of Occupational Therapy. https://doi.org/10.5014/ajot.2020.041723
Kao, Y.-C., Kramer, J. M., Liljenquist, K., & Coster, W. J. (2015). Association between impairment, function, and daily life task management in children and adolescents with autism. Developmental Medicine & Child Neurology, 57(1), 68–74. https://doi.org/10.1111/dmcn.12562
Kao, Y.-C., Kramer, J. M., Liljenquist, K., Tian, F., & Coster, W. J. (2012). Comparing the functional performance of children and youth with autism, developmental disabilities, and without disabilities using the revised Pediatric Evaluation of Disability Inventory (PEDI) Item Banks. American Journal of Occupational Therapy, 66(5), 607–616. https://doi.org/10.5014/ajot.2012.004218.Comparing
Kao, Y.-C., Orsmond, G. I., Cohn, E. S., & Coster, W. J. (2020). Variables associated with shift of responsibility for daily tasks. American Journal of Occupational Therapy, 74(6), 7406205070p1-7406205070p10.
Kenny, L., Hattersley, C., Molins, B., Buckley, C., Povey, C., & Pellicano, E. (2016). Which terms should be used to describe autism? Perspectives from the UK autism community. Autism, 20(4), 442–462. https://doi.org/10.1177/1362361315588200
Kenworthy, L., Anthony, L. G., Naiman, D. Q., Cannon, L., Wills, M. C., Luong-Tran, C., Werner, M. A., Alexander, K. C., Strang, J., Bal, E., Sokoloff, J. L., & Wallace, G. L. (2014). Randomized controlled effectiveness trial of executive function intervention for children on the autism spectrum. Journal of Child Psychology and Psychiatry and Allied Disciplines, 55(4), 374–383. https://doi.org/10.1111/jcpp.12161
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(4), 320–338. https://doi.org/10.1007/s11065-008-9077-7
Kirsch, A. C., Huebner, A. R. S., Mehta, S. Q., Howie, F. R., Weaver, A. L., Myers, S. M., Voigt, R. G., & Katusic, S. K. (2020). Association of comorbid mood and anxiety disorders with autism spectrum disorder. JAMA Pediatrics, 174(1), 63–70. https://doi.org/10.1001/jamapediatrics.2019.4368
Kraemer, H. C., Wilson, G. T., Fairburn, C. G., & Agras, W. S. (2002). Mediators and moderators of treatment effects in randomized clinical trials. Archives of General Psychiatry, 59(10), 877–883. https://doi.org/10.1001/archpsyc.59.10.877
Kramer, J. M., Coster, W. J., Kao, Y.-C., Snow, A., & Orsmond, G. I. (2012). A new approach to the measurement of adaptive behavior: Development of the PEDI-CAT for children and youth with autism spectrum disorders. Physical & Occupational Therapy in Pediatrics, 32(1), 34–47. https://doi.org/10.3109/01942638.2011.606260
Kraper, C. K., Kenworthy, L., Popal, H., Martin, A., & Wallace, G. L. (2017). The gap between adaptive behavior and intelligence in autism persists into young adulthood and is linked to psychiatric co-morbidities. Journal of Autism and Developmental Disorders, 47(10), 3007–3017. https://doi.org/10.1007/s10803-017-3213-2
Leung, R. C., Vogan, V. M., Powell, T. L., Anagnostou, E., & Taylor, M. J. (2016). The role of executive functions in social impairment in autism spectrum disorder. Child Neuropsychology, 22(3), 336–344. https://doi.org/10.1080/09297049.2015.1005066
Masi, A., Demayo, M. M., Glozier, N., & Guastella, A. J. (2017). An overview of autism spectrum disorder, heterogeneity and treatment options. Neuroscience Bulletin, 33(2), 183–193. https://doi.org/10.1007/s12264-017-0100-y
Morrison, J. Q., Sansosti, F. J., & Hadley, W. M. (2009). Parent perceptions of the anticipated needs and expectations for support for their college-bound students with Asperger’s syndrome. Journal of Postsecondary Education and Disability, 22, 78–87.
Munsell, E. G. S., & Coster, W. J. (2020). Self-management of daily life tasks for adolescents with autism spectrum disorder without intellectual disability. American Journal of Occupational Therapy, 74(4 Supplement 1), 7411500080p1-7411500080p1.
O’Hearn, K., Asato, M., Ordaz, S., & Luna, B. (2008). Neurodevelopment and executive function in autism. Development and Psychopathology, 20(4), 1103–1132. https://doi.org/10.1017/S0954579408000527
Preacher, K. J., Hayes, A. F., & Preacher, K. J. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40(3), 879–891. https://doi.org/10.3758/BRM.40.3.879
Pugliese, C. E., Anthony, L. G., Strang, J. F., Dudley, K., Wallace, G. L., Naiman, D. Q., & Kenworthy, L. (2016). Longitudinal examination of adaptive behavior in autism spectrum disorders: Influence of executive function. Journal of Autism and Developmental Disorders, 46(2), 467–477. https://doi.org/10.1007/s10803-015-2584-5
Pugliese, C. E., Anthony, L., Strang, J. F., Dudley, K., Wallace, G. L., & Kenworthy, L. (2015). Increasing adaptive behavior skill deficits from childhood to adolescence in autism spectrum disorder: Role of executive function. Journal of Autism and Developmental Disorders, 45(6), 1579–1587. https://doi.org/10.1002/nbm.3369.Three
Rogoff, B. (2003). The cultural nature of human development. Oxford University Press.
Rosenthal, M., Wallace, G. L., Lawson, R., Wills, M. C., Yerys, B. E., & Kenworthy, L. (2013). Impairments in real world executive function increase from childhood to adolescence in autism spectrum disorders. Neuropsychology, 27(1), 13–18. https://doi.org/10.1037/a0031299
Roux, A. M., Shattuck, P. T., Rast, J. E., Rava, J. A., & Anderson, K. A. (2015). National autism indicators report: Transition into young adulthood. Life Course Outcomes Research Program, A.J. Drexel Autism Institute, Drexel University.
Rutter, M., Bailey, A., & Lord, C. (2003). The Social Communication Questionnaire: Manual. Western Psychological Services.
Soto, E. F., Kofler, M. J., Singh, L. J., Wells, E. L., Irwin, L. N., Groves, N. B., & Miller, C. E. (2020). Executive functioning rating scales: Ecologically valid or construct invalid? Neuropsychology, 34(6), 605–619. https://doi.org/10.1037/neu0000681
Sze, K. M., & Wood, J. J. (2008). Enhancing CBT for the treatment of autism spectrum disorders and concurrent anxiety. Behavioural and Cognitive Psychotherapy, 36(4), 403–409. https://doi.org/10.1017/S1352465808004384
Tarazi, R. A., Mahone, E. M., & Zabel, T. A. (2007). Self-care independence in children with neurological disorders: An interactional model of adaptive demands and executive dysfunction. Rehabilitation Psychology, 52(2), 196–205. https://doi.org/10.1037/0090-5550.52.2.196
Wallace, G. L., Kenworthy, L., Pugliese, C. E., Haroon, P. S., White, E. I., Brodsky, E., & Martin, A. (2016). Real-world executive functions in adults with autism spectrum disorder: Profiles of impairment and associations with adaptive functioning and co-morbid anxiety and depression. Journal of Autism and Developmental Disorders, 46, 1071–1083. https://doi.org/10.1007/s10803-015-2655-7
Whitehouse, A. J. O., & Bishop, D. V. M. (2009). Communication checklist—Adult. Pearson.
Whitehouse, A. J. O., Coon, H., Miller, J., Salisbury, B., & Bishop, D. V. M. (2010). Narrowing the broader autism phenotype: A study using the Communication Checklist-Adult Version (CC-A). Autism, 14(6), 1362–3613. https://doi.org/10.1177/1362361310382107
Acknowledgments
This study was part of Elizabeth Munsell’s dissertation at Boston University. This research was supported by the Institute of Education Sciences, U.S. Department of Education, through Grant R34A160113 to Gael Orsmond. The opinions expressed are those of the authors and do not represent views of the Institute or the U.S. Department of Education.
Author information
Authors and Affiliations
Contributions
All authors contributed to the development of study methods. EGSM completed data analysis and led manuscript writing. All authors participated in data analysis interpretation and manuscript review and editing. All authors approved the manuscript to be submitted and published.
Corresponding author
Ethics declarations
Conflict of interest
All authors declare that they have no conflict of interest.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Munsell, E.G.S., Orsmond, G.I., Fulford, D. et al. Metacognition Mediates the Effect of Social Communication and Internalizing Behaviors on Self-management of Daily Life Tasks for Diploma-Track Autistic Youth. J Autism Dev Disord 52, 4274–4285 (2022). https://doi.org/10.1007/s10803-021-05306-z
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10803-021-05306-z