Independent Living Skills and Executive Functions in Autistic Young Adults

Research Objectives: To examine the (a) differences in independent living skills (ILS) and executive functions (EF) between autistic and neurotypical young adults, (b) the relationship between novel self-report and performance-based assessments of ILS and EF to criterion standard assessments in autistic young adults

Design: Cross-sectional comparison between groups

Setting: General community and community day programs for adults with autism

Participants: Eighty-four age-matched participants (n=52 autistic adults, n=32 neurotypical peers), without intellectual disability. Participants were selected through convenience and snowball sampling.

Interventions: Not applicable

Main Outcome Measures: ILS: criterion standard Adaptive Behavior Assessment System (ABAS-3) and the Daily Living Questionnaire (DLQ). EF: criterion standard Behavior Rating Inventory of Executive Function (BRIEF-A), and the Weekly Calendar Planning Activity (WCPA), a performance-based functional assessment of EF.

Results: Performance on all outcome measures of ILS and EF were significantly lower in autistic adults (p < .001). Autistic adults measured 2.02 SD below the normative in self-reported independent living skills (ABAS-3) and 1.13 SD below the normative mean in EF (as measured by BRIEF-A). A self-report measure of functional ILS impacted by EF (DLQ) correlated strongly with ABAS-3 in autistic adults (r = -.608, p < .001). The novel performance-based assessment of EF (WCPA) significantly differentiated autistic young adults, as indicated by following fewer rules, utilizing fewer strategies, lower accuracy, and lower self-awareness of performance. WCPA accuracy approached significant correlation with the self-report BRIEF-A (BRI subscore) (r = -.262, p = .060).

Conclusions: These results are consistent with previous’ studies of significant differences between autistic and neurotypical young adults in ILS and EF. The WCPA can provide insight into the autistic individual’s pattern of EF that impacts everyday functional performance. Significant correlations with criterion standard assessments indicate that DLQ and WCPA may help characterize functional cognition. Further study is needed to determine their clinical utility for guiding therapeutic intervention.

Author(s) Disclosures: No conflicts of interest