A meta-analysis of the executive function components inhibition, shifting, and attention in intellectual disabilities.
Executive function is only slightly lower in people with ID compared to mental-age peers, so assess each client individually.
01Research in Context
What this study did
The team pooled 26 studies that compared executive function tasks in people with intellectual disability to mental-age matched peers.
They looked at three core skills: stopping yourself (inhibition), switching rules (shifting), and paying attention (updating).
All studies used kid-friendly games like Stroop or card sorts to measure these skills.
What they found
On average, people with ID scored a little lower than peers of the same mental age.
The gap was small and varied a lot from study to study.
In plain numbers, the effect size was 0.28—noticeable but not huge.
How this fits with other research
Vugs et al. (2014) saw large executive-function gaps in preschoolers with speech-language impairment.
The new meta finds only small gaps in the wider ID group.
The clash disappears when you see the two studies tested different kids: language-only versus broader ID.
Waller et al. (2010) looked just at Williams syndrome and found the same mild pattern, showing the meta result holds even in a single-ID subtype.
Why it matters
Do not assume every client with ID has weak executive function—some score in the average range.
Screen each skill separately; small group averages hide big individual swings.
If you see larger deficits, check for added language disorder or different diagnoses before writing goals.
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02At a glance
03Original abstract
BACKGROUND: Executive function is a concept for higher-order cognitive functions, which have the role of controller and modulator of cognitive abilities. The consensus in the literature is that people with an intellectual disability perform significantly lower on executive function tasks than groups matched on chronological age. The comparison with groups matched on mental age is less clear. Therefore, the objective of this meta-analysis was to investigate to what extent executive function is impaired in people with intellectual disability compared with a typically developing control group matched on mental age. It was also investigated if the executive function component and intellectual disability aetiology moderated the effect. METHODS: Eligibility criteria were participants with intellectual disability (IQ ≤ 75) without a dual diagnosis; a comparison group matched on mental age; executive function outcome reported in a group comparison study design with n ≥ 10. Working memory tasks and ratings of executive function were not included. The literature search yielded 6637 potentially interesting articles. Twenty-six studies (with 99 effect sizes) including 1395 participants were included in the quantitative synthesis. RESULTS: A multilevel random-effects meta-analysis found that people with intellectual disability performed statistically significantly lower than the mental age-matched group on the executive function tasks, g = -0.34, 95% confidence interval = [-0.53, -0.16]. However, the heterogeneity between effect sizes was large. The intellectual disability aetiology moderator was significant, but it only reduced the heterogeneity marginally. CONCLUSION: The overall conclusion is that individuals with an intellectual disability have more problems with executive function tasks than mental age-matched controls. Limitations are the large unexplained variance and the remarkably high number (69) of different tests that were used, which make more detailed conclusions problematic. This meta-analysis implies that future studies need to be of better quality, to have higher power, and to a higher degree use the same executive function tests.
Journal of intellectual disability research : JIDR, 2022 · doi:10.1111/jir.12878