Assessment & Research

Executive functioning skills in early childhood children with autism, intellectual disability, and co-occurring autism and intellectual disability.

McClain et al. (2022) · Research in developmental disabilities 2022
★ The Verdict

Working memory is the earliest and most common EF hurdle for toddlers with autism, ID, or both.

✓ Read this if BCBAs who assess or treat children under six with autism and/or intellectual disability.
✗ Skip if Clinicians serving only older populations or pure ADHD cases.

01Research in Context

01

What this study did

McClain et al. (2022) asked parents of toddlers and preschoolers to fill out the BRIEF-P.

The sample had three groups: autism only, intellectual disability only, and both together.

The goal was to map which executive-function (EF) skills looked weakest in each group.

02

What they found

Working-memory problems showed up in every group.

It was the only EF area that was clearly low across autism, ID, and combined diagnoses.

Other EF scores varied more by group.

03

How this fits with other research

Terroux et al. (2025) saw the same working-memory dip in autism-only preschoolers.

They also found inhibition trouble, showing the target picture extends to everyday skills.

Ohan et al. (2015) looked at older kids with mild-borderline ID and saw no extra EF hit from adding autism.

Brunson’s toddler data now suggest age matters: when you test very early, the double diagnosis does look worse, updating the 2015 null result.

Danielsson et al. (2012) already noted working-memory gaps in school-age ID; Brunson confirms this starts before kindergarten.

04

Why it matters

If working memory is the shared weak spot, screen it early no matter the label.

Use brief working-memory games or BRIEF-P items during intake.

Target holding and updating rules in your ABA programs: keep instructions short, use visual cues, and rehearse steps aloud.

Boosting this one skill may lift learning across language, play, and self-care.

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Add one working-memory probe to your intake and teach one visual rehearsal strategy in your next session.

02At a glance

Intervention
not applicable
Design
other
Sample size
87
Population
autism spectrum disorder, intellectual disability
Finding
not reported

03Original abstract

BACKGROUND: Many children with autism and intellectual disability (ID) experience executive functioning (EF) difficulties. However, there is minimal research on EF skills in children with autism, ID, and co-occurring autism/ID in early childhood. AIMS: To address this gap in the research, we evaluated EF profiles using the BRIEF-P among early childhood children (2-5 years of age) with autism, ID, and co-occurring autism/ID. METHOD AND PROCEDURES: Participants in the current study were 87 children between the ages of 24 and 71 months (M = 46.8, SD = 12.7) diagnosed with autism (n = 24, 27.6 %), ID (n = 23, 26.4 %), or co-occurring autism/ID (n = 40, 46.0 %) that completed a comprehensive psychological evaluation at a university development center. We used a mixed Analysis of Variance (ANOVA) and between- and within-subjects ANOVAs as follow-up analyses. OUTCOMES AND RESULTS: Results suggested that early childhood children with autism, ID, and autism/ID may have unique EF skill profiles. Children with ID exhibited the most significant EF impairments and children with autism had the least. Working memory was the most impaired EF domain across all diagnostic groups. CONCLUSIONS AND IMPLICATIONS: Overall, our findings show that early childhood children with autism, ID, and autism/ID exhibit difficulties in EF skills. Children with ID exhibit the most significant EF impairments whereas children with autism show the least. However, regardless of diagnosis, working memory is the most impaired EF skill.

Research in developmental disabilities, 2022 · doi:10.1016/j.ridd.2021.104169