Assessment & Research

Executive Functions in Older Adults With Autism Spectrum Disorder: Objective Performance and Subjective Complaints.

Davids et al. (2016) · Journal of autism and developmental disorders 2016
★ The Verdict

Older autistic adults feel more executive problems than their test scores show—plan extra time and supports.

✓ Read this if BCBAs working with autistic adults over 60 in day programs or supported living.
✗ Skip if Clinicians serving only children or teens.

01Research in Context

01

What this study did

Researchers tested the adults with autism and 28 same-age peers without autism.

All participants were 60-83 years old and lived in the community.

They gave two kinds of tests: paper puzzles that measure planning and questionnaires that ask how hard daily tasks feel.

02

What they found

On the planning puzzle (Tower of London), the autism group took longer to finish but got the same number right.

When asked about daily life, the autism group said they had more trouble keeping track of tasks and switching between chores.

In short: older autistic adults feel more executive problems than their test scores show.

03

How this fits with other research

Parsons et al. (2019) looked at the same age group and found high rates of epilepsy, sleep, and heart problems.

Together with Spriggs et al. (2016), this tells us to screen both medical health and executive skills in clients over 60.

Bao et al. (2017) followed 74 autistic adults for 25 years and saw most behavior problems drop while core autism stayed.

This supports the idea that daily-life complaints in older age may come more from executive load than from autism traits themselves.

Eussen et al. (2016) studied planning in autistic children and found that search depth, not speed, marked autism.

Spriggs et al. (2016) now shows the opposite pattern in older adults: speed, not accuracy, is the main gap.

The two studies do not really clash—they just show that the signature of autism shifts with age.

04

Why it matters

If your client is over 60 and says, "I can’t keep my day straight," believe them even if their planning test looks fine.

Add extra time for task switching and give written step lists.

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Give your 60-plus client a printed checklist for morning routines and add five extra minutes between tasks.

02At a glance

Intervention
not applicable
Design
case control
Sample size
72
Population
autism spectrum disorder, neurotypical
Finding
mixed
Magnitude
small

03Original abstract

Although deficits in Executive Functioning (EF) are reported frequently in young individuals with Autism Spectrum Disorders (ASD), they remain relatively unexplored later in life (>50 years). We studied objective performance on EF measures (Tower of London, Zoo map, phonetic/semantic fluency) as well as subjective complaints (self- and proxy reported BRIEF) in 36 ASD and 36 typically developed individuals (n = 72). High functioning older adults with ASD reported EF-impairments in metacognition, but did not deviate in EF task performance, except for a longer execution time of the Tower of London. The need for additional time to complete daily tasks may contribute to impairments in daily life and may be correlated to a higher level of experienced EF-difficulties in ASD.

Journal of autism and developmental disorders, 2016 · doi:10.1007/s10803-016-2831-4