Assessment & Research

Profiling executive dysfunction in adults with autism and comorbid learning disability.

Barnard et al. (2008) · Autism : the international journal of research and practice 2008
★ The Verdict

In adults with autism plus learning disability, only working-memory and planning—not overall executive skills—clearly separate them from learning-disabled peers.

✓ Read this if BCBAs completing assessments or writing support plans for adults with dual diagnosis of autism and intellectual disability.
✗ Skip if Practitioners who work solely with high-functioning autism or with children under 12.

01Research in Context

01

What this study did

Barnard et al. (2008) compared adults who have both autism and a learning disability to adults who only have a learning disability. They wanted to see which thinking skills set the two groups apart.

The team gave each adult a short battery of executive-function tests. They looked at working memory, planning, flexibility, and self-control. Then they built simple scores to see where the groups differed.

02

What they found

Only two scores stood out. The autism-plus-LD group scored lower on working-memory and planning tasks. Other executive areas looked the same as the LD-only group.

In plain words, poor working memory and weak planning—not a broad executive mess—best flagged the dual-diagnosis adults.

03

How this fits with other research

Lai et al. (2017) pooled data from kids with high-functioning autism. They saw wide, moderate deficits across most executive skills. Louise saw a narrow hit in adults who also have ID. Age and IQ matter: kids with HFASD show a broad dip, adults with autism plus ID show a focused one.

Koolen et al. (2014) tested high-functioning adults on working-memory monitoring. Performance stayed fine with simple pictures but fell once the items turned wordy. Louise's adults, who have ID, already struggled on basic working-memory and planning loads. Together the papers hint that extra cognitive load—whether from task complexity or low IQ—makes the autism-related WM gap pop out.

Gandhi et al. (2022) tried computerized working-memory training with youth who have autism and ID. They saw gains on memory and far-transfer tasks. Louise told us where the bottleneck sits; A et al. showed you can move it with practice.

04

Why it matters

If you assess an adult with both autism and ID, zero in on working-memory and planning tasks. These two scores give you the clearest picture of support needs. Skip broad executive screens that waste time and show no difference. For intervention, target memory strategies and step-by-step planning rather than wide executive drills. Short rehearsal, visual organizers, and forward-planning scripts fit the profile Louise flagged.

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Add a quick visual working-memory span task and a planning checklist to your intake battery for adults with autism and ID.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
43
Population
autism spectrum disorder, intellectual disability
Finding
positive
Magnitude
medium

03Original abstract

Executive dysfunction is thought to be primary to autism. We examined differences in executive function between 20 adults with autism and learning disability and 23 individuals with learning disabilities outside the autistic spectrum. All participants were matched for chronological age and full-scale IQ, and were given a battery of tasks assessing fluency, planning, set-shifting, inhibition and working memory. Analyses of the individual tasks revealed very few significant differences between the two groups. However, analyses of composite scores derived for each executive domain revealed that the group with autism showed impaired performance on the working memory and planning tests. Together, these two measures were sufficient to classify participants into their diagnostic groups significantly better than would be expected by chance (75% of the autism group; 65% of the control group). Executive impairments were neither universal nor exclusive to the autism group, and we suggest that an alternative cognitive theory may better explain the cognitive profile we found.

Autism : the international journal of research and practice, 2008 · doi:10.1177/1362361307088486