Do cognitive deficits persist into adolescence in autism?
Theory-of-mind deficits stick around in autistic teens, but you can still teach them with the right program.
01Research in Context
What this study did
The team tracked three thinking skills in autistic and neurotypical teens.
They looked at theory-of-mind, executive function, and local processing bias.
Kids were tested once in late elementary and again in mid-adolescence.
What they found
Theory-of-mind gaps stayed wide in every autistic teen.
Executive-function scores caught up to typical peers.
Local processing differences faded after early childhood.
How this fits with other research
Cummings et al. (2024) pooled many studies and saw the same EF catch-up, so the closure is real.
Frazier et al. (2023) later showed that direct ToM-social-skills training can still produce large gains in autistic teens, proving the deficit is moveable.
Riches et al. (2016) followed adults and found ToM gaps start to shrink after age 50, extending the timeline and showing the teen lag is not lifelong.
Guy et al. (2019) saw local-to-global interference stay constant through adolescence, a small apparent contradiction that may come from using different visual tasks.
Why it matters
Keep teaching perspective-taking in middle and high school; the window for growth is still open.
Pair social stories with live practice, not just worksheets.
Use the same EF supports you would for any teen—planning sheets and timers now work equally well.
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02At a glance
03Original abstract
SEVERAL THEORIES HAVE ATTEMPTED TO CHARACTERISE AUTISM SPECTRUM DISORDERS (ASDS) AT THE COGNITIVE LEVEL, MOST NOTABLY: THEORY OF MIND (TOM), EXECUTIVE FUNCTION (EF), AND A LOCAL PROCESSING BIAS (LB). THE AIM OF THIS STUDY WAS TO INVESTIGATE HOW THESE COGNITIVE FUNCTIONS DEVELOP OVER TIME: The three cognitive domains (ToM, EF, and LB) were examined in a group of high-functioning children (age: 8-12, mean 10.85; IQ: 78-139, mean 105.48) with ASD and a matched group of children with neurotypical development (NTD) (IQ: 75-145, mean: 109.47), and several tasks were used within each domain to ensure the validity of the cognitive measures. Approximately 3 years later (mean age: 14.34), all children and their families were invited to participate in the follow-up (ASD, N = 21; NTD, N = 30). While the understanding of other's minds does improve from childhood to adolescence, ToM impairment persists in adolescents with ASD relative to their peers. Likewise, a development in EF was observed in the ASD group, while no significant improvement was seen in the NTD group, leading the ASD group to catch up in this domain. We did not detect any group differences at any time point regarding local bias processing (LB). Individual patterns of development were seen, but remarkably, ToM deficits were present in every child with ASD in whom we could detect any cognitive impairment at baseline, and a similar pattern was found at follow-up. These findings indicate that ToM is a persistent cognitive deficit in ASD. Autism Res 2018, 11: 1229-1238. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: This was the first study to investigate the development of three well-known cognitive functions into adolescence: While the understanding of other's minds improves from childhood to adolescence, adolescents with ASD are still impaired relative to their peers. The EFs, however, seem to improve to a neurotypical level in ASD as children enter adolescence, while local processing bias seems to differentiate the groups only in early childhood.
Autism research : official journal of the International Society for Autism Research, 2018 · doi:10.1002/aur.1976