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Assessment of Executive Functions in Preschool-Aged Children with Autism Spectrum Disorders: Usefulness and Limitation of BRIEF-P in Clinical Practice

Magda Di Renzo, Federico Bianchi di Castelbianco, Elena Vanadia, Massimiliano Petrillo, Lidia Racinaro, Mirko Stracqualursi and Monica Rea

This study examines the context of executive functioning in preschool children with Autism Spectrum Disorders (ASDs) and verifies the degree of agreement between the compilation of the Behavior Rating Inventory of Executive Functions-Preschool Version (BRIEF-P) by parents and therapists. To this end, parents and professionals of 46 ASD children aged between 24 and 71 months completed the BRIEF-P in order to highlight the level of agreement between these two different evaluators and then investigate the correlations between executive functions impairment, the degree of autistic symptomatology, the level of cognitive development, the chronological age and the therapy duration. The results showed that parents tend to underestimate the impairment of executive functions in ASD children compared to what estimated by specialized operators. A low level of agreement was found between the two evaluators. Moreover, both for parents and professionals, the EF impairment was not related to the severity of autistic symptoms, assessed with the ADOS-2, while it was correlated to cognitive development in professional evaluations, and to chronological age and therapy duration in parental evaluations. These results indicate that, even if among the pathogenic assumptions about ASDs there has been included also that of the EF impairment, this, if present, does not correlate with the severity of autistic symptoms. With regard to cognitive development, the greater correlation between cognitive and executive impairment seems to be rather obvious. The use of the BRIEF-P completed by parents allows them a greater awareness but does not add clinical data to the diagnosis.