A preliminary randomized, controlled trial of executive function training for children with autism spectrum disorder

This randomized, controlled study examined the initial efficacy of an executive function training program for children with autism spectrum disorder. Seventy 7- to 11 year-olds with autism spectrum disorder and intelligence quotients ⩾80 were randomly assigned to receive a web-based set of executive function training games combined with in-person metacognition coaching or to a waitlist. Primary outcomes were evaluated for neural responses related to executive function, lab-based executive function behavior, and generalization of executive function skills. Secondary outcomes included measures of social function. Post-testing and analyses were conducted by staff naïve to group assignment. Children exhibited a change in neural response following training relative to the waitlist group (ηp2=0.14). Training effects were not detected via lab-based tasks (ηp2s<0.02) or generalized to caregiver-reported executive function skills outside the lab (ηp2=0.0001). However, the training group demonstrated reduced symptoms of repetitive behavior (ηp2<0.015) following training. There were no adverse events or attrition from the training group. Findings suggest that brief, targeted computer-based training program accompanied by coaching is feasible and may improve neural responses and repetitive behaviors of school-aged children with autism spectrum disorder.