Date Presented 03/23/24

This scoping review provides information on current available literature and gaps in evidence-based research on executive functioning (EF) interventions for autistic adults and adults with intellectual disabilities (ID).

Primary Author and Speaker: Stephanie Johnson

Additional Authors and Speakers: Sophie Davis, Virginia Dilcher, Ashley Everett, Sarah Lee, Leah Miller, Melissa Morris, Haley Parrish

This review describes the available literature regarding cognitive strategies to improve executive functioning in autistic adults and adults with intellectual disabilities. There are gaps in the literature concerning this population versus the information available for children. Using the Levac et al., 2010 Framework, we conducted a scoping review investigating cognitive interventions in adults over the age of 18, who have a diagnosis of autism and/ or intellectual disabilities. Articles included in the initial search were restricted to the last 10 years and English language. We searched five data sources (CINAHL, Psycinfo, PubMed, ERIC, and Cochrane). Inclusion criteria included population age over 18, an autistic population or population with intellectual disabilities, cognitive intervention, and executive function outcomes. Articles were screened by title and abstract, then full text. Triangulation was ensured by two data reviewers checking one another. Pertinent data extraction included population, age, country of origin, intervention type, administrator type, outcome measures, and recommendation for use. Thirteen articles met the inclusion criteria out of 12,463 articles. Analysis is ongoing, but preliminary findings reveal themes for psychosocial cognitive interventions, such as Cognitive Remediation Therapy, Cognitive Behavioral Therapy, and social skill groups. Overall, there is minimal OT involvement in interventions and lack of comparison groups within half of the studies. Eight of the studies were conducted in United States, three in Asia, and two in Europe. Preliminary findings suggest a gap in the literature regarding cognitive interventions in autistic adults and adults with intellectual disabilities. This research could advance the field of occupational therapy by increasing awareness for the need for further research and education on cognitive strategies to improve executive functioning within autistic adults and adults with ID

References

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Demetriou, E. A., Lampit, A., Quintana, D. S., Naismith, S. L., Song, Y., Pye, J. E., Hickie, I., & Guastella, A. J. (2018). Autism spectrum disorders: A meta-analysis of executive function. Molecular psychiatry, 23(5), 1198–1204. https://doi.org/10.1038/mp.2017.75

Spaniol, M., & Danielsson, H. (2022). A meta-analysis of the executive function components inhibition, shifting, and attention in intellectual disabilities. Journal of Intellectual Disability Research, 66(1–2), 9–31. https://doi.org/10.1111/jir.12878

Tanner, K., Hand, B.N., O’Toole, G., & Lane, A.E. (2015). Effectiveness of interventions to improve social participation, play, leisure, and restricted and repetitive behaviors in people with autism spectrum disorder: A systematic review. AJOT. https://doi.org/10.5014/ajot.2015.017806