Executive function and self-injurious behaviour in autistic children with a co-occurring intellectual disability

Wright, Claire Louise ORCID: 0000-0002-1570-0515 (2022). Executive function and self-injurious behaviour in autistic children with a co-occurring intellectual disability. University of Birmingham. Clin.Psy.D.

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Abstract

Background: Self-injurious behaviours (SIB) occur at a high rate in autistic children with a co-occurring intellectual disability (ID). Delineating the individual characteristics which contribute to the observed differences in SIB emergence and outcomes will extend the operant model and inform proactive intervention strategies. The present study extended prior work, which has identified a role for reduced behavioural inhibition, through the direct measurement of executive function (EF) abilities in this population.

Method: A developmentally-appropriate EF battery was administered remotely to 60 autistic children with ID (mean age = 10.22, range 5-15, 70% SIB, 14 girls). Questionnaire data on SIB, EF, and adaptive behaviour were collected. Analyses evaluated the relationship between the EF outcome measures and SIB, as well as the unique contribution of EF to the presence and severity of SIB.

Results: SIB was moderately associated with a direct measure of updating and inhibition (r = - .28, p < .05), and caregiver-rated impulsivity (r = .41, p = .001) and overactivity (r = .33, p < .05). Impulsivity and overactivity were significant unique predictors of SIB (p < .05), over and above general cognitive ability. In an age-and-ability matched subset, children who displayed SIB were rated as significantly more impulsive on average than those who did not (g = .78).

Conclusions: The results replicated previous findings of a robust relationship between caregiver-rated impulsivity and SIB. While no direct measure of EF significantly predicted SIB in this small pilot sample, the direction and magnitude of effects offer tentative support for a role of behavioural inhibition in the developmental course of SIB. Overall, the study supports the feasibility of remote EF assessment in this under-represented group.

Type of Work:

Thesis (Doctorates > Clin.Psy.D.)

Award Type:

Doctorates > Clin.Psy.D.

Supervisor(s):