Neurocognitive Functions and Their Associations With Autistic Symptoms, Emotion, and Behavior in High-Functioning Children and Adolescents With Autism Spectrum Disorder

Objective Studies have revealed the prognostic significance of intelligence in children with autism spectrum disorder (ASD), but the correlations of non-social cognitive functions and clinical characteristics of high-functioning children and adolescents with ASD remain unclear. To identify individual needs, this study aimed to investigate their correlations in high-functioning children and adolescents with ASD and conduct an exploratory comparison between subgroups.Methods We recruited children and adolescents who met the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria for ASD, excluding those with intellectual disability. The Wechsler Intelligence Scale for Children, Fourth Edition and Conners’ Continuous Performance Test, Second-Edition were administered to assess intelligence and attention. Their parents completed questionnaires, including the Child Behaviour Checklist, the Social Responsiveness Scale, and the Aberrant Behaviour Checklist, to report their clinical characteristics. Group differences were analyzed using t-tests and chi-square tests. Partial correlation was used to measure correlations between variables of cognitive tests and questionnaires, while adjusting for age, sex, and, where appropriate, the presence of attention-deficit/hyperactivity disorder.Results A total of 98 high-functioning participants with ASD were recruited (mean age, 11.44±3.13 years; 75.5% male). Significant correlations were found between their non-social cognitive functions and clinical characteristics. Specifically, Full Scale Intelligence Quotient (FSIQ), working memory, processing speed, attention, and impulse control were negatively associated with the severity of autistic, emotional, and behavioral symptoms. In addition, the Asperger’s disorder group demonstrated significantly better FSIQ, perceptual reasoning, working memory, processing speed, attention, and impulse control than the high-functioning autism group.Conclusion Significant correlations between non-social cognitive functions and autistic, emotional, and behavioral symptoms underscore the increased needs of high-functioning individuals with relatively poorer non-social cognitive abilities. Individualized support and management strategies can be developed and provided accordingly.