Executive functioning deficits are common in children with neurodevelopmental disorders. However, prior research mainly focused on clinical populations employing cross-sectional designs, impeding conclusions on temporal neurodevelopmental pathways. Here, we examined the prospective association of executive functioning with subsequent autism spectrum disorder (ASD) traits and attention-deficit/hyperactivity disorder (ADHD) traits. This study included young children from the Generation R Study, a general population birth cohort. The Brief Rating Inventory of Executive Function-Preschool Version was used to assess parent-reported behavioral executive functioning when the children were 4 years old. ASD traits were assessed at age 6 (n = 3938) using the parent-reported Social Responsiveness Scale. The Teacher Report Form was used to assess ADHD traits at age 7 (n = 2749). Children with high scores were screened to determine possible clinical ASD or ADHD diagnoses. We were able to confirm an ASD diagnosis for n = 56 children by retrieving their medical records and established an ADHD diagnosis for n = 194 children using the Diagnostic Interview Schedule for Children-Young Child version (DISC-YC). Data were analyzed using hierarchical linear and logistic regressions. Impaired executive functioning was associated with more ASD and ADHD traits across informants (for ASD traits and diagnoses: β = 0.33, 95% CI [0.30–0.37]; OR = 2.69, 95% CI [1.92–3.77], respectively; for ADHD traits and diagnoses: β = 0.12, 95% CI [0.07–0.16]; OR = 2.32, 95% CI [1.89–2.85], respectively). Deficits in all subdomains were associated with higher levels of ASD traits, whereas only impaired inhibition, working memory, and planning/organization were associated with more ADHD traits. The findings of the current study suggest a graded association of executive functioning difficulties along the continuum of ASD and ADHD and that problems in executive functioning may be a precursor of ASD and ADHD traits from an early age onwards.

中文翻译：

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幼儿期的执行功能和神经发育障碍：一项基于人群的前瞻性研究

执行功能缺陷在患有神经发育障碍的儿童中很常见。然而，先前的研究主要集中于采用横断面设计的临床人群，阻碍了关于颞神经发育途径的结论。在这里，我们研究了执行功能与随后的自闭症谱系障碍（ASD）特征和注意力缺陷/多动障碍（ADHD）特征的前瞻性关联。这项研究包括来自一般人口出生队列 R 世代研究的幼儿。执行功能简明评定量表-学前版用于评估家长报告的儿童4岁时的行为执行功能。使用家长报告的社会反应量表对 6 岁时 (n = 3938) 的 ASD 特征进行评估。教师报告表用于评估 7 岁时的 ADHD 特征 (n = 2749)。对得分高的儿童进行筛查以确定可能的自闭症谱系障碍 (ASD) 或多动症 (ADHD) 临床诊断。我们能够通过检索 n = 56 名儿童的医疗记录来确认他们的 ASD 诊断，并使用儿童-幼儿版本诊断访谈时间表 (DISC-YC) 为 n = 194 名儿童确定 ADHD 诊断。使用分层线性和逻辑回归分析数据。执行功能受损与受访者中更多的 ASD 和 ADHD 特征相关（对于 ASD 特征和诊断：分别为 β = 0.33，95% CI [0.30–0.37]；OR = 2.69，95% CI [1.92–3.77]；对于 ADHD性状和诊断：β = 0.12，95% CI [0.07–0.16]；OR = 2.32，95% CI [1.89–2.85]。所有子域的缺陷都与较高水平的 ASD 特征相关，而只有抑制、工作记忆和计划/组织受损与更多的 ADHD 特征相关。目前的研究结果表明，执行功能困难与 ASD 和 ADHD 的连续体存在分级关联，并且执行功能问题可能是自幼时期开始出现 ASD 和 ADHD 特征的先兆。