Efficacy of executive function training in preschool children with ASD: a randomized controlled trial.

BACKGROUND

This two-arm, assessor-blinded, randomized controlled trial investigated the effect of a 16-week Executive Function Training Course (EFTC) based on the principles of ABA for preschool children with ASD.

METHODS

Seventy-two children aged 3-6 years were randomly allocated to the intervention group (EFTC + treatment as usual, TAU) or control group (TAU). Executive function (EF) served as the primary outcome, evaluated using both performance-based tasks and parent-report rating scales. Secondary outcomes included core autism symptoms, emotional-behavioral comorbidities, developmental progress, and parental stress.

RESULTS

Linear mixed model analysis revealed significant group × time interactions for total EF [F (1, 67.94) = 9.712, p = 0.003], inhibition [F (1, 66.97) = 5.916, p = 0.018], and working memory [F (1, 67.15) = 6.173, p = 0.015] measured by the task-based EF assessment. No significant differences were observed in parent-reported EF or other secondary outcomes.

CONCLUSIONS

These findings provide empirical evidence for the effectiveness of EFTC on EF in preschool children with ASD. More studies are needed to explore the effects of EFTC in ecological contexts, as well as on broader symptomatology and development, and long-term effects on EF in preschool children with ASD.

TRIAL REGISTRATION: The trial is registered in the Chinese Clinical Trial Registry, ChiCTR2400091585 (2024.10.30), https://www.chictr.org.cn/bin/project/edit?pid=249048 .