What are executive function delays? Research shows that they are similar for ADHD and autism

Neurodevelopmental disorders such as attention deficit hyperactivity disorder (ADHD) and autism approximately one in ten children. These conditions affect learning, behavior and development.

Executive function delays are at the heart of the challenges faced by people with neurodevelopmental disorders. This includes skills such as paying attention, switching attention, impulse control, planning, organizing and problem solving.

These skills are critical for learning and long-term development. They have been linked to future professional, social, academic and mental outcomes. Children with better executive skills and support for these skills do better in the long term.

Decades of research describe the causes of difficulties with attention and impulse control ADHD. Meanwhile, difficulties with switching attention and flexibility of thinking have been proposed as the basis autism.

As a result, various supports and interventions designed for different neurodevelopmental conditions target these skills. It creates a system in which a diagnosis is first made and then a set of support is provided based on it.

But our latest study published in Nature Human Behaviorshows that executive function problems are similar across neurodevelopmental conditions. Understanding these common needs could lead to better access to support before waiting for a specific diagnosis.

Our study found more similarities than differences

We looked at 180 studies conducted over 45 years that compared executive function skills in two or more neurodevelopmental conditions.

We combined research on all neurodevelopmental conditions defined in diagnostic manuals, including ADHD, Tourette’s syndrome, communication disorders and intellectual disabilities.

Surprisingly, we found that most children with neurodevelopmental disorders showed very similar delays in executive skills.

For example, children with ADHD showed difficulties with attention and impulse control, but also children with autism, communication and specific learning conditions.

There were very few differences between each neurodevelopmental condition and the type of executive function delay.

This suggests that executive function delay is best considered a common difficulty in all children with neurodevelopmental disorders. All of these children could benefit from similar support to improve executive functioning skills.

But the supports have been silenced

The research has been going on for decades failed to integrate results in various conditions. This has led to the separation of research and practice into the education, health and disability sectors.

Our data showed a gradual change in the types of conditions that have been studied since 1980. In earlier days, a much greater percentage of research was conducted on tic disorders such as Tourette’s syndrome. Over the last ten years, autism has become a subject of increased attention.

This means that research and practice also become separated, based on a focus on funding and community interest. Some groups lose good science and practice as they become less noticeable in the political landscape.

This has led to a skewed support system in which specific interventions can only be offered to children with a specific diagnosis. It also limits access to support if families do not have access to diagnostic services, which can be particularly tough in regional and rural communities.

Thanks to diagnosis-based research practices, there are now assessment services, guidelines, and treatments recommended for autism. These are usually stand-alone and are not offered to children with ADHD, Tourette’s syndrome, communication disorders or intellectual disabilities, despite significant overlap in children’s needs.

How does this affect access to support?

It is often tough for families to get the assist they need. They often describe the assessment and support process as confusing, with long waiting times and plenty barriers.

We have shown earlier Carers often operate assessment and support services for a wide range of needs, but many needs are left unaddressed.

Last national child mental health, autism AND ADHD the guidelines call for more integrated support for children. However, most services are not well configured for this. If this is to be achieved, such a system change will take time to implement.

Why we need integrated research

More integrated research will lead to more coherent education, health and disability support systems for all children in need.

Research shows, for example, that many risk factors (genetic and environmental) are common to all neurodevelopmental conditions. These include a wide overlap of risk genes that are the same across conditions, and common environmental factors that influence development in the womb, such as the operate of certain medications, stress and a significant immune response.

Other research shows that most children diagnosed with one neurodevelopmental disorder will also be diagnosed with one others.

But gaps remain. While we know that some stimulant medications can work well for ADHD, for example, we have less information about how they can assist children with other neurodevelopmental conditions and attention difficulties.

Contrary to what we know about social support for children with autism, we don’t do much research on how we can assist children with ADHD meet their social needs.

We should take a broader look at children’s needs

It is critical for families to be aware that if their child meets criteria for one neurodevelopmental condition, it is very likely that their child will meet criteria for other neurodevelopmental conditions. They will likely have many needs related to other conditions.

It is worth asking clinical services about needs that go beyond the diagnosis. This should take into account developmental, mental and physical health needs.

It is also critical to consider that there are many of them interventions has the potential to support all children with neurodevelopmental disorders.

This is an critical issue for the government. Reviews into supporting the needs of people with autism, intellectual disability AND ADHD.

It is time to establish more integrated systems, supports and strategies for all people with neurodevelopmental disorders at home, school, play and work.