A review of neuropsychological and neuroimaging research in autistic spectrum disorders: Attention, inhibition and cognitive flexibility

Autistic spectrum disorders (ASD) are devastating neurodevelopmental disorders of unknown aetiology with characteristic deficits in social interaction, communication and behaviour. Individuals with ASD show deficits in executive function (EF), which are hypothesised to underlie core repetitive, stereotyped behaviours of autism. Neuroimaging research has identified structural brain abnormalities in ASD, which coincide with brain regions involved in EF. Therefore, we reviewed the literature on four specific executive functions in ASD-sustained attention, orienting attention, response inhibition and set shifting. Medline and Embase searches were carried out using specific search terms. This task was followed by the identification of further relevant publications from papers referenced in initial search results. Discussion with experts in neuropsychology, neuroimaging and autism research yielded further publications that were reviewed. Based on these data there is evidence to suggest that deficits in orienting attention, response inhibition and set shifting exist in ASD, but sustained attention ability appears to be normal. A striking lack of research attempting to link neural correlates with these deficits in orienting attention, response inhibition and set shifting was noted. Future research should focus on understanding links between the neuropsychological deficits and structural and functional brain abnormalities. (C) 2007 Elsevier Ltd. All rights reserved.