Executive Functioning, Attention Problems, and Social Impairments in Youth with Neurofibromatosis Type 1 and Autism Spectrum Disorder

Abstract

Objectives: Youth with Neurofibromatosis Type 1 (NF1) and children with Autism Spectrum Disorder (ASD) exhibit social impairments and challenges in executive functioning and attention. Biopsychosocial models underscore the interplay between cognitive processes and social functioning and could inform intervention development. This study evaluated whether diagnostic group moderated associations between cognitive functioning and social impairments in youth with NF1 and youth with ASD. Participants and Methods: Youth ages 8–12 (M = 10.3) with NF1 (n = 29), ASD (n = 35), and typically developing controls (TDC) (n = 26), matched on age, sex, and race, completed neuropsychological evaluations. Caregivers completed questionnaires assessing executive function and social behavior. Analyses evaluated group differences in cognitive and social functioning, and whether diagnostic group moderated the associations between cognitive processes and social impairments. Results: Significant correlations between parent-reported executive functioning and attention problems and social impairments were observed only for the NF1 and ASD groups. Moderation analysis revealed behavior regulation and attention problems were similarly related to social impairments across all three groups, while metacognition was significantly associated with social impairments only for the NF1 and ASD group. Auditory attention was not significantly associated with social impairments for any group. Conclusions: Findings highlight shared and distinct cognitive-social associations across NF1 and ASD groups. Interventions targeting executive functioning and attention may improve social functioning for children with NF1 and ASD. Future longitudinal work assessing the underlying neurocognitive mechanisms of social impairments in these populations is needed.