A - 43 Executive Functioning and Concussion in Autistic Youth

Abstract Purpose The impact of concussion on executive functions (EF) in youth with autism spectrum disorder (ASD) is understudied. This retrospective review compares differences in EF between ASD and non-ASD children following concussion. Method 162 patients ages 10–20 years (m = 14.69+/− 2.37, 68% male) and their parents seen in an outpatient clinic following concussion (m = 24.97+/− 29.73) completed the Post Concussion Executive Inventory (PCEI). ASD patients (n = 39) were double-matched with non-ASD peers (n = 90) based on age, sex, and year of visit (+/−1 year). T-tests compared parent and child retrospective baseline and retrospective adjusted post-injury difference (RAPID) scores on the PCEI. Results Parents of ASD youth reported higher total overall mean (SD) levels of EF challenges at baseline (32.48(14.91)) than parents of non-ASD youth (13.75(11.24); p < 0.001). This was also true for the baseline working memory (13.25(6.15) vs 5.28(4.80); p < 0.001), emotional control (11.96(6.99) vs 5.12(5.74); p < 0.001), and task initiation (7.26(3.85) vs 3.42(3.22), p < 0.001) domains of the PCEI. However, neither total nor domain-based RAPID scores were different between groups (p > 0.05). ASD patients self-reported significantly higher baseline total PCEI scores (18.72(11.77)) than their non-ASD peers (13.06(10.21); p = 0.007), as well as significantly higher baseline working memory (7.10(5.38) vs 5.24(4.52); p = 0.045), and task initiation scores (8.05(5.68) vs 5.10(4.29); p = 0.002). Emotional control baseline scores did not differ, nor did any self-report RAPID scores (p > 0.05). Conclusions While ASD children may struggle with more EF challenges at baseline, their level of change from baseline following a concussion is not different from their non-ASD peers.