Executive functions and risk factors in ASD diagnosis: A perspective from family reports and clinical support levels

This study explores the relationship between autism risk history and executive functions (EF) reported by families during the diagnostic evaluation process of individuals with Autism Spectrum Disorder (ASD) Level 1 and 2. A total of 305 clinical protocols were analyzed between 2021 and 2022, collecting information on developmental history, biomedical, sensory, and communicative factors, alongside EF scores obtained through parent-reported BRIEF-2 and BRIEF-P questionnaires. Results showed significant associations between language and communication difficulties and several EF domains, including inhibition, cognitive flexibility, working memory, and planning. Notably, children classified as receiving Level 1 support—considered to have lower intervention needs—were perceived by their families as having greater EF difficulties within the home context compared to those receiving Level 2 support. This apparent contradiction highlights a potential disconnect between family perceptions and clinical judgment, possibly influenced by contextual factors such as family support strategies or environmental demands. Findings emphasize the importance of incorporating family-reported information in assessments and planning interventions, and suggest that multi-informant approaches may enhance the accuracy of EF evaluations and guide tailored, family-centered support strategies. • What is already known about this topic?: Executive functions are often impaired in individuals with autism and relate to adaptive behavior and emotional regulation. • What this paper adds?: Family-reported developmental risk,especially lenguage dificulties, are linked to executive function impairments in ADS. • Implications for practice, research or policy: Findings highlight the need for family-centered assessments and integrating clinical and family reports to guide suport.