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. 2025 Feb 10;15(1):4925.
doi: 10.1038/s41598-025-87863-2.

Simple Executive Function as an endophenotype of autism-ADHD, and differing associations between simple versus complex Executive Functions and autism/ADHD traits

Alexandra Hendry  1 , Rachael Bedford  2 , Mary Agyapong  3 , Jannath Begum Ali  4 , Tessel Bazelmans  4 , Mutluhan Ersoy  5 , Amy Goodwin  6 , Luke Mason  6 , Nisha Narvekar  3 , Greg Pasco  3 , Mark H Johnson  7 , Emily J H Jones  4 , Tony Charman  3 ; STAARS Team
Collaborators, Affiliations

Simple Executive Function as an endophenotype of autism-ADHD, and differing associations between simple versus complex Executive Functions and autism/ADHD traits

Alexandra Hendry et al. Sci Rep. .

Abstract

Autism and ADHD are associated with difficulties with Executive Functions (EFs), but the prevalence and nature of these difficulties in early development is not well understood. In this longitudinal study, 107 children with a family history of autism and/or ADHD (FH-autism/ADHD), and 24 children with No-FH-autism/ADHD completed multiple EF tasks (5 at age 2 years, 7 at age 3 years). Parents reported on their child's autism- (Q-CHAT at age 2, SRS-2 at age 3), and ADHD-related traits (CBCL DSM-ADHD scale, both ages). Compared to the No-FH-autism/ADHD group, the FH-autism/ADHD group showed lower scores on simple EFs (involving response inhibition, and holding in mind) at ages 2 and 3. Exploratory analysis linked FH-autism specifically with lower Executive Attention (top-down attentional control) at age 2, and the combination of FH-autism and FH-ADHD with lower Complex EF (involving selectively deploying responses, or updating information) at age 3. Three-year-olds' Simple EF scores were negatively associated with ADHD-related traits. Complex EF scores were negatively associated with autism traits (before correcting for multiple comparisons). Toddlers with a family history of autism and/or ADHD may benefit from interventions to support simple EF development, whilst those already showing autistic traits may benefit from support with more-complex EF skills.

Keywords: ADHD; Autism; Endophenotype; Executive Function; Preschool; Toddler.

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Conflict of interest statement

Declarations. Competing interests: TC has served as a paid consultant to F. Hoffmann-La Roche Ltd. and Servier; and has received royalties from Sage Publications and Guilford Publications. MJ receives royalties from Wiley-Blackwell, OUP and MIT Press.

Figures

Fig. 1
Fig. 1
Behavioural performance scores by Family History (FH) at age 2 years. The bold black line indicates the group mean, the light grey bands the 95% confidence interval, and the black border the full data distribution. Note that data is presented in FH subgroups for descriptive purposes only. Primary analyses contrasting the ‘No-FH-autism/ADHD’ group with the ‘FH-autism only’, ‘FH-autism and ADHD’ and ‘FH-ADHD only’ sub-groups combined (‘FH-autism/ADHD’) showed group mean differences for Executive Attention (A) (*p < .10) and Prohibition (C) (**p < .05).
Fig. 2
Fig. 2
Behavioural performance scores by Family History (FH) group at age 3 years. The bold black line indicates the group mean, the light grey bands the 95% confidence interval, and the black border the full data distribution. Note that data is presented in FH subgroups for descriptive purposes only. Primary analyses contrasting the ‘No-FH-autism/ADHD’ group with the ‘FH-autism only’, ‘FH-autism and ADHD’ and ‘FH-ADHD only’ sub-groups combined (‘FH-autism/ADHD’) showed group mean differences for Simple EF (A) (**p < .05).
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