Executive Function Training Program for Children With ASD

A Randomized Controlled Trial for the Development and Validation of an Executive Function Training Program for Elementary School Students

The goal of this clinical trial is to learn whether a structured executive function training program can improve executive function, adaptive behavior, and self-regulation in elementary school students with autism spectrum disorder (ASD). The main questions it aims to answer are:

Does the program improve participants' executive function skills and their ability to use these skills in daily life? Does the program improve participants' adaptive behavior and self-regulation?

Researchers will compare participants who receive the executive function training program with participants in a waitlist control group to determine whether the program is effective.

Participants will be randomly assigned to either the intervention group or the waitlist control group and will complete assessments before and after the intervention. The intervention consists of a structured, group-based program provided once a week for 12 weeks. Children participate in sessions designed to teach and practice executive function strategies, while their parents participate in parent education and review of home practice to support the use of these skills in daily life.

The program focuses on skills such as planning and prioritizing, organization, time management and task initiation, emotional and impulse control, and flexible thinking. Participants practice applying these strategies to situations encountered at home, at school, and in everyday life.

Executive function refers to a set of skills that support goal-directed behavior and independent functioning, including planning, organization, task initiation, time management, emotional and impulse control, flexible thinking, working memory, and self-monitoring. Difficulties in executive function may affect how children with autism spectrum disorder (ASD) manage everyday demands at home, at school, and in social situations. These difficulties may also be related to adaptive functioning and self-regulation.

This study evaluates a structured executive function training program developed for elementary school students with ASD. The program is designed to help children understand executive function strategies, practice them in structured activities, and apply them to situations encountered in everyday life. Rather than focusing only on performance on cognitive tasks, the intervention emphasizes the practical use of executive function skills for daily activities, school routines, emotional and behavioral regulation, and interactions with others.

The program is delivered in a group format over 12 weekly sessions. Intervention sessions use explicit instruction, therapist modeling, guided practice, role-play and other activities, feedback, and home practice. The major areas addressed include planning and prioritizing, organization, time management and task initiation, emotional and impulse control, and flexible thinking. Visual materials and age-appropriate activities are used to help children understand and practice the strategies.

Parents participate in a parallel parent component. They review the skills taught to their children, receive guidance on supporting the use of these strategies, and review the child's home practice with the intervention team. Parent involvement is intended to promote generalization of skills learned during the sessions to everyday settings.

Participants are randomly assigned to an intervention group or a waitlist control group. After the initial intervention period and post-intervention assessment, participants in the waitlist control group are also offered the program. The study examines whether participation in the program is associated with improvement in executive function and its use in daily life, as well as adaptive behavior, self-regulation, and related psychosocial functioning.

Inclusion Criteria:

• Children aged 9 to 12 years who are attending elementary school
• Diagnosis of autism spectrum disorder (ASD) based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)
• Full-scale intelligence quotient (IQ) of 70 or higher
• Ability to understand the study procedures and participate in the intervention program
• Availability of a parent or legal guardian who is able to participate in the parent sessions and study assessments

Exclusion Criteria:

• Presence of a severe neurological or medical condition that may interfere with participation in the study
• Presence of a severe psychiatric or behavioral condition that may interfere with participation in the group-based intervention
• Significant sensory or physical impairment that would prevent participation in the intervention or assessments
• Concurrent participation in another structured intervention program targeting executive function during the study period