Comparative Analysis of Executive Function Deficits in Autism and ADHD

Author(s): Supriya kumari, Shilpi Sharma, Amardeep Kumar, Anant kumar Verma, Rajesh Kumar Pradhan.

Background: Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) are neurodevelopmental diseases linked to deficiencies in executive function (EF). Although both conditions share overlapping cognitive impairments, the nature and severity of these deficits differ and remain underexplored in low- and middle-income regions. Methods: This cross-sectional study was performed from July 2024 to July 2025 at BMIMS, Pawapuri, Nalanda, Bihar. A total of 110 children (6–16 years) diagnosed with ASD (n = 55) or ADHD (n = 55) were recruited. Standardized tools were used to evaluate cognitive flexibility, working memory, planning, inhibitory control, and emotions. Independent t-tests, and chi-square tests were used to evaluate the data. Results: Both groups exhibited high prevalence of EF deficits (ASD: 69.1%, ADHD: 76.4%). Children with ADHD had significantly greater impairments in working memory (71.8 ± 12.1) and inhibitory control (74.1 ± 10.8), whereas children with ASD demonstrated more pronounced deficits in cognitive flexibility (68.4 ± 11.7) and planning (66.1 ± 12.4). Emotional control challenges were common in both groups, affecting over 50% of participants. Conclusion: EF deficits are prominent in both ASD and ADHD but follow distinct patterns. Early recognition and tailored interventions targeting the dominant domains in each disorder may improve functional outcomes and quality of life.