Objective-The cognitive features and treatment of autism spectrum disorder (ASD) have been the subject of much debate in recent years. Therapeutic approaches to date have focused on skills acquisition, support tailored to the characteristics of ASD, and interventions in social cognitive functioning; there have been few reports describing interventions aimed at neurocognitive dysfunction. In this study we focus on impairment of executive functioning in ASD patients and investigate improvements in executive functioning and their generalization to social functioning. Method-The intervention adopted for this study was cognitive remediation therapy using the frontal/executive program (FEP). To investigate the effectiveness of FEP, 15 subjects who consented to participate in the study were randomly assigned to an intervention group or control group. FEP was administered to the intervention group for about 6 months. Both groups were evaluated using the same scales: BACS-J, WCST and CPT for cognitive assessment, SCoRS-J, GAF and LASMI for social functioning, and GSE for self-efficacy. Results-Both groups had lower scores for cognitive functioning than normal individuals at baseline. After completion of FEP, the intervention group showed improved performance on BACS-J for overall score, digit sequencing, verbal fluency, and Tower of London tasks. Improvements were also seen on SCoRS-J and LASMI scales of 4 social functioning. Conclusions-This was the first study to use FEP to focus on neurocognitive dysfunction in ASD patients. FEP is effective in improving impaired executive functioning in ASD patients and may also lead to improvements in some aspects of social functioning.

Abstract:Introduction:

IntroductionStudies on autism spectrum disorder in recent years have controversially indicated similarities with schizophrenia. Cognitive dysfunction is present in both disorders, and while there is a rich array of interventions for cognitive dysfunction in schizophrenia, there are few such treatments for autism spectrum disorder. In this study, we have investigated a potentially useful approach in autism spectrum disorder by comparing autism spectrum disorder with schizophrenia in regard to the characteristics of cognitive dysfunction and therapeutic response to cognitive remediation therapy.MethodWe studied seven patients with autism spectrum disorder and eight patients with schizophrenia, using a frontal/executive programme as the intervention. The characteristics of cognitive dysfunction in autism spectrum disorder before frontal/executive programme and the therapeutic response to frontal/executive programme in autism spectrum disorder patients were compared with those in schizophrenia patients, based on evaluation of cognitive function and social function. The changes in cognitive and social function after treatment in each patient group were compared using the Mann–Whitney’s U test.ResultsThe severity of cognitive dysfunction did not differ significantly between autism spectrum disorder and schizophrenia. Frontal/executive programme was effective in autism spectrum disorder, with subjects showing about the same therapeutic response as in schizophrenia.ConclusionFrontal/executive programme appears to be useful for patients with autism spectrum disorder. Furthermore, the similarities in cognitive dysfunction and therapeutic response between autism spectrum disorder and schizophrenia are highly relevant to the recent debate concerning the similarity between these two disease concepts.

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