(PS3-B27) Anxiety in Autistic Teens Is Associated with Greater Executive Functioning Challenges in the Classroom and Reduced Opportunity to Practice Executive Function Skills at Home and School

Co-occurring anxiety and executive function (EF) challenges are well-documented in autistic youth. Past studies show greater parent-reported anxiety is related to EF challenges in home, lab-based, and classroom settings in young autistic children. This relationship has yet to be explored during adolescence, when anxiety disorders typically increase in the classroom setting, including teens’ internal experience of their anxiety. We examined associations between parent- and teen-report of teens’ anxiety and how they impact global EF skills, EF in the classroom, and opportunities to practice EF skills at home and school.

Participants were 72 autistic teens (73.6% male; 69.4% white; FSIQ: M = 97.2, SD = 13.9) aged 14-18 years (M = 16.2, SD = 1.23) with a community diagnosis and school classification of autism supported by the Social Communication Questionnaire (≥ 7). Anxiety was measured by the Parent-Rated Anxiety Scale for Youth with Autism Spectrum Disorder (PRAS-ASD) and Anxiety Scale for Children-ASD (ASC-ASD). Parents and teens also reported on teens’ EF skills on the Behavior Rating Inventory of Executive Function-2 (BRIEF-2) and opportunities to practice EF skills at home/school on the American Institutes for Research Self-Determination Scale. Using a novel classroom observation tool, a researcher rated the presence/absence of target EF-related behaviors (e.g., flexibility). Teachers rated the severity of EF-related classroom challenges using an adaptation of the Swanson, Kotkin, Agler, M-Flynn, and Pelham Scale. Pearson correlations examined associations between parent- and teen-reported anxiety, parent- and teen-reported EF skills, observed and teacher-reported classroom EF-related skills, and opportunities to practice EF skills at home/school (ps > .05).

Parent and teen report of teens’ anxiety was not correlated (p > .05). Greater anxiety on the PRAS-ASD was related to greater parent-reported EF challenges on the BRIEF-2 (r = .66, p < .001, large effect), greater observed (r = -.28, p < .05) and teacher-reported (r = .25, p < .05) EF challenges in the classroom (small-med effect), and fewer parent-reported opportunities to practice EF skills at home (r = -.33, p < .01, med effect), but not at school. Greater anxiety on the ASC-ASD was related to greater teen-reported EF challenges on the BRIEF-2 (r = .42, p < .001, med effect), fewer teen-reported opportunities to practice EF skills at home (r = -.30, p < .05) and school (r = -.39, p < .001, med effect), but was not related to observed or teacher-reported EF in the classroom.

Higher teen anxiety was related to greater parent- and teen-reported EF challenges on the BRIEF-2. Greater parent-reported anxiety was related to greater EF challenges in the classroom and fewer parent-reported opportunities to practice EF skills at home. Teen report of anxiety was not related to EF in the classroom, but it was related to fewer opportunities to practice EF skills related to self-determined behavior at home and school. It is crucial to get multiple perspectives, including teens’, when probing the relationship between anxiety and EF as parents, observers, and teachers are limited to reporting on EF skills they see in specific contexts, and teens are reporting on their inner experiences across contexts.