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Child Neuropsychology: A Journal on

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Neurocognitive performance of
children with higher functioning Autism
Spectrum disorders on the NEPSY-II
a ab a
Sarianna Barron-Linnankoski , Outi Reinvall , Anne Lahervuori ,
b a a
Arja Voutilainen , Pekka Lahti-Nuuttila & Marit Korkman
a
Institute of Behavioural Sciences, University of Helsinki,
Helsinki, Finland
b
Department of Pediatric and Adolescent Medicine, Helsinki
University Central Hospital, Helsinki, Finland
Published online: 08 Jan 2014.
To cite this article: Sarianna Barron-Linnankoski, Outi Reinvall, Anne Lahervuori, Arja Voutilainen,
Pekka Lahti-Nuuttila & Marit Korkman (2015) Neurocognitive performance of children with
higher functioning Autism Spectrum disorders on the NEPSY-II, Child Neuropsychology: A
Journal on Normal and Abnormal Development in Childhood and Adolescence, 21:1, 55-77, DOI:
10.1080/09297049.2013.873781
To link to this article: http://dx.doi.org/10.1080/09297049.2013.873781
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Child Neuropsychology, 2015
Vol. 21, No. 1, 55–77, http://dx.doi.org/10.1080/09297049.2013.873781
Neurocognitive performance of children with higher

functioning Autism Spectrum disorders on the NEPSY-II
Sarianna Barron-Linnankoski1, Outi Reinvall1,2, Anne Lahervuori1,

Arja Voutilainen2, Pekka Lahti-Nuuttila1, and Marit Korkman1†
1
Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
2
Department of Pediatric and Adolescent Medicine, Helsinki University Central Hospital,
Helsinki, Finland
This study examined patterns of strengths and weaknesses in the neurocognitive performance of
children with higher functioning autism spectrum disorder (ASD). The participants were 30 children
with higher functioning ASD ranging from 6 to 11 years, and 60 typically developing (TD) children,
who were matched with the children with higher functioning ASD in terms of age, gender, and
maternal education. The TD children were drawn from the Finnish standardization sample for the
NEPSY-II. The cognitive abilities of the children with higher functioning ASD were assessed with the
WISC-III, and the neurocognitive performance of the children with higher functioning ASD and TD
children on the NEPSY-II was compared. The children with higher functioning ASD were found to
have strengths in verbal reasoning skills with respect to the population mean and weaknesses in set-
shifting, verbal fluency, and narrative memory in comparison with the TD children. Minor weak-
nesses were also observed in facial memory and fine and visuomotor skills.
Keywords: Autism spectrum disorder; Asperger syndrome; Neurocognitive performance; Children;

NEPSY-II.
Autism spectrum disorders (ASD) are characterized by core impairments in social com-
munication and interaction and restricted repetitive behaviors (Hyman, 2013). The term
high-functioning ASD has often been used to refer to individuals with Asperger syn-
drome, High-Functioning Autism (HFA), and Pervasive Developmental Disorders Not
Otherwise Specified (PDDNOS; Oliveras-Rentas, Kenworthy, Roberson, Martin, &
Wallace, 2012; Scheeren, Koot, & Begeer, 2012; Volker et al., 2010). These individuals
demonstrate normal range intelligence. Asperger syndrome has been considered to differ
†Deceased
This study was supported by the Finska Läkaresällskapet, the Emil Aaltonen Foundation, and the Sigrid
Jusélius Foundation. We thank all the children and parents who participated in the study. We express our
gratitude to Lennart von Wendt† for his dedication to this project. We also warmly thank Susan Laitala, Annina
Mara, Annina Marila, and Mia Nykopp for participation in data collection; Taina Nieminen-von Wendt for her
collaboration; and Laura Hokkanen for her comments on the manuscript.
Address correspondence to Sarianna Barron-Linnankoski, Institute of Behavioural Sciences, P.O. Box 9,
FI-00014 University of Helsinki, Finland. E-mail: sarianna.barron-linnankoski@hus.fi
© 2014 Taylor & Francis

56 S. BARRON-LINNANKOSKI ET AL.
from HFA and PDDNOS by its relative preservation of linguistic development. In the last
decades, a large body of research has focused on assessing whether Asperger syndrome
can be separated from other ASDs, especially from HFA, with respect to neurophysiolo-
gical, cognitive, and behavioral factors (Frith, 2004; Miller & Ozonoff, 2000; Ozonoff,
South, & Miller, 2000; Planche & Lemonnier, 2012; Williams, Goldstein, Kojkowski, &
Minshew, 2008). These studies indicate that Asperger syndrome belongs to the same
continuum of autism spectrum and is not qualitatively separable from other ASDs. In line
with this research, the new Diagnostic and Statistical Manual of Mental Disorders, fifth
edition (DSM-V; American Psychological Association [APA], 2013) defines Asperger
syndrome under a single umbrella disorder, Autism spectrum disorder (Hyman, 2013).
In this study, we will use the term higher functioning ASD to refer to individuals with
Asperger syndrome and HFA.
Three core cognitive deficits have been considered to underlie behavioral character-
istics and processing styles in individuals with ASD: deficits in executive functioning (EF),
weak central coherence (WCC), and deficits in the theory of mind (ToM) skills. The term EF
is typically used to refer to multiple cognitive functions that are especially important for
responding in an adaptive way in nonroutine situations (Diamond, 2013; Lezak, 2004).
These multiple cognitive functions include planning, inhibition, working memory, flex-
ibility, initiation, and monitoring actions (Hill, 2004; Rabbitt, 1997). Deficits in EFs are
considered to underlie many nonsocial and social characteristics of ASD (Frith, 2004; Hill,
2004). Impairments in EFs have been suggested to account for symptoms such as rigidity,
stereotyped behaviors, routines, and restricted interests (Hill, 2004; Lopez, Lincoln,
Ozonoff, & Lai, 2005). In other words, individuals with ASD may have difficulty coping
with nonroutine situations due to their EF deficits and often prefer routine situations, exhibit
repetitive actions and benefit from external structure (Hill, 2004). With respect to social
characteristics, the relationship between EF and ToM has been much discussed. Studies
concerning typically developing (TD) children indicate that performance in EF tasks
predicts performance in ToM tasks but the performance in ToM tasks does not predict the
performance in EF tasks (Hughes, 1998; Hughes & Ensor, 2007). Similar results have also
been found in children with higher functioning autism (Pellicano, 2007). However, the
nature of the EF-ToM relationship is still not clear (Hill, 2004; Pellicano, 2007).
The WCC theory introduced by Frith (1989, 2003) has been suggested to account
for symptoms such as attention to detail, “islets of ability,” detachment from context, and
reduced top-down processing. In relation to WCC, individuals with ASD have been
suggested to have weakness in making global inferences from stories (Happé, 1994;
Jolliffe & Baron-Cohen, 2000; Norbury & Bishop, 2002) and subtle impairments in visual
processing abilities, such as visual discrimination, spatial vision, and motion perception
(Dakin & Frith, 2005; Happé & Frith, 2006; Simmons et al., 2009) in comparison to TD
individuals. Also, the tendency for local processing has been suggested to affect recogni-
tion of faces (Deruelle, Rondan, Gepner, & Tardif, 2004; Rondan & Deruelle, 2007) and
facial emotions (Happé & Frith, 2006) in children with higher functioning ASD.
Deficits in ToM skills have been suggested to account for the social impairment that
individuals with ASD have in the ability to attribute mental states to other people and in
understanding that other people may have mental states different from one´s own (Baron-
Cohen, 2000; Baron-Cohen, Leslie, & Frith, 1985; Leslie & Frith, 1988). It is currently
thought that these three core cognitive constructs, namely EF, WCC, and ToM, are
complementary rather than mutually exclusive in explaining the processing abnormalities
in persons with ASD (Frith, 2003).
NEUROCOGNITIVE PERFORMANCE OF CHILDREN WITH ASD 57
Apart from research on these core cognitive constructs, evidence of strengths and
weaknesses in the neurocognitive performance in individuals with ASD has accumulated
in the last decades. Only few studies have investigated the comprehensive neurocognitive
performance of children with higher functioning ASD. In a study by Hooper, Poon,
Marcus, and Fine (2006), a reanalysis of the validation study of the NEPSY – A
Developmental Neuropsychological Assessment (NEPSY; Korkman, Kirk, & Kemp,
1998), a comprehensive, pediatric, and multidomain neuropsychological battery, the
children with higher functioning ASD (HFA) showed significantly poorer performance
than control children in the NEPSY subtests of attention and executive functions, lan-
guage, memory and learning, sensorimotor functions, and visuospatial processing. Also,
in a study by Narzisi, Muratori, Calderoni, Fabbro, and Urgesi (2012), children with
higher functioning ASD (Autistic Disorder or PDDNOS) were found to have widespread
neuropsychological impairments on the NEPSY-II (Korkman, Kirk, & Kemp, 2007) in

subtests of attention and executive functions, language, learning and memory, sensorimo-
tor processing, and social perception. Williams, Goldstein and Minshew (2006) compared
the performance of children with higher functioning ASD (HFA) and control children in a
wide range of neurocognitive tasks. Children with higher functioning ASD were found to
have impairments in complex language, complex memory, sensory-perceptual, and motor
domains. More studies have focused on single domains of neurocognitive performance.
In the domain of attention and EF, many studies in children and adults with higher
functioning ASD report difficulties in tasks requiring planning and mental flexibility
(Ambery, Russell, Perry, Morris, & Murphy, 2006; Corbett, Constantine, Hendren,
Rocke, & Ozonoff, 2009; Geurts, Verté, Oosterlaan, Roeyers, & Sergeant, 2004; Hill &
Bird, 2006; Kenworthy et al., 2005; Miller & Ozonoff, 2000; Ozonoff & Jensen, 1999;
Sinzig, Morsch, Bruning, Schmidt, & Lehmkuhl, 2008; Szatmari, Tuff, Finlayson, &
Bartolucci, 1990; Verté, Geurts, Roeyers, Oosterlaan, & Sergeant, 2006). With respect to
inhibitory control, some studies have reported deficient functioning (Geurts et al., 2004;
Johnson et al., 2007), while others have failed to find any differences between individuals
with higher functioning ASD and TD individuals (Ambery et al., 2006; Bishop &
Norbury, 2005; Hill & Bird, 2006; Ozonoff & Jensen, 1999). Studies on fluency in
children and adults have also offered mixed findings of intact and impaired abilities in
both design and verbal fluency (Ambery et al., 2006; Happé, Booth, Charlton, & Hughes,
2006; Hill & Bird, 2006; Kleinhans, Akshoomoff, & Delis, 2005; Robinson, Goddard,
Dritschel, Wisley, & Howlin, 2009; Verté et al., 2006).
Regarding language abilities little research has focused on examining basic recep-
tive and expressive skills in children with higher functioning ASD, especially regarding
children previously diagnosed with Asperger syndrome. A study by Szatmari, Archer,
Fisman, Streiner, and Wilson (1995) showed that children with Asperger syndrome
performed just below normal or within a standard deviation of normal scores in a variety
of tasks measuring receptive and expressive language skills. Saalasti et al.’s study (2008)
found that children with Asperger syndrome demonstrated more difficulties in following
verbal instructions in comparison to TD children. Noterdaeme, Wriedt, and Höhne´s study
(2010) showed that children with HFA had more receptive and expressive language
difficulties than children with Asperger syndrome, yet more than 30% of the children
with Asperger syndrome had difficulties in receptive language tasks of word and sentence
comprehension. A larger body of research has focused on deficits in the social use of
language, or in pragmatics, in children with higher functioning ASD (Adams, Green,
Gilchrist, & Cox, 2002; Landa, 2000).
Regarding memory and learning, the findings on the performance of children with
higher functioning ASD in working memory tasks have been mixed. Studies on verbal
working memory have provided evidence of normal capacity or strength (e.g., Cui, Gao,
Chen, Zou, & Wang, 2010; Williams, Goldstein, Carpenter, & Minshew, 2005; Zinke
et al., 2010) and weakness (Alloway, Rajendran, & Archibald, 2009; Manjiviona & Prior,
1999). As to more complex verbal material, children with higher functioning ASD have
been reported to have more difficulties than TD children in story memory tasks (Fein
et al., 1996; Williams et al., 2006). Studies concerning visuospatial working memory have
also yielded evidence of both preserved (Alloway et al., 2009; Geurts et al., 2004;
Ozonoff & Strayer, 2001) and impaired (Cui et al., 2010; Goldberg et al., 2005;
Williams et al., 2005; Zinke et al., 2010) performance in children with higher functioning
ASD. Children with higher functioning ASD have been observed to have deficits in facial
recognition memory (Kuusikko-Gauffin et al., 2011; Szatmari et al., 1990; Wolf et al.,
2008) although spared performance has also been reported (O´Hearn, Schroer, Minshew,
& Luna, 2010).
Deficits in gross and fine motor skills and in visual-motor integration skills have
been frequently reported in children with higher functioning ASD (Gillberg, 1989; Ham,
Corley, Rajendran, Carletta, & Swanson, 2008; Klin, Volkmar, Sparrow, Cichetti, &
Rourke, 1995; Lopata, Hamm, Volker, & Sowinski, 2007; Manjiviona & Prior, 1995;
Szatmari, Bartolucci, & Bremner, 1989; Szatmari et al., 1990; Volker et al., 2010). In
addition, children with higher functioning ASD have been found to have deficits in
imitating hand postures and finger positions (Ham et al., 2008).
Regarding social perception, individuals with higher functioning ASD have been
reported to pass first and second order tests of theory of mind, involving inferring a
person’s own mental state and reasoning about what one person thinks of another
person’s thoughts (Bowler, 1992; Ozonoff, Pennington, & Rogers, 1991). Baron-
Cohen, O´Riordan, Stone, Jones, and Plaisted (1999) proposed that children with
higher functioning ASD have ToM deficits at a higher level than either first- or
second-order false belief tasks. Children, adolescents, and adults with higher function-
ing ASD have been found to have impaired performance in Happé´s Strange Stories
task that comprise higher order social communication such as pretense, jokes, white
lies, indirect requests, figures of speech, and irony (Happé, 1994; Kaland et al.,
2002). Further, children with ASD have been found to have difficulties in emotion
recognition (Kuusikko-Gauffin et al., 2009; Rump, Giovanelli, Minshew, & Strauss,
2009). Also, qualitative differences in the ability to identify a range of emotions have
been reported (Grossman, Klin, Carter, & Volkmar, 2000; Wong, Beidel, Sarver, &
Sims, 2012).
Research on visuospatial abilities in children with higher functioning ASD is
relatively scant. While Klin et al. (1995) reported deficits in visuospatial abilities in
children with Asperger syndrome, other studies have not found differences between
children with higher functioning ASD and TD children (Edgin & Pennington, 2005;
Semrud-Clikeman, Walkowiak, Wilkinson, & Christopher, 2010). Research on vision
and visual perception in individuals with ASD has, however, provided evidence of subtle
differences in visual processing capabilities between individuals with higher functioning
ASD and TD individuals, although the findings have been somewhat varying (see Dakin
& Frith, 2005; Simmons et al., 2009, for reviews).
Altogether, the available data obtained by neurocognitive research in higher func-
tioning individuals with ASD provide mainly specific information of single areas of
functioning. Thus, not much is known about the comprehensive neurocognitive perfor-
mance of these individuals across the whole spectrum of domains. In addition, most
neurocognitive studies have included children and adolescents or children, adolescents,
and adults pooled into the same sample instead of examining neurocognitive performance
in narrower age ranges. Recent studies in individuals with higher functioning ASD
indicate age-related changes in neurocognitive performance (Happé et al., 2006;
Kuusikko-Gauffin et al., 2011). Hence, neurocognitive studies separately assessing chil-
dren, adolescents, and adults with higher functioning ASD are needed. Finally, ASDs are
commonly diagnosed during the early school years. This gives cause for further specifica-
tion of the neurocognitive performance of young school-age children with higher func-
tioning ASD.
The purpose of the present study was to compare the neurocognitive performance of
higher functioning children with ASD and TD children. We aimed at defining patterns of
both strengths and weaknesses in the neurocognitive profile of children with higher
functioning ASD. We also intended to evaluate the findings with respect to the three
cognitive constructs, namely EF, WCC, and ToM, considered central to ASD. We
attempted to take into account the aforementioned issues by assessing performance across
the different neurocognitive domains using the developmental neuropsychological assess-
ment NEPSY-II (Korkman, Kirk, & Kemp, 2008a) and by including only children in our
sample. On the basis of earlier research, we expected higher functioning children with
ASD to show deficits foremost in the subtests of attention and EF, social perception, and
sensorimotor skills.
METHOD
Participants
Thirty children with Asperger syndrome were recruited from the Hospital for
Children and Adolescents at the Pediatric Neurology Unit in Helsinki University
Central Hospital (HUCH) and from a private neuropsychiatric center in Helsinki for the
higher functioning ASD group. The inclusion criteria for the higher functioning ASD
group were (a) age between 6 years 0 months and 11 years 11 months and (b) a clinical
diagnosis of Asperger syndrome. The age limit of 11 years 11 months was selected for the
present study because there is evidence that pubertal timing, which is often used to define
the onset of adolescence, takes place at the age 12 or 13 in the majority of individuals
(Bellis, Downing, & Ashton, 2006; Patton & Viner, 2007). Furthermore, in other neuro-
cognitive studies, 12-year-old participants have also been included in the “older” or
adolescent group (Happé et al., 2006; Kuusikko-Gauffin et al., 2011). The exclusion
criteria for the higher functioning ASD group included diagnoses of major genetic (e.g.,
Fragile X) or neurologic (e.g., epilepsy) disorders.
Prior to the study, participants had been clinically diagnosed with Asperger syn-
drome based on the criteria of the International Statistical Classification of Diseases and
Related Health Problems, 10th revision (ICD-10; World Health Organization [WHO],
1993) by experienced child neurologists and/or multidisciplinary teams in the field of
child neurology. The average age of receiving the clinical Asperger syndrome diagnosis
was 7.5 years. In this study, the clinical diagnoses of Asperger syndrome were confirmed
based on both standard ICD-10 (WHO, 1993) and Diagnostic and Statistical Manual of
Mental Disorders, fourth edition (DSM-IV; American Psychological Association [APA],

1994) at clinical case conferences together with the qualified nurses, psychologists, and/or
neuropsychologists who participated in the data collection and the senior pediatric
neurologist responsible for the research project. The Autism Diagnostic Interview-
Revised (ADI-R; Lord, Rutter, & LeCouteur, 1994; Rutter, LeCouteur, & Lord, 2003)
and the patient medical records were used as supplementary sources of diagnostic criteria.
The ADI-R was conducted as a part of this study if it had not been done previously during
the clinical diagnostic procedures. All participants showed no early language delays and
attended mainstream schools. One child had a diagnosis of a mild unilateral sensorineural
hearing loss according to patient medical records. Eight children were diagnosed with
attention deficit disorder, and 5 children were diagnosed with specific learning disorder
based on the patient medical records. Of the specific learning disorders, 4 children had
difficulties in reading, and 1 child had difficulties in visual perception. Three participants
were taking psychostimulant medication according to parent reports. Maternal education
levels were divided into low (elementary or comprehensive school), medium (matricula-
tion examination or vocational education), and high (polytechnic or university education).
Sixty TD children were selected from the appropriate strata of the standardiza-
tion sample of the Finnish version of the NEPSY-II: A Developmental
Neuropsychological Assessment, second edition (Korkman et al., 2008a). First, poten-
tial TD children for the TD group were selected to match each child in the higher
functioning ASD group as carefully as possible for age, gender, and maternal educa-
tion. Then, 2 TD children for each child with Asperger syndrome were randomly
selected from the potential TD children. The standardization sample was recruited
during the years 2006 and 2007. It consisted of 923 TD children aged between 3 and
15, except for the age groups of 10, 12, and 14 years. Therefore, each 10-year-old
child with Asperger Syndrome (n = 8) in our study was matched as consistently as
possible with one 9-year-old and one 11-year-old TD child. In the other age groups,
the age difference between each child with Asperger syndrome and the matched TD
children was within 6 months. On the basis of patient medical records or parent
reports, all TD children attended regular school classes and had no language or
learning difficulties, nor any neurologic or psychiatric diagnoses based on parent
reports. The demographic variables of the higher functioning ASD and TD groups
are summarized in Table 1.
Table 1 Demographic Variables for the ASD and TD Groups.
Background Data ASD (n = 30) TD (n = 60)
Age in years
M (SD) 9.1 (1.3) 9.1 (1.4)
Range 6.6–11.1 6.2–11.2
Gender
Boys n (%) 28 (93.3) 56 (93.3)
Girls n (%) 2 (6.7) 4 (6.7)
Maternal Education
Low n (%) 2 (6.7) 4 (6.7)
Medium n (%) 9 (30.0) 18 (30.0)
High n (%) 19 (63.3) 38 (63.3)
Measures
General cognitive abilities of the individuals with higher functioning ASD were
assessed with eight subtests of the Finnish version of the Wechsler Intelligence Scale for
Children, third edition (WISC-III; Wechsler, 1999). The full battery of WISC-III subtests
was not administered due to time constraints. Our selection of specific WISC-III subtests
was based on psychometric and clinical rationale, as well as on previous studies concern-
ing intellectual functioning in individuals with higher functioning ASD. We selected eight
subtests on the basis of psychometric rationale in order to obtain more valid and reliable
estimates of Full Scale IQ (FSIQ), Verbal IQ (VIQ), and Performance IQ (PIQ) in
comparison to shorter versions of the WISC-III (Sattler, 2001). We selected four verbal
and four performance subtests in order to acquire information equally from both of these
domains. Further, based on clinical rationale and previous studies, we selected specific
WISC-III subtests with regard to research findings of cognitive strengths and weaknesses
in individuals with higher functioning ASD (Barnhill, Hagiwara, Myles, & Simpson,
2000; Ghaziuddin & Mountain-Kimchi, 2004; Noterdaeme et al., 2010) and administra-
tion length of the subtests. The eight WISC-III subtests selected for the purposes of this
study were Information, Similarities, Arithmetic, Comprehension, Picture Completion,
Coding, Block Design, and Object Assembly. The Finnish version of WISC-IV was not
yet available at that time.
Neurocognitive performance was assessed with the Finnish version of the NEPSY-II
(Korkman et al., 2008a). The NEPSY-II is a comprehensive neuropsychological assess-
ment comprising 29 subtests from six domains of performance: attention and EF, lan-
guage, memory and learning, sensorimotor skills, social perception, and visuospatial
processing. In this study, 16 age-appropriate NEPSY-II subtests, two to four subtests
from each domain, were chosen in order to provide a comprehensive neuropsychological
profile. The Auditory Attention and Response Set consisted two parts, which were
analyzed separately, and the Inhibition subtest consisted of three parts, which were also
analyzed separately, thus adding up to 19 NEPSY-II subtests. The NEPSY- II subtests
administered in this study were Auditory Attention and Response Set, Design Fluency,
Inhibition (i.e., Inhibition Naming, Inhibition, and Inhibition Switching) and Visual
Attention in the Attention and EF domain; Comprehension of Instructions and Word
Generation in the Language domain; Memory for Designs, Memory for Faces, and
Narrative Memory in the Memory and Learning domain; Imitating Hand Positions and
Visuomotor Precision in the Sensorimotor domain; Affect Recognition and Theory of
Mind in the Social Perception domain; and Design Copying, Picture Puzzles, and
Geometric Puzzles in the Visuospatial Processing domain. Subtests were selected on the
basis of the EF, WCC, and ToM theories about ASD and previous research on higher
functioning ASD. In addition, the selection of subtests was influenced by the findings of
the “special group” study on children with Asperger Syndrome reported in the NEPSY-II,
United States edition (Korkman et al., 2007). A standard score of ≥ 8 represented an
average or above average performance, a standard score of 6 or 7 slightly below average,
and a score of 5 or below significantly below average (Korkman, Kirk, & Kemp, 2008b).
Procedure
Ethical approval for the study was given by the ethics review board at HUCH. All
participants and parents received written information about the study. The information
letter for children was specifically designed for them by making it shorter and using easier
vocabulary than in the information letter designed for parents. All children received their
own assent form, and parents received their own consent form. In addition, children and
parents received oral information about the study prior to the assessments. Written
informed consent was obtained from at least one caregiver of the children. Children
participated voluntarily. Additionally, the majority of children (80%) gave written assent.
The parents also filled a data form on demographic, educational, and medical variables.
The parental ADI-R interviews were conducted by trained professionals, who were
psychologists or qualified nurses. The WISC-III and NEPSY-II assessments were con-
ducted for the participants with higher functioning ASD in approximately three sessions,
each session lasting 1.5 hours.
Statistical Analysis
Statistical analyses were performed with the SPSS software (PASW 18; SPSS Inc.,
Chicago, IL). The missing values of the NEPSY-II subtest scores were replaced using the
regression method imputation function in SPSS based on all NEPSY-II variables, age,
gender, and maternal education. Imputation was carried out for 11 randomly missing
values of the 1676 observations (<1%). Due to the presentation ages of the NEPSY-II
subtests, 6-year-old children (n = 6) had missing values in three subtests and 11-year-old
children (n = 14) had missing values in one subtest. In order to analyze all age groups and
all subtests with multivariate analysis of variance (MANOVA), these values were simi-
larly imputed. The normality of the WISC-III and NEPSY-II data was analyzed with the
Shapiro-Wilk’s test and the homogeneity of variance with the Levene´s test (p < .001).
The data were relatively normally distributed with the exception of the results of the
NEPSY-II subtest Auditory Attention in both groups (p < .001) and Response Set, Affect
Recognition, and Picture Puzzles in the TD group (p < .001). Graphical screening showed
similar negative skewness and positive kurtosis in Auditory Attention in both groups
(ASD group skewness = –1.78, SE = 0.43; kurtosis = 4.39, SE = 0.83; TD group
skewness = –2.12, SE = 0.31; kurtosis = 4.21, SE = 0.61). The TD group had a slightly
negative skewness and positive kurtosis in Response Set (skewness = –1.19, SE = 0.31;
kurtosis = 1.83, SE = 0.61), Affect Recognition (skewness = –1.50, SE = 0.31, kurto-
sis = 2.00, SE = 0.61), and Picture Puzzles (skewness = –1.48, SE = 0.31; kurtosis = 2.22,
SE = 0.61) with a few outliers (range 3–6) among the lowest scores. Since the data were
relatively normally distributed with similar characteristics in both groups, parametric
analyses were carried out. Age differences between the higher functioning ASD and TD
group were analyzed with an independent samples t-test. Cross-tabulation and the chi-
square test were used to compare the groups with respect to gender and maternal
education.
The WISC-III VIQ, PIQ, and FSIQ scores of the higher functioning ASD group
were compared with the population mean by one-sample t-tests. A paired samples t-test
was used to assess possible difference between VIQ and PIQ in children with higher
functioning ASD. Cohen´s d was used as an indicator of effect size. The NEPSY-II age-
adjusted standard deviation scores were used in the analyses. MANOVA was conducted
using group as the independent variable and the 19 NEPSY-II subtests as the dependent
variables. Partial eta-squared (ηp2) was used as an indicator of effect size. For exploratory
analyses, we compared the group mean for each NEPSY-II subtest using independent-
sample t-tests and Cohen’s d for effect size. The alpha level was set at α < .05. The
Benjamini and Hochberg (1995) procedure was used to control for multiple comparisons;
the False Discovery Rate (FDR) was controlled at the 0.1 level. Results concerning
NEPSY-II subtests are reported before and after the correction for FDR. The relationship
between WISC-III FSIQ and NEPSY-II subtest performance as well as between chron-
ological age and NEPSY-II subtest performance in individuals with higher functioning
ASD was assessed with Pearson´s correlations.
RESULTS
The higher functioning ASD and TD groups did not differ from each other with
respect to age, gender, and maternal education level (Table 1). The FSIQ of the partici-
pants with higher functioning ASD ranged from 77 to 138 (Md = 110.50), the VIQ from
79 to 148 (Md = 112.50), and the PIQ from 64 to 144 (Md = 109.00). The higher
functioning ASD group exhibited a significantly higher FSIQ (M = 107.2, SD = 17.3), t
(29) = 2.26, p = .031, d = .48, and VIQ (M = 110.9, SD = 19.4), t(29) = 3.07, p = .005,
d = .73, in comparison to the population means for Finnish children according to the test
norms but did not differ in terms of PIQ (M = 104.2, SD = 20.9). Within the higher
functioning ASD group there was a trend for a higher VIQ in comparison to
PIQ (p = .05).
MANOVA showed significant differences between the group means across the 19
NEPSY-II subtests (Wilks's λ = 0.53), F(19,70) = 3.28, p < .001, ηp2 = 0.47. Exploratory
follow-up analyses indicated significant group differences in 6 of the 19 NEPSY-II
subtests with a medium-to-large effect size, with the higher functioning ASD group
performing poorer than the TD group (see Table 2). The higher functioning ASD group
Table 2 Descriptive Results for Between-Group Comparisons.
ASD TD
ASD/TD
NEPSY-II subtests n M (SD) M (SD) df t p d
Auditory Attention 30/60 9.70 (2.20) 9.97 (2.76) 88 0.46 .646 .10
Response Set 27/57 7.63 (3.04) 10.19 (2.89) 82 3.74 <.001*** .87
Design Fluency 30/60 10.33 (3.75) 10.37 (2.84) 88 0.05 .963 .01
Inhibition: Naming 30/60 8.47 (1.59) 8.13 (1.70) 88 −0.90 .373 −.20
Inhibition 30/60 8.59 (3.05) 9.32 (2.11) 88 1.33 .189 .30
Switching 27/57 9.68 (3.04) 9.25 (2.90) 82 −0.63 .533 −.15
Visual Attention 30/60 9.57 (2.61) 10.05 (2.21) 88 0.91 .364 .20
Comprehension of Instructions 30/60 10.87 (2.69) 10.08 (2.85) 88 −1.26 .211 −.28
Word Generation 30/60 8.13 (3.00) 9.93 (3.01) 88 2.68 .009** .60
Memory for Designs 30/60 10.67 (3.06) 10.30 (3.03) 88 −0.54 .591 −.12
Memory for Faces 30/60 8.50 (3.16) 10.08 (3.16) 88 2.24 .028* .50
Narrative Memory 28/46 7.43 (4.47) 9.78 (3.07) 72 2.69 .009** .64
Imitating Hand Positions 30/60 9.10 (2.93) 10.70 (2.63) 88 2.62 .010** .59
Visuomotor Precision 30/60 8.50 (3.75) 9.97 (1.93) 36.9 2.01 .051† .55
Affect Recognition 30/60 8.87 (3.30) 9.56 (2.96) 88 1.00 .318 .22
Theory of Mind 30/60 9.87 (2.40) 10.58 (1.90) 88 1.54 .127 .34
Design Copying 30/60 8.23 (4.16) 10.07 (3.28) 88 2.28 .025* .51
Geometric Puzzles 30/60 9.50 (3.96) 10.30 (2.82) 88 1.10 .273 .25
Picture Puzzles 27/57 11.00 (2.39) 10.01 (2.96) 82 −1.52 .133 −.35
† p = .051. * p < .05. ** p < .01. *** p < .001.

performed significantly poorer in the Response Set, Word Generation, Narrative Memory,
Memory for Faces, Imitating Hand Positions, and Design Copying subtests. There was a
trend for poorer performance also in the Visuomotor Precision subtest. Due to unequal
variances in the Visuomotor Precision subtest, a t-test not assuming equality of variances
was used.
After adjustment for multiple testing by the Benjamini and Hochberg (1995)
procedure, only the p values of Response Set, Word Generation, and Narrative Memory
were statistically significant (see Figure 1). Additionally, the Word Generation subtest was
examined to see if the performance of the groups differed regarding the raw scores of
semantic and phonemic categories when age was controlled. However there was no
statistically significant Group × Word category interaction in a two-way mixed analysis
of covariance (ANCOVA).
The outcome of an exploratory analysis of the distributions of scores of the

children with higher functioning ASD and TD children ranging from average or above
average (standard scores of 8 or above), slightly below average (standard scores of 6
or 7), to significantly below average (standard scores of 5 or below) in the six
subtests, which differentiated the groups, and in the Visuomotor Precision subtest,
which marginally differentiated the groups, is shown in Figure 2. None of the children
with higher functioning ASD scored within the average range (standard scores of 8 or
above) in all of the seven subtests, while 37% of the TD children did. Ten percent of
the children with higher functioning ASD scored below average (standard scores of 7
12
Group:
TD
11
ASD
10
9
Mean
5
*** ** * ** ** † *
0
Au
R ory
D ons ent
In n F et
In tion ncy
In tion mi
Vi tion ibi
C l A itc
W reh tion
M Ge ion
M ory atio Ins
N ry De
Im tive Fac s
Vi ing em
Af mo nd
Th t Re Pre itio
D ry o gnit ion
G n C ind
Pi etr ying
es
es
om tte hi
ar
es
eo
hi
hi
hi
em ne
em fo
su
su H or
ct
or
fe to Po
ita
eo co cis ns
di
bi lue
bi Na
bi Inh g
ra or ign
ur ic P
p
ig
ig M on
c
d ens
m op
a Sw on
o
t
p n ng
t M
o r
e
Pu zz
f
At
e ion
zz les
r
S
a y
t
r of
le
s
n
s
ti
i
es
n
s
tru
ct
io
ns
Figure 1 The neuropsychological profiles of the higher functioning ASD (ASD) and typically developing (TD) groups.
*** p < .001, ** p < .01, * p < .05, † p = .051 for independent samples t-tests; ♦ q < .1 for Benjamini-Hochberg FDR.
100 %
8
90 % 6–7
<6
80 %
70 %
60 %
50 %
40 %
30 %
20 %
10 %
0%
ASD TD ASD TD ASD TD ASD TD ASD TD ASD TD ASD TD
Response Set Word Memory for Narrative Imitating Hand Visuomotor Design
Generation Faces Memory Positions Precision Copying
Figure 2 The distribution of scores of the higher functioning ASD (ASD) and typically developing (TD) groups
on the seven differentiating NEPSY-II variables.
or below) in one of these subtests, 63% in two or three subtests, and 27% in four to
six subtests. Respectively, 33% of the TD children scored below average (standard
scores of 7 or below) in one subtest, 28% in two or three subtests, and 2% in four to
six subtests.
When examining the relationship between FSIQ and NEPSY-II subtest performance
in individuals with higher functioning ASD, statistically significant positive correlations
(p < .05) were found in six subtests: Design Fluency (r = .49), Inhibition Switching
(r = .51), Comprehension of Instructions (r = .45), Design Copying (r = .61), Geometric
Puzzles (r = .39), and Picture Puzzles (r = .43). The correlations between chronological
age and NEPSY-II subtest performance in individuals with higher functioning ASD were
statistically significant in two subtests, with a negative correlation in Inhibition Naming
(r = −.44, p = .014) and positive correlation in Auditory Attention (r = .36, p = .05).
DISCUSSION
In the present study, the neurocognitive performance of children with higher
functioning ASD was compared to that of TD children. The results of the WISC-III
assessment indicated strengths in verbal reasoning skills in children with higher function-
ing ASD compared to the population mean. The results of the NEPSY-II assessment
indicated that there were significant differences in the neurocognitive performance of
children with higher functioning ASD and TD children. The children with higher func-
tioning ASD performed significantly more poorly than the TD children in set shifting,
verbal fluency, and narrative memory. There was a trend for the children with higher
functioning ASD to perform more poorly than the TD children also in facial memory and
fine and visuomotor skills.
On the basis of FSIQ and VIQ scores, the performance of the children with higher
functioning ASD was above the population mean for Finnish children and they demon-
strated strengths especially in verbal reasoning skills. There was a trend for higher VIQ in
comparison to PIQ within the higher functioning ASD group as 70% of the children had a
higher VIQ than PIQ. Our results give partial support to earlier findings of higher VIQ
than PIQ scores in children with high-functioning ASD (i.e., Asperger Syndrome)
(Ghaziuddin & Mountain-Kimchi, 2004; Klin et al., 1995; Lincoln, Allen, & Kilman,
1995; Ozonoff, Rogers, & Pennington, 1991).
Using only eight subtests of the WISC-III instead of all 10 standard subtests may
have affected the results. The most pertinent question is whether and how our decision
to omit the Vocabulary subtest impacts the results. The Vocabulary subtest has the
highest correlation with the VIQ (r = .97) (Wechsler, 1999) and is included in almost
every WISC-III short form due to its exceptional psychometric properties (Sattler,
2001). The probable direction of the impact of omitting the Vocabulary subtest is
that the VIQ is underestimated in children with higher functioning ASD in our study.
The reported standard score means on the Vocabulary subtest in individuals with higher
functioning ASD have been higher than on the Arithmetic subtest that has the lowest
correlation with the VIQ (r = .89) (Barnhill et al., 2000; Ghaziuddin & Mountain-
Kimchi, 2004; Noterdaeme et al., 2010; Ozonoff et al., 2000; Planche & Lemonnier,
2012). The effect is, however, unlikely to be very large in the present study, since the
reported reliability and validity coefficients have been high (rtt = .892–.925;
r = .838–.904) even regarding WISC-III short forms without the Vocabulary subtest
(Sattler, 2001).
In addition, it should be taken into account that the general cognitive abilities of the
TD children were not assessed and, therefore, the results rely on WISC-III norms, which
were relatively old at the time of the study. Thus, the results should be interpreted with
caution due to the possible Flynn effect, that is, the increase in IQ scores over time (e.g.,
Flynn, 1984, 1987).
In the Attention and EF domains, the higher functioning ASD group performed
significantly poorer than the TD group with a mean score below average in the Response
Set subtest, which is designed to assess selective auditory attention, sustained auditory
attention, and set-shifting. Over 50% of the children with higher functioning ASD
performed below average as opposed to 15% of the TD children. No significant group
differences were found, however, in the Auditory Attention subtest, which is designed to
assess selective and sustained auditory attention. There are earlier studies reporting
children with higher functioning ASD having deficits in the NEPSY/NEPSY-II subtest
of Auditory Attention and Response Set (Hooper et al., 2006; Narzisi et al., 2012).
However, our results suggest that children with higher functioning ASD have difficulties
specifically in set-shifting. This is consistent with previous studies reporting impaired set-
shifting abilities in children and adults with Asperger syndrome or autism (Ambery et al.,
2006; McEvoy, Rogers, & Pennington, 1993; Ozonoff et al., 2004; Szatmari et al., 1990;
Verté et al., 2006). No differences between the groups were found in the Inhibition
subtests. This was contrary to the findings of Narzisi et al. (2012), but was consistent
with other studies not finding difficulties in Stroop tests in children and adults with ASD
(Ambery et al., 2006; Hill & Bird, 2006; Kleinhans et al., 2005; Ozonoff & Jensen, 1999).
No significant differences between the groups were found in the Design Fluency or Visual
Attention subtests, which is consistent with the findings of Narzisi et al. (2012). Our
results also corroborate the studies of Kleinhans et al. (2005) and Turner (1999), in which
significant group differences were not found in tasks of design fluency between children
with higher functioning ASD and TD children.
Although the Word Generation subtest is listed under the language domain in the
NEPSY-II, it can also be seen as an EF subtest. The higher functioning ASD group had a
significantly lower score than the TD group in this subtest. No significant interactions
were found between Word Generation subtest categories (semantic vs. phonemic). Our
finding supports previous reports of poorer verbal fluency in individuals with ASD as
compared to TD individuals (Ambery et al., 2006; Geurts et al., 2004; Rumsey &
Hamburger, 1988, 1990; Turner, 1999; Verté et al., 2006). The groups did not differ
from each other with respect to comprehension of verbal instructions. Thus, Saalasti
et al.’s (2008) finding that children with Asperger Syndrome have more difficulties than
TD children in following verbal instructions was not corroborated.
Regarding memory and learning, the higher functioning ASD group performed
significantly poorer than the TD group in the Narrative Memory subtest, with a mean
score below average. The higher functioning ASD group provided fewer relevant events
or details in the combined free- and cued-recall score than the TD group. Fifty percent of
the children with higher functioning ASD performed below average, and most of them
(36%) had significant difficulties in the task. Our results are consistent with the findings
of Narzisi et al. (2012) showing that children with higher functioning ASD have impaired
narrative memory on the basis of the NEPSY-II. They are also in line with the findings of
O´Shea, Fein, Cillesen, Klin, and Schultz (2005) according to which children with higher
functioning ASD recall fewer details in the Story Free Recall Task (Garcia, 2001; Lindsay,
Johnson, & Kwon, 1991) than TD children. Studies on memory for wordlists have
indicated that individuals with higher functioning ASD are impaired in their ability to
develop complex organization strategies for free recall of information (Bowler, Matthews,
& Gardiner, 1997; Minshew, Goldstein, Muenz, & Payton, 1992; Minshew, Goldstein,
Taylor, & Siegel, 1994, Narzisi et al., 2012) but not so in cued-recall situations (Bowler
et al., 1997; Bowler, Gardiner, & Berthollier, 2004; Gardiner, Bowler, & Grice, 2003).
Similarly, our finding of impaired narrative memory may reflect difficulties in applying
retrieval strategies or in integrating details into a whole, thus suggesting some support to
the EF or WCC theories. However, since our analysis combined free and cued recall, it
was not possible to differentiate between these conditions. Considering that the story is a
personal narrative of a boy and his dog including elements of understanding emotions,
impaired performance could also be related to poor ToM skills. Furthermore, impairment
in this type of performance may also reflect difficulties that children with higher function-
ing ASD might have in relating to the listener’s expectations when they tell a story.
However, more research is needed for the verification of the hypothesis underlying
impaired narrative memory.
The higher functioning ASD group showed a trend for poorer performance than the
TD group in the Memory for Faces subtest. Our findings are partially in line with previous
studies indicating poor facial recognition in ASD (e.g., Akshoomoff, 2005; Barton et al.,
2004; Barton, Hefter, Cherkasova, & Manoach, 2007; Hooper et al., 2006; Klin et al.,
1999; Narzisi et al., 2012; Nieminen-von Wendt et al., 2005; Szatmari et al., 1990) giving
some support for the WCC account. No group differences were found in the performance
of the Memory for Designs subtest. Our results did not corroborate those of Narzisi et al.
(2012) but gave support for studies that have not found group differences between
individuals with higher functioning ASD and TD individuals with respect to performance
in visuospatial working memory tasks (Alloway et al., 2009; Ozonoff & Strayer, 2001).
However, since our analysis combined immediate and delayed recall scores, visuospatial
working memory and long-term memory conditions were not examined separately.
In the Sensorimotor domain, there was a trend for the children with higher function-
ing ASD to perform more poorly than the TD children in the Imitating Hand Positions
subtest as well as in the Visuomotor Precision subtest. Our results give partial support to
earlier findings of deficits in fine and visuomotor skills in children with higher functioning
ASD (Ham et al., 2008; Hooper et al., 2006; Narzisi et al., 2012). In the Visuomotor
Precision subtest, the unequal variances of the groups were probably the reason why
statistical significance was not reached.
As to social perception, no significant differences between the higher functioning
ASD and TD groups were found in the performance in the Affect Recognition or Theory
of Mind subtests, which was in contrast to our expectations. Previous studies applying
affect recognition and ToM tasks have offered somewhat mixed evidence of ToM deficits
in children with higher functioning ASD (Baron-Cohen et al., 1999; Dahlgren, Dahlgren-
Sandberg, & Hjelmqvist, 2003; Happé, 1994; Jones et al., 2011; Kaland et al., 2002;
Narzisi et al., 2012; Ozonoff, Pennington, et al., 1991; Rump et al., 2009). These varying
findings have been interpreted to be related, at least partly, to differences in the sensitiv-
ities of tests used. Some variation may also partly be due to the different studies not
having consisted of children of the same subtype of ASD. It should be noted that the
children with higher functioning ASD in our study all had a diagnosis of Asperger
Syndrome, thus indicating relative preservation of linguistic development. Our findings
suggest the lack of sensitivity of the NEPSY-II Theory of Mind subtest in detecting
difficulties in comprehending the mental states of others with respect to school-aged
children with higher functioning ASD. This issue should be further examined.
In the Visuospatial domain, the children with higher functioning ASD showed a
trend for poorer performance in the Design Copying subtest in comparison to the TD
children, which is in keeping with the findings of Narzisi et al. (2012) and Ham et al.
(2008). Our results on the Visuomotor Precision and Design Copying subtests suggest
weaker visuomotor integration in children with higher functioning ASD in comparison to
TD children. Subtests of visuospatial processing without a motor response, Geometric
Puzzles and Picture Puzzles, did not discriminate between the groups.
Finally, no significant correlations were found between general cognitive perfor-
mance (FSIQ) on the WISC-III and impaired neurocognitive functioning on the NEPSY-II
in children with higher functioning ASD. None of the three subtests (i.e., set-shifting,
verbal fluency, and narrative memory) that differentiated the higher functioning ASD and
TD groups on the NEPSY-II showed significant correlations with FSIQ. The lack of
correlation between IQ and impaired NEPSY-II subtest performance has also been
observed among children with fetal alcohol spectrum disorder (FASD), a set of conditions
resulting from prenatal alcohol exposure (Rasmussen et al., 2013), offering support for the
usefulness of NEPSY-II in assessing different clinical groups. There was a significantly
positive correlation between FSIQ and Design copying, in which subtest the higher
functioning ASD group performed poorer than the TD group on the basis of exploratory
analysis. This finding may be related to the poorer PIQ than VIQ performance within the
higher functioning ASD group. Further work is needed in order to clarify the relationship
between PIQ subtest performance (i.e., perceptual organization and visuomotor abilities)
and Design copying. No significant correlations were found between chronological age
and the performance in NEPSY-II subtests that differentiated the higher functioning ASD
and TD groups.
Overall, the children with higher functioning ASD formed a highly heterogeneous
group. The performance of children with higher functioning ASD varied in terms of the
distribution of scores in the seven differentiating subtests. Their performance varied also
in terms of the number of subtests in which they scored below average. It is noteworthy
that none of the children with higher functioning ASD performed within the average range
in all seven subtests. Furthermore, 90% scored below average in two or more NEPSY-II
subtests. It should be noted that also TD children have a tendency for some low scores in
NEPSY-II subtests when multiple subtests are administered (Brooks, Sherman, & Iverson,
2010). Brooks et al. (2010) reported the base rates of low NEPSY-II scores in relation to
the number of subtests administered, age, and parental education based on the NEPSY-II
standardization sample. When a 2-hour battery was administered and the level of parental
education was 16 years or more, 28% of the TD participants (age range 7–16) obtained a
standard score ≤6 in two or more subtests, and 68% obtained standard scores ≤7–8 in two
or more subtests. Thus, although TD children tend to get some low scores on the NEPSY-
II subtests, the children with higher functioning ASD in our study seem to obtain more
low scores. This kind of comparison should be interpreted, however, with caution because
Brooks et al. (2010) presented the base rates of low scores to a largely different selection
of NEPSY-II subtests than that used in our study. Furthermore, we examined the distribu-
tion of scores only in the seven NEPSY-II subtests that differentiated the groups on the
basis of exploratory analyses. Further analysis of a larger sample is required in order to
specify if the heterogeneity in the performance of children with higher functioning ASD
can be explained on the basis of variation in the severity of neurocognitive deficits or on
the basis of differential and distinguishable neurocognitive performance of individuals
with higher functioning ASD.
The present study has some limitations. Firstly, the sample of children with higher
functioning ASD was rather small, which probably made it more difficult to demonstrate
statistically significant differences between the groups after the correction for multiple
comparisons. Therefore, studies with larger sample sizes are needed in order to examine
this issue further. Secondly, the overrepresentation of boys in the higher functioning ASD
group also gives cause for further study with a larger sample. The gender distribution in
this study (boy to girl ratio 14:1) did not correspond to evidence from epidemiological
research suggesting boy-to-girl ratios of 4:1 in Asperger syndrome (Chakrabarti &
Fonbonne, 2005; Ehlers & Gillberg, 1993; Kadesjö, Gillberg, & Hagberg, 1999; Mattila
et al., 2007). However, our gender distribution is more in line with Gillberg and collea-
gues (2006) finding of a boy-to-girl ratio of 16.7:1.6 of children referred for Asperger
syndrome diagnostic assessments. More boys than girls may be referred for assessments
due to gender differences in the expression of social and communication deficits. The
children with higher functioning ASD in our study were recruited from neurologic and
neuropsychiatric units specialized in ASDs and may thus not be representative of most
children with higher functioning ASD. Furthermore, the stringent criteria of both ICD-10
and DSM-IV criteria and the small sample size in our study may have partly contributed to
the scarcity of girls. Thirdly, we could not utilize the WISC-IV since at the time of the
study the Finnish version of the WISC-IV was not available.
In conclusion, the neurocognitive performance of children with higher functioning
ASD was compared to that of TD children comprehensively across different neurocogni-
tive domains with standardized neuropsychological assessments. Firstly, our results
suggest that children with higher functioning ASD have strengths in verbal reasoning
skills compared to the population mean. Secondly, our results indicate that children with
higher functioning ASD have weaknesses in set-shifting, verbal fluency, and narrative
memory with respect to TD children. These impairments were apparent irrespective of
general intellectual functioning. Minor differences were also found in facial memory and
fine and visuomotor skills with the children with higher functioning ASD performing
qualitatively poorer than the TD children. Thirdly, our results indicate that children with
higher functioning ASD form a highly heterogeneous group. Of the three core cognitive
constructs considered to underlie behavioral and processing characteristics in high-func-
tioning ASD, our study gives most support to the EF theory (e.g., Response Set, Word
Generation, and Narrative Memory subtests). Our results provide some indications of
WCC or deficits in ToM skills (e.g., Memory for Faces and Narrative Memory subtests)
that, however, could not be verified due to methodological constraints. Our results provide
specification to earlier findings regarding the neurocognitive performance of children with
higher functioning ASD.
Original manuscript received February 8, 2013

Revised manuscript accepted December 5, 2013
First published online January 8, 2014
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Barron Linnankoski2014

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This article was downloaded by: [University of Aberdeen]

On: 14 November 2014, At: 23:50

Child Neuropsychology: A Journal on

To link to this article: http://dx.doi.org/10.1080/09297049.2013.873781

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Neurocognitive performance of children with higher

Sarianna Barron-Linnankoski1, Outi Reinvall1,2, Anne Lahervuori1,

Keywords: Autism spectrum disorder; Asperger syndrome; Neurocognitive performance; Children;

© 2014 Taylor & Francis

neuropsychological impairments on the NEPSY-II (Korkman, Kirk, & Kemp, 2007) in

Mental Disorders, fourth edition (DSM-IV; American Psychological Association [APA],

Table 1 Demographic Variables for the ASD and TD Groups.

Background Data ASD (n = 30) TD (n = 60)

Table 2 Descriptive Results for Between-Group Comparisons.

† p = .051. * p < .05. ** p < .01. *** p < .001.

The outcome of an exploratory analysis of the distributions of scores of the

M ory atio Ins

Original manuscript received February 8, 2013

inadequate communication: Developmental language disorder, Autism, Low IQ (pp. 123–154).

in Autism (pp. 89–117). New York, NY: Plenum Press.

10, 201–221. doi:10.1080/01688638808408236

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† p = .051. * p < .05. p < .01. * p < .001.