Cognition in Autism Spectrum Disorder

Research has shown that verbal adults with autism spectrum disorder and without co-occurring
intellectual disability have difficulties with cognition.

Have you considered if your verbal ASD client:

• Processes information slowly?
• Struggles with understanding the main point when reading and conversing?
• Has difficulty at tending to relevant information?
• Exhibits challenges with cognitive flexibility (e.g., difficulty shifting attention; being open to new ideas)?
• Has difficulty with working memory and problem solving?
• Seems to have trouble getting motivated?
• Struggles in school, or has difficulty getting or keeping a job?

How to help

Difficulties with Attention, Memory and Problem Solving are common in autism spectrum disorder, even in verbal adults without co-occurring intellectual disability, and can lead
to significant functional disability.

Strategies/Interventions that could help

• Computer software designed to improve attention, memory and problem solving:
  • www.PSSCogRehab.com
  • https://brainhq.co
  • https://psyberguide.org/apps/cogpack
  • www.happy-neuron.com
• Encourage a healthy daily schedule (e.g., healthy sleep schedule, good nutrition, chores,
  exercise, relaxation) and to take responsibility for being on time
• Encourage the use of visual prompts, if needed (e.g.,’to do’ lists, post-its, cell phone reminders)
• Encourage the use of auditory prompts (e.g., alarm clock, cell phone)
• Encourage breaking tasks into smaller steps and tackling the easy parts first; recognizing and rewarding progress
• Cognitive Enhancement Therapy (CET) – an innovative cognitive remediation approach that integrates neurocognitive and social cognitive enhancement approaches. CET will be coming soon to PA

Did you know?

• ASD is a “no fault” brain disorder
• Current estimate: 1 in 59 people are affected
• There is a broad range of functioning and abilities
• Cognitive difficulties occur in ASD, even in verbal adults without co-occurring intellectual
  disability.

What are common cognitive challenges in ASD?

• Slower processing of information
• Challenges in focusing on relevant information outside one’s areas of interest
• Reduced working memory capacity
• Difficulty with problem solving, particularly in social situations
• Difficulty figuring out the main point in conversations, books and films

How does this affect me?

• Challenges in school
• Difficulty getting and/or keeping a job
• Difficulty communicating with people

Difficulties paying attention to information outside one’s area of interest, and challenges with memory and problem-solving skills are often experienced by verbal adults without intellectual
disability. These difficulties can affect motivation and functioning at school, work and when interacting with other people.

What can I do to build my cognitive skills?

• Use computer software designed to improve attention, memory and problem solving:
  • www.PSSCogRehab.com
  • https://www.brainhq.com
  • https://psyberguide.org/apps/cogpack
  • www.happy-neuron.com
• Be aware of when I become distracted and cue myself to get back on track
• Create a healthy daily schedule
• Make a list of tasks I need to complete
• Break tasks into smaller steps. Tackle the easy parts first to build motivation
• Use reminders to keep on schedule (e.g., set alarm on cell phone, use a daily planner
  and/or ‘post-its’)
• Consider participating in Cognitive Enhancement Therapy, an innovative approach designed to help improve cognition. CET will be coming soon to PA.

Difficulties in social communication and interactions are among the hallmarks
of autism spectrum disorder. Social cognitive difficulties exist even in verbal adults without co-occurring intellectual disability.

Have you considered if your verbal ASD client:

• Has difficulty understanding the perspectives and intentions of other people?
• Exhibits difficulty appraising the social context and determining what behavior is appropriate in different social settings?
• Struggles to understand the non-verbal behavior of others (facial expression, body language)?
• Has difficulty understanding how their verbal and non-verbal behavior affects others?
• Has challenges with social and emotional reciprocity?
• Has limited foresight or the ability to plan ahead?

Strategies/Interventions that could help:

• Dr. Paul Ekman’s facial emotion training: www.paulekman.com
• Being clear and direct, people with autism have trouble picking up on subtle cues
• Avoiding complex sentences – Break sentences down into smaller main points or ‘gists’
• Difficulty understanding the intentions of others and poor social context appraisal
  can put individuals at risk to be taken advantage of. Caution your clients about ‘lending’ money to others; as well as phone or internet scams
• Cognitive Enhancement Therapy – an innovative 18-month comprehensive cognitive remediation approach that targets problems in social cognition. It is a small group approach that integrates neurocognitive training and social cognitive group sessions. Training in CET will be coming soon to PA.

Did you know that difficulties with social cognition are very common in autism spectrum
disorder, even among verbal adults without a co-occurring intellectual disability?

What are typical social cognitive problems in ASD?

• Difficulty understanding other people’s thoughts and feelings
• Problems recognizing and understanding facial expressions and body language in others
• Difficulty figuring out how to act and/or what to say in different social settings
• Difficulty expressing empathy and support to others
• Saying too much, or too little when interacting with others
• Difficulty communicating effectively
• Difficulty managing emotions

How does this affect me?

• Feeling like I don’t belong or “fit in” with others
• Difficulty starting and maintaining a conversation
• Challenges forming and maintaining friendships
• Difficulty interacting successfully with teachers and other students
• Difficulty interacting successfully with an employer and co-workers

Difficulty with social cognition is characteristic of autism spectrum disorder. Understanding different social settings and communicating effectively can be challenging, even for verbal adults without intellectual disability. The good news is that it is possible to develop and improve social cognitive skills.

What can I do to build my social cognition skills?

• Dr. Paul Ekman’s Micro Expressions Training Tools (www.paulekman.com) may be helpful in learning to identify facial expressions in others.
• Ask questions and get clarification when talking to people.
• Observe the social setting. How are people behaving? What subjects are people talking about?
• Pay attention to what people say and their facial expressions. Try to establish eye contact with other people.
• Be careful where you place your trust. Do not assume everyone is honest or trustworthy. Talk with a trusted family member or friend before you give or loan money to others.
• Consider that other people may have perspectives that are different than yours. Remain open to the opinions and interests of others.
• Cognitive Enhancement Therapy – an innovative 18-month comprehensive cognitive remediation approach that targets problems in social cognition. It is a small group approach that integrates training in attention, memory and problem solving with social cognitive group sessions. Opportunities to participate in CET will be coming soon to PA.