Neuropsychological assessment of executive functions in autistic children and adolescents: Challenges, future directions, and clinical recommendations

Autistic children are often linked to cognitive challenges, particularly in executive functions (EFs), which can emerge as early as the preschool years. EFs encompass a complex set of cognitive processes that enable individuals to regulate impulses, retain and manipulate relevant information, filter distractions, and shift between tasks or attentional demands. Examining these functions in autistic children is particularly important given their close association with academic achievement, quality of life, behavioural and emotional regulation, and their role in understanding the heterogeneity of autism. Various tools have been developed to assess EFs, including performance-based measures and informant-report ratings. This narrative review synthesises the current literature on neuropsychological tools used to evaluate executive functioning in autistic children and adolescents (ages 3–18) with average intellectual profiles. The analysis of empirical studies published between 2013 and 2025 highlights substantial variability in findings, which appears to be strongly influenced by age, task characteristics, and the involvement of linguistic and fine motor demands. These factors represent key methodological challenges in EF assessment and may contribute to inconsistent results across studies. Future research should prioritise the development of more sensitive tools to isolate EF abilities from other cognitive domains, as well as the adoption of strength-based approaches. Longitudinal and multidimensional studies across diverse contexts are also warranted. From a clinical perspective, adopting a multidimensional and integrative assessment framework, such as the executive attention approach, may help address these limitations, improve the interpretation of EF profiles, and support the development of more targeted interventions and educational strategies for autistic individuals.