Executive Function Interventions in Adolescents and Adults with Autism Spectrum Disorder: : A Systematic Review, Critical Appraisal, and Future Directions
Year: 2026
Type: review
Study design: Systematic Review
Abstract: Executive functions (EF) are among the cognitive domains most consistently affected in autism spectrum disorder (ASD) and therefore represent important targets for intervention. However, systematic reviews focusing specifically on adolescents and adults remain scarce. This systematic review aimed to synthesize the characteristics and effects of interventions targeting EF in adolescents and adults with ASD, while also examining the methodological quality and scope of the available evidence. A systematic search was conducted in seven databases (Scopus, ScienceDirect, SciELO, PubMed, PsycInfo, BVS, and ERIC), in addition to reference-list screening, with no time restrictions. Study selection, data extraction, and risk-of-bias assessment (using the RoB 2 and ROBINS-I tools) were conducted independently by two reviewers. Nine empirical studies (N = 286 participants) met the inclusion criteria. The available evidence was composed predominantly of U.S.-based studies (67%), most of which were pilot designs (56%) with relatively small samples and participants broadly compatible with lower support needs. Interventions were predominantly non-computerized and group-based, targeting working memory, planning/organization, and cognitive flexibility. Although 67% of the studies reported positive effects on EF, as well as on social and adaptive outcomes, the overall evidence base was methodologically fragile, particularly because of selective reporting and insufficient detail regarding randomization procedures. Programs such as SUCCESS, Unstuck & On Target, and CWMT showed promising results in relation to autonomy and everyday functioning. Overall, interventions targeting EF in adolescents and adults with ASD appear promising, but the current evidence remains limited. Important gaps persist, including the underrepresentation of females, the absence of studies involving individuals requiring more substantial support, and the geographical concentration of the literature. Greater methodological rigor, clearer reporting, and more diverse samples are needed to support stronger evidence-based recommendations.
Institution: Universidade Federal de Pernambuco
Language: Portuguese
Subfield: Cognitive Neuroscience
Field: Neuroscience
Domain: Life Sciences
Open Access status: diamond
OpenAlex ID: W7209070472