Planning an Executive Functions Curriculum and Evaluating Its Effectiveness on Improving the Empathy in Children with High Performance Autism Spectrum Disorder

Document Type : Research Paper


1 PhD Student of Psychology, Department of Psychology, Faculty of Literature and Humanities, Urmia University, Urmia, Iran. student

2 Associate Professor, Department of Psychology, Faculty of Literature and Humanities, Urmia University, Urmia,


This study aims to plan and detect the effectiveness of the educational package of executive functions on improving the empathy in children with a high-performance autism spectrum disorder. In term of purpose, this research is applied, and the research method is semi-experimental with a post-test–pre-test with a control group. The statistical population consists of children with autism disorder aged 6 to 12 years old in Urmia (274 people) in the academic year of 2019–20 from the exceptional school for children with autism. Out of the statistical population, 40 high-performance autism children were selected using Gilliam Autism Rating Scale (GARS) and randomly assigned to two experimental (20) and control (20) groups. Then, the Griffith cognitive and emotional empathy scale (GEM) was filled out by the parents of both groups. After the pre-test, the experimental group was trained for twenty-four sessions, and the post-test was performed. The data was analyzed using SPSS software and univariate analysis of covariance. The data showed a significant difference between the control and experimental groups in terms of the post-test scores and empathy scores after adjusting the effect of the pre-test of Empathy (p < 0.01). Based on this study, it can be propposed that improving executive functions can increase the levels of empathy.


احمدی، ج.، صفری، ط.، همتیان، م.، و خلیلی، ز. (1391). اثربخشی روش تحلیل رفتار کاربردی بر علائم اوتیسم. تحقیقاتعلومرفتاری. 10(4)، 300-292.
اکبری بیاتیانی، ز. (1397). اختلال طیف اوتیسم از تشخیص تا درمان. علوم اعصاب شفای خاتم. 6(4)، 101-93.
خانجانی، ز.، شریعتی، م.، و امین، ی. (1393). مقایسۀ تحول همدلی در کودکان دارای اختلالات درونی‌سازی 5 تا 11 سال. آموزشوارزشیابی. 7(39)، 27-50.
خلیلی، ز.، و انصاری شهیدی، م. (1397). بررسی اثربخشی نمایش درمانی بر مهارت‌های اجتماعی و بازشناسی هیجانی در کودکان اوتیسم با عملکرد بالا. توانمندسازی کودکان استثنایی. 9(1)، 65-78.
مدنی س. س.، علیزاده، ح.، فرخی، ن.، و حکیمی راد، ا. (1396). تدوین برنامۀ آموزشی کارکردهای اجرایی (بازداری پاسخ، به‌روز‌‌رسانی، توجه پایدار) و ارزیابی میزان اثربخشی آن بر کاهش نشانه‌های کودکان با اختلال نارسایی توجه/بیش‌فعالی. روانشناسی افراد استثنایی. 7(26)، 25-1.
معین، ن.، اسدی گندمانی، ر.، و امیری، م. (1397). اثربخشی درمان نوروفیدبک بر بهبود کارکردهای اجرایی در کودکان با اختلال نقص توجه/ بیش‌فعالی. مجلۀ توان‌بخشی. 19(3)، 227-220.
میرزاخانی، ن.، پورجبار، ن.، رضایی، م.، دیباج‌نیا، پ.، و اکبرزاده باغبان، ع. (1395). بررسی تأثیر بازی ساختاریافته بر عملکرد اجرایی کودکان اوتیسم با عملکرد بالا 5-12 سال. طب توان‌بخشی. 5(3)، 48-35.
هاشمی رزینی، ه.، و کرم‌پور، م. (1394). اثربخشی آموزش کارکردهای اجرایی بر مهارت‌های اجتماعی و ارتباطی کودکان طیف اوتیسم. مطالعات روان‌شناسی بالینی. 20(5)، 187-161.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. 5th Edition. Arlington: American Psychiatric Association.
Aan het Rot, M., & Hogenelst, K. (2014) The Influence of Affective Empathy and Autism Spectrum Traits on Empathic Accuracy. PLoS ONE. 9(6), e98436.
Baer, R. A., & Nietzel, M. T. (1991). Cognitive and Behavioral Treatment of Impulsivity in Children: A Meta-Analytic Review of the Outcome Literature. Journal of Clinical Child Psychology. 20(4),400–412.
Barenberg, J., Berse, T., & Dutke, S. (2013). Executive Functions in Learning Processes: Do They Benefit from Physical Activity? Review Article. Educational Research Review. 6(3), 208–222.
Baron-Cohen, P. D. P. S., & Baron-Cohen, S. (2013). The Essential Difference: Male and Female Brains and the Truth about Autism. New York: Basic Books.
Barkley, R. A. (2006). Attention-Deficit Hyperactivity Disorder. New York: Guilford Press.
Blakey, E., & Carroll, D. J. (2015). A Short Executive Function Training Program Improves Preschoolers’ Working Memory. Frontiers in Psychology. 6,18– 27.
Brown, T. E. (2009). ADD/ADHD and Impaired Executive Function in Clinical Practice. Current Psychiatry Reports. 10(5), 407–411.
Cairns, F.D., & Cammock, J. (1978). Development of a More Reliable Version of the Matching Familiar Figures Test. Developmental Psychology. 5, 555–560.
Chapman, R. A., Shedlack, K. J., & France, J. (2006). Stop-Think-Relax: An Adapted Self-Control Training Strategy for Individuals with Mental Retardation and Coexisting Psychiatric Illness. Cognitive and Behavioral Practice. 13(3), 205–214.
Chen, Z., & Kuo, L. J. )2017). Language and Literacy Development among Children with Autism Spectrum Disorder. Journal of Childhood and Developmental Disorder. 3(3), 1–4.
Closson, M. S. (2010). Investigating the Role of Executive Function in Social Decision Making in Children with ADHD. Hofstra University.
Cuff, B. M. P., Brown, S. J., Taylor, L., & Howat, D. J. (2016). Empathy: A Review of Concept. Emotion Review. 8(2), 144–153.
Cunico, L., Sartori, R., Marognolli, O., & Meneghini, A. M. (2012). Developing Empathy in Nursing Students: A Cohort Longitudinal Study. Journal of Clinical Nursing. 21(13-14), 2016–2025.
Dadds, M. R., Hunter, K., Hawes, D., Frost, A. J., Vassallo, S., Bunn, P., Merz, S., & El Masry, Y. (2008). Measurement of Empathy in Children Using Parental Ratings. Child Psychiatry and Human Development. 39(2), 111–122.
Diamond, A., Barnett, W. S., Thomas, J., & Munro, S. (2007). Preschool Program Improves Cognitive Control. Science (New York, N.Y.). 318(5855), 1387–1388.
Fogel, Y., Rosenblum, S., Hirsh, R., Chevignard, M., & Josman, N. (2020). Daily Performance of Adolescents with Executive Function Deficits: An Empirical Study Using a Complex-Cooking Task. Occupational Therapy International. 2020(3), 1–11.
Gawrilow, C., & Gollwitzer, P. M. (2007). Implementation Intentions Facilitate Response Inhibition in Children with ADHD. Cognitive Therapy and Research. 32, 261–280.
Gebauer, L., Skewes, J., Horlyck, L., & Vuust, P. (2014). Atypical Perception of Affective Prosody in Autism Spectrum Disorder. NeuroImage: Clinical. 6, 370–378.
Gilliam, J. E. (1995). Gilliam Autism Rating Scale. Austin, TX: PRO-ED.
Golan, O., Baron-Cohen, S., & Golan, Y. (2008). The ‘Reading the Mind in Films’ Task [Child Version]: Complex Emotion and Mental State Recognition in Children with and without Autism Spectrum Conditions. Journal of Autism and Developmental Disorders. 38(8), 1534–1541. 
Greenwood, J. D. (2019). Social Cognition, Social Neuroscience, and Evolutionary Social Psychology: What’s Missing? Journal for the Theory of Social Behavior. 49(2), 161–178.
Gross, T.F. (2008). Recognition of Immaturity and Emotional Expressions in Blended Faces by Children with Autism and Other Developmental Disabilities. Journal of Autism and Developmental Disorders. 38(2), 297–311.
Happé, F., Cook, J. L., & Bird, G. (2017). The Structure of Social Cognition: In(ter)dependence of Sociocognitive Processes. Annual Review of Psychology. 68,243–267.
Isaksson, J., Van’t Westeinde, A., Cauvet, É., Kuja-Halkola, R., Lundin, K., Neufeld, J., Willfors, C., & Bolte, S. (2019). Social Cognition in Autism and Other Neurodevelopmental Disorders: A Co-Twin Control Study. Journal of Autism and Developmental Disorders. 49(7), 2838–2848.
Joseph, R. M., & Tager-Flusberg, H. (2004). The Relationship of Theory of Mind and Executive Functions to Symptom Type and Severity in Children with Autism. Development and Psychopathology. 16(1), 137–155.
Klingberg, T., Fernell, E., Olesen, P. J., Johnson, M., Gustafsson, P., Dahlström, K., Gillberg, C. G., Forssberg, H., & Westerberg, H. (2005). Computerized Training of Working Memory in Children with ADHD: A Randomized, Controlled Trial. Journal of the American Academy of Child and Adolescent Psychiatry44(2), 177–186.
Lovett, B. J., & Sheffield, R. A. (2007). Affective Empathy Deficits in Aggressive Children and Adolescents: A Critical Review. Clinical Psychology Review. 27(1), 1–13.
Lui, J. H. L. (2014). Callous-Unemotional Traits and Empathy Deficits: Mediating Effects of Affective Perspective-Taking and Facial Emotion Recognition. Master Theses. Retrieved from
MacDonald, H. Z., & Price, J. L. (2019). The Role of Emotion Regulation in the Relationship between Empathy and Internalizing Symptoms in College Students. Mental Health and Prevention. 13, 43–49.
Maione, L., & Mirenda, P. (2006). Effects of Video Modeling and Video Feedback on Peer-Directed Social Language Skills of a Child with Autism. Journal of Positive Behavior Interventions. 8(2), 106–118.
Mathersul, D., McDonald, S., & Rushby, J. A. (2013). Psychophysiological Correlates of Social Judgement in High-Functioning Adults with Autism Spectrum Disorder. International Journal of Psychophysiology: Official Journal of the International Organization of Psychophysiology. 87(1), 88–94.
Meil, W. M., & Puskar, A. H. (2011). Empathy and ExecutiveFunction in College Students, Program No.123.98. Neuroscience Meeting Planner. Washington, DC: Society for Neuroscience.
Monette, S., Bigras, M., & Guay, M. (2011). The Role of the Executive Functions in School Achievement at the End of Grade. Journalof Experimental Child Psychology. 109(2), 158–173.
Otero, T. M., Barker, L. A., & Naglieri, J. A. (2014). “Executive Function Treatment and Intervention in Schools,” Applied Neuropsychology: Child. 3(3), 205–214.
Pinkham, A. E., Hopfinger, J. B., Pelphrey, K. A., Piven, J., & Penn, D. L. (2008). Neural Bases for Impaired Social Cognition in Schizophrenia and Autism Spectrum Disorders. Schizophrenia Research. 99(1-3), 164–175.
Raaijmakers, M., Smidts, D., Sergeant, J., Maassen, G., Posthumus, J., & Van Engeland, H. (2008). Executive Functions in Preschool Children with Aggressive Behavior: Impairments in Inhibitory Control. Journal ofAbnormal Child Psychology. 36, 1097–1107.
Rahmi, I., & Wimbarti, S. (2018). Inhibition in ADHD and Non-ADHD Children Ages 6–12 Years. International Journal of Research Studies in Psychology. 7(1), 73–85.
Reinhardt, M. C., & Reinhardt, C. A. (2013). Attention Deficit-Hyperactivity Disorder, Comorbidities, and Risk Situations. Jornal de Pediatria. 89(2), 124–130.
Rueda, P., Fernández-Berrocal, P., & Baron-Cohen, S. (2015). Dissociation between Cognitive and Affective Empathy in Youth with Asperger Syndrome. European Journal of Developmental Psychology. 12(1), 85–98.
Savas, B., & Ilyas, Y. (2014). Investigating Causal Attributions of Success and Failure and Mathematics Instructions of Students in Turkish High Schools. Procedia - Social and Behavioral Sciences. 2(2), 1940–1943.
Semrud-Clikeman, M., Fine, J. G., Bledsoe, J., & Zhu, D. C. (2012). Gender Differences in Brain Activation on a Mental Rotation Task. International Journal of Neuroscience. 122(10), 590–597.
Shelton, J. F., Tancredi, D. J., & Hertz Picciotto, I. (2010). Independent and Dependent Contributions of Advanced Maternal and Paternal Ages to Autism Risk. Autism Research: Official Journal of the International Society for Autism Research. 3(1), 30–39.
Sigelman, C. K., & Rider, E. A. (2018). Life-Span Human Development. USA: Cengage Learning.
Spreen, O., & Strauss, E. (1998). A Compendium of Neuropsychological Tests. New York: Oxford University Press.
Starcke, K., Wiesen, C., Trotzke, P., & Brand, M. (2016). Effects of Acute Laboratory Stress on Executive Functions. Frontiers in Psychology. 7, 461.
Tarbox, J., Dixon, D. R., Sturmey, P. & Mat­son, J. L. (2014). Handbook of Early In­tervention for Autism Spectrum Disorders. New York: Springer.
Tervo, R. C. (2006). Identifying Patterns of Developmental Delays Can Help Diagnose Neurodevelopmental Disorders. Clinical Pediatrics. 45(6), 509–517.
Vivanti, G., McCormick, C., Young, G. S., Abucayan, F., Hatt, N., Nadig, A., Ozonoff, S., & Rogers, S. J. (2011). Intact and Impaired Mechanisms of Action Understanding in Autism. Developmental Psychology, 47(3), 841–856.
Vogan, V. M., Francis, K. E., Morgan, B. R., Smith, M. L., & Taylor, M. J. (2018(. Load Matters: Neural Correlates of Verbal Working Memory in Children with Autism Spectrum Disorder. Journal of Neurodevelopmental Disorders. 10(1), 19.
Wechsler, D. (1989). Wechsler Preschool and Primary Scale of Intelligence-Revised. San Antonio: The Psychological Corporation.
Yamaguchi, S., Dongming, Z., Oka, .T, & Bokura, H. (2008). The Key Locus of Common Response Inhibition Network for No-Go and Stop Signals. Journal of Cognitive Neuroscience. 20(8), 1434–1442.
Yan, Z., Hong. S., Liu, F., & Su, Y. (2020). A Meta-Analysis of the Relationship between Empathy and Executive Function. Psych Journal. 9(1), 34–43.
Yerys, B. E., Hepburn, S. L., Pennington, B. F., & Rogers, S. J. (2007). Executive Function in Preschoolers with Autism: Evidence Consistent with a Secondary Deficit. Journal of Autism and Developmental Disorders. 37(6), 1068–1079.
Zachi, E. C., Costa, T. L., Barboni, M. T. S., Costa, M. F., Bonci, D. M. O., & Ventura, D. F. (2017). Color Vision Losses in Autism Spectrum Disorders. Frontiers in Psychology. 8, 1127.
Ziermans, T., de Bruijn, Y., Dijkhuis, R., Staal, W., & Swaab, H. (2019). Impairments in Cognitive Empathy and Alexithymia Occur Independently of Executive Functioning in College Students with Autism. Autism: The International Journal of Research and Practice. 23(6), 1519–1530.
Zinat, T. (2018). The Relationship between Executive Function and Empathy: An fMRI Investigation in Healthy Adults. Thesis. Faculty of Arts and Sciences, Department of Psychology. Georgia State University.