Evaluation the effectiveness of the cognitive rehabilitation therapy model for improvement executive functions in high- functions autistic children, by using neuroimaging, neuropsychological and molecular genetics technique

Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized mainly by difficulty in social communication and impaired executive performance. Executive functions are cognitive multi-dimensional capabilities required for complex behaviors. In recent years, serious efforts have been made better to understand certain executive deficiencies in children with ASD. Herein, we used a D-KEFS-based training program to increase the executive performance of autistic children on the Wisconsin card sorting test (WCST). Also, we evaluated children’s brain activity using electroencephalography (EEG) during the training course and their expression profile of BDNF, CREB1, and FOXP2 genes, which are associated with neural development. 

Methods: Twenty autistic children referred to clinics and mental counseling centers were enrolled in this non-randomized beforeafter trial compared to twenty normal children. The WSCT as pre and post-test was used to evaluate the training program’s effectiveness on executive functions. Blood samples were obtained for gene expression, and all subjects were evaluated with a five-minute closed-eye EEG. The D-KEFS training program was conducted for patients for five weeks. 

Results: improvement of executive functions after the training program and increase in expression level of BDNF and CREB1 genes in autistic subjects showed in results. Also theta and bdelta waves were increased in cortical areas of children with autism after five weeks training. 

Conclusion: The study results showed that cognitive rehabilitation therapy might improve executive functions in children with ASD, probably through gene expression and neural activity alterations.