研究背景：執行功能（executive function, EF）為支持目標導向行為與自我調節的重要認知歷程。學齡前階段是執行功能快速發展與分化的關鍵時期，而自閉症類群障礙（autism spectrum disorder, ASD）兒童在執行功能與日常適應表現上常呈現明顯異質性。既有研究雖指出ASD兒童可能具有執行功能困難，但不同研究因測量工具與評估情境差異而結果不一。此外，ASD兒童常伴隨不同程度之ADHD相關特質，此類特質可能進一步影響其注意控制、工作記憶、抑制控制與日常執行功能表現。
研究目的：本研究旨在比較學齡前ASD兒童與典型發展（typical development, TD）兒童在結構化測驗情境與日常生活情境中之執行功能表現差異，並進一步於ASD組內檢視ASD症狀嚴重度與ADHD特質對執行功能、注意力表現及日常執行功能困難之解釋力。
研究方法：本研究採橫斷式研究設計，以4歲至未滿7歲之學齡前兒童為研究對象，並分為ASD組與TD組。所有兒童皆須具備WPPSI-IV全量表智商70分以上。研究工具包括WPPSI-IV工作記憶指標、NEPSY-II Statue、K-CPT、TC-CHEXI，以及ASD與ADHD相關症狀評估工具。ASD組另以ADOS-2之社交情感校準嚴重度分數（Social Affect Calibrated Severity Score, SA-CSS）與侷限及重複行為校準嚴重度分數（Restricted and Repetitive Behaviors Calibrated Severity Score, RRB-CSS）作為ASD症狀嚴重度指標，並以ADHDT作為ADHD特質之連續性指標。統計分析包括組間比較與ASD組內階層迴歸分析。
研究結果：結果顯示，ASD組在WPPSI-IV工作記憶指標上顯著低於TD組，且在TC-CHEXI總分與各分量表上呈現較多日常執行功能困難；然而，NEPSY-II Statue與K-CPT各項注意力指標未呈現顯著組間差異。ASD組內分析顯示，ADOS-2之SA-CSS與RRB-CSS未能穩定解釋測驗型執行功能、注意力表現或日常執行功能困難。相較之下，在控制ASD症狀嚴重度後，ADHDT分數可顯著額外解釋TC-CHEXI總分，但未能穩定解釋TC-CHEXI各分量表、WPPSI-IV工作記憶指標、NEPSY-II Statue或K-CPT指標。
結論：本研究結果顯示，學齡前ASD兒童之執行功能困難較明顯反映於照顧者所觀察到的日常生活情境，而未必能由短時間、結構化測驗穩定捕捉。ASD核心症狀嚴重度未能充分說明ASD兒童在執行功能表現上的個體差異；ADHD相關特質則可能是理解其日常執行功能困難的重要臨床特徵。此結果支持於學齡前ASD兒童執行功能評估中採取多方法與跨情境評估觀點，並於臨床概念化與介入規劃時納入ADHD相關特質與日常功能表現。

Executive function (EF) is central to goal-directed behavior and self-regulation, yet findings regarding EF in preschool autistic children remain inconsistent, partly because different measures capture different aspects of functioning. This study examined EF across structured testing and everyday contexts in preschool-aged children with autism spectrum disorder (ASD). It also investigated whether ASD symptom severity and ADHD traits explained within-group variability in EF among autistic children. Preschool children with ASD and typically developing (TD) children completed standardized cognitive and neuropsychological assessments, including WPPSI-IV Working Memory Index, NEPSY-II Statue, and the Kiddie Continuous Performance Test (K-CPT). Caregivers completed the TC-CHEXI as an index of everyday EF difficulties. Within the ASD group, ADOS-2 calibrated severity scores and ADHDT scores were examined using hierarchical regression. Results showed that the ASD group performed significantly lower than the TD group on working memory and showed greater caregiver-reported everyday EF difficulties across TC-CHEXI indices. However, group differences were not significant on NEPSY-II Statue or K-CPT attention indices. Within the ASD group, ADOS-2 severity scores did not consistently explain EF outcomes, whereas ADHD traits significantly explained overall everyday EF difficulties beyond ASD symptom severity. These findings highlight the importance of multi-method assessment and suggest that ADHD-related traits contribute to everyday EF difficulties in preschool autistic children.

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