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Neuropsychological Profile in High Functioning Autism Spectrum Disorders
Abstract
A comprehensive investigation of the neuropsychological strengths and weaknesses of children with autism may help to better describe their cognitive abilities and to design appropriate interventions. To this end we compared the NEPSY-II profiles of 22 children with high-functioning autism spectrum disorders (HFASD) with those of 44 healthy control (HC) children 2:1 matched by gender, age, race and education. Results showed that only Visuospatial Processing was relatively spared in HFASD, while deficits were observed in Attention and Executive Functions, Language, Learning and Memory, and Sensorimotor Processing. Theory of Mind difficulties were observed in verbal tasks but not in the understanding of emotional contexts, suggesting that appropriate contextual cues might help emotion understanding in HFASD children. These widespread neuropsychological impairments reflect alterations in multiple cognitive domains in HFASD.
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“Maintaining a daily routine with structured activities and being supported by the provision of specialised educational and healthcare services is of essence for children with ASD and their parents alike [64].”
From Exploring the Impact of COVID-19 on Mental Health Outcomes in Children and Adolescents: A Systematic Review (2020) · cites this paper as [64]
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“This ability helps children to understand that other people have intentions, thoughts and emotions and act as a trigger of empathy [40, 105].”
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“It is widely reported that children with ASC have executive functioning deficits [6] and they could show issues in planning their daily life activities, especially when their routine is broken.”
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“ASD can be considered as a group of early-onset neuroevolutionary disorders which seem to be at the basis of alterations in brain connectivity, with cascading effects on many neuropsychological functions [1,2].”
BackgroundBehavioral sleep problems and their potential impact on developing executive function in children
Turnbull, K., Reid, G. J., & Morton, J. B. (2013) · Sleep · doi:10.5665/sleep.2814 · Cited by 218
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Brief report: Cognitive flexibility in autism spectrum disorders: A quantitative review
Leung, R. C., & Zakzanis, K. K. (2014) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-014-2136-4 · Cited by 192
“…0.04 1.16 0.45 0.86 6 NEPSY inhibition switching Narzisi et al. (2013) 1 1.46 – 30.0 -2.03 -0.89 1.46 1.46 6.3 NEPSY animal sorting Barron-Linnankoski et al. (2014) Narzisi et al. (2013) 2 0.70 0.78 57.0 -6.31 7.70 0.15 1.25 5 POP task red trial mean response time Solomon et al. (2009) Solomon…”
InfluentialA quantitative meta-analysis of face recognition deficits in autism: 40 years of research.
Griffin, J. W., Bauer, R. M., & Scherf, K. S. (2020) · Psychological Bulletin · doi:10.1037/bul0000310 · Cited by 134
On the Application of Quantitative EEG for Characterizing Autistic Brain: A Systematic Review
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“…there is still much debate about the morphological, functional, and neuropsychological characteristics of the “autistic” brain (Schipul et al., 2011; Calderoni et al., 2012; Muratori et al., 2012; Narzisi et al., 2012), and thus the neural basis of altered behaviors in ASD remains largely unclear.”
BackgroundInfluentialSelf-citationTrastornos psiquiátricos en los niños y adolescentes en tiempo de la pandemia por COVID-19
Palacio-Ortíz, J. D., Londoño-Herrera, J. P., Márquez, A. N., Robledo-Rengifo, P., & Quintero-Cadavid, C. P. (2020) · Revista Colombiana de Psiquiatría · doi:10.1016/j.rcp.2020.05.006 · Cited by 148
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“Extensive research has defined impairments in higher-order abilities across all neuropsychological domains associated with ASD (Huebner 1992), including in those with greater intellectual ability (Eack et al. 2013a; Fried et al. 2016; Narzisi et al. 2013; Williams et al. 2015).”
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“Autism Spectrum Disorders (ASD) are a set of early-onset neurodevelopmental disorders that are characterized by a disrupted development of brain connectivity with several cascading effects on neuropsychological functions (Narzisi et al., 2013; Kana et al., 2014).”
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“Of note, executive functions (EF) appear to be an area of weakness in children with ASD (Joseph et al. 2005; Narzisi et al. 2013; Robinson et al. 2009).”
Intelligence May Moderate the Cognitive Profile of Patients with ASD
Rommelse, N. N. J., Langerak, I., van der Meer, J., de Bruijn, Y. G. E., Staal, W., Oerlemans, A. M., & Buitelaar, J. K. (2015) · PLoS ONE · doi:10.1371/journal.pone.0138698 · Cited by 69
“Their high IQ may make them appear cognitively rather similar to their healthy peers, despite our study as well as previous ones indicating they are not [57,58].”
ResultPsychiatric disorders in children and adolescents during the COVID-19 pandemic
Palacio-Ortíz, J. D., Londoño-Herrera, J. P., Márquez, A. N., Robledo-Rengifo, P., & Quintero-Cadavid, C. P. (2020) · Revista Colombiana de Psiquiatría (English ed ) · doi:10.1016/j.rcpeng.2020.11.003 · Cited by 60
Contextual priors do not modulate action prediction in children with autism
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GOLIAH: A Gaming Platform for Home-Based Intervention in Autism – Principles and Design
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“The literature on interventions in ASD has become quite extensive, with increasing convergence between behavioral and developmental methods (24, 25).”
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Griffin, J. W., Bauer, R. M., & Gavett, B. E. (2021) · Neuropsychology Review · doi:10.1007/s11065-021-09493-5 · Cited by 57
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“Indeed, existing literature suggests that deficits in inhibition and emotional control have been reported among children and adolescents with ASD (Konstantareas and Stewart 2006; Verte et al. 2006; Narzisi et al. 2013).”
Olfactory Processing in Male Children with Autism: Atypical Odor Threshold and Identification
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Self-citationSocial Cognition in Neurodevelopmental Disorders and Epilepsy
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“and it can be hypothesized that it affects social communication difficulties and social interaction typical of these subjects (15).”
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“However, Sparks et al. [2002] and Nordahl et al. [2011] could not confirm overall brain enlargement in girls with autism but rather found increased brain size as an indicator for the level of regression in autistic boys [Nordahl et al., 2011].”
BackgroundBeery VMI performance in autism spectrum disorder
Green, R. R., Bigler, E. D., Froehlich, A. L., Prigge, M. B. D., Travers, B. G., Cariello, A. N., Anderson, J. S., Zielinski, B. A., Alexander, A. L., LANGE, N. D., et al. (2015) · Child Neuropsychology · doi:10.1080/09297049.2015.1056131 · Cited by 52
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“Our findings are partially in line with previous studies indicating poor facial recognition in ASD (e.g., Akshoomoff, 2005; Barton et al., 2004; Barton, Hefter, Cherkasova, & Manoach, 2007; Hooper et al., 2006; Klin et al., 1999; Narzisi et al., 2012; Nieminen-von Wendt et al., 2005; Szatmari et al., 1990) giving some…”
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Lieb, R. W., & Bohnert, A. M. (2017) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-017-3205-2 · Cited by 43
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“Attention switching, that is the capacity of an individual to flexibly shift mental set to different cognitive demands, is impaired in people with ASD, probably because the restriction of interests hampers them to switch between multiple clues [60,61].”
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“lower global performance in the NEPSY-II (Narzisi et al., 2013).”
Oromotor skills in autism spectrum disorder: A scoping review
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Executive function is affected in autism spectrum disorder, but does not correlate with intelligence
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“debates about the morphological, functional, and neuropsychological characteristics of the autistic brain, with the neural basis of altered behaviors in ASD remains largely unclear.(19) Electroencephalography (EEG) is a powerful method for studying the complex neuropsychiatric disorders,(20) it identifies epileptiform…”
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Are Executive Dysfunctions Relevant for the Autism-Specific Cognitive Profile?
Hemmers, J., Baethge, C., Vogeley, K. T., & Falter‐Wagner, C. M. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.886588 · Cited by 32
Neuropsychological assessment of children with epilepsy and average intelligence using NEPSY II
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“Interestingly, when comparing performance in the two subtest parts, children with autism were specifically impaired in the verbal task, but not in the contextual emotion recognition task (Narzisi et al., 2013), a pattern of findings that matches their important deficits in language domain.”
BackgroundSelf-citationDeveloping set‐shifting improvement tasks (SSIT) for children with high‐functioning autism
Saniee, S., Pouretemad, H., & Zardkhaneh, S. A. (2019) · Journal of Intellectual Disability Research · doi:10.1111/jir.12633 · Cited by 26
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Evaluation of a Peer Mentorship Program for Autistic College Students
Trevisan, D. A., Leach, S., Iarocci, G., & Birmingham, E. (2020) · Autism in Adulthood · doi:10.1089/aut.2019.0087 · Cited by 23
Fong, H. X., Cornish, K. M., Kirk, H., Ilias, K., Shaikh, M. F., & Golden, K. J. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.733905 · Cited by 27
“All these findings are consistent with previous reports of the elevated vulnerability of children on the autism spectrum with disruption of routine due to their executive functioning difficulties (42).”
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“Additional deficits in cognition, especially in specific executive domains have been widely studied and described in the last decades (e.g., Happé et al., 2006; Hill, 2004; Narzisi et al., 2013; Weiss et al., 2016a, 2016b; Weiss et al. 2018).”
Papangelo, P., Pinzino, M., Pelagatti, S., Fabbri‐Destro, M., & Narzisi, A. (2020) · Brain Sciences · doi:10.3390/brainsci10060398 · Cited by 22
“, [38] who found that children with ASDs performed equally well as TD children in the affect recognition test (see also [39]), and with Tracy et al.”
BackgroundSelf-citationPupil Response to Precision in Surgical Task Execution
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The study of executive function domains in children with high-functioning autism
Golshan, F., Soltani, A., & Afarinesh, M. R. (2019) · Learning and Motivation · doi:10.1016/j.lmot.2019.101578 · Cited by 22
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“, 2020; Liu & Breslin, 2013), and line orientation discrimination (Korkman et al., 2007; Narzisi et al., 2013) in individuals with ASD.”
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“While we recognize that our statistical analyses are underpowered, this is not uncommon in preliminary clinical research (Leung, Vogan, Powell, Anagnostu, & Taylor, 2016; Narzisi et al., 2013).”
Williams, M. E., Wheeler, B. Y., Linder, L. K., & Jacobs, R. A. (2017) · Intellectual and developmental disabilities · doi:10.1352/1934-9556-55.3.192 · Cited by 13
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A Neuro-Phenomenological Perspective on the Autism Phenotype
Narzisi, A., & Muccio, R. (2021) · Brain Sciences · doi:10.3390/brainsci11070914 · Cited by 10
Self-citationButti, N., Biffi, E., Romaniello, R., Finisguerra, A., Valente, E. M., Strazzer, S., Borgatti, R., & Urgesi, C. (2024) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-024-06349-8 · Cited by 11
Self-citationChen, L., Liu, J., Kang, J. B., Rosenberg‐Lee, M., Abrams, D. A., & Menon, V. (2024) · Autism · doi:10.1177/13623613231223354 · Cited by 9
“…recognition memory paradigms, which do not include tasks with differing pattern separation requirements (Anns et al., 2020; Hashimoto et al., 2021; Jiang et al., 2015; Li et al., 2021; Lind & Bowler, 2009; Loveland et al., 2008; Mogensen et al., 2020; Narzisi et al., 2013; Williams et al., 2006b).”
BackgroundResultNithya, G. D., Vasudevan, D., & Mythili, V. (2021) · The Indian Journal of Occupational Therapy · doi:10.4103/ijoth.ijoth_34_21 · Cited by 11
Diagnosis of autism spectrum disorder using EEG microstates and chaos game representation
Han, L., Huang, Z., Li, C., & Chen, J. (2025) · Biomedical Signal Processing and Control · doi:10.1016/j.bspc.2025.108722 · Cited by 8
Rueda, P., Fernández‐Berrocal, P., & Schonert-Reichl, K. A. (2014) · Review Journal of Autism and Developmental Disorders · doi:10.1007/s40489-014-0026-5 · Cited by 13
“Some of the studies did specify the diagnosis included under this name (Back et al. 2007; Bal et al. 2013; Loth et al. 2008; Narzisi et al. 2012;Ta bl e 2 (c on tin ue d) A ut ho rs Pa rt ic ip an ts D ia gn os is cr ite ri a M ea su re of IQ M ea su re s R es ul ts Si lli m an et al .”
BackgroundCognitive predictors of Social processing in congenital atypical development
Ferrari, E., Butti, N., Gagliardi, C., Romaniello, R., Borgatti, R., & Urgesi, C. (2022) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-022-05630-y · Cited by 8
Self-citationJunior-Real Time neuropsychological testing (j-RTNT) for a young patient undergoing awake craniotomy
Guarracino, I., Ius, T., Pauletto, G., Maieron, M., Škrap, M., & Tomasino, B. (2020) · Brain and Cognition · doi:10.1016/j.bandc.2020.105535 · Cited by 8
Núñez-Gaunaurd, A., & Tovin, M. M. (2024) · Journal of Developmental and Physical Disabilities · doi:10.1007/s10882-024-09951-x · Cited by 7
“Diagnostic and Statistical Manual of Mental Disorders:DSM-5, 2013; Bhat, 2021; Croen et al., 2015; Narzisi et al., 2013).”
Mental rotation and language in autism spectrum disorder
Larson, C., Bochyńska, A., & Vulchanova, M. (2024) · Autism Research · doi:10.1002/aur.3128 · Cited by 7
“For instance, autistic individuals show strengths in visuospatial skills, such as (Narzisi et al., 2013; Simmons et al., 2009) visual search (O ’ Riordan, 2004) and visual discrimination tasks (Joseph et al., 2009), as well as enhanced visuospatial perception and processing (Mottron et al., 1999).”
BackgroundSocial Signal Processing and Socially Assistive Robotics in Developmental Disorders
Chétouani, M., Boucenna, S., Chaby, L., Plaza, M., & Cohen, D. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316676202.028 · Cited by 7
“This process helps children to understand that other people have intentions, thoughts, and emotions and act as a trigger of empathy (Decety and Jackson, 2004; Narzisi et al., 2012).”
Lebersfeld, J. B., Brasher, C. J., Biasini, F. J., & Hopkins, M. I. (2019) · International Journal of Pediatrics & Neonatal Care · doi:10.15344/2455-2364/2019/151 · Cited by 7
“Autism Spectrum Disorder (ASD) is a neurodevelopmental disability involving deficits in social communication and the presence of restricted, repetitive patterns of behavior [1], and difficulties with attention and motivation often co-occur [2, 3].”
BackgroundUrbano, M. R., Raffaele, C. T., Kreiser, N. L., Flaherty, J. M., & Hartmann, K. (2018) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2018.09.013 · Cited by 6
“in set-shifting, verbal fluency, learning, narrative memory, and sensorimotor processing compared to their typically developing peers (Barron-Linnanloski et al., 2015; Narzisi et al., 2013).”
Substance Use in Youth With Autism Spectrum Disorder
Castellanos, D., Carcache, L., & Ng, C. (2019) · Addictive Disorders & Their Treatment · doi:10.1097/adt.0000000000000192 · Cited by 6
“Successful interaction with the world requires both local and global processing because the needs of the moment can rely on either kind of information, or both.(13,14) Persons with ASD who focus on too many focal aspects of a therapeutic intervention may not adequately progress in achieving the goals of their treatmen…”
BackgroundNeuropsychological performance of Finnish and Egyptian children with autism spectrum disorder
Elsheikh, S., Kuusikko‐Gauffin, S., Mattila, M., Jussila, K. K., Ebeling, H. E., Loukusa, S., Omar, M. M. M., Riad, G., Rautio, A., & Moilanen, I. K. (2016) · International Journal of Circumpolar Health · doi:10.3402/ijch.v75.29681 · Cited by 6
Neurodiversity, Autism, and Psychiatric Disability: The Harmful Dysfunction Perspective
Wakefield, J. C., Wasserman, D., & Conrad, J. A. (2020) · The Oxford Handbook of Philosophy and Disability · doi:10.1093/oxfordhb/9780190622879.013.29 · Cited by 6
Bochyńska, A., Vulchanova, M., Vulchanov, V., & Landau, B. (2019) · Cognitive Psychology · doi:10.1016/j.cogpsych.2019.101249 · Cited by 5
Billeci, L., Caterino, E., Tonacci, A., & Gava, M. L. (2020) · Brain Sciences · doi:10.3390/brainsci10060382 · Cited by 5
“This is often difficult in children with high-functioning ASD due to the presence of deficits in executive functions [3,4], in social perception [5] and in narrative and pragmatic skills.”
BackgroundButti, N., Oldrati, V., Ferrari, E., Romaniello, R., Gagliardi, C., Borgatti, R., & Urgesi, C. (2023) · The Cerebellum · doi:10.1007/s12311-023-01580-y · Cited by 5
Self-citationEmbracing neurodiversity-informed dentistry. Part five: Diverse minds in the dental profession
Murphy, J., Andrews, F., & Morgan, M. Z. (2023) · BDJ Team · doi:10.1038/s41407-023-2026-8 · Cited by 5
Narzisi, A., Barbetti, F., Fabbri‐Destro, M., Berloffa, S., Fantozzi, P., Viglione, V., Muccio, R., Valente, E., Accorinti, I., Foti, E., et al. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1765698 · Cited by 5
Self-citationNode Centrality Measures Identify Relevant Structural MRI Features of Subjects with Autism
Zanghieri, M., Menichetti, G., Retico, A., Calderoni, S., Castellani, G., & Remondini, D. (2021) · Brain Sciences · doi:10.3390/brainsci11040498 · Cited by 4
“The anterior-most region of the parahippocampal gyrus, the entorhinal cortex, is part of the key anatomical structures critical for memory function, which is disrupted in ASD subjects when evaluated with a comprehensive test battery [37,38].”
BackgroundSelf-citationEveryday narrative skills in autistic adolescents
Harvey, A., Spicer‐Cain, H., Botting, N., & Henry, L. A. (2025) · First Language · doi:10.1177/01427237251315253 · Cited by 4
“For example, Narzisi et al. (2013) found that autistic children with typical-range cognitive abilities had significant difficulties on a narrative recall task when compared to a neurotypical comparison group.”
DIAGNÓSTICO DO TRANSTORNO DO ESPECTRO AUTISTA DE ALTA FUNCIONALIDADE: REVISÃO DE ESCOPO1
OLIVEIRA, F. G., Sugita, B. M., Jamus, D. R., KIMURA, E. C., OLIVEIRA, P. N. P., & Mello, R. G. (2025) · Revista Brasileira de Educação Especial · doi:10.1590/1980-54702025v31e0093 · Cited by 6
Metacognition and Cognitive Flexibility in Autistic and Neurotypically‐Developing Populations
Ordin, M., Barbarroja, N., Polyanskaya, L., Manrique, H. M., & Castelo-Branco, M. S. (2025) · Brain and Behavior · doi:10.1002/brb3.70668 · Cited by 4
“…between ASD and TD populations were explored in low-level perception tasks (e.g., visual discrimination, visual search, and identification; see Narzisi et al., 2013 and Simmons et al., 2009 for review), whereas explicit metacognition might be more engaged by higher-level cognitive processes…”
Baumeister, F., Wolfer, P., Borrellas, E. V., Solaimani, E., Eigsti, I., & Durrleman, S. (2026) · Open Mind · doi:10.1162/opmi.a.349 · Cited by 3
“Results showed that autistic children had lower attention scores than NT children, consistent with existing research (e.g., Berenguer et al., 2018; Narzisi et al., 2013).”
Power Spectral Study of EEG Signal from the Frontal Brain Area of Autistic Children
Rajak, B. L., Gupta, M., Bhatia, D., Mukherjee, A., Paul, S., & Sinha, T. K. (2018) · Lecture notes in networks and systems · doi:10.1007/978-981-10-6890-4_51 · Cited by 3
Lee, S. C. (2022) · The Open Journal of Occupational Therapy · doi:10.15453/2168-6408.1856 · Cited by 4
Neurodevelopmental Impairments in Adult Psychosomatic Patients
Christensen, N., Linden, M., & Muschalla, B. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13185566 · Cited by 2
“This aligns with previous research highlighting the presence of neuropsychological deficits in developmental disorders [67], ADHD [16,18,19], and personality disorders [11].”
ResultIC Technology to Support Children with Autism Spectrum Disorder
Kalyani, N., & Reddy, K. S. (2017) · Lecture notes in networks and systems · doi:10.1007/978-981-10-3932-4_42 · Cited by 2
Perfil cognitivo y social en niños y niñas con Trastorno del Espectro Autista
Arroyave, T. Z., Reyes, A. C. D., Valencia, J. B. Z., Aldana, L. A., López, J. V. S., Duque, L. M. S., de Mejía, F. R., Galvis, C. A. N., Cardozo, M. O., Torres, L. R. G., et al. (2023) · Quaderns de Psicologia · doi:10.5565/rev/qpsicologia.1818 · Cited by 6
Azka, F., & Hendrawan, D. (2023) · Jurnal Psikologi · doi:10.22146/jpsi.73068 · Cited by 3
Perfil neuropsicológico e comportamental de crianças com doença falciforme
Abreu, K. C. (2013) · doi:10.11606/d.59.2013.tde-29072013-180153 · Cited by 2
Metadata
- Authors
- Narzisi, A., Muratori, F., Calderoni, S., Fabbro, F., & Urgesi, C.
- Affiliations
- University of Pisa (IT)
- University of Udine (IT)
- Corresponding author
- Narzisi, Antonio
- Urgesi, Cosimo
- Venue
- Journal of Autism and Developmental Disorders
- Published
- 2012-12-08
- Volume
- 43
- Issue
- 8
- Pages
- 1895-1909
- ISSN
- 0162-3257 (ISSN-L)
- 1573-3432
- OpenAlex
- W2034362253
- Cited by
- 126
- References
- 113
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 7 · 2023: 10 · 2022: 5 · 2021: 11 · 2020: 20 · 2019: 8 · 2018: 10 · 2017: 12 · 2016: 11 · 2015: 8 · 2014: 7 · 2013: 5
- FWCI
- 3.28
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of Autism and Developmental Disorders (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System (University of Udine) (submittedVersion)
- CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Social Sciences › Psychology › Developmental and Educational Psychology › Child and Animal Learning Development
- Keywords
- high-functioning autism, neuropsychological profile, NEPSY-II, visuospatial processing, attention deficits, executive function, language deficits, learning and memory, sensorimotor processing, theory of mind, emotional understanding, children
- MeSH terms
- Adolescent, Attention, Child, Child Development Disorders, Pervasive, Child, Preschool, Cognition Disorders, Emotions, Humans, Language, Male, Memory, Neuropsychological Tests, Psychomotor Performance, Space Perception, Executive Function, Theory of Mind
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