For many families, daily life with autism or ADHD is shaped less by diagnostic labels and more by emotional outbursts, frustration, and difficulty coping with change. These challenges can affect school, work, and relationships, often leaving people misunderstood or misdiagnosed. New research suggests that a shared cognitive mechanism may sit beneath these experiences, linking how people think with how they manage their emotions. The findings were published in Neuroscience and Biobehavioral Reviews.
A large systematic review has examined the relationship between executive function and emotional regulation across autism, ADHD, and their co-occurrence. Executive function refers to mental skills such as working memory, impulse control, and cognitive flexibility. Emotional regulation describes the ability to manage emotional responses in ways that fit the situation. Problems in either area can make everyday demands feel overwhelming.
The review analysed 22 studies published over the past decade, covering children, adolescents, and adults. Most of the research focused on ADHD, with far fewer studies examining autism alone or the overlap between autism and ADHD. Despite differences in age groups and methods, a consistent pattern emerged. Difficulties in executive function were often associated with poorer emotional regulation across conditions.
In autism, the evidence was mixed but revealing. Studies using parent or therapist reports tended to find that greater executive function difficulties went hand in hand with emotional dysregulation. In contrast, studies relying on structured laboratory tasks often failed to show this link, especially in very young children. This suggests that real world emotional challenges may not always be captured by simplified test settings.
The pattern was clearer in ADHD. Most studies reported that impairments in inhibition, working memory, or cognitive flexibility were linked to emotional lability, irritability, and difficulty managing stress. These links appeared across childhood and adulthood. In everyday terms, problems with self control and mental organisation may directly fuel emotional volatility in people with ADHD.
The review also highlighted the relative lack of research on people with both autism and ADHD, despite this being a common clinical presentation. The limited evidence available suggests that cognitive inflexibility plays a particularly strong role in emotional dysregulation when the two conditions overlap. This may help explain why individuals with combined autism and ADHD profiles often experience more severe emotional and behavioural difficulties.
Importantly, the findings point to limitations in how these conditions are currently assessed. Task based cognitive tests may underestimate difficulties seen in daily life, while informant reports may better reflect real world functioning. This gap matters because emotional regulation problems are often what prompt families to seek help in the first place.
Clinically, the review supports a shift away from rigid diagnostic boundaries. Executive function and emotional regulation appear to act as shared mechanisms across neurodevelopmental conditions. Understanding how these processes interact could improve diagnostic accuracy, reduce delays, and guide more personalised support. Interventions that strengthen executive skills may also help people better manage emotions, with potential benefits for mental health and quality of life.
The authors argue that earlier identification of these cognitive emotional patterns could prevent long term difficulties such as academic failure, social isolation, and low self esteem. They also call for more research that directly compares autism, ADHD, and their overlap using methods that reflect everyday challenges rather than ideal test conditions.