Unlocking Speech Through the Mind's Eye: Executive Functions as Cognitive Bridges between Visual-Spatial Abilities and Speech Utterance Competence in Children with Autism Spectrum Disorder

Abstract

This study investigates the mediating role of executive functions, specifically working memory, inhibitory control, and cognitive flexibility, in the relationship between visual-spatial abilities and speech utterance competence in children with Autism Spectrum Disorder (ASD). Utilising a cross-sectional quantitative design, data were collected from 356 children with ASD and their instructors across educational institutions in the Klang Valley and Kuching, Sarawak regions of Malaysia. Structural equation modelling (SEM) was employed to test the hypothesised mediation pathways. The findings reveal a statistically significant positive relationship between visual-spatial abilities and speech utterance competence (p < 0.001). Critically, executive functions, particularly working memory (p < 0.01) and cognitive flexibility (p < 0.05), were identified as partial mediators of this relationship, while inhibitory control did not demonstrate statistically significant mediation. These findings advance the theoretical understanding of the cognitive architecture underlying speech development in ASD and provide empirical support for the development of the Executive Function-Mediated Visual-Spatial Speech (EF-MVS²) Framework. The framework proposes a structured intervention pathway that sequentially activates visual-spatial processing, engages executive functions, and facilitates speech production. Implications for educators, therapists, and curriculum developers are discussed, with recommendations for integrating visual-spatial and executive function training within speech therapy programmes for children with ASD in the Malaysian educational context.