Cognitive flexibility in children and adolescents with autism spectrum disorder: current status and research directions

Objectives: This study investigated cognitive flexibility (CF) in Turkish children and adolescents with Autism Spectrum Disorder (ASD), examining the influence of key demographic and clinical variables such as age, gender, autism severity, parental education, family income, and the presence of additional disabilities. Methods: The study included a sample of parents and teachers of 248 students with ASD from various schools in Istanbul. Data were collected using two primary instruments: the Cognitive Flexibility Scale (CFS) to assess CF and the Childhood Autism Rating Scale (CARS) to determine autism severity. Results: Gender was found to significantly differentiate CF, but only in the Routines/Rituals subdimension, where males showed greater flexibility than females. Autism severity had a varied impact: it was inversely related to flexibility in the Routines/Rituals and Generativity subdimensions but directly related to flexibility in the Special Interests sub-dimension. The presence of additional disabilities was associated with greater flexibility in Special Interests but less flexibility in Generativity. No significant relationships were observed between CF and age, parental education, or family income. Conclusions: The findings suggest that CF in ASD is a multidimensional construct, with factors like autism severity and additional disabilities exerting differential effects across its subdimensions. This highlights the need for tailored and individualized interventions. The study also underscores the importance of future research incorporating objective, performance-based measures to overcome the limitations of parent-report data.