Brief report: Cognitive flexibility in autism spectrum disorders: A quantitative review

Leung, Rachel C.; Zakzanis, Konstantine K.

doi:10.1007/s10803-014-2136-4

Cited by 192Autism Spectrum Disorder ResearchDevelopmental and Educational NeuropsychologyChild Nutrition and Feeding Issues

Brief report: Cognitive flexibility in autism spectrum disorders: A quantitative review

Leung, Rachel C., Zakzanis, Konstantine K.·2014·Journal of Autism and Developmental Disorders

DOI 10.1007/s10803-014-2136-4

Open this paper in CoChat — free account

Abstract

Impairments in cognitive flexibility have been used to characterize the neuropsychological presentation of persons with autism spectrum disorders (ASDs). Previous studies have yielded mixed results. Our objective was to systematically review the sensitivity of cognitive flexibility measures in ASD using quantitative methods employed by meta-analytic statistical techniques. Seventy-two studies met inclusion criteria for analysis and included a total of 2,137 individuals with ASD and 2,185 healthy controls. Our findings demonstrate that while the shift sub-scale of the self-report version of the Behavioral Rating Inventory of Executive Function (BRIEF) showed approximate absolute discriminability, of all the performance measures that were systematically reviewed and evaluated, none could reliably differentiate between individuals with ASD and controls; this is not surprising given that cognitive flexibility is not a core deficit of ASD. Our findings suggest that while the shift sub-scale of the self-report version of the BRIEF is a promising clinical marker, clinical performance measures of cognitive flexibility may lack ecological validity and lastly, reinforces that impairments in cognitive flexibility do not uniformly characterize all persons with ASD.

Integrity signals

Registry

Crossref · 10.1007/s10803-014-2136-4

Cites

127 of 127 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

We couldn’t retrieve this paper’s full text, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

For ASD, only half of the samples in each cohort showed FLEX-EMOT, challenging the often held notion that cognitive inflexibility is the hallmark EF comorbidity in ASD.
“For ASD, only half of the samples in each cohort showed the FLEX-EMOT profile, which challenges the often held notion of cognitive inflexibility as the hallmark EF comorbidity in ASD (Leung & Zakzanis, 2014).”
From Data‐driven identification of subtypes of executive function across typical development, attention deficit hyperactivity disorder, and autism spectrum disorders (2020) · cites this paper as Leung & Zakzanis, 2014
The difficulty with cognitive strategies may be reflective of the challenges many autistic people experience with cognitive flexibility.
“For example, several participants reported that cognitive strategies were difficult because they had trouble changing their thoughts, which may be reflective of the challenges many autistic people experience with cognitive flexibility (Leung & Zakzanis, 2014).”
From A mixed methods study of autistic adults' mental health therapy experiences (2023) · cites this paper as Leung & Zakzanis, 2014
Several participants reported that cognitive strategies were difficult because they had trouble changing their thoughts.
“For example, several participants reported that cognitive strategies were difficult because they had trouble changing their thoughts, which may be reflective of the challenges many autistic people experience with cognitive flexibility (Leung & Zakzanis, 2014).”
From A mixed methods study of autistic adults' mental health therapy experiences (2023) · cites this paper as Leung & Zakzanis, 2014
Individuals with ASD exhibit impairment in set-shifting across a broad range of samples, tasks, and measurement constructs.
“individuals with ASD exhibited an impairment in set-shifting”
From Can Bilingualism Mitigate Set-Shifting Difficulties in Children With Autism Spectrum Disorders? (2019) · cites this paper as Leung & Zakzanis, 2014
Effect size for set-shifting difficulties is consistently and substantially larger for daily life measures than for experimental tasks.
“effect size is consistently and substantially larger for set-shifting difficulties in daily life relative to that observed on experimental tasks”
From Can Bilingualism Mitigate Set-Shifting Difficulties in Children With Autism Spectrum Disorders? (2019) · cites this paper as Leung & Zakzanis, 2014

1 retracted

Cognitive flexibility in autism spectrum disorder: Explaining the inconsistencies?
Van Eylen, L., Boets, B., Steyaert, J., Evers, K., Wagemans, J., & Noens, I. (2011) · Research in Autism Spectrum Disorders · doi:10.1016/j.rasd.2011.01.025 · Cited by 183 · see citing works
Retracted
Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2013) · doi:10.1176/appi.books.9780890425596 · Cited by 116,369 · see citing works
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,841 · see citing works
Statistical Power Analysis for the Behavioral Sciences
Muller, K. E., & Cohen, J. (1989) · Technometrics · doi:10.2307/1270020 · Cited by 99,588 · see citing works
Statistical power analysis for the behavioral sciences
Cohen, J. (1990) · Computers Environment and Urban Systems · doi:10.1016/0198-9715(90)90050-4 · Cited by 65,406 · see citing works
Statistical Power Analysis for the Behavioral Sciences (2nd ed.).
Lachenbruch, P. A., & Cohen, J. (1989) · Journal of the American Statistical Association · doi:10.2307/2290095 · Cited by 37,385 · see citing works
Diagnostic and Statistical Manual of Mental Disorders, 5th ed.
Carter, M. J. (2014) · Therapeutic Recreation Journal · Cited by 15,154 · see citing works
Book Reviews: Statistical Methods for Meta-Analysis Larry V. Hedges and Ingram Olkin New York: Academic Press, 1985. xxii + 369 pp
Wasserman, S. S., Hedges, L. V., & Olkin, I. (1988) · Journal of Educational Statistics · doi:10.2307/1164953 · Cited by 10,347 · see citing works
VALIDITY OF THE TRAIL MAKING TEST AS AN INDICATOR OF ORGANIC BRAIN DAMAGE
Reitan, R. M. (1958) · Perceptual and Motor Skills · doi:10.2466/pms.1958.8.3.271 · Cited by 7,925 · see citing works
Diagnostic and Statistical Manual of Mental Disorders, 3rd ed
Cooper, A. M., & Michels, R. (1981) · American Journal of Psychiatry · doi:10.1176/ajp.138.1.128 · Cited by 7,417 · see citing works
Diagnostic and Statistical Manual of Mental Disorders, 3rd ed
Kendell, R. E. (1980) · American Journal of Psychiatry · doi:10.1176/ajp.137.12.1630 · Cited by 5,181 · see citing works
Meta-Analytic Procedures for Social Research
Rosenthal, R. (1991) · doi:10.4135/9781412984997 · Cited by 4,635 · see citing works
Meta-Analytic Procedures for Social Research.
Metcalfe, A., & Rosenthal, R. (1994) · Journal of the Royal Statistical Society Series D (The Statistician) · doi:10.2307/2348600 · Cited by 4,249 · see citing works
The Handbook of Research Synthesis.
Howel, D., Cooper, H., & Hedges, L. V. (1995) · Biometrics · doi:10.2307/2533295 · Cited by 3,657 · see citing works
Executive functions and developmental psychopathology.
Pennington, B. F., & Ozonoff, S. (1996) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.1996.tb01380.x · Cited by 3,150 · cited 2× · see citing works
“One of the most widely examined constructs of executive function is cognitive flexibility, the ability to shift between discrepant tasks and demands (Pennington and Ozonoff 1996).”
Wisconsin Card Sorting Test Manual – Revised and Expanded
Heaton, R. K., Chelune, C., Talley, J., Kay, G., & Curtiss, G. (1981) · Medical Entomology and Zoology · Cited by 2,975 · see citing works
Delis-Kaplan Executive Function System
Delis, D. C., Kaplan, E., & Kramer, J. H. (2012) · PsycTESTS Dataset · doi:10.1037/t15082-000 · Cited by 2,683 · see citing works
A Modified Card Sorting Test Sensitive to Frontal Lobe Defects
Nelson, H. E. (1976) · Cortex · doi:10.1016/s0010-9452(76)80035-4 · Cited by 2,454 · see citing works
A Fail-Safe N for Effect Size in Meta-Analysis
Orwin, R. G. (1983) · Journal of Educational Statistics · doi:10.2307/1164923 · Cited by 2,064 · see citing works
The Handbook of Research Synthesis.
Light, R. J., Cooper, H., & Hedges, L. V. (1994) · Journal of the American Statistical Association · doi:10.2307/2291021 · Cited by 1,880 · see citing works
Statistical methods for meta-analysis
Hedges, L. V., & Olkin, I. 1.-2. (1985) · Cited by 1,832 · see citing works
Executive function deficits in high-functioning autistic individuals: Relationship to theory of mind
Ozonoff, S., Pennington, B. F., & Rogers, S. J. (1991) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.1991.tb00351.x · Cited by 1,766 · see citing works
Wisconsin Card Sorting Test manual
Heaton, R. K. (1981) · Medical Entomology and Zoology · Cited by 1,604 · see citing works
Behavior Rating Inventory for Executive Function
Gioia, G. A., Isquith, P. Κ., & Roth, R. M. (2017) · Springer eBooks · doi:10.1007/978-3-319-56782-2_1881-2 · Cited by 1,571 · see citing works
TEST REVIEW: Dean C. Delis, Edith Kaplan & Joel H. Kramer, Delis Kaplan Executive Function System (D-KEFS), The Psychological Corporation, San Antonio, TX, 2001. $415.00 (complete kit)
Shunk, A. W., Davis, A. S., & Dean, R. S. (2006) · Applied Neuropsychology · doi:10.1207/s15324826an1304_9 · Cited by 1,528 · see citing works
Diagnostic and Statistical Manual of Mental Disorders
(2018) · Sage eBooks · doi:10.4135/9781506326139.n198 · Cited by 1,243 · see citing works
Planning and spatial working memory following frontal lobe lesions in man
Owen, A. M., Downes, J. J., Sahakian, B. J., Polkey, C. E., & Robbins, T. W. (1990) · Neuropsychologia · doi:10.1016/0028-3932(90)90137-d · Cited by 1,241 · see citing works
Behavioural Assessment of the Dysexecutive Syndrome
(2004) · Methodology Of Frontal And Executive Function · doi:10.4324/9780203344187-15 · Cited by 1,149 · see citing works
Writing meta-analytic reviews.
Rosenthal, R. (1995) · Psychological Bulletin · doi:10.1037/0033-2909.118.2.183 · Cited by 1,108 · see citing works
Theory of mind and rule-based reasoning
Frye, D., Zelazo, P. D., & Palfai, T. (1995) · Cognitive Development · doi:10.1016/0885-2014(95)90024-1 · Cited by 923 · see citing works
Evaluating the theory of executive dysfunction in autism
Hill, E. L. (2004) · Developmental Review · doi:10.1016/j.dr.2004.01.001 · Cited by 846 · see citing works
How specific is a deficit of executive functioning for attention-deficit/hyperactivity disorder?
Sergeant, J. A., Geurts, H., & Oosterlaan, J. (2002) · Behavioural Brain Research · doi:10.1016/s0166-4328(01)00430-2 · Cited by 784 · cited 2× · see citing works
“However, all three reviews (Hill 2004; Russo et al. 2007; Sergeant et al. 2002) were narrative in nature, and therefore did not seek to quantify the magnitude of effect across studies reviewed using meta-analytic methodology.”
NEPSY : A Developmental Neuropsychological Assessment
Dumont, R., & Willis, J. O. (2008) · Wiley eBooks · doi:10.1002/9780470373699.speced1463 · Cited by 775 · see citing works
Brief Report: Specific Executive Function Profiles in Three Neurodevelopmental Disorders
Ozonoff, S., & Jensen, J. (1999) · Journal of Autism and Developmental Disorders · doi:10.1023/a:1023052913110 · Cited by 724 · see citing works
Executive function in preschoolers: Links with theory of mind and verbal ability
Hughes, C. H. (1998) · British Journal of Developmental Psychology · doi:10.1111/j.2044-835x.1998.tb00921.x · Cited by 715 · see citing works
How specific are executive functioning deficits in attention deficit hyperactivity disorder and autism?
Geurts, H. M., Verté, S., Oosterlaan, J., Roeyers, H., & Sergeant, J. A. (2004) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2004.00276.x · Cited by 705 · see citing works
Executive function deficits in autism spectrum disorders and attention-deficit/hyperactivity disorder: Examining profiles across domains and ages
Happé, F., Booth, R., Charlton, R., & Hughes, C. (2006) · Brain and Cognition · doi:10.1016/j.bandc.2006.03.004 · Cited by 638 · see citing works
Examining the relationship between executive functions and restricted, repetitive symptoms of autistic disorder
Lopez, B. R., Lincoln, A. J., Ozonoff, S., & Lai, Z. (2005) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-005-5035-x · Cited by 603 · see citing works
Examining executive functioning in children with autism spectrum disorder, attention deficit hyperactivity disorder and typical development
Corbett, B. A., Constantine, L. J., Hendren, R., Rocke, D., & Ozonoff, S. (2009) · Psychiatry Research · doi:10.1016/j.psychres.2008.02.005 · Cited by 584 · see citing works
Neuropsychologic functioning in autism: Profile of a complex information processing disorder.
MINSHEW, N. J., GOLDSTEIN, G., & SIEGEL, D. J. (1997) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617797003032 · Cited by 572 · see citing works
A Fail-Safe N for Effect Size in Meta-Analysis
Orwin, R. G. (1983) · Journal of Educational Statistics · doi:10.3102/10769986008002157 · Cited by 562 · see citing works
The paradox of cognitive flexibility in autism
Geurts, H. M., Corbett, B., & Solomon, M. (2009) · Trends in Cognitive Sciences · doi:10.1016/j.tics.2008.11.006 · Cited by 538 · see citing works
Effect Sizes for Research
Grissom, R. J., & Kim, J. J. (2012) · doi:10.4324/9780203803233 · Cited by 470 · see citing works
Executive functions in children with Autism Spectrum Disorders
Robinson, S., Goddard, L., Dritschel, B., Wisley, M., & Howlin, P. (2009) · Brain and Cognition · doi:10.1016/j.bandc.2009.06.007 · Cited by 403 · see citing works
Performance on Cambridge Neuropsychological Test Automated Battery subtests sensitive to frontal lobe function in people with autistic disorder: Evidence from the Collaborative Programs of Excellence in Autism network
Ozonoff, S., Cook, I., Coon, H., Dawson, G., Joseph, R. M., Klin, A., McMahon, W. M., Minshew, N., Munson, J. A., Pennington, B. F., et al. (2004) · Journal of Autism and Developmental Disorders · doi:10.1023/b:jadd.0000022605.81989.cc · Cited by 391 · see citing works
Development and Psychopathology
Cicchetti, D. (2015) · doi:10.1002/9780470939383.ch1 · Cited by 383 · see citing works
Effect Sizes for Research: Univariate and Multivariate Applications
Grissom, R. J., & Kim, J. J. (2005) · Cited by 376 · see citing works
Neural correlates of executive function in Autistic Spectrum Disorders
Schmitz, N., Rubia, K., Daly, E., Smith, A., Williams, S., & Murphy, D. G. M. (2006) · Biological Psychiatry · doi:10.1016/j.biopsych.2005.06.007 · Cited by 365 · see citing works
The Handbook of Research Synthesis
Cooper, H., & Hedges, L. V. (1994) · Project Muse (Johns Hopkins University) · Cited by 354 · see citing works
Links between theory of mind and executive function in young children with autism: Clues to developmental primacy.
Pellicano, E. (2007) · Developmental Psychology · doi:10.1037/0012-1649.43.4.974 · Cited by 352 · see citing works
Subtle executive impairment in children with autism and children with ADHD
Goldberg, M. C., Mostofsky, S. H., Cutting, L. E., Mahone, E. M., Astor, B. C., Denckla, M. B., & Landa, R. J. (2005) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-005-3291-4 · Cited by 349 · cited 8× · see citing works
“…and Goldberg (2005) Ozonoff et al. (2004) 4 0.37 0.35 74.0 -0.18 0.92 0.04 0.86 3.4 CANTAB ID/ED stage 8 ED trials to criterion Edgin and Pennington (2005) Goldberg et al. (2005) Happé et al. (2006) Landa and Goldberg (2005) Ozonoff et al. (2004) 5 0.43 0.31 69.5 0.04 0.81 0.07 0.85 5.75 CANTAB…”
Influential
Statistics to tell the truth, the whole truth, and nothing but the truth Formulae, illustrative numerical examples, and heuristic interpretation of effect size analyses for neuropsychological researchers
Zakzanis, K. K. (2001) · Archives of Clinical Neuropsychology · doi:10.1093/arclin/16.7.653 · Cited by 346 · see citing works
Self-citation
Neuropsychological Findings in High-Functioning Men with Infantile Autism, Residual State
Rumsey, J. M., & Hamburger, S. D. (1988) · Journal of Clinical and Experimental Neuropsychology · doi:10.1080/01688638808408236 · Cited by 341 · see citing works
The Flexible Item Selection Task (FIST): A Measure of Executive Function in Preschoolers
Jacques, S., & Zelazo, P. D. (2001) · Developmental Neuropsychology · doi:10.1207/s15326942dn2003_2 · Cited by 332 · see citing works
Behavior Rating Inventory of Executive Function®--Adult Version
Roth, R. M., Isquith, P. K., & Gioia, G. A. (2022) · PsycTESTS Dataset · doi:10.1037/t86244-000 · Cited by 323 · see citing works
Impairments in real-world executive function increase from childhood to adolescence in autism spectrum disorders
Rosenthal, M., Wallace, G. L., Lawson, R., Wills, M. C., Dixon, E., Yerys, B. E., & Kenworthy, L. (2013) · Neuropsychology · doi:10.1037/a0031299 · Cited by 312 · see citing works
Attention deficit/hyperactivity disorder symptoms moderate cognition and behavior in children with autism spectrum disorders
Yerys, B. E., Wallace, G. L., Sokoloff, J. L., Shook, D. A., James, J. D., & Kenworthy, L. (2009) · Autism Research · doi:10.1002/aur.103 · Cited by 299 · cited 9× · see citing works
“…and Pennington (2005) Goldberg et al. (2005) Kaufmann et al. (2013) Landa and Goldberg (2005) Ozonoff et al. (2000) HFA and ASP Sachse et al. (2013) Yerys et al. 2009 8 0.30 0.20 78.7 0.14 0.46 0.11 0.69 4 CANTAB ID/ED total number of trials to complete all 9 categories Roelofs et al.…”
Influential
Language, social, and executive functions in high functioning Autism: a continuum of performance
Landa, R. J., & Goldberg, M. C. (2005) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-005-0001-1 · Cited by 296 · see citing works
Reliability and validity of the Wisconsin Card Sorting Test in studies of autism.
Ozonoff, S. (1995) · Neuropsychology · doi:10.1037/0894-4105.9.4.491 · Cited by 293 · see citing works
DSM-IV-Defined Asperger Syndrome: Cognitive, Behavioral and Early History Differentiation from High Functioning Autism
Ozonoff, S. J., South, M., & Miller, J. N. (2000) · Autism · doi:10.1177/1362361300004001003 · Cited by 285 · see citing works
Dependence and independence in responding to double stimulation: A comparison of stop, change, and dual-task paradigms.
Logan, G. D., & Burkell, J. (1986) · Journal of Experimental Psychology: Human Perception and Performance · doi:10.1037/0096-1523.12.4.549 · Cited by 280 · see citing works
Reduced behavioral flexibility in autism spectrum disorders.
D'Cruz, A.-M., Ragozzino, M. E., Mosconi, M. W., Shrestha, S., Cook, E. H., & Sweeney, J. A. (2013) · Neuropsychology · doi:10.1037/a0031721 · Cited by 279 · see citing works
Executive functioning in high-functioning children with autism
Liss, M., Fein, D., Allen, D., Dunn, M., Feinstein, C., Morris, R., Waterhouse, L., & Rapin, I. (2001) · Journal of Child Psychology and Psychiatry · doi:10.1111/1469-7610.00717 · Cited by 273 · see citing works
The neural substrates of cognitive control deficits in autism spectrum disorders
Solomon, M., Ozonoff, S. J., Ursu, S., Ravizza, S., Cummings, N., Ly, S., & Carter, C. S. (2009) · Neuropsychologia · doi:10.1016/j.neuropsychologia.2009.04.019 · Cited by 263 · see citing works
Multiple cognitive capabilities/deficits in children with an autism spectrum disorder: “Weak” central coherence and its relationship to theory of mind and executive control
PELLICANO, E., MAYBERY, M., DURKIN, K., & MALEY, A. (2006) · Development and Psychopathology · doi:10.1017/s0954579406060056 · Cited by 253 · see citing works
Neuropsychological functioning in nonmentally retarded autistic individuals
Minshew, N. J., Muenz, L. R., Goldstein, G., & Payton, J. B. (1992) · Journal of Clinical and Experimental Neuropsychology · doi:10.1080/01688639208402860 · Cited by 244 · see citing works
Deconstructing executive deficits among persons with autism: Implications for cognitive neuroscience
Russo, N., Flanagan, T., Iarocci, G., Berringer, D., Zelazo, P. D., & Burack, J. A. (2007) · Brain and Cognition · doi:10.1016/j.bandc.2006.04.007 · Cited by 237 · see citing works
Executive processes in Asperger syndrome: Patterns of performance in a multiple case series
Hill, E. L., & Bird, C. M. (2006) · Neuropsychologia · doi:10.1016/j.neuropsychologia.2006.06.007 · Cited by 228 · see citing works
Abstract reasoning in autism: A disassociation between concept formation and concept identification.
Minshew, N. J., Meyer, J., & Goldstein, G. (2002) · Neuropsychology · doi:10.1037/0894-4105.16.3.327 · Cited by 222 · see citing works
Conceptual problem-solving in highly verbal, nonretarded autistic men
Rumsey, J. M. (1985) · Journal of Autism and Developmental Disorders · doi:10.1007/bf01837896 · Cited by 214 · see citing works
Behavior Rating Inventory of Executive Function, Adult Version
National Cancer Institute (2020) · Definitions · doi:10.32388/xlccsc · Cited by 212 · see citing works
Set-shifting in children with autism spectrum disorders: Reversal shifting deficits on the Intradimensional/Extradimensional Shift Test correlate with repetitive behaviors
Yerys, B. E., Wallace, G. L., Harrison, B., Celano, M. J., Giedd, J. N., & Kenworthy, L. E. (2009) · Autism · doi:10.1177/1362361309335716 · Cited by 207 · see citing works
Behavioural assessment of the dysexecutive syndrome
Wilson, B., Evans, J., Alderman, N., Burgess, P. W., & Emslie, H. C. (1997) · UCL Discovery (University College London) · Cited by 190 · see citing works
Executive Functioning in Children with an Autism Spectrum Disorder: Can We Differentiate Within the Spectrum?
Verté, S., Geurts, H. M., Roeyers, H., Oosterlaan, J., & Sergeant, J. A. (2006) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-006-0074-5 · Cited by 180 · see citing works
Attentional processes in autism
Goldstein, G., Johnson, C. R., & Minshew, N. J. (2001) · Journal of Autism and Developmental Disorders · doi:10.1023/a:1010620820786 · Cited by 179 · see citing works
Neuropsychological divergence of high-level autism and severe dyslexia
Rumsey, J. M., & Hamburger, S. D. (1990) · Journal of Autism and Developmental Disorders · doi:10.1007/bf02284715 · Cited by 175 · see citing works
Elderly with Autism: Executive Functions and Memory
Geurts, H. M., & Vissers, M. E. (2011) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-011-1291-0 · Cited by 174 · see citing works
Cognitive Control Involved in Overcoming Prepotent Response Tendencies and Switching Between Tasks
Barber, A. D., & Carter, C. S. (2004) · Cerebral Cortex · doi:10.1093/cercor/bhh189 · Cited by 172 · see citing works
Response inhibition and response re-engagement in attention-deficit/hyperactivity disorder, disruptive, anxious and normal children
Oosterlaan, J., & Sergeant, J. A. (1998) · Behavioural Brain Research · doi:10.1016/s0166-4328(97)00167-8 · Cited by 171 · see citing works
Spatial Cognition in Autism Spectrum Disorders: Superior, Impaired, or Just Intact?
Edgin, J. O., & Pennington, B. F. (2005) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-005-0020-y · Cited by 166 · see citing works
Executive Functioning in Children with Asperger Syndrome, ADHD-Combined Type, ADHD-Predominately Inattentive Type, and Controls
Semrud-Clikeman, M., Walkowiak, J., Wilkinson, A., & Butcher, B. (2010) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-010-0951-9 · Cited by 159 · see citing works
Neural correlates of switching set as measured in fast, event-related functional magnetic resonance imaging
Smith, A. B., Taylor, E., Brammer, M., & Rubia, K. (2004) · Human Brain Mapping · doi:10.1002/hbm.20007 · Cited by 152 · see citing works
Executive functioning in children with autism and Tourette syndrome
VERTÉ, S., GEURTS, H. M., ROEYERS, H., OOSTERLAAN, J., & SERGEANT, J. A. (2005) · Development and Psychopathology · doi:10.1017/s0954579405050200 · Cited by 152 · see citing works
Executive Function/Attention Deficits in Boys with Asperger Syndrome, Attention Disorder and Reading/Writing Disorder
Nydén, A., Gillberg, C., Hjelmquist, E., & Heiman, M. (1999) · Autism · doi:10.1177/1362361399003003002 · Cited by 151 · see citing works
Autism is characterized by dorsal anterior cingulate hyperactivation during social target detection
Dichter, G. S., Felder, J. N., & Bodfish, J. W. (2009) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsp017 · Cited by 145 · see citing works
Neuropsychological functioning in adults with Asperger syndrome
Ambery, F. Z., Russell, A., Perry, K., Morris, R. G., & Murphy, D. (2006) · Autism · doi:10.1177/1362361306068507 · Cited by 134 · see citing works
Neuropsychological profile in high functioning autism spectrum disorders
Narzisi, A., Muratori, F., Calderoni, S., Fabbro, F., & Urgesi, C. (2013) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-012-1736-0 · Cited by 126 · cited 4× · see citing works
“…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…”
Influential
"Motor" Impairment in Asperger Syndrome: Evidence for a Deficit in Proprioception
Weimer, A. K., Schatz, A., Lincoln, A. J., Ballantyne, A. O., & Trauner, D. A. (2001) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/00004703-200104000-00002 · Cited by 125 · see citing works
Cognitive control in autism spectrum disorders
Solomon, M., Ozonoff, S. J., Cummings, N., & Carter, C. S. (2008) · International Journal of Developmental Neuroscience · doi:10.1016/j.ijdevneu.2007.11.001 · Cited by 124 · see citing works
Integrating intention and context: assessing social cognition in adults with Asperger syndrome
Báez, S., Rattazzi, A., González-Gadea, M. L., Torralva, T., Vigliecca, N. S., Decety, J., Manes, F. F., & Ibáñez, A. M. (2012) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2012.00302 · Cited by 124 · see citing works
Caudate Nucleus Volume and Cognitive Performance: Are They Related in Childhood Psychopathology?
Voelbel, G. T., Bates, M. E., Buckman, J. F., Pandina, G., & Hendren, R. L. (2006) · Biological Psychiatry · doi:10.1016/j.biopsych.2006.03.071 · Cited by 110 · see citing works
Brief Report: Cognitive Flexibility and Focused Attention in Children and Adolescents with Asperger Syndrome or High-Functioning Autism as Measured on the Computerized Version of the Wisconsin Card Sorting Test
Kaland, N., Smith, L., & Mortensen, E. L. (2007) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-007-0474-1 · Cited by 101 · see citing works
Private Speech and Executive Functioning among High-Functioning Children with Autistic Spectrum Disorders
Winsler, A., Abar, B. W., Feder, M. A., Schunn, C. D., & Alarcón, D. (2006) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-006-0294-8 · Cited by 101 · see citing works
Executive and Visuo-motor Function in Adolescents and Adults with Autism Spectrum Disorder
Sachse, M., Schlitt, S., Hainz, D., Ciaramidaro, A., Schirman, S., Walter, H., Poustka, F., Bölte, S., & Freitag, C. M. (2012) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-012-1668-8 · Cited by 95 · see citing works
Cognitive variability in adults with ADHD and AS: Disentangling the roles of executive functions and social cognition
González-Gadea, M. L., Báez, S., Torralva, T., Castellanos, F. X., Rattazzi, A., Bein, V., Rogg, K., Manes, F. F., & Ibáñez, A. M. (2012) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2012.11.009 · Cited by 93 · see citing works
Executive Function Deficits in Non-Retarded Autistic Children
Shu, B., Lung, F., Tien, A. Y., & Chen, B.-C. (2001) · Autism · doi:10.1177/1362361301005002006 · Cited by 90 · see citing works
Cognitive Flexibility in ASD; Task Switching with Emotional Faces
de Vries, M., & Geurts, H. M. (2012) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-012-1512-1 · Cited by 89 · see citing works
Computerized version of the Wisconsin card sorting test in children with high-functioning autistic disorder or attention-deficit/hyperactivity disorder
Tsuchiya, E., Oki, J., Yahara, N., & Fujieda, K. (2005) · Brain and Development · doi:10.1016/j.braindev.2004.06.008 · Cited by 80 · see citing works
Dissociation Between Key Processes of Social Cognition in Autism: Impaired Mentalizing But Intact Sense of Agency
David, N., Gawronski, A., Santos, N. S., Huff, W., Lehnhardt, F., Newen, A., & Vogeley, K. T. (2007) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-007-0425-x · Cited by 79 · see citing works
Neuroimaging of cognitive brain function in paediatric obsessive compulsive disorder: a review of literature and preliminary meta-analysis
Brem, S., Hauser, T. U., Iannaccone, R., Brandeis, D., Drechsler, R., & Walitza, S. (2012) · Journal of Neural Transmission · doi:10.1007/s00702-012-0813-z · Cited by 79 · see citing works
Abnormal cingulum bundle development in autism: a probabilistic tractography study
Ikuta, T., Shafritz, K. M., Bregman, J., Peters, B. D., Gruner, P., Malhotra, A. K., & Szeszko, P. R. (2014) · Psychiatry Research: Neuroimaging · doi:10.1016/j.pscychresns.2013.08.002 · Cited by 69 · see citing works
Time-Based and Event-Based Prospective Memory in Autism Spectrum Disorder: The Roles of Executive Function and Theory of Mind, and Time-Estimation
Williams, D., Boucher, J., Lind, S. E., & Jarrold, C. (2012) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-012-1703-9 · Cited by 62 · see citing works
Attentional set shifting in autism spectrum disorder: Differentiating between the role of perseveration, learned irrelevance, and novelty processing
Maes, J. H. R., Eling, P., Wezenberg, E., Vissers, C., & Kan, C. C. (2010) · Journal of Clinical and Experimental Neuropsychology · doi:10.1080/13803395.2010.501327 · Cited by 61 · see citing works
Cognitive deficits and symbolic play in preschoolers with autism
Lam, Y. G., & Yeung, S.-S. S. (2011) · Research in Autism · doi:10.1016/j.rasd.2011.07.017 · Cited by 56 · see citing works
Co-segregation of Social Cognition, Executive Function and Local Processing Style in Children with ASD, their Siblings and Normal Controls
Oerlemans, A. M., Droste, K., van Steijn, D. J., de Sonneville, L. M. J., Buitelaar, J. K., & Rommelse, N. N. J. (2013) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-013-1807-x · Cited by 54 · see citing works
Do Adults with Autism Spectrum Disorders Compensate in Naturalistic Prospective Memory Tasks?
Altgassen, M., Koban, N., & Kliegel, M. (2012) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-012-1466-3 · Cited by 54 · see citing works
Verhaltensinventar zur Beurteilung exekutiver Funktionen (BRIEF) : deutschsprachige Adaptation des Behavior Rating Inventory of Executive Function (BRIEF) von Gerard A. Gioia, Peter K. Isquith, Stephen C. Guy und Lauren Kenworthy und der Self-Report Version (BRIEF-SR) von Stephen C. Guy, Peter K. Isquith und Gerard A. Gioia
Drechsler, R., & Steinhausen, H. ‐. (2013) · Huber eBooks · Cited by 51 · see citing works
Impaired ability to organize information in individuals with autism spectrum disorders and their siblings
Sumiyoshi, C., Kawakubo, Y., Suga, M., Sumiyoshi, T., & Kasai, K. (2010) · Neuroscience Research · doi:10.1016/j.neures.2010.11.007 · Cited by 49 · see citing works
Dorsolateral Prefrontal Cortex Magnetic Resonance Imaging Measurements and Cognitive Performance in Autism
Griebling, J., Minshew, N. J., Bodner, K. E., Libove, R. A., Bansal, R., Prasad, K. M. R., Keshavan, M. S., & Hardan, A. Y. (2010) · Journal of Child Neurology · doi:10.1177/0883073809351313 · Cited by 47 · see citing works
Impact of IQ Discrepancy on Executive Function in High-Functioning Autism: Insight into Twice Exceptionality
Kalbfleisch, M. L., & Loughan, A. R. (2011) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-011-1257-2 · Cited by 46 · see citing works
Neural correlates of moral reasoning in autism spectrum disorder
Schneider, K., Pauly, K. D., Gossen, A., Mevissen, L., Michel, T. M., Gur, R. C., Schneider, F. W., & Habel, U. (2012) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nss051 · Cited by 46 · see citing works
Neurocognitive performance of children with higher functioning Autism Spectrum disorders on the NEPSY-II
Barron-Linnankoski, S. T. A., Reinvall, O., Lahervuori, A., Voutilainen, A., Lahti‐Nuuttila, P., & Korkman, M. (2014) · Child Neuropsychology · doi:10.1080/09297049.2013.873781 · Cited by 44 · see citing works
Consciousness and Control in Task Switching
Meiran, N., Hommel, B., Bibi, U., & Lev, I. (2002) · Consciousness and Cognition · doi:10.1006/ccog.2001.0521 · Cited by 42 · see citing works
Performance on the dimensional change card sort and backward digit span by young children with autism without intellectual disability
Faja, S., & Dawson, G. (2013) · Child Neuropsychology · doi:10.1080/09297049.2013.856395 · Cited by 34 · see citing works
Behavioral flexibility in individuals with autism: Theory, assessment, and intervention
Green, V. A., Sigafoos, J., O’Reilly, M. F., Pituch, K. A., Didden, R., Lancioni, G. E., & Singh, N. N. (2007) · CINECA IRIS Institutional Research Information System (University of Bari Aldo Moro) · Cited by 33 · see citing works
Assessing Planning and Set‐Shifting Abilities in Autism: Are Experimenter‐Administered and Computerised Versions of Tasks Equivalent?
Williams, D. M., & Jarrold, C. (2013) · Autism Research · doi:10.1002/aur.1311 · Cited by 33 · see citing works
Brief Report: CANTAB Performance and Brain Structure in Pediatric Patients with Asperger Syndrome
Kaufmann, L., Zotter, S., Pixner, S., Starke, M., Haberlandt, E., Steinmayr-Gensluckner, M., Egger, K. E., Schocke, M. F. H., Weiss, E. M., & Marksteiner, J. (2012) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-012-1686-6 · Cited by 29 · see citing works
Event-related potential correlates of extradimensional and intradimensional set-shifts in a modified Wisconsin Card Sorting Test
Watson, T. D., Azizian, A., & Squires, N. K. (2006) · Brain Research · doi:10.1016/j.brainres.2006.03.098 · Cited by 27 · see citing works
Executive functioning in individuals with intellectual disabilities and autism spectrum disorders
Roelofs, R. L., Visser, E., Berger, H. J. C., Prins, J. B., Valk, H. M. J. V. S. L., & Teunisse, J. (2013) · Journal of Intellectual Disability Research · doi:10.1111/jir.12085 · Cited by 26 · see citing works
Conceptual and Perceptual Set-shifting executive abilities in young adults with Asperger's syndrome
Brady, D. I., Schwean, V. L., Saklofske, D. H., McCrimmon, A. W., Montgomery, J. M., & Thorne, K. J. (2013) · Research in Autism · doi:10.1016/j.rasd.2013.09.009 · Cited by 25 · see citing works
Brief Report: Impaired Flexible Item Selection Task (FIST) in School-Age Children with Autism Spectrum Disorders
Yerys, B. E., Wolff, B. C., Moody, E., Pennington, B. F., & Hepburn, S. L. (2012) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-012-1443-x · Cited by 25 · see citing works
[Assessment of executive/attentional performance in Asperger's disorder].
Kılınçaslan, A., Mukaddes, N. M., Küçükyazıcı, G. S., & Gurvit, H. I. (2010) · PubMed · Cited by 24 · see citing works
Impaired theory of mind but intact decision-making in Asperger syndrome: Implications for the relationship between these cognitive domains
Torralva, T., Gleichgerrcht, E. L., Roca, M., Ibáñez, A. M., Marenco, V., Rattazzi, A., & Manes, F. F. (2012) · Psychiatry Research · doi:10.1016/j.psychres.2012.08.023 · Cited by 23 · see citing works
Comparing response inhibition and flexibility for two components of executive functioning in children with autism spectrum disorder and normal children.
roodbarde, F. P., Kafi, S.-M., & Sotodeh, S.-O. (2013) · Europe PMC (PubMed Central) · Cited by 20 · see citing works
Visual Scanning Patterns during the Dimensional Change Card Sorting Task in Children with Autism Spectrum Disorder
Yi, L., Liu, Y., Li, Y., Fan, Y.-B., Huang, D., & Gao, D. (2012) · Autism Research and Treatment · doi:10.1155/2012/123053 · Cited by 16 · see citing works
Social attribution in children with high functioning autism and Asperger syndrome: An exploratory study in the Chinese setting
Chan, R. C. K., Hu, Z.-Y., Cui, J., Wang, Y., & McAlonan, G. M. (2011) · Research in Autism · doi:10.1016/j.rasd.2011.02.017 · Cited by 13 · see citing works
Use of the Progressive Figures Test in evaluating brain-damaged children, children with academic problems, and normal controls
Reitan, R. M. (2003) · Archives of Clinical Neuropsychology · doi:10.1016/s0887-6177(03)00045-3 · Cited by 8 · see citing works

Flagged first, then by citations

Sorted by citations

Autism spectrum disorders: a meta-analysis of executive function
Demetriou, E. A., Lampit, A., Quintana, D. S., Naismith, S. L., Song, Y. J. C., Pye, J. E., Hickie, I., & Guastella, A. J. (2018) · Molecular Psychiatry · doi:10.1038/mp.2017.75 · Cited by 841 · see citing works
Executive Function in Autism Spectrum Disorder: History, Theoretical Models, Empirical Findings, and Potential as an Endophenotype
Demetriou, E. A., DeMayo, M. M., & Guastella, A. J. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00753 · Cited by 274 · see citing works
“A meta-analysis on cognitive flexibility (96) indicated life span impairment in ASD.”
Meta-analysis of neuropsychological measures of executive functioning in children and adolescents with high-functioning autism spectrum disorder
Lai, C. L. E., Lau, Z., Lui, S. S. Y., Lok, E., Tam, V., Chan, Q., Cheng, K. M., Lam, S. M., & Cheung, E. F. C. (2017) · Autism Research · doi:10.1002/aur.1723 · Cited by 250 · see citing works
“Fourth, previous meta-analyses [Geurts et al., 2014; Leung & Zakzanis, 2014] included studies conducted on samples with ASD and comorbid intellectual disability.”
BackgroundMethodResultInfluential
The set-shifting profiles of anorexia nervosa and autism spectrum disorder using the Wisconsin Card Sorting Test: a systematic review and meta-analysis
Westwood, H., Stahl, D. R., Mandy, W., & Tchanturia, K. (2016) · Psychological Medicine · doi:10.1017/s0033291716000581 · Cited by 179 · see citing works
“A recent meta-analysis (Leung & Zakzanis, 2014) comparing neuropsychological performance between patients with ASD and HCs on number of perseverative errors on the computerized WCST, which again pooled both child and adult studies, reported a medium mean effect size (d = 0.68).”
BackgroundMethodInfluential
The Effects of Exercise Interventions on Executive Functions in Children and Adolescents with Autism Spectrum Disorder: A Systematic Review and Meta-analysis
Liang, X., Li, R., Wong, S. H., Sum, R. K. W., Wang, P., Yang, B., & Sit, C. H. P. (2021) · Sports Medicine · doi:10.1007/s40279-021-01545-3 · Cited by 187 · see citing works
Working memory and cognitive flexibility‐training for children with an autism spectrum disorder: a randomized controlled trial
de Vries, M., Prins, P. J. M., Schmand, B. A., & Geurts, H. M. (2014) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12324 · Cited by 163 · see citing works
PTSD and autism spectrum disorder: Co-morbidity, gaps in research, and potential shared mechanisms.
Haruvi-Lamdan, N., Horesh, D., & Golan, O. (2017) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/tra0000298 · Cited by 151 · see citing works
Data‐driven identification of subtypes of executive function across typical development, attention deficit hyperactivity disorder, and autism spectrum disorders
Vaidya, C. J., You, X., Mostofsky, S., Pereira, F., Berl, M. M., & Kenworthy, L. (2020) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13114 · Cited by 126 · see citing works
Executive functioning in autism spectrum disorders: Influence of task and sample characteristics and relation to symptom severity
Van Eylen, L., Boets, B., Steyaert, J., Wagemans, J., & Noens, I. (2015) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-015-0689-1 · Cited by 123 · see citing works
“[37] and is consistent with many other reports of increased perseverative errors on the original WCST (for reviews, see [55, 56]).”
Result
A Review of Language, Executive Function, and Intervention in Autism Spectrum Disorder
Friedman, L., & Sterling, A. M. (2019) · Seminars in Speech and Language · doi:10.1055/s-0039-1692964 · Cited by 119 · see citing works
“However, the authors reported that the majority of the studies included in the metaanalysis had compared individuals with ASD to age-matched controls, but the authors did not consider group matching status in their inclusionary criteria.(5) Therefore, results from this meta-analysis may not generalize to all individua…”
Result
Can Bilingualism Mitigate Set-Shifting Difficulties in Children With Autism Spectrum Disorders?
Gonzalez-Barrero, A. M., & Nadig, A. S. (2019) · Child Development · doi:10.1111/cdev.12979 · Cited by 114 · see citing works
“This is likely because the DCCS task is not a highly sensitive measure of set-shifting impairment, with a 95% confidence interval of [-1.82, 2.85] pooled over the two studies just mentioned (Leung & Zakzanis, 2014).”
BackgroundMethodResultInfluential
Characterizing the Factor Structure of Parent Reported Executive Function in Autism Spectrum Disorders: The Impact of Cognitive Inflexibility
Granader, Y., Wallace, G. L., Hardy, K. K., Yerys, B. E., Lawson, R. A., Rosenthal, M., Wills, M. C., Dixon, E., Pandey, J., Penna, R., et al. (2014) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-014-2169-8 · Cited by 106 · see citing works
“This makes the BRIEF a useful clinical tool in ASD (Leung and Zakzanis 2014; Tunc et al. 2014), but assumptions about the factor structure of the BRIEF in ASD populations should not be premised on findings from TDC.”
Method
A meta-analysis of cognitive flexibility in autism spectrum disorder
Lage, C., Smith, E. S., & Lawson, R. P. (2023) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2023.105511 · Cited by 112 · see citing works
“The only quantitative review to date focused specifically on cognitive flexibility in autistic people (Leung and Zakzanis, 2014) reported extensive variation in the magnitude of cognitive flexibility difficulties.”
Background
Effects of Cognitive Training Programs on Executive Function in Children and Adolescents with Autism Spectrum Disorder: A Systematic Review
Pasqualotto, A., Mazzoni, N., Bentenuto, A., Mulè, A., Benso, F., & Venuti, P. (2021) · Brain Sciences · doi:10.3390/brainsci11101280 · Cited by 103 · see citing works
Executive function predicts school readiness in autistic and typical preschool children
Pellicano, E., Kenny, L., Brede, J., Klaric, E., Lichwa, H., & McMillin, R. (2017) · Cognitive Development · doi:10.1016/j.cogdev.2017.02.003 · Cited by 96 · see citing works
Metacognitive Aspects of Executive Function Are Highly Associated with Social Functioning on Parent-Rated Measures in Children with Autism Spectrum Disorder
Torske, T., Nærland, T., Øie, M. G., Stenberg, N., & Andreassen, O. A. (2018) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2017.00258 · Cited by 87 · see citing works
“Meta-analyses and reviews have been written about domains like inhibition and interference control (Geurts et al., 2014b), cognitive flexibility (Leung and Zakzanis, 2014) and working memory in ASD (Barendse et al., 2013; Wang et al., 2017).”
Background
Executive Function Skills in School-Age Children With Autism Spectrum Disorder: Association With Language Abilities
Weismer, S. E., Kaushanskaya, M., Larson, C., Mathée‐Scott, J., & Bolt, D. M. (2018) · Journal of Speech Language and Hearing Research · doi:10.1044/2018_jslhr-l-rsaut-18-0026 · Cited by 77 · see citing works
“Based on a meta-analysis of shifting/cognitive flexibility studies, Leung and Zakzanis (2014) concluded that the Shift subscale of the Behavior Rating Inventory of Executive Functions (BRIEF) is a promising clinical marker for ASD, yet their results also highlighted the fact that cognitive…”
Executive Functions in Older Adults With Autism Spectrum Disorder: Objective Performance and Subjective Complaints
Davids, R. C. D., Groen, Y., Berg, I. J., Tucha, O. M., & van Balkom, I. D. C. (2016) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-016-2831-4 · Cited by 75 · see citing works
“This is in line with a previous review on the sensitivity of cognitive flexibility measures in individuals with ASD by Leung and Zakzanis (2014).”
Result
Traumatic Exposure and Psychological Well-Being: The Moderating Role of Cognitive Flexibility
Fu, F., & Chow, A. Y. M. (2016) · Journal of Loss and Trauma · doi:10.1080/15325024.2016.1161428 · Cited by 69 · see citing works
Virtual collaborative gaming as social skills training for high‐functioning autistic children
Ke, F., & Moon, J. (2018) · British Journal of Educational Technology · doi:10.1111/bjet.12626 · Cited by 69 · see citing works
Neuropsychological assessment in autism spectrum disorder and related conditions
Zwick, G. P. (2017) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2017.19.4/gzwick · Cited by 69 · see citing works
Associations Among Symptoms of Autism, Symptoms of Depression and Executive Functions in Children with High-Functioning Autism: A 2 Year Follow-Up Study
Andersen, P. N., Skogli, E. W., Hovik, K. T., Egeland, J., & Øie, M. (2015) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-015-2415-8 · Cited by 63 · see citing works
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 62 · see citing works
“Importantly however, cognitive deficits were not generalized across all domains (particularly set shifting was completely normal in ASD participants across the IQ range, in line with a recent review [63] and were overall of small to moderate size at best, suggesting cognitive deficits not to be the core or sole cause…”
MethodResult
Addressing the autism mental health crisis: the potential of phenomenology in neurodiversity-affirming clinical practices
Pantazakos, T., & Vanaken, G.-J. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1225152 · Cited by 59 · see citing works
“, thinking errors and cognitive distortions); facing demands for unachievable cognitive flexibility and perspective-taking (Minshew et al., 2002; Koenig and Levine, 2011; Leung and Zakzanis, 2014; Cooper et al., 2018); difficulty with interpreting social cues, facial expressions, and nonverbal communication; building…”
Background
Impaired cognitive flexibility across psychiatric disorders
Grant, J. E., & Chamberlain, S. R. (2023) · CNS Spectrums · doi:10.1017/s1092852923002237 · Cited by 58 · see citing works
“Many psychiatric disorders are characterized by repetitive compulsive behaviors (including, for example, alcohol and substance use disorders, schizophrenia, autism spectrum disorders, eating disorders, gambling disorder, trichotillomania, and skin-picking disorder).(1-7) Obsessivecompulsive disorder (OCD) may reflect…”
Background
Diagnóstico de autismo no século XXI: evolução dos domínios nas categorizações nosológicas
Fernandes, C. S., Tomazelli, J. G., & Girianelli, V. R. (2020) · Psicologia USP · doi:10.1590/0103-6564e200027 · Cited by 104 · see citing works
Autism spectrum disorder and schizophrenia: boundaries and uncertainties
Pina‐Camacho, L., Parellada, M., & Kyriakopoulos, M. (2016) · BJPsych Advances · doi:10.1192/apt.bp.115.014720 · Cited by 55 · see citing works
“Both patients with ASD and those with schizophrenia can show odd mannerisms, stereotyped behaviours and a rigid, inflexible pattern of thinking and behaving (Delahunty 1993; Ridley 1994; Leung 2014).”
Same room - different windows? A systematic review and meta-analysis of the relationship between self-report and neuropsychological tests of cognitive flexibility in healthy adults
Howlett, C. A., Wewege, M. A., Berryman, C. F., Oldach, A. M., Jennings, E., Moore, E., Karran, E. L., Szeto, K., Pronk, L., Miles, S., et al. (2021) · Clinical Psychology Review · doi:10.1016/j.cpr.2021.102061 · Cited by 61 · see citing works
What does it take to be rigid? Reflections on the notion of rigidity in autism
Petrolini, V., Jorba, M., & Vicente, A. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1072362 · Cited by 49 · see citing works
Autism Spectrum Traits Linked with Reduced Performance on Self-Report Behavioural Measures of Cognitive Flexibility
Albein‐Urios, N., Youssef, G. J., Kirkovski, M., & Enticott, P. G. (2018) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-018-3503-3 · Cited by 45 · see citing works
“Poorer performance on the BRIEF-A shift subscale has been shown consistently in individuals with ASD (Gioia et al. 2002; Leung and Zakzanis 2014).”
Method
Putative Brain Networks Underlying Repetitive Negative Thinking and Comorbid Internalizing Problems in Autism
Burrows, C. A., Timpano, K. R., & Uddin, L. Q. (2017) · Clinical Psychological Science · doi:10.1177/2167702616683506 · Cited by 43 · see citing works
“There is also ample evidence for reduced cognitive flexibility across development in ASD, both in laboratory assessments (Lopez et al., 2005; Panerai et al., 2014) and on self- and parent-reports (Leung & Zakzanis, 2014).”
Background
Characteristic Executive Dysfunction for High‐Functioning Autism Sustained to Adulthood
Xie, R., Sun, X., Yang, L., & Guo, Y. (2020) · Autism Research · doi:10.1002/aur.2304 · Cited by 45 · see citing works
“…memory, planning, cognitive flexibility, inhibition, and so on [Hill, 2004b], and has long been of interest for its proposed role in specific impairments in ASD in a set of cognitive and behavioral control process [Demetriou et al., 2018; Leung & Zakzanis, 2014; Olde Dubbelink & Geurts, 2017].”
Background
Bilingual language development in autism
Prévost, P., & Tuller, L. (2021) · Linguistic Approaches to Bilingualism · doi:10.1075/lab.21018.pre · Cited by 46 · see citing works
Prospective memory in autism: theory and literature review
Sheppard, D. P., Bruineberg, J. P., Kretschmer-Trendowicz, A., & Altgassen, M. (2018) · The Clinical Neuropsychologist · doi:10.1080/13854046.2018.1435823 · Cited by 40 · see citing works
“…et al., 2004) and switching flexibly between different tasks or foci of attention (Corbett, Constantine, Hendren, Rocke, & Ozonoff, 2009; Kenworthy, Yerys, Anthony, & Wallace, 2008; Leung & Zakzanis, 2014; Ozonoff et al., 2004; but see Geurts, Corbett, & Solomon, 2009 for a critical review).”
Adding the missing voice: How self-report of autistic youth self-report on an executive functioning rating scale compares to parent report and that of youth with attention deficit hyperactivity disorder or neurotypical development
Kenworthy, L. E., Verbalis, A. D., Bascom, J., daVanport, S., Strang, J. F., Pugliese, C. E., Freeman, A. J., Jeppsen, C., Armour, A. C., Jost, G. M., et al. (2021) · Autism · doi:10.1177/13623613211029117 · Cited by 40 · see citing works
“In the case of autism, Leung and Zakzanis (2014) conducted a quantitative review of 72 studies and found that (1) autistic individuals without intellectual disability demonstrated variability in the magnitude of EF impairment depending on the type of assessment measure and (2) parent-report and…”
PSMC3 proteasome subunit variants are associated with neurodevelopmental delay and type I interferon production
Ebstein, F., Küry, S., Most, V., Rosenfelt, C., Scott-Boyer, M.-P., van Woerden, G. M., Besnard, T., Papendorf, J. J., Studencka-Turski, M., Wang, T., et al. (2023) · Science Translational Medicine · doi:10.1126/scitranslmed.abo3189 · Cited by 36 · see citing works
Examining the relationship between cognitive inflexibility and internalizing and externalizing symptoms in autistic children and adolescents: A systematic review and meta‐analysis
Lei, J., Charman, T., Leigh, E., Russell, A., Mohamed, Z., & Hollocks, M. J. (2022) · Autism Research · doi:10.1002/aur.2826 · Cited by 35 · see citing works
“Previous systematic and literature reviews on the topic of CI have evaluated the psychometric properties of standardized measures, including their discriminability (Leung & Zakzanis, 2014) and ecological validity when completed by autistic individuals (Geurts et al., 2009).”
Background
Bilingualism Effects on the Cognitive Flexibility of Autistic Children: Evidence From Verbal Dual-Task Paradigms
Peristeri, E., Vogelzang, M., & Tsimpli, I. M. (2021) · Neurobiology of Language · doi:10.1162/nol_a_00055 · Cited by 36 · see citing works
“Heterogeneity in EF in autism has been verified by Leung and Zakzanis’ (2014) meta-analysis, which has exhibited considerable variability of effect size in set-shifting performance across autistic populations, further implying that EF deficits do not constitute a uniform characteristic of the…”
Result
Effects of therapeutic recreation on adults with ASD and ID: a preliminary randomized control trial
García-Villamisar, D. A., Dattilo, J., & Muela, C. (2016) · Journal of Intellectual Disability Research · doi:10.1111/jir.12320 · Cited by 36 · see citing works
A mixed methods study of autistic adults' mental health therapy experiences
Mazurek, M. O., Pappagianopoulos, J., Brunt, S., Sadikova, E., Nevill, R., Menezes, M., & Harkins, C. (2023) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2835 · Cited by 33 · see citing works
Real-world executive functioning for autistic children in school and home settings
Tschida, J. E., & Yerys, B. E. (2021) · Autism · doi:10.1177/13623613211041189 · Cited by 32 · see citing works
“While broad executive function impairments characterize autism spectrum disorder (ASD), shifting has been proposed as a promising clinical marker from caregiver informant data given its notable ability to differentiate autistic and typically developing (TD) individuals (Leung & Zakzanis, 2014).”
Influential
Cognitive flexibility in autism: Evidence from young autistic children
Ανδρέου, Μ., Konstantopoulos, K., & Peristeri, E. (2022) · Autism Research · doi:10.1002/aur.2828 · Cited by 32 · see citing works
“…category within a limited period of time, are two common neuropsychological tests used to assess cognitive flexibility in both clinical and typical school-aged child populations (e.g., Koren et al., 2005; Leung & Zakzanis, 2014; Pastor-Cerezuela et al., 2016; Stad et al., 2019; Zhao et al., 2013).”
Background
Mutations in neuroligin-3 in male mice impact behavioral flexibility but not relational memory in a touchscreen test of visual transitive inference
Norris, R. H. C., Churilov, L. P., Hannan, A. J., & Nithianantharajah, J. (2019) · Molecular Autism · doi:10.1186/s13229-019-0292-2 · Cited by 29 · see citing works
Advancing the Personalization of Assessment and Intervention in Autistic Adolescents and Young Adults by Targeting Self-Determination and Executive Processes
Shogren, K. A., Mosconi, M. W., Raley, S. K., Dean, E. E., Edwards, B., Wallisch, A. M., Boyd, B. A., & Kiblen, J. C. (2021) · Autism in Adulthood · doi:10.1089/aut.2021.0010 · Cited by 34 · see citing works
One-Class Support Vector Machines Identify the Language and Default Mode Regions As Common Patterns of Structural Alterations in Young Children with Autism Spectrum Disorders
Retico, A., Gori, I., Giuliano, A., Muratori, F., & Calderoni, S. (2016) · Frontiers in Neuroscience · doi:10.3389/fnins.2016.00306 · Cited by 29 · see citing works
“, 2001), as well as in cognitive flexibility and in the ability to regulate the breadth of attention (Leech and Sharp, 2014), functions frequently impaired in patients with ASD (Bruck et al., 2007; Leung and Zakzanis, 2014; Orekhova and Stroganova, 2014).”
Background
Cognitive emotion regulation difficulties increase affective reactivity to daily-life stress in autistic adolescents and young adults
Ilen, L., Feller, C. M., & Schneider, M. (2023) · Autism · doi:10.1177/13623613231204829 · Cited by 28 · see citing works
“It is possible that executive functioning difficulties (Kenworthy et al., 2008) or cognitive rigidity (Leung & Zakzanis, 2014), associated with autism, could interfere with effective problem-solving and coping with perceived stress related to daily-life activities.”
Background
Feasibility of a school-based mindfulness program for improving inhibitory skills in children with autism spectrum disorder
Juliano, A., Alexander, A., DeLuca, J., & Genova, H. M. (2020) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2020.103641 · Cited by 29 · see citing works
Machine Learning for Differential Diagnosis Between Clinical Conditions With Social Difficulty: Autism Spectrum Disorder, Early Psychosis, and Social Anxiety Disorder
Demetriou, E. A., Park, S. H., Ho, N., Pepper, K. L., Song, Y. J. C., Naismith, S. L., Thomas, E. E., Hickie, I. B., & Guastella, A. J. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00545 · Cited by 24 · see citing works
Reading and Writing Skills in Adolescents With Autism Spectrum Disorder Without Intellectual Disability
Baixauli, I., Miranda, B. R., Berenguer, C., Lorenzo, M. T. D. M., & Miranda, A. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.646849 · Cited by 25 · see citing works
Developing 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 25 · see citing works
Broad Cognitive Profile in Children and Adolescents with HF-ASD and in Their Siblings: Widespread Underperformance and its Clinical and Adaptive Correlates
Rosa, M., Puig, O., Lázaro, L., Vallés, V., Lera‐Miguel, S., Sánchez‐Gistau, V., & Calvo, R. M. (2017) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-017-3137-x · Cited by 23 · see citing works
“2016) but some mixed results remain in the literature (Geurts et al. 2009; Leung and Zakzanis 2014; May et al. 2013; Oerlemans et al. 2013; Rommelse et al. 2015; Semrud-Clikeman et al. 2014).”
Flexibility in autism during unpredictable shifts of socio-emotional stimuli: Investigation of group and sex differences
Lacroix, A., Dutheil, F., Logemann, A., Cserjesi, R., Peyrin, C., Biro, B., Gomot, M., & Mermillod, M. (2022) · Autism · doi:10.1177/13623613211062776 · Cited by 21 · see citing works
“However, laboratory results on flexibility in autism are inconsistent (for overviews, see Geurts et al., 2009; Leung & Zakzanis, 2014).”
Result
Cholinergic neurons in the pedunculopontine nucleus guide reversal learning by signaling the changing reward contingency
Ruan, Y., Li, K.-Y., Zheng, R., Yan, Y., Wang, Z., Chen, Y., Liu, Y., Tian, J., Zhu, L., Lou, H., et al. (2022) · Cell Reports · doi:10.1016/j.celrep.2022.110437 · Cited by 22 · see citing works
Quantitative prediction of individual cognitive flexibility using structural MRI
Zhu, J., Zhu, D., Zhang, C., Wang, Y., Yang, Y., & Yu, Y. (2018) · Brain Imaging and Behavior · doi:10.1007/s11682-018-9905-1 · Cited by 22 · see citing works
Parahippocampal deactivation and hyperactivation of central executive, saliency and social cognition networks in autism spectrum disorder
Mouga, S., Duarte, I. C., Café, C., Sousa, D., Duque, F., Oliveira, G., & Castelo-Branco, M. S. (2022) · Journal of Neurodevelopmental Disorders · doi:10.1186/s11689-022-09417-1 · Cited by 22 · see citing works
Autism and Pervasive Developmental Disorders
(2019) · Cambridge University Press eBooks · doi:10.1017/9781108297769 · Cited by 24 · see citing works
Planning in Children with Autism Spectrum Disorder: The Role of Verbal Mediation
Larson, C., Gangopadhyay, I., Prescott, K. E., Kaushanskaya, M., & Weismer, S. E. (2020) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-020-04639-5 · Cited by 22 · see citing works
“I have to charge my social battery”: Perspectives from autistic young adults on Quality of Life
Øverland, E., Hauge, Å. L., Orm, S., Øie, M. G., Skogli, E. W., Pellicano, E., & Andersen, P. N. (2024) · Autism · doi:10.1177/13623613241245578 · Cited by 18 · see citing works
“Transitions often involve uncertainty about what is ahead, and uncertainty can be experienced as more challenging for autistic people than non-autistic people (Leung & Zakzanis, 2014).”
Background
Evaluating the feasibility of the NIH toolbox cognition battery for autistic children and adolescents
Jones, D. R., Dallman, A., Harrop, C., Whitten, A., Pritchett, J., Lecavalier, L., Bodfish, J. W., & Boyd, B. A. (2022) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-021-04965-2 · Cited by 18 · see citing works
Dimensional associations between executive function processes and symptoms of ADHD, ASD, oppositional defiance and anxiety in young school-referred children
Anning, K. L., Langley, K., Hobson, C., & Van Goozen, S. H. M. (2023) · Cortex · doi:10.1016/j.cortex.2023.06.005 · Cited by 18 · see citing works
“Previous research has indicated that cognitive flexibility is the most commonly identified EF problem in individuals with ASD (Leung & Zakzanis, 2014); it is also linked to disorder-specific symptoms (Hill & Bird, 2006; South et al., 2007) and challenges (e.g., theory of mind; Jones et al., 2018).”
Background
Psychological Factors in Autism Spectrum Disorders
Vivanti, G., Yerys, B. E., & Salomone, E. (2019) · Cambridge University Press eBooks · doi:10.1017/9781108297769.004 · Cited by 16 · see citing works
The role of executive functions in preschool children with autism spectrum disorder: A short narrative review
Petrolo, E., Guerrera, S., Logrieco, M. G., Casula, L., Vicari, S., & Valeri, G. (2025) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2024.104905 · Cited by 18 · see citing works
The relationships between motor skills and executive functions in children with and without autism spectrum disorder
Pan, C., Sung, M., Tsai, C., Chen, F., Chen, Y., & Chen, C. (2024) · Autism Research · doi:10.1002/aur.3136 · Cited by 16 · see citing works
“However, the current finding regarding the difference of cognitive flexibility performance is not consistent with previous literature (Leung & Zakzanis, 2014; Robinson et al., 2009), which found preserved cognitive flexibility among autistic individuals.”
Result
Ergenlerde İyi Oluşun Yordanmasında Bilişsel Esneklik ve Öz-Şefkatin Rolü
Topkaya, N., Köksal, Z., & BAYRAM, S. (2022) · Batı anadolu eğitim bilimleri dergisi · doi:10.51460/baebd.1084576 · Cited by 14 · see citing works
A systematic review of ecological momentary assessment in autism research
Chen, Y., Xi, Z., Greene, T., & Mandy, W. (2024) · Autism · doi:10.1177/13623613241305722 · Cited by 13 · see citing works
“Although some previous researchers expressed concerns about autistic people’s capacity to transition between activities (Leung & Zakzanis, 2014), autistic participants in Chen et al. (2014) reported that they were able to shift back and forth between responding to signals and daily activities. a…”
Contrasting Views of Autism Spectrum Traits in Adults, Especially in Self-Reports vs. Informant-Reports for Women High in Autism Spectrum Traits
Taylor, S. C., Gehringer, B. N., Dow, H. C., Langer, A., Rawot, E., Smernoff, Z., Steeman, S. L., Almasy, L. A., Rader, D. J., Bućan, M., et al. (2022) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-022-05822-6 · Cited by 15 · see citing works
“Additionally, a previous meta-analysis showed that self-report BRIEF scales performed better in terms of clinical ASD discrimination than informant-report BRIEF scales (Leung & Zakzanis, 2014).”
Increased risk of acute stress disorder and post-traumatic stress disorder in children and adolescents with autism spectrum disorder: a nation-wide cohort study in Taiwan
Li, S.-T., Chien, W., Chung, C., & Tzeng, N. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1329836 · Cited by 13 · see citing works
Adolescent treadmill exercise enhances hippocampal brain-derived neurotrophic factor (BDNF) expression and improves cognition in autism-modeled rats
King, C., Rogers, L. G., Jansen, J., Sivayokan, B., Neyhard, J., Warnes, E., Hall, S. E., & Plakke, B. (2024) · Physiology & Behavior · doi:10.1016/j.physbeh.2024.114638 · Cited by 13 · see citing works
Cognitive flexibility in autism: How task predictability and sex influence performances
Lacroix, A., Torija, E., Logemann, H. N. A., Baciu, M., Cserjési, R., Dutheil, F., Gomot, M., & Mermillod, M. (2024) · Autism Research · doi:10.1002/aur.3281 · Cited by 17 · see citing works
Adaptive responding to prolonged stress exposure: A binational study on the impact of flexibility on latent profiles of cognitive, emotional and behavioural responses to the COVID‐19 pandemic
Hemi, A., Sopp, M. R., Schäfer, S. K., Michael, T., & Levy‐Gigi, E. (2022) · Health & Social Care in the Community · doi:10.1111/hsc.14053 · Cited by 12 · see citing works
“It enables individuals to shift between discrepant tasks or demands and adapt to different challenges (Koesten et al., 2009; Leung & Zakzanis, 2014).”
Background
Enhanced fear limits behavioral flexibility in Shank2-deficient mice
Yun, M., Kim, E., & Jung, M. W. (2022) · Molecular Autism · doi:10.1186/s13229-022-00518-1 · Cited by 13 · see citing works
“People with ASD often show impairments in tasks requiring cognitive flexibility, such as the Wisconsin card sorting test [11, 12], and impaired cognitive flexibility has been proposed to underlie repetitive and restrictive patterns of behavior in this disorder [13].”
Background
Are preconceptional stressful experiences crucial elements for the aetiology of autism spectrum disorder? Insights from an animal model
Pisu, M. G., Boero, G., Garau, A., Casula, C., Cisci, S., Biggio, F., Concas, A., Follesa, P., Maciocco, E., Porcu, P., et al. (2019) · Neuropharmacology · doi:10.1016/j.neuropharm.2019.107686 · Cited by 13 · see citing works
Mapping the structure of biomarkers in autism spectrum disorder: a review of the most influential studies
Jin, F., & Wang, Z. (2024) · Frontiers in Neuroscience · doi:10.3389/fnins.2024.1514678 · Cited by 12 · see citing works
Intrinsic Structural Connectivity of the Default Mode Network and Behavioral Correlates of Executive Function and Social Skills in Youth with Autism Spectrum Disorders
Blume, J., Kahathuduwa, C. N., & Mastergeorge, A. M. (2022) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-022-05460-y · Cited by 11 · see citing works
“…of Laboratory Sciences and Primary Care, Department of Psychiatry, Texas Tech University Health Sciences Center, Lubbock, USA 1 3 skills (e.g., initiation, working memory) in contrast (Freeman et al., 2017; Leung & Zakzanis, 2014; Ozonoff et al., 2004; Pugliese et al., 2015; Torske et al., 2018).”
Using the cognitive rigidity-flexibility dimension to deepen our understanding of the autism spectrum
Cahalan, S., Mitroff, S. R., Subiaul, F., & Rosenblau, G. (2025) · Personality Neuroscience · doi:10.1017/pen.2025.10002 · Cited by 11 · see citing works
“Slower shifts in extra-dimensional reversal learning has been shown to scale with behavioral inflexibility in individuals with an autism diagnosis (D ’ Cruz et al., 2013; Geurts et al., 2009; Leung & Zakzanis, 2014; Yerys et al., 2009).”
Your Need for Cognition, Cognitive Flexibility, and Cognitive Emotion Regulation Strategies Matter! The Path beyond a Satisfied Life
Kaynak, H., Nazlıgül, M. D., & Cengil, B. B. (2024) · The Journal of Psychology · doi:10.1080/00223980.2024.2352730 · Cited by 13 · see citing works
“In addition, people with greater cognitive flexibility are more adaptable and open to change, readily modifying their thought processes, opinions, and problem-solving strategies in response to new information or challenges (Leung & Zakzanis, 2014).”
A Problem-Solving Intervention Using iPads to Improve Transition-Related Task Performance of Students With Autism Spectrum Disorder
Yakubova, G., & Zeleke, W. A. (2016) · Journal of Special Education Technology · doi:10.1177/0162643416650023 · Cited by 10 · see citing works
Attentional Cueing and Executive Deficits Revealed by a Virtual Supermarket Task Coupled With Eye-Tracking in Autism Spectrum Disorder
Mouga, S., Duarte, I. C., Café, C., Sousa, D., Duque, F., Oliveira, G., & Castelo-Branco, M. S. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.671507 · Cited by 11 · see citing works
Age-related differences in inhibitory control and memory updating in boys with Asperger syndrome
Weiss, E. M., Gschaidbauer, B., Kaufmann, L., Fink, A., Schulter, G., Mittenecker, E., & Papousek, I. (2016) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-016-0756-8 · Cited by 10 · see citing works
“Some authors suggest that EF deficits in adults with AS and high-functioning autism may not be apparent in standard neuropsychological tests of EFs such as the Wisconsin card sorting test (WCST) which are rather unspecific indicators of brain functions because they confound several cognitive components and processes […”
Background
Associations of autistic traits, executive dysfunction and the FKBP5 gene with emotion regulation in Chinese college students
Gong, J., He, Y., Zhou, L., Mo, Y., Yu, F., Liu, M., Yang, L., & Liu, J. (2021) · Personality and Individual Differences · doi:10.1016/j.paid.2021.111293 · Cited by 10 · see citing works
Cognitive flexibility in neurodevelopmental disorders: insights from neuroimaging and neuropsychology
Koithan, E. M., Demeter, D. V., Ali, S. A., Feigelis, M., & Greene, D. J. (2024) · Current Opinion in Behavioral Sciences · doi:10.1016/j.cobeha.2024.101429 · Cited by 10 · see citing works
Slow but Steady: Similarities and Differences in Executive Functioning Between Autistic and Non‐Autistic Adults
Jertberg, R., Begeer, S., Geurts, H. M., Chakrabarti, B., & der Burg, E. V. (2025) · Autism Research · doi:10.1002/aur.70015 · Cited by 9 · see citing works
Spanish version of the Adult Executive Functioning Inventory (ADEXI): Psychometric properties in adults with Autism Spectrum Disorders and Intellectual Disability
García-Villamisar, D. A., Jodra, M., Sáez‐Suanes, G. P., & Thorell, L. B. (2020) · Revista de Psicopatología y Psicología Clínica · doi:10.5944/rppc.26183 · Cited by 9 · see citing works
“In addition, a review of studies of cognitive flexibility showed that ratings, but not tests, could discriminate between individuals with ASD and controls (Leung & Zakzanis, 2014).”
Background
Atypical Neural Responses of Cognitive Flexibility in Parents of Children With Autism Spectrum Disorder
Cheng, X., Li, Y., Cui, X., Cheng, H., Li, C., Fu, L., Jiang, J., Hu, Z., & Ke, X. (2021) · Frontiers in Neuroscience · doi:10.3389/fnins.2021.747273 · Cited by 11 · see citing works
Accumbal Adenosine A2A Receptors Enhance Cognitive Flexibility by Facilitating Strategy Shifting
Zhou, J., Wu, B., Lin, X., Dai, Y., Li, T., Zheng, W., Guo, W. M., Vakal, S., Chen, X., & Chen, J. (2019) · Frontiers in Cellular Neuroscience · doi:10.3389/fncel.2019.00130 · Cited by 9 · see citing works
Heterogeneity of executive functions among preschool children with psychiatric symptoms
Teivaanmäki, S., Huhdanpää, H., Kiuru, N. H., Aronen, E. T., Närhi, V. M., & Klenberg, L. (2019) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-019-01437-y · Cited by 9 · see citing works
Successful attentional set-shifting in 2-year-olds with and without Autism Spectrum Disorder
Smith, H., Carter, A. S., Blaser, E., & Káldy, Z. (2019) · PLoS ONE · doi:10.1371/journal.pone.0213903 · Cited by 9 · see citing works
Cognitive flexibility moderates the efficacy of a visuospatial intervention following exposure to analog trauma
Hemi, A., Sopp, M. R., Perel, A., Holmes, E. A., & Levy‐Gigi, E. (2023) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2023.101858 · Cited by 8 · see citing works
Probing heterogeneity to identify individualized treatment approaches in autism: Specific clusters of executive function challenges link to distinct co-occurring mental health problems
Pugliese, C. E., Handsman, R., You, X., Anthony, L. G., Vaidya, C. J., & Kenworthy, L. E. (2024) · Autism · doi:10.1177/13623613241246091 · Cited by 8 · see citing works
“…meta-analyses have identified inconsistency in the magnitude and specificity of EF challenges (Demetriou et al., 2018; C. L. E.Lai et al., 2017; Leung & Zakzanis, 2014), calling for a more nuanced, ground-up investigation of this construct in autism using a multi-dimensional, data-driven…”
Subgroups of Children with Autism Spectrum Disorder without Intellectual Disability: A Longitudinal Examination of Executive and Socio-Adaptive Behaviors in Adolescence
Roselló, R., Berenguer, C., Martı́nez-Raga, J., Miranda, A., & Cortese, S. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10102220 · Cited by 8 · see citing works
Neural correlates of schema-dependent episodic memory and association with behavioral flexibility in autism spectrum disorders and typical development
Cook, K. M., You, X., Cherry, J. B. C., Merchant, J. S., Skapek, M., Powers, M. D., Pugliese, C. E., Kenworthy, L. E., & Vaidya, C. J. (2021) · Journal of Neurodevelopmental Disorders · doi:10.1186/s11689-021-09388-9 · Cited by 8 · see citing works
“Moreover, behavioral inflexibility is associated with the two core characteristics of ASD, difficulty in social interaction [25] and engagement in restricted and repetitive behaviors [42, 45], and also predicts socially adaptive outcomes [10, 59, 60], although the direct link between cognitive and behavioral flexibili…”
Background
Olfactory capacity in anorexia nervosa: correlations with set-shifting ability
Karavia, A., Kapsali, F., Gonidakis, F., Koliou, A., Tsigkaropoulou, E., Papageorgiou, C., & Michopoulos, I. (2021) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/s40519-021-01188-3 · Cited by 7 · see citing works
An ecologically valid understanding of executive functioning
Monteiro, E. M. (2021) · Psychology in the Schools · doi:10.1002/pits.22627 · Cited by 7 · see citing works
Did you hear? Auditory prospective memory cues are more beneficial for autistic than for non-autistic children and adolescents
Sheppard, D. P., & Altgassen, M. (2021) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2021.104001 · Cited by 7 · see citing works
Brief Report: An Exploration of Cognitive Flexibility of Autistic Adolescents with Low Intelligence Using the Wisconsin Card Sorting Task
Lung, S. L. M., & Bertone, A. (2021) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-021-05134-1 · Cited by 7 · see citing works
Cognitive flexibility in schizophrenia: A confirmatory factor analysis of neuropsychological measures
Knížková, K., Siroňová, A., Večeřová, M., Keřková, B., Šustová, P., Jonáš, J., Hrubý, A., & Rodríguez, M. (2023) · Applied Neuropsychology Adult · doi:10.1080/23279095.2023.2230508 · Cited by 6 · see citing works
“;) or in a set of tests (Champagne-Lavau et al., 2012; Leung & Zakzanis, 2014; Zmigrod et al., 2019).”
Attention and sensory integration for gait in young adults with autism spectrum disorder
Bick, N. A., Redfern, M. S., Jennings, J. R., Eack, S. M., Iverson, J. M., & Cham, R. (2024) · Gait & Posture · doi:10.1016/j.gaitpost.2024.04.035 · Cited by 6 · see citing works
Understanding cognitive flexibility in emotional evaluation in autistic males and females: the social context matters
Lacroix, A., Bennetot-Deveria, Y., Baciu, M., Dutheil, F., Magnon, V., Gomot, M., & Mermillod, M. (2024) · Molecular Autism · doi:10.1186/s13229-024-00622-4 · Cited by 8 · see citing works
Tracking Representational Flexibility Development through Speech Data Mining
Ke, F.-F., Moon, J., & Sokolikj, Z. (2020) · Frontiers in Education Conference · doi:10.1109/fie44824.2020.9273818 · Cited by 6 · see citing works
“The literature indicates card sorting, flexible item selection, and insight problems, along with qualitative observation or interviewing are the major methods of flexibility evaluation [9].”
Method
Probing the Neurodynamic Mechanisms of Cognitive Flexibility in Depressed Individuals with Autism Spectrum Disorder
Elmaghraby, R., Blank, E., Miyakoshi, M., Gilbert, D. L., Wu, S. W., Larsh, T., Westerkamp, G., Liu, Y., Horn, P. S., Erickson, C. A., et al. (2025) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2024.0109 · Cited by 5 · see citing works
“Among EF impairments, dif ﬁ culties in cognitive ﬂ exi-bility are frequently cited as the most impactful and are related to core ASD features (D ’ Cruz et al., 2016; D ’ Cruz et al., 2013; Dirks et al., 2020; Van Eylen et al., 2011; Hoofs et al., 2018; Leung and Zakzanis, 2014; Lage et al., 2022).”

Autism Spectrum Traits Linked with Reduced Performance on Self-Report Behavioural Measures of Cognitive Flexibility
Albein‐Urios, N., Youssef, G. J., Kirkovski, M., & Enticott, P. G. (2018) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-018-3503-3 · Cited by 45 · see citing works
A meta-analysis of cognitive flexibility in autism spectrum disorder
Lage, C., Smith, E. S., & Lawson, R. P. (2023) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2023.105511 · Cited by 112 · see citing works
The paradox of cognitive flexibility in autism
Geurts, H. M., Corbett, B., & Solomon, M. (2009) · Trends in Cognitive Sciences · doi:10.1016/j.tics.2008.11.006 · Cited by 538 · see citing works
Cognitive flexibility in children and adolescents with autism spectrum disorder: current status and research directions
Hocaoğlu, A. Y., & Güvendir, M. A. (2025) · International Journal of Developmental Disabilities · doi:10.1080/20473869.2025.2548527 · Cited by 2 · see citing works
The Flexibility Scale: Development and Preliminary Validation of a Cognitive Flexibility Measure in Children with Autism Spectrum Disorders
Strang, J. F., Anthony, L. G., Yerys, B. E., Hardy, K. K., Wallace, G. L., Armour, A. C., Dudley, K., & Kenworthy, L. (2017) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-017-3152-y · Cited by 70 · see citing works

Authors: Leung, R. C., & Zakzanis, K. K.
Affiliations: University of Toronto (CA)
Corresponding author: Leung, Rachel C.
ORCID: Leung, Rachel C.
Zakzanis, Konstantine K.
Venue: Journal of Autism and Developmental Disorders
Publisher: Springer Science and Business Media LLC
Published: 2014-05-27
Volume: 44
Issue: 10
Pages: 2628-2645
ISSN: 0162-3257 (ISSN-L)
1573-3432
DOI: 10.1007/s10803-014-2136-4
OpenAlex: W1981575082
Cited by: 192
References: 127
Citations by year: 2026: 11 · 2025: 20 · 2024: 28 · 2023: 19 · 2022: 18 · 2021: 32 · 2020: 11 · 2019: 16 · 2018: 11 · 2017: 8 · 2016: 10 · 2015: 5 · 2014: 3
FWCI: 0.84
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
Locations: Journal of Autism and Developmental Disorders (publishedVersion)
PubMed (publishedVersion)
Funders: Sick Kids Foundation
Topics: Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
Keywords: cognitive flexibility, autism spectrum disorder, executive function, neuropsychological assessment, discriminability, ecological validity, clinical biomarkers
MeSH terms: Child, Child Development Disorders, Pervasive, Cognition, Female, Humans, Neuropsychological Tests, Executive Function, Self Report

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Brief report: Cognitive flexibility in autism spectrum disorders: A quantitative review

Abstract

Integrity signals

Claims the paper makes

Claims other papers make about this one

Cites

Cited by

Related

Record

About these checks