The DOI matches its Crossref record; 126 of the 127 references it cites were found in a registry or an index.
Brief Report: Cognitive Flexibility in Autism Spectrum Disorders: A Quantitative Review
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.
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In the citing paper
“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
In the citing paper
“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
In the citing paper
“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
In the citing paper
“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
In the citing paper
“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
Citations
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Cognitive flexibility in autism spectrum disorder: Explaining the inconsistencies?
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Research works printed but not linked: 3
- De Sonneville, L. M. J. (1999). Amsterdam neuropsychological tasks: A computer aided assessment program. In B. P. L. M. Den Brinker, P. J. Beek, A. N. Brand, F. J. Maarse, & L. J. M. Mulder (Eds.), Cognitive ergonomics, clinical assessment and computer assisted learning: Computers in psychology (pp. 187–203). Lisse: Swets and Zeitlinger.
- Gioia, G. A., Isquith, P. K., Guy, S. C., & Kenworthy, L. (2000). Behavior Rating of Executive Function. Lutz, FL: Psychological Assessment Resources.
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Cited by
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
Demetriou, E. A., DeMayo, M. M., & Guastella, A. J. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00753 · Cited by 274
“A meta-analysis on cognitive flexibility (96) indicated life span impairment in ASD.”
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
“Fourth, previous meta-analyses [Geurts et al., 2014; Leung & Zakzanis, 2014] included studies conducted on samples with ASD and comorbid intellectual disability.”
BackgroundMethodResultInfluentialWestwood, H., Stahl, D. R., Mandy, W., & Tchanturia, K. (2016) · Psychological Medicine · doi:10.1017/s0033291716000581 · Cited by 194
“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).”
BackgroundMethodInfluentialLiang, 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 194
Metadata
- Authors
- Leung, R. C., & Zakzanis, K. K.
- Affiliations
- University of Toronto (CA)
- Corresponding author
- Leung, Rachel C.
- Venue
- Journal of Autism and Developmental Disorders
- Published
- 2014-05-27
- Volume
- 44
- Issue
- 10
- Pages
- 2628-2645
- ISSN
- 0162-3257 (ISSN-L)
- 1573-3432
- 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
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