Cognitive flexibility training intervention among children with autism: a longitudinal study

Cristina De Andrade Varanda,Fernanda Dreux Miranda Fernandes

doi:10.1186/s41155-017-0069-5

Cristina De Andrade Varanda, Fernanda Dreux Miranda Fernandes

Open Access

https://doi.org/10.1186/s41155-017-0069-5

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Abstract

Autism is defined by persistent deficits in social communication and social interaction in multiple contexts as well as restricted and repetitive patterns of behavior. There are also reported difficulties in the dynamic activation and modification of cognitive processes in response to changes in tasks’ demands. Such difficulties are believed to be due to poor flexible cognition. This research aimed to assess and intervene in cognitive flexibility in subjects with autism.Ten subjects diagnosed with autism by psychiatrists, aged 5 years to 13 years and 5 months, were assessed in non-verbal intelligence through Raven’s Progressive Matrices in pretest. They were also assessed in cognitive flexibility through Wisconsin Card Sorting Test (WCST) and in patterns of social interactions, behaviors, and communication through Autism Diagnostic Interview-Revised (ADI-R). An intervention program of 14 to 21 sessions was established to enhance cognitive flexibility. In posttest, they were assessed in WCST and ADI-R.All measures of cognitive flexibility improved in posttest except for failure to maintain set. Among the measures improved in posttest, perseverative errors and responses improved in posttest with statistical significance as well as categories completed. Total scores on ADI-R were lower in posttest as well as scores on communication abilities.The qualitative improvement showed by the individuals of this research concerning cognitive flexibility and also patterns of restricted behavior, social interaction, and communication abilities suggests that individuals with autism can benefit from the development of strategies for the enhancement of cognitive flexibility. Nevertheless, more research is suggested with a larger sample among subjects on the autism spectrum.

Highlights

Autism is a disorder characterized by alterations present since the age of three and by qualitative impairments in communication and social interaction and by the presence of restricted patterns of interest and behavior
One of the theories that explain autism states that executive functions related to planning, working memory, impulse control, inhibition, and mental flexibility are typically impaired in people with neurodevelopmental disorders involving frontal lobe deficits. Such clinical disorders include attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder, Tourette’s syndrome, phenylketonuria, and schizophrenia (Hill, 2004). According to this theory called as executive dysfunction theory, the difficulties in communication and social interaction and, mainly, the restricted patterns of interests and Varanda and Fernandes Psicologia: Reflexão e Crítica (2017) 30:15 behavior could be explained by inadequate ability for planning, deficient working memory abilities, lack of control and impulse inhibition, and insufficient mental flexibility (Ozonoff, Pennington, & Rogers, 1991; Lopez, Lincoln, Ozonoff, & Lai, 2005)
Discussion the subjects were not a cognitively homogenous group, in which only 30% of them accounted for intellectual deficiency, the authors decided to keep those individuals in the study once one of the aims of the research was to verify qualitative gains in communication, interaction, and patterns of behavior and interests as well as cognitive flexibility within this specific group regardless the possibility of generalization of results

Summary

Introduction

Autism is a disorder characterized by alterations present since the age of three and by qualitative impairments in communication and social interaction and by the presence of restricted patterns of interest and behavior. One of the theories that explain autism states that executive functions related to planning, working memory, impulse control, inhibition, and mental flexibility are typically impaired in people with neurodevelopmental disorders involving frontal lobe deficits Such clinical disorders include attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder, Tourette’s syndrome, phenylketonuria, and schizophrenia (Hill, 2004). According to this theory called as executive dysfunction theory, the difficulties in communication and social interaction and, mainly, the restricted patterns of interests and Varanda and Fernandes Psicologia: Reflexão e Crítica (2017) 30:15 behavior could be explained by inadequate ability for planning, deficient working memory abilities, lack of control and impulse inhibition, and insufficient mental flexibility (Ozonoff, Pennington, & Rogers, 1991; Lopez, Lincoln, Ozonoff, & Lai, 2005)

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