The paradox of cognitive flexibility in autism

Abstract

We present an overview of current literature addressing cognitive flexibility in autism spectrum disorders. Based on recent studies at multiple sites, using diverse methods and participants of different autism subtypes, ages and cognitive levels, no consistent evidence for cognitive flexibility deficits was found. Researchers and clinicians assume that inflexible everyday behaviors in autism are directly related to cognitive flexibility deficits as assessed by clinical and experimental measures. However, there is a large gap between the day-to-day behavioral flexibility and that measured with these cognitive flexibility tasks. To advance the field, experimental measures must evolve to reflect mechanistic models of flexibility deficits. Moreover, ecologically valid measures are required to be able to resolve the paradox between cognitive and behavioral inflexibility.

Figure 1

ID/ED task of the Cambridge Neuropsychological Test Automated Battery (CANTAB^®). The correct choice for each stage is marked with a green box. During the initial ID discrimination stages, the participants learn via trial and error to respond selectively to a specific shape while simultaneously ignoring another shape and lines. When criterion is reached (six correct responses), the next level requires the participant to reverse from a previously rewarded response to a new choice (ID reversal learning). During stages (vi) and (vii) (ID-shift), new shapes and lines are presented, but shape is still the relevant response dimension. The crucial ED-shift occurs at stage (viii), as the correct rule changes to the ‘extra’ dimension as the lines become the relevant response dimension. During stage (xi), the participant must reverse to the previously non-reinforced line (ED-reversal). Reproduced, with permission, from (CANTAB), © Copyright 2008 Cambridge Cognition, Ltd, Cambridge, UK), Ref [33].