Cognitive shifting and externalising problem behaviour in intellectual disability and autism spectrum disorder.
A quick caregiver shifting checklist predicts behaviour problems in teens with ID or ASD better than lab tests or the ASD label.
01Research in Context
What this study did
The team asked caregivers to rate how well teens with mild ID or ASD could shift plans.
They also gave the teens tabletop shifting games.
The goal was to see which measure best predicted later hitting, yelling, or breaking things.
What they found
Caregiver checklists predicted externalising problems.
The lab games did not.
An ASD label by itself also failed to predict behaviour.
How this fits with other research
Leung et al. (2014) already showed that lab flexibility tests rarely separate ASD from typical kids.
Perez et al. (2015) now shows the same tests also fail to flag behaviour risk, backing the earlier warning.
Shire et al. (2022) adds that even within pure ID, shifting skill is mixed—some kids show no switch cost at all.
Together the three papers tell you to skip fancy tasks and trust caregiver reports like the BRIEF Shift scale.
Why it matters
Next time you write an FBA for a student with ID or ASD, add a short caregiver shifting checklist.
It takes five minutes and gives you a clearer picture of behaviour risk than any puzzle game or diagnosis box.
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02At a glance
03Original abstract
BACKGROUND: Behavioural problems are frequently reported in residential care for people with an intellectual disability (ID) in particular when they are additionally diagnosed with autism spectrum disorder (ASD). There are indications that impairment in cognitive shifting may be associated with problem behaviour. The objectives of this study were (1) to examine the relationship of cognitive shifting and severity of ASD symptoms with externalising problem behaviour in individuals with ID, with and without ASD, and (2) to examine whether a diagnosis based on shifting impairment is more predictive of externalising problem behaviour than an ASD diagnosis. METHOD: Participants consisted of adolescents and young adults with mild ID, with and without ASD (n = 41). Pearson intercorrelations were computed to explore the relationship between shifting impairment and severity of ASD symptoms on the one hand and ratings of externalising problem behaviour on the other hand. t-Tests were performed to analyse differences in externalising problem behaviour. RESULTS: Unlike ASD symptom severity, shifting scores were found to be associated with externalising problem behaviour, but only if shifting was measured using rating scales and not when using neuropsychological tasks. Externalising problem behaviour scores significantly differed when groups were classified according to shifting impairment (impaired vs. non-impaired) but not when they were classified according to ID and ASD diagnoses. CONCLUSIONS: It is proposed to use a cognition-based approach when analysing problem behaviour, thus concentrating not so much on ID and ASD diagnosis and their corresponding symptoms, but rather placing the focus on cognitive symptoms.
Journal of intellectual disability research : JIDR, 2015 · doi:10.1111/jir.12182