Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Nov;16(11):2208-2219.
doi: 10.1002/aur.3025. Epub 2023 Sep 12.

Measuring flexibility in autistic adults: Exploring the factor structure of the flexibility scale self report

Matthew J Hollocks  1 , Goldie A McQuaid  2 , Benjamin E Yerys  3   4 , John F Strang  5 , Laura G Anthony  6 , Lauren Kenworthy  7   8 , Nancy R Lee  9 , Gregory L Wallace  10
Affiliations

Measuring flexibility in autistic adults: Exploring the factor structure of the flexibility scale self report

Matthew J Hollocks et al. Autism Res. 2023 Nov.

Abstract

Cognitive flexibility differences are common for autistic individuals and have an impact on a range of clinical outcomes. However, there is currently a lack of well validated measurement tools to assess flexibility in adulthood. The Flexibility Scale was originally designed as a parent-report measure of real-world flexibility challenges in youth. The original Flexibility Scale provides a total score and five subscales: Routines and Rituals, Transitions and Change, Special Interests, Social Flexibility, and Generativity. In this study, we evaluate the factorial validity of the Flexibility Scale as a self-report (Flexibility Scale Self Report) measure of cognitive flexibility, adapted from the original Flexibility Scale, for use by autistic adults. This study includes both a primary sample (n = 813; mean age = 40.3; 59% female) and an independently recruited replication sample (n = 120; mean age = 32.8; 74% female) of individuals who completed the Flexibility Scale Self Report. The analysis consisted of an initial confirmatory factor analysis (CFA) of the original Flexibility Scale structure, followed by exploratory factor analysis (EFA) and factor optimization within a structural equation modeling framework to identify the optimal structure for the questionnaire in adults. The identified structure was then replicated through CFA in the replication sample. Our results indicate an alternative optimal scale structure from the original Flexibility Scale, which includes fewer items, and only three (Routines/Rituals, Transitions and Change, Special Interests) of the five subscales contributing to the flexibility total score. Comparisons revealed no structural differences within the scale based on sex assigned at birth. Here the Generativity and Social Flexibility scales are treated as independent but related scales. The implications for measurement of cognitive flexibility in clinical and research settings, as well as theoretical underpinnings are discussed.

Keywords: adults; autism; executive functions; factor analysis; measurement; neuropsychology; questionnaire.

PubMed Disclaimer

Conflict of interest statement

CONFLICT OF INTEREST STATEMENT

No conflicts of interest are report.

Figures

FIGURE 1
FIGURE 1
Proportion of FS item responses in the Primary (a) and Replication study (b) samples. Asterisks indicate items that are part of the original FS but were removed from the adult self-report FS. Responses: 0 = No or not true; 1 = Somewhat or sometimes true; 2 = Very much or often true, 3 = Almost always or always true. *Indicates items that were dropped from the scale prior to PCA.
FIGURE 2
FIGURE 2
Scree plot showing inflection points for number of principal components in the primary sample.
FIGURE 3
FIGURE 3
Confirmatory factor analyses for the five-factor flexibility total score in the primary sample.
FIGURE 4
FIGURE 4
Optimal three-factor flexibility total score with Social Flexibility and Generativity as independent indices in the primary sample.
See this image and copyright information in PMC

References

    1. Berry AS, Shah VD, Baker SL, Vogel JW, O’Neil JP, Janabi M, Schwimmer HD, Marks SM, & Jagust WJ (2016). Aging affects dopaminergic neural mechanisms of cognitive flexibility. The Journal of Neuroscience, 36(50), 12559–12569. 10.1523/JNEUROSCI.0626-16.2016 - DOI - PMC - PubMed
    1. Bertollo JR, Strang JF, Anthony LG, Kenworthy L, Wallace GL, & Yerys BE (2020). Adaptive behavior in youth with autism spectrum disorder: The role of flexibility. Journal of Autism and Developmental Disorders, 50(1), 42–50. 10.1007/s10803-019-04220-9 - DOI - PubMed
    1. Carter Leno V, Wright N, Pickles A, Bedford R, Zaidman-Zait A, Kerns C, Mirenda P, Zwaigenbaum L, Duku E, Bennett T, Georgiades S, Smith I, Vaillancourt T, Szatmari P, & Elsabbagh M (2022). Exposure to family stressful life events in autistic children: Longitudinal associations with mental health and the moderating role of cognitive flexibility. Autism, 26(7), 1656–1667. 10.1177/13623613211061932 - DOI - PMC - PubMed
    1. Dajani DR, & Uddin LQ (2015). Demystifying cognitive flexibility: Implications for clinical and developmental neuroscience. Trends in Neurosciences, 38(9), 571–578. 10.1016/j.tins.2015.07.003 - DOI - PMC - PubMed
    1. Davids RC, Groen Y, Berg IJ, Tucha OM, & van Balkom ID (2016). Executive functions in older adults with autism spectrum disorder: Objective performance and subjective complaints. Journal of Autism and Developmental Disorders, 46, 2859–2873. - PubMed

Publication types