Comparative Analysis of Cognitive Flexibility in Autism and ADHD Adolescents

Thesis Abstract

Cognitive flexibility, a core component of executive functioning, influences adaptive behavior and problem-solving capabilities in adolescents with neurodevelopmental disorders, yet comparative analyses between autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) remain limited. This study aims to examine and compare the levels of cognitive flexibility among adolescents diagnosed with ASD and ADHD, with the overarching goal of identifying distinctive cognitive profiles that may inform tailored interventions. The specific objectives include (1) to quantify and compare cognitive flexibility in adolescents with ASD and ADHD using standardized assessment tools; (2) to explore the relationship between cognitive flexibility and executive functioning components within each group; and (3) to investigate demographic and clinical correlates that may influence cognitive flexibility in these populations. The research adopts a cross-sectional comparative design grounded in the theoretical frameworks of the Executive Function Model (Davidson and Hilko, 2010) and the Cognitive Flexibility Theory (Tversky & Kahneman, 1981), positing that differences in flexibility manifest from divergent underlying neurocognitive mechanisms. The study population comprises 120 adolescents aged 12-18 years, equally divided into four groups 30 with diagnosed ASD, 30 with diagnosed ADHD, 30 age- and gender-matched typically developing controls, and 30 with comorbid conditions as a secondary control. Participants are recruited from pediatric neurodevelopmental clinics and special education centers in metropolitan areas. A stratified random sampling technique ensures representative sampling within each subgroup. Data collection employs the Wisconsin Card Sorting Test (WCST) and the Tower of London (TOL) test to evaluate cognitive flexibility and planning, alongside parent-report questionnaires—such as the Behavior Rating Inventory of Executive Function (BRIEF)—to assess externalized executive functions. Validity and reliability of instruments are confirmed through pilot testing and internal consistency measures (Cronbach’s alpha > 0.80). Data are analyzed utilizing Analysis of Variance (ANOVA) to detect significant differences in cognitive flexibility scores across groups, supplemented by post hoc Tukey tests for multiple comparisons. Multiple regression analyses explore predictive relationships between demographic variables, clinical severity, and cognitive flexibility within each diagnostic group. The potential influence of comorbidities is examined through subgroup analyses. It is hypothesized that adolescents with ASD will display significantly lower cognitive flexibility compared to their ADHD counterparts, driven by distinct neurocognitive profiles as suggested by the Executive Function Model; additionally, both clinical groups are expected to perform less flexibly than typically developing peers, with variations attributable to severity and co-occurring conditions. Expected findings include statistically significant disparities in WCST and TOL performance between ASD and ADHD groups, with the ASD group exhibiting more perseverative responses and difficulties in set-shifting tasks. Insights from the regression models are anticipated to reveal that symptom severity and executive dysfunction measures account for substantial variance in cognitive flexibility scores. This research contributes to the body of knowledge by delineating the cognitive profiles of adolescents with ASD and ADHD, thereby enhancing understanding of disorder-specific executive functioning patterns. The study concludes that tailored interventions targeting cognitive flexibility should consider diagnostically nuanced approaches, emphasizing neurocognitive differences elucidated by this comparative analysis. Recommendations include integrating flexibility training into behavioral therapy protocols and employing neuropsychological assessments for precise intervention planning. Future research avenues involve longitudinal studies to track developmental trajectories of cognitive flexibility and intervention efficacy across neurodevelopmental disorders, thereby advancing personalized therapeutic strategies.