Developing set-shifting improvement tasks (SSIT) for children with high-functioning autism.

BACKGROUND

Children with autism spectrum disorder (ASD) experience set-shifting deficit as a part of executive function, which can lead to cognitive and behavioural flexibility deficits and/or restricted behaviours. Despite the increasing body of research on this cognitive deficit, set-shifting training has not been exclusively studied in ASD.

AIMS

In this study, a training condition [set-shifting improvement tasks (SSIT)] was developed to improve set-shifting ability; afterwards, the possible effects of these tasks were investigated.

METHODS AND PROCEDURES

With the aim of improving set-shifting ability in children with autism, a training program (SSIT), involving a computer game (Tatka, a puzzle game produced by our research team) with some home-based tasks (for generalisation purposes), was developed. Then, in a quasi-experimental design, the effects of SSIT tasks were studied on children (n = 13, 5-7 years old) with high-functioning autism. Outcome measures (pre-training, post-training and a 6-week follow-up) were assessed using Modified Wisconsin Card Sorting Test, Bender-Gestalt Test and Behavioural Flexibility Rating Scale.

RESULTS AND OUTCOMES

A significant change was observed in both cognitive (Bender Gestalt, ; WCST; ) and behavioural flexibilities ( ) and also in repetitive behaviours ( ). Furthermore, the result remained stable to some extent for about 1 month after the training condition.

CONCLUSIONS AND IMPLICATIONS

Developing the SSIT is just an initial step in the major target of creating cognitive rehabilitation tools to be used by clinicians and parents for children diagnosed with ASD and should be understood as a supplement, rather than an alternative, to the main treatments such as applied behaviour analysis. Future research with larger samples are needed to confirm whether this intervention is effective for children with ASD.