Department of Child & Adolescent Psychiatry, King's College London, London, UK.
Department of Psychology, George Mason University, Fairfax, Virginia, USA.
Autism Res. 2023 Nov;16(11):2208-2219. doi: 10.1002/aur.3025. Epub 2023 Sep 12.
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.
认知灵活性差异在自闭症个体中很常见，并且会对一系列临床结果产生影响。然而，目前缺乏经过充分验证的测量工具来评估成年人的灵活性。灵活性量表最初是作为一种评估青少年现实世界灵活性挑战的父母报告测量工具而设计的。原始的灵活性量表提供了一个总分和五个分量表：常规和仪式、过渡和变化、特殊兴趣、社交灵活性和创造力。在这项研究中，我们评估了从原始灵活性量表改编而来的，用于自闭症成年人的自我报告（灵活性量表自我报告）测量认知灵活性的灵活性量表的因子有效性。这项研究包括一个主要样本（n=813；平均年龄=40.3；59%为女性）和一个独立招募的复制样本（n=120；平均年龄=32.8；74%为女性），他们都完成了灵活性量表自我报告。分析包括对原始灵活性量表结构的初始验证性因子分析（CFA），然后是探索性因子分析（EFA）和结构方程建模框架内的因子优化，以确定该问卷在成年人中的最佳结构。然后在复制样本中通过 CFA 对识别出的结构进行复制。我们的结果表明，与原始灵活性量表相比，存在一种替代的最佳量表结构，该结构包含更少的项目，并且只有五个分量表中的三个（常规/仪式、过渡和变化、特殊兴趣）对灵活性总分有贡献。比较表明，基于出生时指定的性别，该量表在结构上没有差异。在这里，创造力和社交灵活性量表被视为独立但相关的量表。讨论了在临床和研究环境中测量认知灵活性的意义，以及理论基础。
