The Challenge Task: The Development of a Group Observational Measure for Flexibility in Children with High-Functioning Autism Spectrum Disorders

Background: Parents, teachers and clinicians of children with high-functioning autism spectrum disorders (ASD) have observed cognitive and behavioral flexibility deficits that inhibit the child's ability to socialize and complete every day tasks in various settings. A recent review of the literature revealed that it is very difficult to capture these observed deficits in laboratory measures (Geurts, Corbett, & Solomon, 2009). To date, a group observational measure that is sensitive to core flexibility difficulties and capable of tracking improvements in children with high-functioning ASD has not been developed. Objectives: Design and pilot test an ecologically-valid observational measure that captures difficulties, strengths and change in flexibility in children with high-functioning ASD. Methods: Eighteen school-aged children with high-functioning ASD participated in the Flexibility Challenge Task at a summer camp program designed to improve social and executive functioning. Subjects participated in two tasks (pre- and post- camp). Each task takes place in a group format of 4-5 children and takes approximately 45-60 minutes to complete. The Flexibility Challenge Task consists of several socially-relevant activities which include games that require shifting an activity or accommodating another person's actions, such as working together to: complete a jigsaw puzzle, draw specified scenes, play charade-like games, and make clay sculptures collaboratively. These activities are designed to elicit difficulties and strengths in cognitive and behavioral flexibility. Activities specifically target initiation, shifting, coping, social reciprocity, generativity, inhibition, and global flexibility. Videos of the Challenge Tasks were coded by an observer who was blind to whether it was a pre- or post- camp task. Reliability observations were then completed with a second coder for 25% of the videotapes. Results: Preliminary analyses of 12 of the 18 subjects revealed significant differences in children's pre- and post- camp scores on paired sample T-tests. Children improved on the following task items: number of guesses in charades (generativity) t(12)=-2.43, p=.039; perseveration (shifting) t(12)=2.53, p=.03; stereotypical behaviors (ASD symptoms) t(12)=2.83, p=.02; negative emotions (affect) t(12)=2.94, p=.01; and global flexibility t(12)=-2.83, p=.02. Inter-rater reliability between video coders was 90%. Final analyses on additional children will be presented. Conclusions: Our preliminary findings suggest that this group observational measure is sensitive to difficulties, strengths and change in flexibility and can be coded reliably. Ultimately, the Flexibility Challenge Task can assist researchers to accurately measure change in core flexibility deficits over time in an ecologically-valid measure. References: Geurts, H.M., Corbett, B., & Solomon, M. (2009),The paradox of cognitive flexibility in autism. Trends in Cognitive Sciences 13(2), 74-82