Improvements in Block Design Task Following Flexibility Intervention Related to Increased Time Spent on Items

Friday, May 15, 2015: 5:30 PM-7:00 PM
Imperial Ballroom (Grand America Hotel)
C. Luong-Tran1, L. G. Anthony2, M. Wills3, J. Sokoloff3, K. M. Dudley2, A. C. Armour2, Y. Granader2, J. F. Strang2, M. A. Werner4, J. L. Martucci2, L. Mohamed5, C. Haake6 and L. Kenworthy7, (1)Children's National Medical Center, Rockville, MD, (2)Center for Autism Spectrum Disorders, Children's National Medical Center, Rockville, MD, (3)CNMC, Rockville, MD, (4)Model Asperger Program, Ivymount School, Rockville, MD, (5)Children's National Health System, Rockville, MD, (6)Department of Neuropsychology, Children's National Medical Center, Rockville, MD, (7)Children’s Research Institute, Children's National Medical Center, Washington, DC
Background:   Children with ASD have cognitive flexibility deficits that interfere with their ability to utilize a variety of problem-solving strategies.  Participants who received Unstuck and On Target!, an executive function curriculum, in Kenworthy et al.’s 2013 comparative effectiveness trial demonstrated significant improvements on a block design task between pre and post intervention when compared to those who received a social skills intervention (and made no improvement on the task). Even though these results were striking, it was not clear if the improvements related to quicker processing, less impulsivity (i.e., slower processing), or fewer incorrect answers.

Objectives:   This study investigates differences in pre-intervention and post-intervention performances on the Block Design task in order to understand the mechanisms underlying the observed changes.

Methods:   67 children (age M=9.52, SD=1.02) with ASD and IQ>70 (M=108.45, SD=18.01) were evaluated at pre and post intervention using the Block Design subtest of the Wechsler Abbreviated Scale of Intelligence (WASI). WASIs were administered by trained research assistants. The Block Design subtest is a measure of speeded problem solving, and has been used as an executive functioning measure is other studies.

Results:   A paired-samples t-test demonstrated significant improvements in pre to post-intervention t-scores on the block design (BD) task.  Pearson chi square identified item-level improvements between pre- and post- on items 7 & 8 of BD, X2 (1, N = 118) = 4.735, p <.05 and X2 (1, N = 105) = 3.464, p <.05, respectively. Paired samples t-tests indicated that relative to pre-testing, participants spent significantly more time on four BD items (items 3, 4, 5 & 10) at post-testing (t’s(55)=2.109-3.187, p’s<.05).

Conclusions:   Improvements in BD scores at post-intervention related to improvements in task accuracy and increased time spent on items.  Increased time spent on BD items may be an indicator of decreased impulsivity and/or increased use of varying strategies for problem solving, an indicator of cognitive flexibility.