Behavioral flexibility in children with autism spectrum disorder and intellectual disability

Children with autism spectrum disorder (ASD) have particular difficulty with behavioral flexibility, but the knowledge base on behavioral flexibility in children with a diagnosis of ASD plus intellectual disability (ID) compared to children with ID only is still scarce. The aim of the present study was to assess behavioral flexibility in 111 children (84 boys) with ASD (87 autistic disorder; 24 PDD-NOS) plus ID (IQ range 10.59-72.67) and compare their scores to those of a control group consisting of 65 children with ID only (42 boys). Their age range was between 2:7 and 9:11 years/months. Behavior flexibility was measured using a Dutch version of the Behavioral Flexibility Rating Scale - Revised (Green et al., 2006; Peters-Scheffer et al., 2008). Results showed that behavioral flexibility in children with ASD plus ID was predicted by autism severity, developmental age, and initiating social interaction. A lack of behavioral flexibility seems to influence emotional and behavioral problems and maternal stress, but not adaptive behavior. (C) 2013 Elsevier Ltd. All rights reserved.