Adaptive Behavior in Youth with Autism Spectrum Disorder: The Role of Flexibility

  • Jennifer R. BertolloEmail author
  • John F. Strang
  • Laura G. Anthony
  • Lauren Kenworthy
  • Gregory L. Wallace
  • Benjamin E. Yerys
Original Paper


Cognitive and behavioral flexibility are important predictors of adaptive behavior in school-age autistic youth. While prior research has utilized broad measures of flexibility, the current study uses the multi-dimensional Flexibility Scale-Revised to examine which specific flexibility skills relate to adaptive functioning. Through parent-report measures on 216 autistic youth, flexibility explained 22.2% of variance in adaptive socialization skills (p < 0.001). Specifically, Social Flexibility accounted for significant variance in adaptive socialization skills, while Transitions/Change approached significance. In exploratory analyses, flexibility explained 11.5% of variance in Communication skills (p < 0.001). This pattern remained after controlling for co-occurring ADHD symptoms. The current study helps to refine the relationship between flexibility and adaptive behavior, which may ultimately help to inform more targeted interventions.


Executive function Flexibility Adaptive behavior Autism spectrum disorder 



We would like to thank the children and caregivers who participated in our study. We would also like to acknowledge our funding sources: Isadore and Bertha Gudelsky Family Foundation (Grant No. P30H0040677), National Institute for Health (K23MH086111, PI: B.E. Yerys; R21MH092615, PI: B.E. Yerys; RC1MH088791, PI: R.T. Schultz; P30HD026979, PI: M. Robinson and R.T. Schultz), Pennsylvania State Department of Health (SAP #4100042728, PI: R.T. Schultz;, SAP # 4100047863, PI: R.T. Schultz), Philadelphia Foundation (PI: B.E. Yerys), Robert Wood Johnson Foundation (#6672, PI: R.T. Schultz).

Author Contributions

JRB and BEY contributed to the study conception and design. Data collection was completed by BEY, JFS, LGA, and LK. Data analyses were performed by JRB. The first draft of the manuscript was written by JRB and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Compliance with Ethical Standards

Conflict of interest

Lauren Kenworthy receives royalties from the Behavior Rating Inventory of Executive Function, Second Edition (BRIEF-2). No other authors have conflicts of interest that are relevant to this manuscript.

Research Involving Human Participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from the parent of each individual participant included in the study.

Supplementary material

10803_2019_4220_MOESM1_ESM.docx (77 kb)
Supplementary material 1 (DOCX 76 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Jennifer R. Bertollo
    • 1
    • 2
    Email author
  • John F. Strang
    • 3
  • Laura G. Anthony
    • 3
    • 4
    • 5
  • Lauren Kenworthy
    • 3
  • Gregory L. Wallace
    • 6
  • Benjamin E. Yerys
    • 2
  1. 1.Virginia TechDepartment of PsychologyBlacksburgUSA
  2. 2.Children’s Hospital of Philadelphia, Center for Autism ResearchPhiladelphiaUSA
  3. 3.Center for Autism Spectrum Disorders, Children’s National Health SystemWashingtonUSA
  4. 4.Department of PsychiatryUniversity of Colorado School of MedicineAuroraUSA
  5. 5.Children’s Hospital of Colorado Pediatric Mental Health InstituteAuroraUSA
  6. 6.Department of Speech, Language, and Hearing SciencesThe George Washington UniversityWashingtonUSA

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