Cognitive Flexibility in Autism - גמישות מחשבתית בקרב אוטיסטים

גמישות מחשבתית בקרב אוטיסטים - למאמר בעברית

What is Cognitive Flexibility?

Cognitive flexibility is part of the executive functions. It refers to the ability to “shift gears” in our thinking and behavior, move between rules, tasks, or different points of view, and adapt ourselves to changes in the environment.

It is the ability to set aside a familiar habit and try a new approach, for example, when rules in a game change, or when something in the daily routine does not go as expected.

Difficulties with cognitive flexibility in autism may appear as challenges with changes in routine, strict adherence to rules, or difficulty shifting from one task to another.

Among autistic individuals, difficulties in cognitive flexibility have been linked to increased social difficulties, higher levels of restricted and repetitive behaviors, and the presence of co-occurring symptoms such as anxiety and low mood.

In addition, growing evidence suggests that cognitive flexibility plays a central role in various functional outcomes, including academic achievement, adaptive behavior, and overall quality of life.

A recent and comprehensive meta-analysis (2024), in which the researchers aggregated dozens of studies including hundreds of autistic participants and age and IQ matched comparison groups, found that autistic children, adolescents, and adults show greater difficulties in cognitive flexibility compared to non-autistic groups, and that this gap appears consistently across studies and tasks.

Importantly, the gap remained even after controlling for factors such as IQ. In other words, difficulties in cognitive flexibility among autistic children are not solely explained by intellectual ability, but may be more strongly related to core characteristics of autism.

Cognitive Flexibility in Autism – Examples

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Daily routines and changes

• A strong need for predictable routines: even small, unexpected changes (a different route to school, a schedule change) may lead to intense distress or a meltdown.

• Difficulty transitioning from a preferred activity to a new one (for example, moving from screen time to dinner), sometimes leading to outbursts or lengthy negotiations, not due to stubbornness, but because the mental shift is hard.

  
  

Thinking style and problem-solving

• “All or nothing” or very literal thinking, such as rigid rules about what is right or wrong, and difficulty considering grey areas or alternative solutions.

• Getting “stuck” on a single way of playing or completing a task, and struggling to try a new strategy even when the first approach isn’t working (for example, insisting on arranging toys in one precise pattern every time).

  
  

Interests, focus, and attention

• Very intense focus on specific interests and difficulty shifting conversation or play away from the topic, even when others try to change it.

• Over-focus on details (parts of objects) and difficulty seeing the bigger picture, which makes it hard to shift attention flexibly between different aspects of a situation.

  
  

Social communication and play

• Sticking to one script in conversations (repeating the same questions, stories, or jokes) and difficulty adjusting language to different people or contexts.

• Repetitive and less varied play (repeating the same scene, game rules, or sequence of actions) and difficulty engaging in imaginative play that changes rapidly.

  
  

Emotions and coping

• Increased stress when sudden changes occur, because it is difficult to update expectations quickly and form a new plan.

• Using the same coping strategy repeatedly (for example, leaving the room or repeating a phrase) and difficulty finding alternative ways to self-soothe or resolve interpersonal conflicts.

  
  

  These patterns relate to a different cognitive style, not to a lack of intelligence or motivation, and many autistic people can become more flexible with explicit support, preparation for change, and practice in safe and predictable contexts.

Does Cognitive Flexibility Improve With Age in Autism?

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A recent 2025 study examined cognitive flexibility in autistic adults aged 18-45, and compared them to adults who are not autistic.

The study included 263 adults who completed a rule-switching task: each trial required them to respond according to a different rule, sometimes based on a letter and sometimes based on a number that appeared together on the screen.

The predictability of the rule-switch varied between unexpected, partially expected, and highly expected conditions, without participants being aware of this manipulation.

Researchers measured reaction time and accuracy.

The findings showed that when the task became more predictable, all participants, autistic and non-autistic, responded faster and with higher accuracy.

However, the gap in reaction time between autistic and non-autistic adults actually increased under the highly predictable condition.

This suggests that autistic individuals tend to rely less on “predicting ahead” and more on processing information moment by moment.

Gender differences were also observed: within the autistic group, women tended to be more accurate than men, whereas in the non-autistic group men were more accurate than women.

The task did indeed measure cognitive flexibility, as switching between rules slowed response times and reduced accuracy, which is an expected outcome in tasks of this type.

Overall, the findings strengthen the understanding that autistic people have a different processing style, particularly in structured and predictable contexts, and that difficulties in cognitive flexibility may persist into adulthood if not supported through appropriate intervention and guidance.

What can parents take away about cognitive flexibility in autism?

גמישות מחשבתית בקרב אוטיסטים - למאמר בעברית

• The findings do not suggest that something is “wrong” with the child, but rather describe a different style of information processing, with relatively greater difficulty in handling changes and shifting between rules.

  
  

• At the same time, many autistic individuals show strengths in areas such as accuracy, systematic thinking, and stability in routine, strengths that can be used to gradually teach more flexible ways of thinking and acting.

  
  

• Order, repetition, and routine can indeed help, yet even within a structured framework a child may respond differently than others. The reason is that they rely less on predicting what will happen next, and more on examining each situation anew, even if it is familiar and expected.

  This finding also has a deep emotional meaning: the need to reevaluate every situation reflects an inner experience of restlessness.

  For the individual, the unexpected is always present in the background, even within a known routine, which creates ongoing strain.

  Therefore, a task that seems to us like something the child “already knows by heart” may still feel stressful for them each time. Stress levels do not decrease automatically, and emotional effort is required again and again.

  
  

• It is also important to remember that there are differences between autistic boys and girls. Autistic girls may appear more flexible or better adjusted, while still exerting tremendous internal effort; therefore, it is crucial not to minimize their difficulties just because they function well outwardly. This aligns with the phenomenon of masking and the different presentation of autism in girls.

  
  

• For parents, understanding that the autistic brain works differently, not less effectively, can reduce guilt and pressure at home and help adjust expectations and support for their child.

  
  

Tips for practicing cognitive flexibility in autism

גמישות מחשבתית בקרב אוטיסטים - למאמר בעברית

• First, it should be noted that a tendency toward cognitive rigidity can also be an advantage in certain situations. for example, in tasks that require increased alertness to changes within predictable and routine contexts.

  For instance, in aerial photo interpretation, one must detect changes relative to a standard pattern, or in programming work where errors in code must be identified.

  
  

• Second, it is best to avoid impatient or angry responses such as “You’ve done this a hundred times already.” These will not help and will only increase stress levels.

  
  

• It is recommended to aim for tailored interventions such as preparing in advance for changes in routine, using visual cues, practicing graded transitions and rule changes within a safe and supportive environment.

  
  

• Start with events that are as predictable as possible and introduce one small change at a time. Praise effort in trying to make a change, even if the execution is not perfect.

  “I saw that it was hard for you, and you still tried to handle the change.”

  This builds resilience, not just compliance.

  
  

• Practice flexibility through play, games with changing rules, rotating roles, or open-ended endings.

  For example, asking “What else could happen now?” allows for natural, non-threatening practice.

  
  

  It is possible to reduce stress and make the environment more accessible and supportive for autistic individuals!

  
  

References:

Lacroix, A., Torija, E., Logemann, A., Baciu, M., Cserjesi, R., Dutheil, F., ... & Mermillod, M. (2025). Cognitive flexibility in autism: How task predictability and sex influence performances. Autism Research, 18(2), 281-294.‏   https://doi.org/10.1002/aur.3281

Lage, C., Smith, E. S., & Lawson, R. P. (2024). A meta-analysis of cognitive flexibility in autism spectrum disorder. Neuroscience & Biobehavioral Reviews, 157, 105511.‏ https://doi.org/10.1016/j.neubiorev.2023.105511

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