Journal of Autism and Developmental Disorders

, Volume 47, Issue 8, pp 2502–2518 | Cite as

The Flexibility Scale: Development and Preliminary Validation of a Cognitive Flexibility Measure in Children with Autism Spectrum Disorders

  • John F. StrangEmail author
  • Laura G. Anthony
  • Benjamin E. Yerys
  • Kristina K. Hardy
  • Gregory L. Wallace
  • Anna C. Armour
  • Katerina Dudley
  • Lauren Kenworthy
Original Paper


Flexibility is a key component of executive function, and is related to everyday functioning and adult outcomes. However, existing informant reports do not densely sample cognitive aspects of flexibility; the Flexibility Scale (FS) was developed to address this gap. This study investigates the validity of the FS in 221 youth with ASD and 57 typically developing children. Exploratory factor analysis indicates a five-factor scale: Routines/rituals, transitions/change, special interests, social flexibility, and generativity. The FS demonstrated convergent and divergent validity with comparative domains of function in other measures, save for the Generativity factor. The FS discriminated participants with ASD and controls. Thus, this study suggests the FS may be a viable, comprehensive measure of flexibility in everyday settings.


Autism spectrum disorder Children Executive function Flexibility 



Funding was provided by the Isadore and Bertha Gudelsky Family Foundation (P30H0040677).

Author Contributions

JFS conceived of the study and its design, performed the statistical analyses, interpreted the data and drafted the manuscript; LGA conceived of the study, participated in its design, helped to interpret the statistical analyses, and co-authored the initial item set of the Flexibility Scale; BEY conceived of the study, participated in its design, helped to interpret the statistical analyses, and co-authored the initial item set of the Flexibility Scale; KKH participated in the study design and provided specialized support for factor analytic techniques employed in the study; GLW participated in the study design, helped to interpret the statistical analyses, and co-authored the inital item set of the Flexibility Scale; ACA supported data collection and performed some of the statistical analyses; KD supported recruitment and data collection and performed some of the statistical analyses; LK conceived of the study, participated in its design, helped to interpret the statistical analyses, and co-authored the initial item set of the Flexibility Scale. All authors read and approved the final manuscript.

Compliance with Ethical Standards

Conflict of interest

John F. Strang, Laura G. Anthony, Benjamin E. Yerys, Kristina K. Hardy, Gregory L. Wallace, Anna C. Armour, Katerina Dudley and Lauren Kenworthy declare that they has no conflict of interest.

Ethical Approval

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 all individual participants in the study.


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • John F. Strang
    • 1
    • 2
    • 3
    • 7
    Email author
  • Laura G. Anthony
    • 1
    • 2
    • 3
  • Benjamin E. Yerys
    • 4
    • 5
  • Kristina K. Hardy
    • 2
    • 3
  • Gregory L. Wallace
    • 6
  • Anna C. Armour
    • 1
  • Katerina Dudley
    • 1
  • Lauren Kenworthy
    • 1
    • 2
    • 3
  1. 1.Center for Autism Spectrum DisordersChildren’s National Health SystemWashingtonUSA
  2. 2.Children’s Research InstituteChildren’s National Health SystemWashingtonUSA
  3. 3.Division of Pediatric NeuropsychologyChildren’s National Health SystemWashingtonUSA
  4. 4.Center for Autism ResearchThe Children’s Hospital of PhiladelphiaPhiladelphiaUSA
  5. 5.Department of Psychiatry, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaUSA
  6. 6.Department of Speech and Hearing SciencesThe George Washington UniversityWashingtonUSA
  7. 7.Children’s National Medical CenterRockvilleUSA

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