Brief Report: Role of Parent-Reported Executive Functioning and Anxiety in Insistence on Sameness in Individuals with Germline PTEN Mutations.
Mirko Uljarević, Thomas W Frazier, Gaëlle Rached and 7 others
PMID 33595755WHAT IT FOUND
Parent-reported executive function difficulties, particularly with shifting attention, and anxiety are strongly linked to insistence on sameness in individuals with PTEN mutations, ASD, and macrocephaly.
Set-shifting was the unique independent predictor, suggesting it as a key target for intervention.
Key findings
01Insistence on sameness scores were significantly associated with parent-reported anxiety and executive function difficulties (inhibitory control, set-shifting, and working memory).
02In the final regression model, parent-reported set-shifting difficulties were the unique independent predictor of insistence on sameness, accounting for a significant portion of the variance.
03The relationship between insistence on sameness and these factors did not significantly differ between individuals with PTEN mutations and ASD, ASD with macrocephaly, or PTEN mutations without ASD.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
The study relied entirely on parent-report measures for both the outcome (insistence on sameness) and the predictors (anxiety and executive function), which may inflate the observed associations due to common-method variance. The sample size was small, particularly within the individual diagnostic subgroups, and the cross-sectional design prevents any conclusions about causality. The authors explicitly state that the data should be treated as preliminary. The groups differed significantly in age and IQ, which may complicate direct comparisons, although the regression models controlled for IQ.
Declared interests
The paper does not report any conflicts of interest or funding sources in the provided text.
The easy way to misread this
Do not interpret the association between executive function difficulties and insistence on sameness as evidence that targeting set-shifting will reduce this behaviour. The study is cross-sectional and relies on parent-report, so it identifies a correlation but does not prove that improving set-shifting will change insistence on sameness.