Measuring flexibility in autistic adults: Exploring the factor structure of the flexibility scale self report.
Matthew J Hollocks, Goldie A McQuaid, Benjamin E Yerys and 5 others
PMID 37698531WHAT IT FOUND
The original five-section self-report flexibility questionnaire did not work well for autistic adults.
A revised three-section total score, plus separate social flexibility and generativity scores, worked better and was confirmed in a second sample.
Key findings
01The original five-subscale self-report flexibility scale did not fit the main adult sample adequately.
02A simplified model using Routines and Rituals, Transitions/Change and Special Interests for the flexibility total score fit better and was replicated in an independent adult sample.
03Social Flexibility and Generativity loaded less strongly onto the flexibility total score and were not retained in the simplified total score.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The main sample did not include autistic adults with a co-occurring intellectual disability, so the scale is not validated for that group. The study sampled only from the United States, so the results may not apply to other countries or settings. The study did not test whether scores are stable over time or sensitive to change after intervention. The study did not compare the self-report scale with performance-based flexibility tasks. The revised five-subscale model improved fit but still did not meet the study's fit standards in the main sample. Most autism diagnoses were self-disclosed, and SPARK does not independently confirm diagnoses. The samples were heterogeneous, and the study did not examine how age, gender diversity or education affected the scale structure.
Declared interests
The authors reported no conflicts of interest. The supplied publication types list NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not read this as evidence that flexibility interventions improve outcomes. The study only examined how questionnaire items group together in autistic adults, and it did not test an intervention.