Planning Skills in Autism Spectrum Disorder Across the Lifespan: A Meta-analysis and Meta-regression.
Linda M E Olde Dubbelink, Hilde M Geurts
PMID 28160225WHAT IT FOUND
People with autism spectrum disorder performed worse on planning tasks than typically developing people, across 50 studies.
The difficulty did not vary clearly by age, task format, or intelligence. Missing studies may mean the gap is smaller.
Key findings
01The review searched databases in 2015 and included 50 studies, with 1755 participants with ASD and 1642 TD comparison participants, covering childhood, adolescent, and adult samples.
02People with ASD performed worse on planning tasks than typically developing people; the pooled difference was 0.52, classified as medium, but studies varied widely.
03Publication bias was suggested, and including 11 missing studies would reduce the pooled difference to 0.37; 3401 null findings would be needed to nullify the overall effect.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The review had publication bias: some studies with smaller or opposite differences may be missing, and the adjusted difference was smaller. There was large unexplained variation between studies, so the average difference does not describe every study or every person. Most included studies assessed people within the normal intelligence range, so the findings may not apply to autistic people with lower IQ. Few studies included middle-aged and older adults, so lifespan conclusions are limited. The review could not test ASD symptom severity, comorbid psychiatric disorders, or medication use as possible explanations. Planning was measured with experimental or clinical neuropsychological tasks, not everyday planning in real life.
Declared interests
The paper names Dr. Leo Kannerhuis as funder. It does not state whether the funder designed the study or wrote the manuscript.
The easy way to misread this
Do not conclude that planning deficits in autism are uniformly large or that every autistic person needs support for planning. The average difference was moderate, studies varied widely, and some studies with smaller or opposite differences may be missing.