title: Cognitive shifting and externalising problem behaviour in intellectual disability and autism spectrum disorder.
abstract: BACKGROUND
  Behavioural problems are frequently reported in residential care for people with an intellectual disability (ID) in particular when they are additionally diagnosed with autism spectrum disorder (ASD). There are indications that impairment in cognitive shifting may be associated with problem behaviour. The objectives of this study were (1) to examine the relationship of cognitive shifting and severity of ASD symptoms with externalising problem behaviour in individuals with ID, with and without ASD, and (2) to examine whether a diagnosis based on shifting impairment is more predictive of externalising problem behaviour than an ASD diagnosis.
  
  
  METHODS
  Participants consisted of adolescents and young adults with mild ID, with and without ASD (n = 41). Pearson intercorrelations were computed to explore the relationship between shifting impairment and severity of ASD symptoms on the one hand and ratings of externalising problem behaviour on the other hand. t-Tests were performed to analyse differences in externalising problem behaviour.
  
  
  RESULTS
  Unlike ASD symptom severity, shifting scores were found to be associated with externalising problem behaviour, but only if shifting was measured using rating scales and not when using neuropsychological tasks. Externalising problem behaviour scores significantly differed when groups were classified according to shifting impairment (impaired vs. non-impaired) but not when they were classified according to ID and ASD diagnoses.
  
  
  CONCLUSIONS
  It is proposed to use a cognition-based approach when analysing problem behaviour, thus concentrating not so much on ID and ASD diagnosis and their corresponding symptoms, but rather placing the focus on cognitive symptoms.
authors.affiliation: Department of Medical Psychology, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: E M
authors.initials: EM
authors.lastname: Visser
authors.affiliation: Department of Medical Psychology, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: H J C
authors.initials: HJ
authors.lastname: Berger
authors.affiliation: Department of Primary and Community Health Care, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: H M J
authors.initials: HM
authors.lastname: Van Schrojenstein Lantman-De Valk
authors.affiliation: Department of Medical Psychology, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: J B
authors.initials: JB
authors.lastname: Prins
authors.affiliation: Department of Medical Psychology, Radboud University Medical Centre, Nijmegen, The Netherlands.|Department of Research and Development, Doorwerth, Dr Leo Kannerhuis, Centre for Autism, Doorwerth, The Netherlands.|Research Group Autism through the Lifespan, HAN University of Applied Sciences, Nijmegen, The Netherlands.
authors.forename: J P
authors.initials: JP
authors.lastname: Teunisse
mesh_terms: D000293:Adolescent; D000328:Adult; D000067877:Autism Spectrum Disorder / Q000150:complications / Q000503:physiopathology* / Q000523:psychology*; D003071:Cognition / Q000502:physiology*; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000150:complications / Q000503:physiopathology* / Q000523:psychology*; D007389:Internal-External Control; D008297:Male; D000066553:Problem Behavior / Q000523:psychology*; D012720:Severity of Illness Index; D055815:Young Adult
keywords: autism; cognitive shifting; externalising problem behaviour; intellectual disability