Assessing Functional Cognition in Autistic Adults: The Weekly Calendar Planning Activity.
Academic Article
Overview
abstract
IMPORTANCE: Autistic adults often experience difficulties with executive functions that affect independent living, education, and employment. The Weekly Calendar Planning Activity (WCPA) is a promising performance-based assessment of functional cognition, but research with autistic adults is limited. OBJECTIVE: To examine patterns of functional cognition in autistic young adults using the WCPA. DESIGN: Cross-sectional between-groups and within-group design. SETTING: Community. PARTICIPANTS: Autistic (n = 55) and neurotypical (n = 32) young adults (ages 18-30) without intellectual disability. OUTCOMES AND MEASURES: We used the Weekly Calendar Planning Activity, adult Level 2, to examine the differences between autistic and neurotypical adults in (1) initial planning time for the activity, (2) rules followed, (3) appointment accuracy, (4) efficiency, (5) types of errors, and (6) strategies used. We also examined the correlation between strategies used and WCPA accuracy of autistic adults. RESULTS: Significant group differences were found in planning time, rules followed, appointment accuracy, efficiency, error types, and strategies used. Among autistic adults, the number of strategies used correlated significantly with WCPA accuracy (r = .42). CONCLUSIONS AND RELEVANCE: Autistic adults experience difficulties in functional cognition, including managing multiple task components, resolving conflicts, managing distractions, and organizing information efficiently. The WCPA has promise as a tool to help guide intervention focused on building self-awareness and strategy use to improve daily functioning. Plain-Language Summary: Autistic young adults often experience difficulties with executive functioning that can make the transition to adult life challenging. Functional cognition, the ability to integrate cognitive skills to manage everyday activity, is essential for independent functioning. However, little is known about how autistic adults perform in real-world tasks that require executive functioning skills. This study used the Weekly Calendar Planning Activity to identify specific areas in which autistic adults may encounter difficulty, such as organizing tasks and managing distractions. These findings can help guide therapists in designing interventions that support autistic adults in developing strategies to improve their daily lives.
