background In an earlier study published in this journal (Berger e.a. 2002) it was shown that the cognitive styles 'weak central coherence' and 'poor cognitive shifting' are common in autism spectrum disorders, but tests have revealed that the styles do not apply to every member of the patient group. This finding could have consequences for the course of treatment.
aim To find out if the cognitive styles of autistic patients can predict whether their social functioning will improve after three years of treatment we conducted a follow-up study in which we examined 44 non-retarded adolescents with an autism spectrum disorder who were receiving residential treatment.
method On the basis of factor scores awarded in an extensive battery of neuropsychological tests, we formed subgroups of patients with weak versus strong central coherence and cognitive shifting. Then analyses of variance were used to discover whether the subgroups were predictors of changes in three aspects of social functioning: autistic symptoms, social intelligence and social competence.
results We found a small but significant gain in all the social domains. However, there were clear individual differences in the degree of improvement. Cognitive shifting was found to be a predictor of a clinically meaningful improvement in social competence.
conclusion The correlation found between cognitive shifting and social competence indicates that patients with an autism spectrum disorder should be given different forms of treatment that take differences in cognitive style into account.