Heterogeneity and temporal variability of neuropsychological profiles in children and adolescents with ASD: a case series analysis

Context and relevance. Autism spectrum disorder (ASD) is marked by significant neuropsychological heterogeneity; however, traditional diagnostic approaches often overlook both inter-individual diversity and intra-individual variability in cognitive functioning. This may lead to underestimation of potential and inappropriate intervention strategies. Objective. The study aimed to identify manifestations of heterogeneity and transitoriness in neuropsychological profiles among children and adolescents with ASD in the context of development, sensory load, and adolescent regression, in order to inform the selection of flexible intervention and support strategies. Hypothesis. We hypothesized that cognitive functions in ASD are not static but exhibit dynamic variability dependent on bio-psycho-social factors. Methods and materials. The research is based on three clinical cases of children and adolescents (aged 8–14) with confirmed ASD diagnoses. Luria’s syndrome analysis and dynamic assessment methods were employed; each participant underwent at least two comprehensive neuropsychological evaluations spaced 5 months to 2 years apart. Results. Pronounced transitoriness was observed in all cases: fluctuations in working memory, cognitive flexibility, and self-control depending on anxiety levels, sensory overload, and hormonal changes. Heterogeneity was evident in unique patterns of strengths and weaknesses for each participant. Conclusions. Findings support the need to move away from single-point diagnostics toward repeated, context-sensitive assessments and personalized intervention strategies that account for the dynamic nature of functional brain systems underlying regulatory, mnestic, and gnostic processes in children and adolescents with ASD.

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