Prototype abstraction predicts response to flexibility intervention in autistic youth
- 1Georgetown University
Abstract
Generalization is a key cognitive process that allows humans to flexibly apply prior knowledge to guide new behaviors. Difficulties with generalization and flexibility are observed across neurodevelopmental disorders, especially autism, limiting adaptive function and quality of life. Cognitive-behavioral treatment benefits some but not all autistic individuals. As treatment requires application of learned skills to everyday life, variability in generalization ability may limit intervention success in autism. While cognitive substrates of learning and generalization are well established, their potential for explaining clinical outcomes is not known. Here, we combined a category learning task with computational modelling to distinguish two learning strategies underlying generalization - prototype abstraction vs. exemplar memorization - and tested whether individual differences in these learning strategies predicted real-world intervention outcomes in autistic youth. Fifty-four participants completed the category learning task at two pre-intervention timepoints, and then completed Unstuck and On Target:14-22 intervention targeting flexible problem solving, goal setting, and planning. We found that participants who consistently relied on prototype abstraction (N=26) were subsequently more likely to benefit from the intervention, showing improvement in parent- and self-reported flexibility. These findings identify prototype abstraction as a clinically relevant cognitive capacity that may help explain individual differences in intervention response and support the tailoring of interventions. More broadly, they demonstrate the value of linking basic cognitive mechanisms to clinical outcomes and may inform strategies to enhance the effectiveness of cognitive-behavioral interventions for youth with developmental disabilities.
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BibTeX
@misc{chen2026prototype,
title = {{Prototype abstraction predicts response to flexibility intervention in autistic youth}},
author = {Y. Chen and H. Puckett and G. Clarot and B. Hawkins and K. Sharp and D. A. Todd and A. Lopez and J. R. Bertollo and H. E. Behar and D. Zeithamova and H. Xie and A. Verbalis and A. S. VanMeter and W. D. Gaillard and L. Kenworthy and C. J. Vaidya},
howpublished = {medRxiv},
year = {2026},
month = sep,
doi = {10.64898/2026.09.01.26361990},
url = {https://www.medrxiv.org/content/10.64898/2026.09.01.26361990v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Prototype abstraction predicts response to flexibility intervention in autistic youth
AU - Y. Chen
AU - H. Puckett
AU - G. Clarot
AU - B. Hawkins
AU - K. Sharp
AU - D. A. Todd
AU - A. Lopez
AU - J. R. Bertollo
AU - H. E. Behar
AU - D. Zeithamova
AU - H. Xie
AU - A. Verbalis
AU - A. S. VanMeter
AU - W. D. Gaillard
AU - L. Kenworthy
AU - C. J. Vaidya
PY - 2026
DA - 2026/09/01
PB - medRxiv
DO - 10.64898/2026.09.01.26361990
UR - https://www.medrxiv.org/content/10.64898/2026.09.01.26361990v1
AB - Generalization is a key cognitive process that allows humans to flexibly apply prior knowledge to guide new behaviors. Difficulties with generalization and flexibility are observed across neurodevelopmental disorders, especially autism, limiting adaptive function and quality of life. Cognitive-behavioral treatment benefits some but not all autistic individuals. As treatment requires application of learned skills to everyday life, variability in generalization ability may limit intervention success in autism. While cognitive substrates of learning and generalization are well established, their potential for explaining clinical outcomes is not known. Here, we combined a category learning task with computational modelling to distinguish two learning strategies underlying generalization - prototype abstraction vs. exemplar memorization - and tested whether individual differences in these learning strategies predicted real-world intervention outcomes in autistic youth. Fifty-four participants completed the category learning task at two pre-intervention timepoints, and then completed Unstuck and On Target:14-22 intervention targeting flexible problem solving, goal setting, and planning. We found that participants who consistently relied on prototype abstraction (N=26) were subsequently more likely to benefit from the intervention, showing improvement in parent- and self-reported flexibility. These findings identify prototype abstraction as a clinically relevant cognitive capacity that may help explain individual differences in intervention response and support the tailoring of interventions. More broadly, they demonstrate the value of linking basic cognitive mechanisms to clinical outcomes and may inform strategies to enhance the effectiveness of cognitive-behavioral interventions for youth with developmental disabilities.
ER -