The Relation Between Executive Function and Theory of Mind is More Than Skin Deep

A simple “expression” account of the relation between executive function (EF) and children's developing theory of mind (ToM) has difficulty accounting for the generality of the changes occurring in children's mental-state understanding during the preschool years. The current study of preschool children (N = 43) showed that EF—especially conflict EF—related uniformly to ToM measures that imposed either high or low executive demands, independent of verbal ability. These findings can be explained within an emergence account wherein executive skills are implicated in the acquisition of mental-state concepts as opposed to merely the expression of these concepts in task performance.     

Cumulative risk disparities in children's neurocognitive functioning: a developmental cascade model

The current longitudinal study examined the role of cumulative social risk on children's theory of mind (ToM) and executive functioning (EF) across early development. Further, we also tested a cascade model of development in which children's social cognition at 18 months was hypothesized to predict ToM and EF at age 4.5 through intermediary language skills at age 3. We then examined whether this developmental mechanism varied as a function of social risk status. Participants were 501 children recruited when they were newborns, at which point eight psychosocial risk factors were assessed and combined into a metric of cumulative social disadvantage. Families were followed up at 18 months, at which point four social‐cognitive skills were assessed using developmentally sensitive tasks: joint attention, empathy, cooperation, and self‐recognition. Language was measured at age 3 using a standardized measure of receptive vocabulary. At age 3 and 4.5, EF and ToM were measured using previously validated tasks. Results showed that there were notable cumulative risk disparities in overall neurocognitive skill development, and these effects became more differentiated over time. Support was also found for a developmental mechanism wherein the effect of social cognition at 18 months on ToM and EF in the preschool period operated specifically through children's receptive language ability at age 3. This pathway functioned similarly for children with both low‐ and high‐risk backgrounds. These results extend previous findings by documenting the role of cumulative social disadvantage on children's neurocognition and the pathways that link key neurocognitive abilities across early development.     

Investigating the neurodevelopmental mediators of aggression in children with a history of child maltreatment:An exploratory field study

Maltreatment of children is a chronic community problem that increases the risk of future aggression. Despite several decades of research highlighting this relationship, few studies have explored the potential neuropsychological deficits that are likely to mediate it. This exploratory study aimed to examine how child maltreatment may be associated with aggression via impairment in the developing prefrontal-limbic-autonomic pathways that are implicated in neuropsychological models of aggression. Furthermore, it aimed to investigate the relationship between child maltreatment and both reactive and proactive aggression subtypes. To investigate this non-invasively in an at-risk population, children with a documented protective care history (n = 20) and a community control group (n = 30), aged between 6 and 12 years, were compared on measures of cardiovascular functioning, affect regulation and cognitive functioning aligned with this neuropsychological model. Whilst no group differences were found on cardiovascular functioning (i.e., resting heart rate, heart rate reactivity, heart rate variability), the protective care group performed significantly worse on measures of affect regulation and cognitive functioning (i.e., global intelligence, executive functioning, smell identification and social cognition). The relationship between child maltreatment and aggression was mediated by executive dysfunction and affect dysregulation but not global IQ, social cognition or olfactory identification. The results suggest that interventions targeting aggression in maltreated children will benefit from clinical assessment and psychological strategies that address the executive dysfunction and affect dysregulation that has been associated with this clinical outcome.     

幼儿执行功能的发展对心理理论发展的影响*

采用追踪研究设计,探讨儿童3至5岁成长过程中,执行功能与心理理论发展间的预测关系。以155名3岁、4岁儿童为被试,采用经典实验任务对儿童的执行功能和心理理论进行间隔1年的追踪测查,并运用分层回归分析检验了二者间的预测关系。结果发现：儿童执行功能、心理理论在3至5岁期间均有显著的发展,且在此期间执行功能、心理理论的个体差异相对稳定;儿童在3岁、4岁时执行功能与心理理论呈显著正相关,但在5岁时二者间相关不显著;儿童3岁时的执行功能能够显著预测3至4岁期间心理理论的发展,而4岁时的执行功能不能预测4至5岁期间心理理论的发展;3至5岁期间,心理理论对执行功能发展始终不具有预测作用。     

Targeting self-regulation and academic functioning among preschoolers with behavior problems: Are there incremental benefits to including cognitive training as part of a classroom curriculum?

The purpose of this study was to examine the additional benefit of an adaptive Cogmed working memory training (CWMT) to a social-emotional/self-regulation classroom curriculum for preschoolers with externalizing behavior problems (EBP). Participants for this study included 49 children (71% boys, M_age = 4.52) with at-risk or clinically elevated levels of EBP. Children participated in an 8-week summer treatment program for Pre-Kindergarteners (STP-PreK), where they were randomly assigned to either adaptive CWMT (n = 24), or nonadaptive CWMT (n = 25). Multiple repeated measures analyses were conducted to examine the impact of adaptive versus nonadaptive CWMT on pre and posttreatment parent-/teacher-reported behavioral functioning, parent-/teacher reported and child task performance of executive functioning, and standardized academic achievement measures. Repeated measures analyses found that children in both groups improved on all measures (d’s = .23-.86). However, there were no significant time X condition effects for parent or teacher-reported behavior, reported or observed executive functioning, or standardized academic measures. These findings suggest that CWMT does not appear to provide any incremental benefits to children’s executive functioning, behavior, or academics when implemented within a comprehensive behavioral modification intervention.     

Sensitivity to criticism and theory of mind: A cross cultural study on Japanese and Italian children

Although recent studies have shown cross-cultural differences in theory of mind (ToM) between children in Western and Eastern cultures, little is known about cross-cultural differences pertaining to social correlates. The present research investigated cultural variations in the relationship between sensitivity to criticism and ToM. Japanese (n = 76) and Italian (n = 76) 6-year-olds completed a sensitivity-to-criticism task (either the teacher condition or the peer condition), second-order false-belief tasks, and a verbal ability test. The results replicated previous findings of an association between ability rating after teacher criticism and ToM in both countries. Cultural variation was found in emotional response and motivation after teacher, but nor peer, criticism. Japanese children responded to teacher criticism more positively than did Italian children. Moreover, Japanese children who failed the second-order false-belief task were more motivated after teacher criticism than were Italian children. These results are discussed in relation to differences in cultural factors.     

Impaired prospective memory but intact episodic memory in intellectually average 7- to 9-year-olds born very preterm and/or very low birth weight

Relatively little is known about episodic memory (EM: memory for personally-experienced events) and prospective memory (PM: memory for intended actions) in children born very preterm (VP) or with very low birth weight (VLBW). This study evaluates EM and PM in mainstream-schooled 7- to 9-year-olds born VP (≤ 32 weeks) and/or VLBW (< 1500 g) and matches full-term children for comparison (n = 35 and n = 37, respectively). Additionally, participants were assessed for verbal and non-verbal ability, executive function (EF), and theory of mind (ToM). The results show that the VP/VLBW children were outperformed by the full-term children on the memory tests overall, with a significant univariate group difference in PM. Moreover, within the VP/VLBW group, the measures of PM, verbal ability and working memory all displayed reliable negative correlations with severity of neonatal illness. PM was found to be independent of EM and cognitive functioning, suggesting that this form of memory might constitute a domain of specific vulnerability for VP/VLBW children.     

Executive function and theory of mind: stability and prediction from ages 2 to 3

Several studies have demonstrated a relation between executive functioning (EF) and theory of mind (ToM) in preschoolers, yet the developmental course of this relation remains unknown. Longitudinal stability and EF-ToM relations were examined in 81 children at 24 and 39 months. At Time 1, EF was unrelated to behavioral measures of ToM but was significantly related to parent report of children's internal-state language, independent of vocabulary size. At Time 2, behavioral batteries of EF and ToM were significantly related (r=.50, p<.01). Furthermore, EF (Time 1) significantly predicted ToM (Time 2), independent of several controls. A reciprocal relation (internal-state language --> EF at Time 2) was nonsignificant with the controls included. Individual differences in EF were relatively stable.     

Conversation on mental states at nursery: Promoting social cognition in early childhood

Despite growing evidence that conversation on inner states fosters gains in children’s social cognition, this mechanism has yet to be tested with toddlers. To address this gap, we examined whether an intervention based on conversing about mental states with small groups of 2-year-old children at nursery had a significant effect on toddlers’ theory of mind (ToM) and emotion understanding (EU). Participants were 68 children (M_age at pre-test: 29.9 months) who were assigned to either an experimental or a control condition. Measures of verbal ability, ToM and EU were administered at pre-test, post-test and follow-up stages. Over a one-month intervention, all children were read a series of brief illustrated stories. After listening to the stories, the experimental group (n = 34) was involved in conversations on mental states, whereas the control group (n = 34) was engaged in conversation regarding the material entities and actions featured in the storybook. The experimental group significantly outperformed the control group on measures of both ToM and EU, independently of gains in verbal ability. Furthermore, these positive effects remained stable over time. We discuss the theoretical and practical implications of these findings.     

Purpose in life and cognitive functioning in adulthood

With an increasingly aging population, more work is needed to identify factors which may promote the maintenance of normal cognitive functioning. The current study tested the concurrent association between sense of purpose in life and the cognitive variables of episodic memory, executive functioning, and composite cognitive functioning in adults (N = 3489, M_age = 56.3 years, SD = 12.27, Range = 32–84 years) from the Midlife in the United States study (MIDUS). Correlational analyses suggested that purpose in life was associated with higher scores for memory, executive functioning, and overall cognition. Bootstrapping tests of moderation found no evidence for a moderating effect of age on purpose and the cognitive variables. Future studies should attempt to explain the mechanisms behind this relationship and explore the potential for interventions to promote healthy cognitive and purposeful aging.     

Executive and attentional contributions to Theory of Mind deficit in attention deficit/hyperactivity disorder (ADHD)

Attention deficit/hyperactivity disorder (ADHD) in children has been associated with attentional and executive problems, but also with socioemotional difficulties possibly associated with deficits in Theory of Mind (ToM). Socioemotional problems in ADHD are associated with more negative prognoses, notably interpersonal, educational problems, and an increased risk of developing other psychiatric disorders that emphasize the need to clarify the nature of their ToM deficits. In this study, we hypothesized that ToM dysfunction in children with ADHD is largely attributable to their attentional and/or executive deficits. Thirty-one children with ADHD (8–12 years, IQ > 85) and 31 typically developing (TD) children were assessed using executive functions (inhibition, planning, and flexibility) and attentional tasks, as well as two advanced ToM tasks (Reading the Mind in the Eyes and Faux Pas) involving different levels of executive control. Children with ADHD performed more poorly than TD children in attentional, executive function, and ToM tasks. Linear regression analyses conducted in the ADHD group indicated that inhibition scores predicted performance on the “Faux Pas” task the best, while attention scores were the best for predicting performance on the Reading the Mind in the Eyes task. When controlled for inhibition and attentional variables, ToM performance in children with ADHD was actually similar to TD children. Contrarily, controlling for ToM scores did not normalize performance for inhibition and attentional tasks in children with ADHD. This unidirectional relationship suggests that deficits in the EF and attentional domains are responsible for ToM deficits in ADHD, which therefore may contribute to their socioemotional difficulties.     

A novel executive function battery for preschoolers: Sensitivity to age differences

The present study investigated sensitivity to age differences in a novel executive function (EF) battery for children aged 18 months to 5 years, and whether the pattern of associations among the measures was consistent with a hierarchical model of EF development. Participants (n = 261, aged 18–67 months) were administered a battery of novel tasks designed to assess 3 key EF components (working memory, inhibition, and shifting). The results indicate that the EF tasks were sensitive to age differences and provide partial support for the hierarchical model of EF development.     

Cognitive,behavioral and psychological functioning in children with metopic synostosis: a meta-analysis examining the impact of surgical status

Neurodevelopmental delays are known to occur in children with metopic synostosis, but it is presently unclear whether the cognitive, behavioral and psychological outcomes of children with metopic synostosis differ to those of their healthy peers. This meta-analysis consolidated data from 17 studies (published prior to August 2017) that examined the cognitive, behavioral and psychological outcomes of children (n = 666; aged ≤19 yrs) with metopic synostosis. Hedges’g (g_w) effect sizes compared the outcomes of samples with metopic synostosis (unoperated, operated) to healthy controls or normative data and, where available, the prevalence of problems/disorders was calculated. Children with unoperated metopic synostosis performed significantly worse than their healthy peers on measures of: general cognition (g_w = ?.38), motor functioning, (g_w = ?.81), and verbal (g_w = ?.82) and visuospatial (g_w = ?.92) abilities. Children with operated metopic synostosis performed significantly worse on measures of motor functioning (g_w = ?.45), visuospatial skills (g_w = ?.32), attention (g_w = ?.50), executive functioning (g_w = ?.36), arithmetic ability (g_w = ?.37), and behavior (g_w = ?.34). Cognitive, behavioral, and psychological problems were prevalent, but variable. Overall, the cognitive, behavioral, and psychological outcomes of children with metopic synostosis are generally worse than their healthy peers, regardless of surgical status. However, research is sparse, samples small, controls are rarely recruited, and the severity of metopic synostosis often not stated. Nevertheless, the findings suggest that children with metopic synostosis are likely to experience a variety of negative outcomes and should therefore receive ongoing monitoring and support.     

Examining the relationship between performance-based and questionnaire assessments of executive function in young preterm children: Implications for clinical practice

The aim of this study was to determine whether specific performance-based executive function assessment tools were associated with executive functioning in everyday life as reported by parents and teachers of four- to five-year-old preterm and term children. At the age of 4 years, 141 preterm children born <33 weeks’ gestation and 77 term children were assessed using performance-based intelligence (WPPSI-III) and executive function (EF) assessment tools (NEPSY-II, Day-Night and Shape School tasks). The assessment results were compared with the parent and teacher completed questionnaires of EF (BRIEF-P) when the children started kindergarten at the age of 4 to 5 years. The performance-based intelligence and EF assessment results were not consistently associated with the parent and teacher reports of EF in everyday life for either preterm or term groups. Clinical implications of using and interpreting performance-based EF assessment tools and EF questionnaires are discussed with a particular focus on young preterm children at the commencement of formal schooling.     

Social functioning using direct and indirect measures with children with High Functioning Autism,nonverbal learning disability,and typically developing children

Social perception is an important underlying foundation for emotional development and overall adaptation. The majority of studies with children with High Functioning Autism (HFA) or nonverbal learning disabilities (NLD) evaluating social functioning have used measures of parent and/or teacher ratings. The present study utilized parent and teacher ratings of behavior as well as executive functioning in addition to direct measures of social perception. Three groups participated in this study (control [n = 38] HFA [n = 36], NLD [n = 31]). Results indicated that the HFA group experienced the most difficulty understanding emotional cues on the direct measure while both the HFA and NLD groups experienced difficulty with nonverbal cues. Significant difficulties were reported on the parent rating scale for sadness and social withdrawal for both clinical groups. Executive functioning was found to be particularly problematic for the clinical groups. The direct social perception measure was highly correlated with the measures of executive functioning and reflects the contribution that executive functions have on social functioning. These findings suggest that the clinical presentation on behavior rating scales may be very similar for children with HFA and NLD. Moreover, it appears that measures of executive functioning are sensitive to the clinical difficulties these groups experience. The findings also suggest there is a commonality in these disorders that warrants further investigation.     

Multivariate base rates for the assessment of executive functioning among children and adolescents

This study provides observed base rates of low executive functioning test scores among healthy children and adolescents, stratifies those base rates by narrow intellectual functioning and age groupings, and provides normative classification ranges to aid the interpretation of performances on the Delis-Kaplan Executive Function System (D-KEFS) in clinical practice and research. Participants included 875 children and adolescents between 8 and 19 years old from the D-KEFS normative sample (48% male; 52% female). Among these participants, 838 had complete data and were included in the current study. The racial/ethnic composition of the sample was: White (73.7%), African American (12.4%), Hispanic (11.1%), and other racial/ethnic backgrounds (2.7%). The Overall Test Battery Mean (OTBM) and the prevalence of low scores at various clinical cut-offs were calculated for the 13 primary scores from the D-KEFS Trail Making Test, Verbal Fluency Test, and Color-Word Interference Test. The OTBM and base rates were also calculated separately for those scores reflecting executive functioning (n = 7) and processing speed (n = 6). Healthy children and adolescents commonly obtained low scores on the D-KEFS tests considered here. Younger age, lower estimated full-scale intelligence quotient, and more test scores interpreted were associated with a greater frequency of low scores. Clinicians and researchers are encouraged to consider these multivariate base rates when assessing and attempting to identify executive functioning impairment among children and adolescents with the D-KEFS.     

Mental playmates: Siblings,executive functioning and theory of mind

This study assessed the theory of mind (ToM) and executive functioning (EF) abilities of 124 typically developing preschool children aged 3 to 5 years in relation to whether or not they had a child‐aged sibling (i.e. a child aged 1 to 12 years) at home with whom to play and converse. On a ToM battery that included tests of false belief, appearance‐reality (AR) and pretend representation, children who had at least 1 child‐aged sibling scored significantly higher than both only children and those whose only siblings were infants or adults. The numbers of child‐aged siblings in preschoolers' families positively predicted their scores on both a ToM battery (4 tasks) and an EF battery (2 tasks), and these associations remained significant with language ability partialled out. Results of a hierarchical multiple regression analysis revealed that independent contributions to individual differences in ToM were made by language ability, EF skill and having a child‐aged sibling. However, even though some conditions for mediation were met, there was no statistically reliable evidence that EF skills mediated the advantage of presence of child‐aged siblings for ToM performance. While consistent with the theory that distinctively childish interaction among siblings accelerates the growth of both ToM and EF capacities, alternative evidence and alternative theoretical interpretations for the findings were also considered.     

Self-Reported Depressive Symptoms Have Minimal Effect on Executive Functioning Performance in Children and Adolescents

The relation between mood and executive functioning in children and adolescents has not been previously reported. This study examined the association between self-reported depressive symptoms in both clinical outpatient and psychiatric inpatient samples to the following measures of executive functioning: the Controlled Oral Word Association Test, Animal Naming, Trail Making Test, and Wisconsin Card Sorting Test. Records from children and adolescents aged 7–17 years old with an IQ > 70 were examined. Data were gathered at either an outpatient neuropsychology clinic (n = 89) or an inpatient psychiatric hospital setting (n = 81). Mood was measured with the Children’s Depression Inventory. Generally, statistical associations between self-reported depressive symptoms and executive functioning were small and non-significant. The variance predicted by mood on measures of executive functioning was minimal (generally less than 2 %) for the total sample, the outpatient group, inpatient group, and a subgroup who endorsed elevated mood symptoms. These results suggest that impaired performance on measures of executive functioning in children and adolescents is minimally related to self-reported depressive symptoms.     

A longitudinal investigation of children internationally adopted at school age

Most existing research on children adopted internationally has focused on those adopted as infants and toddlers. The current study longitudinally tracked several outcomes, including cognitive, behavioral, emotional, attachment, and family functioning, in 25 children who had been internationally adopted at school age (M = 7.7 years old at adoption, SD = 3.4, range = 4–15 years). We examined the incidence of clinically significant impairments, significant change in outcomes over the three study points, and variables that predicted outcomes over time. Clinically significant impairments in sustained attention, full-scale intelligence, reading, language, executive functioning, externalizing problems, and parenting stress were common, with language and executive functioning impairments present at higher levels in the current study compared with past research focusing on children adopted as infants and toddlers. Over the three study points, significant improvements across most cognitive areas and attachment functioning were observed, though significant worsening in executive functioning and internalizing problems was present. Adoptive family-specific variables, such as greater maternal education, smaller family size, a parenting approach that encouraged age-expected behaviors, home schooling, and being the sole adopted child in the family were associated with greater improvement across several cognitive outcomes. In contrast, decreased parenting stress was predicted by having multiple adopted children and smaller family sizes were associated with greater difficulties with executive functioning. Child-specific variables were also linked to outcomes, with girls displaying worse attachment and poorer cognitive performance and with less time in orphanage care resulting in greater adoption success. Implications for future research and clinical applications are discussed.     

Caregiver ratings and performance-based indices of executive function among preschoolers with and without maltreatment experience

Despite the well-documented impact of early maltreatment on children’s executive function (EF), there has been limited consensus about how to best assess this neurocognitive domain in high-risk, vulnerable preschool-aged children. Relevant studies have generally utilized either performance-based tests or caregiver ratings of EF, yet multi-method research has been rare. This study examined the EF profiles of preschoolers exposed to maltreatment, as indexed by the Behavior Rating Inventory of Executive function – Preschool Version (BRIEF-P), and investigated associations between caregiver ratings and performance-based measures (Happy–Sad Stroop, Tapping Test, and Dimensional Change Card Sort – DCCS) of EF in this population. Maltreatment status was further tested as a moderator of associations between these measures. Participants were (n = 107) children aged 4–5 years (M = 4.75; SD = 0.57; 39% female), with various levels of exposure to maltreatment. Children exposed to maltreatment were found to exhibit significantly more caregiver-rated deficits in EF than non-maltreated children, with greater fluctuations apparent across all scales of the BRIEF-P. Consistent with previous research in neurologically impaired children, there were only limited and weak to moderate correlations between BRIEF-P scales and performance-based measures of EF. Furthermore, maltreatment status was found to moderate the association between scores on the BRIEF-P Inhibit Scale and the DCCS, such that the association between these indices was weaker among children exposed to higher levels of maltreatment.