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The Relationship Between Executive Dysfunction and Theory of Mind
The cognitive dysfunctions and the possible relationship between especially Theory of Mind (ToM) and Executive Functions (EF) have recently received an increasing interest.
Russell (1) has suggested that EF is crucial in the development of ToM and that difficulties within EF may lead to failure in developing an understanding of mental states. This was supported by Pellicano (2) who found that a competent EF could be seen without ToM-deficits, however, she was not able to find this the other way around.
White (3), on the other hand, has recently suggested that the reason individuals with ASD have trouble in EF-tasks may be caused by their disability to form an explicit understanding of the experimenter’s expectations of the task (ToM).
Objectives:
The objective of this study was to examine the distribution of deficits in the different domains within the ASD group, and try to identity subgroups of ASD based on their cognitive style.
Methods:
Thirty-one clinically diagnosed high-functioning children with ASD were tested with two ToM tests; “Strange Stories” and “Animated Triangles”, and with two different approaches to EF; “Generativity” with verbal instruction and answers (active experimenter, AE) and a CANTAB-battery covering a range of the classic executive tasks in a computerized version with very few verbal instructions (inactive experimenter, IE).
Results:
We found that about 65% of the ASD group had ToM-dysfunctions (5th percentile of a neurotypically developed, NTD, control group). Within EF we found that about 19% had problems in the AE tasks and only about 10% in the IE tasks (not significant compared to the NTD group).
There was a greater overlap to ToM-difficulties in the AE performance (with half of the group showing additional ToM difficulties), although numbers unfortunately were too small to analyse.
About 11% of the children displaying ToM difficulties had additional difficulties in the AE tasks in EF.
Conclusions:
These results indicate that children with ASD have more difficulties in primary verbal and person-oriented EF tasks compared to computerized, less verbal tasks. Data also indicate that only few ASD children with ToM problems have underlying executive dysfunctions. This slightly supports White’s hypothesis about underlying ToM-disabilities, although we would have expected an even greater overlap.
To investigate the relation between ToM and EF further we need to separate the two cognitive functions in the tasks we use. Therefore we are now compiling a new battery of implicit/intuitive ToM tasks, where we have tried to minimize the executive demands. We will be able to present the first preliminary data from these ToM tasks at IMFAR 2014.
1. Russell J. How executive disorders can bring about an inadequate Theory of Mind. In: Russell, J. (ed.). Autism as an Executive Disorder. 1997;Oxford University Press, pp. 256-304.
2. Pellicano E. Links between theory of mind and executive function in young children with autism: clues to developmental primacy. Developmental psychology. 2007;43(4):974-90. Epub 2007/07/04.
3. White SJ. The Triple I Hypothesis: taking another('s) perspective on executive dysfunction in autism. Journal of autism and developmental disorders. 2013;43(1):114-21. Epub 2012/05/16.