Cool Executive Function and Verbal Comprehension Mediate the Relation of Hot Executive Function and Theory of Mind in Children with Autism Spectrum Disorder.
Cool EF and verbal comprehension are the gatekeepers that let hot EF boost theory-of-mind gains in school-age ASD.
01Research in Context
What this study did
Yu et al. (2021) asked: how does hot executive function reach theory of mind in kids with ASD?
They tested 6- to 12-year-olds with autism and average IQ.
The team measured hot EF, cool EF, verbal comprehension, and ToM, then ran a mediation model.
What they found
Cool EF and verbal comprehension together carry the hot EF-ToM link.
When these two skills are strong, hot EF boosts ToM; when they are weak, the boost fades.
How this fits with other research
Kouklari et al. (2018) also saw working memory drive ToM in 8-12-year-olds with ASD, a close replication of the cool-EF path.
Saban-Bezalel et al. (2019) seems to clash: they found vocabulary, not EF, predicts idiom comprehension in ASD. The difference is the task—idiom tests draw on stored word knowledge, not live social reasoning, so EF never got the chance to mediate.
Panpan et al. (2025) extends the idea to listening comprehension: for Chinese children with ASD, working memory and cognitive flexibility work directly, bypassing verbal IQ—showing the mediation story changes with culture and outcome.
Why it matters
If you run ToM lessons for fluent-verbal elementary students, first check cool-EF games like card sorting and verbal directions. Weave these targets into the same session; they are the bridge that lets emotional EF skills turn into better perspective-taking.
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02At a glance
03Original abstract
Impaired executive function (EF), verbal comprehension, and theory of mind (ToM) may contribute to social difficulties in children with autism spectrum disorder (ASD). The linkage between cool (cognitive) EF and ToM has been widely investigated, but the relations between hot (affective) EF and ToM remain largely unknown. The roles of cool EF and verbal comprehension have not been previously explored together to address hot EF-ToM relations. This study applied mediation analysis to investigate the mediating effects of cool EF and verbal comprehension to further elaborate the link between hot EF and ToM in children with ASD and average intellectual abilities. A total of 97 children with ASD aged from 6 to 12 years participated in this study. Children's cool EF, hot EF, and verbal comprehension were, respectively, measured with the computerized Dimensional Change Card Sort task, Children's Gambling Task, and the verbal comprehension index of the Wechsler Intelligence Scale for Children-fourth edition. Children's ToM was assessed with the Theory of Mind Task Battery. Partial correlation coefficients indicated that hot EF was significantly related with ToM with age controlled for. The results of the mediation analysis showed that cool EF and verbal comprehension mediated the linkage between hot EF and ToM. These findings highlight not only the connections between hot EF and ToM but also the importance of cool EF and verbal comprehension on hot EF-ToM relations in clinical assessments and interventions for school-aged children with ASD and average intellectual abilities. LAY SUMMARY: Relatively few studies have investigated the hot (affective) executive function (EF)-theory of mind (ToM) relations in children with autism spectrum disorder (ASD). This study discovered that hot EF was significantly related to ToM, while cool (cognitive) EF and verbal comprehension mediated the relationship between hot EF and ToM. Therefore, the influence of cool EF and verbal comprehension on hot EF-ToM relations should be considered in studies involving children with ASD. Autism Res 2021, 14: 921-931. © 2020 International Society for Autism Research and Wiley Periodicals LLC.
Autism research : official journal of the International Society for Autism Research, 2021 · doi:10.1002/aur.2412