Assessment & Research

Executive function predicts theory of mind but not social verbal communication in school-aged children with autism spectrum disorder.

Kouklari et al. (2018) · Research in developmental disabilities 2018
★ The Verdict

Working memory drives ToM in school-age autistic kids, but EF does not explain their social verbal gaps.

✓ Read this if BCBAs running social-skills groups for late-elementary clients with ASD.
✗ Skip if Clinicians focused only on early preschool or adult populations.

01Research in Context

01

What this study did

The team gave direct tests of executive function (EF) to 8- to 12-year-olds with and without autism.

They also tested theory-of-mind (ToM) and social verbal communication.

Then they ran regressions to see which EF skills predicted each social outcome.

02

What they found

Working memory predicted ToM in both groups.

Other EF skills did not predict social verbal communication.

Only inhibition and cognitive flexibility scores differed between the autistic and typical kids.

03

How this fits with other research

Granader et al. (2014) saw the same EF-ToM link in preschoolers, so the tie holds across ages.

Fong et al. (2020) used parent-rated EF and found it predicted broader social skills, showing the rater you pick changes the story.

Goldfarb et al. (2024) later showed EF plus ToM explains most of social functioning, extending this paper’s narrow focus.

Fisher et al. (2005) tried training EF and ToM separately; ToM training helped ToM but EF training did not help EF, hinting that direct teaching may not easily move these skills.

04

Why it matters

If you want to boost ToM, working-memory drills are worth a shot. Don’t expect EF work to fix social chat itself. Pair EF tasks with ToM lessons and track both to see real change.

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Add a quick working-memory warm-up before your ToM lesson and note if false-belief scores rise after two weeks.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
64
Population
autism spectrum disorder, neurotypical
Finding
mixed
Magnitude
medium

03Original abstract

BACKGROUND: The association between Executive Function (EF) and Theory of Mind (ToM) in autism spectrum disorder (ASD) has been mainly investigated using false belief tasks, whilst less is known about the EF effect on other ToM facets. Furthermore, the role EF plays in social communication in ASD is mainly assessed using parent-report EF ratings rather than direct assessment. AIMS: The aim of this study was to shed more light on the effect of performance-based EF measures on ToM and social communication in middle childhood in ASD relative to neurotypical controls. METHODS AND PROCEDURES: Cross-sectional data were collected from 64 matched, school-aged children with and without ASD (8-12 years old), tested on measures of EF (inhibition, working memory, cognitive flexibility), ToM mental state/emotion recognition and social verbal communication. OUTCOMES AND RESULTS: Significant group differences were observed only in selective EF skills (inhibition &cognitive flexibility) and social verbal communication. EF working memory contributed to the explained variance of ToM but not social verbal communication in middle childhood. CONCLUSIONS AND IMPLICATIONS: These findings suggest that EF and ToM are still associated in middle childhood and EF may be a crucial predictor of ToM across childhood in ASD. Implications are discussed regarding the social-cognitive impairment relationship in ASD.

Research in developmental disabilities, 2018 · doi:10.1016/j.ridd.2018.02.015