Testing the predictive power of cognitive atypicalities in autistic children: evidence from a 3-year follow-up study.
Preschool EF, not theory of mind or coherence, predicts later social and repetitive severity in autism.
01Research in Context
What this study did
Pellicano (2013) followed preschoolers with autism for three years.
She tested three thinking skills early on: executive function, theory of mind, and central coherence.
Then she checked which skill best predicted social communication and repetitive behaviors later.
What they found
Only early executive function scores forecasted later social and repetitive problems.
Theory of mind and central coherence scores added no extra prediction power.
In short, EF was the crystal ball; the other two were foggy.
How this fits with other research
Gillespie-Lynch et al. (2019) pooled 133 samples and saw tiny links between EF, theory of mind, and social skills. Their weak numbers seem to clash with Elizabeth’s strong EF finding. The gap is method: Kristen mixed cross-sectional snapshots, while Elizabeth used one long-term follow-up.
Happé et al. (2006) and Hastings et al. (2001) argued that weak central coherence shapes autism. Elizabeth shows coherence does not predict later symptoms, so her work updates those older coherence theories.
Petrolo et al. (2025) narrative review now folds Elizabeth’s result into guidance: start EF supports early because EF trails lead to social and behavior gains down the road.
Why it matters
When you assess a preschooler with ASD, give EF tasks the front seat. Use simple delay, shift, or inhibition games and note the results. These scores tell you which kids are most likely to struggle with conversation and repetitive routines three years out, letting you write sharper goals and snag extra support before problems snowball.
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02At a glance
03Original abstract
This follow-up study investigated the predictive power of early cognitive atypicalities. Specifically, it examined whether early individual differences in specific cognitive skills, including theory of mind, executive function, and central coherence, could uniquely account for variation in autistic children's behaviors-social communication, repetitive behaviors, and interests and insistence on sameness-at follow-up. Thirty-seven cognitively able children with an autism spectrum condition were assessed on tests tapping verbal and nonverbal ability, theory of mind (false-belief prediction), executive function (planning ability, cognitive flexibility, and inhibitory control), and central coherence (local processing) at intake and their behavioral functioning (social communication, repetitive behaviors and interests, insistence on sameness) 3 years later. Individual differences in early executive but not theory of mind skills predicted variation in children's social communication. Individual differences in children's early executive function also predicted the degree of repetitive behaviors and interests at follow-up. There were no predictive relationships between early central coherence and children's insistence on sameness. These findings challenge the notion that distinct cognitive atypicalities map on to specific behavioral features of autism. Instead, early variation in executive function plays a key role in helping to shape autistic children's emerging behaviors, including their social communication and repetitive behaviors and interests.
Autism research : official journal of the International Society for Autism Research, 2013 · doi:10.1002/aur.1286