Executive functioning and theory of mind in children clinically referred for attention and behavior problems

Abstract

The present study examined the interrelations of the theory of mind (ToM), executive functioning, and social problems in children referred to an outpatient clinic for attention and behavior problems. ToM tasks consisted of mistaken identity and contents tasks, two versions of unintended transfer tasks, and an emotional false-belief task. Attention problems were assessed using parent and teacher reports of behavior and child omission errors on the Continuous Performance Test (CPT). Auditory working memory was assessed using two subtests of the Woodcock–Johnson Psycho-Educational Battery—Revised. Impulsivity was assessed using parent and teacher reports of behavior, the Dimensional Change Card Sort (DCCS), commission errors on the CPT, and Luria's Hand Game (LHG). Controlling for age, language, and socioeconomic status (SES), ToM was significantly related to aggregate scores for attention problems, memory, impulsivity, and an overall executive functioning aggregate of all three components. In addition, parent and teacher ratings of social problems were negatively related to both ToM and overall executive functioning. Executive functioning and ToM may be indicators of metacognitive deficits that underlie social problems in clinical samples of children with disruptive behavior and attention problems.