Individual Differences in Executive Function and Central Coherence Predict Developmental Changes in Theory of Mind in Autism

There is strong evidence to suggest that individuals with autism show atypicalities in multiple cognitive domains, including theory of mind (ToM), executive function (EF), and central coherence (CC). In this study, the longitudinal relationships among these 3 aspects of cognition in autism were investigated. Thirty-seven cognitively able children with an autism spectrum condition were assessed on tests targeting ToM (false-belief prediction), EF (planning ability, cognitive flexibility, and inhibitory control), and CC (local processing) at intake and again 3 years later. Time I EF and CC skills were longitudinally predictive of change in children's ToM test performance, independent of age, language, nonverbal intelligence, and early ToM skills. Predictive relations in the opposite direction were not significant, and there were no developmental links between EF and CC. Rather than showing problems in TOM, EF and CC as co-occurring and independent atypicalities in autism, these findings suggest that early domain-general skills play a critical role in shaping the developmental trajectory of children's ToM.