The present study analyzed the concurrent and longitudinal relations among cognitive flexibility, theory of mind, and hyperactivity/inattention in a sample of 70 typically developing children (
The ability to focus attention and regulate behavior is a key determinant of scholastic achievement and occupational success [
Much of the research into the development of children’s self-regulation skills has been conducted within the executive function framework [
According to cognitive complexity and control (CCC) theory, cognitive flexibility refers to the ability to flexibly shift between multiple incompatible perspectives or descriptions of an object or event [
Although we are unaware of any research which directly assesses the relationship between cognitive flexibility and hyperactivity/inattention in typical development there is some research which has investigated the cognitive flexibility skills of children with ADHD. A number of studies have found that cognitive flexibility is impaired in children with ADHD [
Another issue worthy of consideration is the relationships among cognitive flexibility, theory of mind (ToM), and hyperactivity/inattention. ToM involves the cognitive capacity to impute causal mental states to self and others in order to explain and predict behavior [
A number of studies have found a correlation between performance on the dimension change card sort (DCCS) task [
There is also some evidence supporting the argument that ToM development facilitates the ability to regulate attention and behavior. Several studies have found that ToM is impaired in children and adults with ADHD [
In summary, there is some evidence in support of the existence of a relationship between cognitive flexibility and ToM. However, the evidence for relationships between these cognitive factors and hyperactivity/inattention is inconsistent and comes from studies of ADHD rather than typical development. Furthermore, the hypothesized relationships between cognitive flexibility, ToM, and self-regulation discussed above also suggest that ToM may mediate the relationship between cognitive flexibility and hyperactivity/inattention [
The purpose of the present study was to further our understanding of the developmental relationships among cognitive flexibility, ToM, and hyperactivity/inattention in typical development by examining these relationships concurrently and longitudinally. Thus, cognitive flexibility, ToM, and hyperactivity/inattention were assessed for a group of children at an early point in their schooling (Year 1: Y1) and again one year later (Y2).
Drawing on CCC theory and the findings of previous research, it was hypothesized that more advanced cognitive flexibility and ToM skills would be associated with lower levels of hyperactivity/inattention. It was also predicted that ToM would mediate the concurrent relationship between cognitive flexibility and hyperactivity/inattention. For the longitudinal analyses, it was hypothesized that Y1 cognitive flexibility would predict Y2 ToM after controlling for Y1 ToM and that Y1 cognitive flexibility and ToM would predict Y2 hyperactivity/inattention after controlling for the relevant Y1 scores. We also investigated the possibility that hyperactivity/inattention interferes with the subsequent development of cognitive flexibility and ToM. This was done by testing whether Y1 hyperactivity/inattention predicts Y2 cognitive flexibility and ToM after controlling for the relevant Y1 scores.
The data reported here represent part of a larger research project. All of the Australian children who participated in the present study spoke English as their first language. The participants were children receiving regular education who were recruited via three primary schools spread across working class to upper middle class areas. Complete sets of the relevant data were available for 70 (33 male) children (64 Caucasian, 6 Asian) aged between 47 and 76 months (
Cognitive flexibility was assessed at Y1 and Y2 using the border version of the dimension change card sort (DCCS) task [
Children’s ToM ability was measured using two batteries of tasks, each including one of the versions of Wellman and Liu’s [
The hyperactivity scale of the strengths and difficulties questionnaire (SDQ; [
Consent forms and information sheets were sent to parents/guardians of all kindergarten and preprimary children attending the three mainstream schools. Questionnaires were mailed to the primary caregivers who chose to participate, and completed questionnaires were mailed directly back to the researcher. The strengths and difficulties questionnaire (SDQ; [
ToM scores were not significantly different between the two task sets at Y1 or Y2 (both
Means and standard deviations of scores.
Variable | Year 1 | Year 2 |
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|
|
|
|
|
|
Cognitive flexibility (max. score 3) | 1.63 | 0.54 | 2.11 | 0.55 | 7.65 | <.01 |
ToM (max. score 8) | 4.09 | 1.88 | 5.40 | 1.43 | 6.44 | <.01 |
Mother rated hyperactivity/inattention (max. score 10) | 3.30 | 2.27 | 3.19 | 2.30 |
|
.59 |
Teacher rated hyperactivity/inattention (max. score 10) | 2.16 | 2.72 | 2.38 | 2.50 | 0.69 | .49 |
Inspection of the correlations between the measures revealed that the main study variables were associated with each other in the expected directions and that the degree of multicollinearity between the predictor variables was acceptable (see Table
Correlations between variables.
Variable | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
---|---|---|---|---|---|---|---|---|
|
— | |||||||
|
.52† | — | ||||||
|
−.42† | −.56† | — | |||||
|
.53† | .40† | −.40† | — | ||||
|
.48† | .50† | −.38† | .25* | — | |||
|
−.40† | −.35† | .65† | −.41† | −.26* | — | ||
|
.36† | .48† | −.29† | .35† | .27* | .00 | — | |
|
.25* | .24* | −.21 | .20 | .19 | −.21 | .03 | — |
Because of the questionable nature of the assumption that the sampling distributions of the indirect effects are normal and the general superiority of bootstrapping over methods that assume such normality [
The hypothesized longitudinal relationships among cognitive flexibility, ToM, and hyperactivity/inattention were assessed via a series of hierarchical regressions. In the first hierarchical regression predicting Y2 hyperactivity/inattention (average
Summary of hierarchical regression analyses for variables predicting year 2 hyperactivity/inattention (average).
Variable |
|
SE ( |
|
|
Squared part correlation |
|
---|---|---|---|---|---|---|
Step 1 | .47* | |||||
Y1 child age in months | .02 | .01 | .21 | .03 | .04 | |
Child gender | −.12 | .16 | −.07 | .47 | .00 | |
Y1 hyperactivity/inattention | .80 | .11 | .70 | <.01 | .43 | |
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Step 2 | .04* | |||||
Y1 cognitive flexibility | −.37 | .16 | −.22 | .03 | .04 | |
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||||||
Step 2 | .00 | |||||
Y1 ToM | −.04 | .06 | −.08 | .49 | .00 |
The next analysis found that after controlling for child age, gender, and Y1 ToM at the first step, as hypothesized, Y1 cognitive flexibility significantly predicted Y2 ToM scores (see Regression 1, Table
Summary of hierarchical regression analyses for variables predicting year 2 ToM.
Variable |
|
SE ( |
|
|
Squared part correlation |
|
---|---|---|---|---|---|---|
Step 1 | .25* | |||||
Y1 child age in months | .01 | .02 | .05 | .70 | .00 | |
Child gender | .21 | .31 | .07 | .51 | .01 | |
Y1 ToM | .35 | .10 | .45 | <.01 | .15 | |
|
||||||
Step 2 | .06* | |||||
Y1 cognitive flexibility | .77 | .32 | .29 | .02 | .06 | |
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||||||
Step 2 | .01 | |||||
Y1 hyperactivity/inattention | −.26 | .23 | −.15 | .26 | .01 |
Summary of hierarchical regression analyses for variables predicting year 2 cognitive flexibility.
Variable |
|
SE ( |
|
|
Squared part correlation |
|
---|---|---|---|---|---|---|
Step 1 | .32* | |||||
Y1 child age in months | .01 | .01 | .19 | .09 | .03 | |
Child gender | .09 | .12 | .08 | .45 | .01 | |
Y1 cognitive flexibility | .45 | .12 | .44 | <.01 | .16 | |
|
||||||
Step 2 | .01 | |||||
Y1 ToM | .03 | .04 | .10 | .47 | .01 | |
|
||||||
Step 2 | .03 | |||||
Y1 hyperactivity/inattention | −.13 | .08 | −.18 | .12 | .03 |
The present study sought to further investigate the developmental relationships among cognitive flexibility, ToM, and hyperactivity/inattention. This was achieved by examining these relationships concurrently and longitudinally in a sample of typically developing children. Cognitive flexibility, ToM, and hyperactivity/inattention were assessed at an early point in schooling (Y1) and again one year later (Y2).
As hypothesized, more advanced cognitive flexibility and ToM skills were associated with lower concurrent levels of hyperactivity/inattention. Furthermore, as predicted, Y1 ToM mediated the relationship between Y1 cognitive flexibility and Y1 hyperactivity/inattention. The mediation hypothesis was also supported by the finding that Y1 cognitive flexibility significantly predicted Y2 ToM scores after controlling for Y1 ToM, whereas Y1 ToM did not significantly predict Y2 cognitive flexibility after controlling for Y1 cognitive flexibility. Thus the current findings provide some evidence that ToM development may mediate the relationship between cognitive flexibility and attention and behavior regulation skills. A possible explanation for this is that the development of cognitive flexibility enables better self-control because “the reasoning involved in inferring mental states is also needed for conceptualizing one’s own actions and controlling one’s behavior” [
Combining Hughes and Ensor’s [
Nevertheless, the current findings are consistent with the argument that the development of cognitive flexibility enables better self-control [
Combining the results of the current study with the findings of previous research indicating that cognitive flexibility training facilitates behavior regulation [
The use of a multi-informant design is one of the strengths of the current study. However, the fact that mother and teacher ratings of children’s hyperactivity/inattention did not change significantly between Y1 and Y2 in the present study may be problematic in that children’s behavior may have been rated in comparison to other children of the same age rather than in some absolute sense.
There is empirical and clinical evidence which indicates that hyperactivity and inattention can represent separate dimensions with different outcomes [
The results of the current study indicate that children with more advanced cognitive flexibility skills demonstrate lower levels of hyperactivity/inattention. The findings provide some support for the argument that the development of cognitive flexibility enables better self-control [
“Which snack would you like best? Would you like a carrot or a cookie best?”
If the child chooses the cookie (carrot): “Well, that’s a good choice, but Mr. Jones really likes carrots (cookies). He doesn’t like cookies (carrots). What he likes best are carrots (cookies).” The child is asked the target question: “So now it’s time to eat. Mr. Jones can only choose one snack, just one. Which snack will Mr. Jones choose? A carrot or a cookie?”
The child is asked the control question: “Which snack does Mr Jones like best? Carrots or cookies?”
The second (analogue) version of the diverse desires task was identical to the first except that the child was told it was playtime and that “Teddy” the teddy bear wanted a toy to play with and could choose between a doll and a truck.
“Where do you think the cat is? In the bushes or in the shed?”
If the child chooses the bushes (shed): “Well, that’s a good idea, but Mr. Jones thinks his cat is in the shed (bushes). He thinks his cat is in the shed (bushes).” The child is asked the target question: “So where will Mr. Jones look for his cat? In the bushes or the shed?”
The child is asked the control question: “Where does Mr. Jones thinks his cat is? In the bushes or the shed?”
The procedure for the second diverse beliefs task was identical to the first except that the child was told that “Teddy” was looking for the jam which might be in the cupboard or in the fridge.
“Okay, what is in the drawer?”
A doll is produced: “Mr. Jones has never seen inside this drawer. Now here comes Mr. Jones.” The child is asked the target question: “So, does Mr. Jones know what is in the drawer?”
Followed by the memory question: “Did Mr. Jones see inside this drawer?”
To be scored correct, the child must answer “dog” to the control question and “no” to both the target and memory questions. The procedure for the second knowledge access task was identical to the first except that the props were the teddy bear and a nondescript case containing a cracker biscuit.
“Okay, what is in the Band-Aid box?”
A doll is produced: “Mr. Jones has never seen inside this Band-Aid box. Now here comes Mr. Jones.” Then the child is asked the first target question (others false belief): “So what does Mr. Jones think is in the box? Band-Aids or a pig?”
Followed by the memory question: “Did Mr. Jones see inside this box?”
Then the second target question (own false belief): “What did you first think was inside the Band-Aids box before we opened it? Band-Aids or a pig?”
The procedure for the second contents false belief task was identical to the first except that the props were the teddy bear and a Smarties box with crayons inside.
“Can you point to what Fred thinks is on the fishing-line?”
Then it is followed by the control question: “Can you point to what is really on the fishing-line?”
To be scored correct, the child must point to the fish in response to the target question and to the boot in response to the control question. The procedure for the second low verbal false belief task was identical to the first except that the protagonist Charlie thinks there is a fish under the reeds when it is really a mermaid.
“So what does Andrew think his Mum got him for his birthday? A kitten or a toy?”
(If correct: That’s right, Andrew thinks he’s getting a toy; if incorrect: But remember, Andrew thinks he’s getting a toy) Then it is followed by the first memory control question: “What did Mum really get Andrew for his birthday? A kitten or a toy?”
(If correct: That’s right, Mum wants to surprise Andrew with a kitten; if incorrect: But remember, Mum wants to surprise Andrew with a kitten).
“Now, Andrew says to Mum, “I’m going outside to play.” On his way outside, Andrew decides to get his roller-skates from the garden shed. When he opens the door to the garden shed, Andrew finds the birthday kitten! (child is shown a picture of a kitten in a shed) Andrew says to himself, “wow, Mum didn’t get me a toy, she really got me a kitten for my birthday.” Now, the important thing is that Mum did not see Andrew go to the garden shed and find the birthday kitten.” The child is then asked the second memory control question: “Does Andrew know that his Mum got him a kitten for his birthday?”
(If yes: That’s right, Andrew saw the kitten in the garden shed; if no: But remember, Andrew saw the kitten in the garden shed) Then it is followed by the third memory control question: “Does Mum know that Andrew saw the birthday kitten in the garden shed?”
(If no: That’s right, Mum did not see Andrew go to the garden shed and find the kitten; if yes: But remember, Mum did not see Andrew go to the garden shed and find the kitten).
“While Andrew is outside, Andrew’s grandmother drops in for a chat with Andrew’s mum. (Child is shown a picture of mum and grandma) Grandma asks Mum, “Does Andrew know what you really got him for his birthday?”” The child is then asked the second-order ignorance question: “What does Mum say to Grandma?”
“Now remember, Mum does not know that Andrew saw what she got him for his birthday. Then, Grandma asks Mum, “What does Andrew think you got him for his birthday?”” The child is then asked the second order false belief target question: “What does Mum say to Grandma?”
It is followed by the justification question: “Why does Mum say that?”
To be scored correct on the first-order false belief, the child must answer both the first-order false belief target question and the first memory control question correctly. To be scored correct on the second-order false belief, the child must answer all of the questions correctly. The procedure for the other second-order false belief task was identical to the first except that the child (Molly) wants a bike for her birthday but her dad tells her he got her a really great toy instead.
The authors declare that there is no conflict of interests regarding the publication of this paper.
The authors wish to thank all of the children, families, and teachers for their generous support and participation in this study. They wish to particularly acknowledge the assistance received from the participants’ teachers (Fleur Aris, Susan Bamblett, Chris Blamey, Emily Bradshaw, Sarah Bye, Karen Colkin, Julie Cummings, Martine Damon, Pamela Dow, Lesley Edelman, Julie Excell, Linda Goss, Michelle Green, Terri Hale, Martija Jukic, Jill Mitchell, Suzie Morrison, Christine Onley, Judith Rangihaeata, Deb Scarterfield, Jenny Smith, Lucy Stewart, Christine Tarnowy, Carolyn Vuletic, Jenny Whiting, Michelle Willis, Megan Wilson, and Veni Zeid).