J Autism Dev Disord (2011) 41:667–678
DOI 10.1007/s10803-010-1087-7
ORIGINAL PAPER
Executive Function Mechanisms of Theory of Mind
Fayeza S. Ahmed • L. Stephen Miller
Published online: 1 September 2010
Ó Springer Science+Business Media, LLC 2010
Abstract This study examined the relationship between
Executive Function (EF) and Theory of Mind (ToM) using
the Delis-Kaplan Executive Function System (D-KEFS)
and three tests of ToM (Reading the Mind in the Eyes test
(RMET), Strange Stories test, and Faux Pas test). Separate
regression analyses were conducted, and EF predictors
varied by ToM test. No EF domains accounted for signifi-
cant variance in RMET scores; only estimated IQ scores
were significant predictors of RMET performance. Verbal
fluency and deductive reasoning were significant predictors
of performance on the Strange Stories test, while verbal
fluency, problem solving, and gender accounted for a sig-
nificant variance in the Faux Pas test. Results suggest that
the ToM tests each utilized differing cognitive mechanisms.
Keywords Executive Function
Theory of Mind

Neuropsychology
The purpose of this study was to determine aspects of
Executive Function (EF) related to the construct of Theory
of Mind (ToM). EF consists of higher-order cognitive
processes (Carlson et al. 2004) involved in goal-oriented
behavior, such as planning and sequencing (Royall et al.
2002). ToM refers to the ability to understand the views
and beliefs of another person (Baron-Cohen 1988). This
broad definition of ToM (Baron-Cohen 1988) illustrates the
complexity and abstractness of perspective-taking, and
therefore it can benefit from further operationalism. While
F. S. Ahmed (&)
L. Stephen Miller
Department of Psychology, University of Georgia, Athens,
Georgia 30602, USA
e-mail: fsag@uga.edu
determining the absolute presence of ToM does not explain
its underlying mechanisms, examining its relationship with
EF may shed light on those processes and lead to a better
understanding of it. Previous research has indicated that
there may be multiple domains of ToM (Ahmed et al. 2007,
February; Brent et al. 2004), and thus there may be dif-
fering EF mechanisms that drive each aspect of ToM.
Theory of Mind
The concept of ToM originated from Premack and
Woodruff’s research on the ability of chimpanzees to take
the perspective of a person (Premack and Woodruff 1978).
Traditionally, in humans, ToM has been measured in false
belief paradigms. For example, the common Sally-and-
Anne test (Baron-Cohen et al. 1985; Wimmer and Perner
1983) involves a scenario in which one character hides an
object while another character leaves the room. Partici-
pants are then asked where they think the character who
has left the room will look for the object. Perspective-
taking capabilities are required in order for participants to
recognize that the character who has left the room does not
know that the object was moved and therefore will look for
the object in the original location (Brüne and Brüne-Cohrs
2005). In addition to false belief paradigms, other measures
of ToM have included tasks assessing emotion recognition
(Baron-Cohen et al. 2001), understanding of cartoon dia-
grams (Sarfati et al. 1997), and the ability to explain the
reason a character in a story behaved in a certain manner
(Gregory et al. 2002; Happé 1994). Though several tests of
ToM exist in the extant literature, studies will often cal-
culate an aggregate ToM score (Saltzman et al. 2000; Fahie
and Symons 2003; Yirmiya et al. 1998). Given the variety
of ToM measures, consolidating the different types of ToM
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domains into one score may not be the best method in
which to examine ToM.
ToM is considered a cognitive construct rather than an
affective one (Baron-Cohen 1988) and its development
occurs across several stages of increasing complexity (for a
review, see Brüne and Brüne-Cohrs 2005). Development
begins at age one and culminates around ages 9 to 11 years
(Brüne and Brüne-Cohrs 2005). Children learn to follow
another’s gaze, engage in pretend play, understand that
another person can hold a different belief than oneself,
comprehend jokes and irony, and finally conceptualize the
faux pas. In addition to the developmental trajectory of
ToM, there has been some research on sex differences in
ToM ability. Specifically, females have been shown to
outperform males on measures of emotion recognition
(Baron-Cohen et al. 1997) and understanding of faux pas
(Baron-Cohen et al. 1999. Additionally, females have been
found to perform better on a measure of empathy, in which
intact ToM has been conceptualized as a necessary com-
ponent (Baron-Cohen and Wheelwright 2004). Not all
studies, however, have found a gender difference (Ozonoff
et al. 1991).
From school, work, and peer and intimate relationships,
perspective-taking is paramount. Consider the importance
of successful social interaction in everyday functioning.
For example, school requires a child to not only learn
course material, but to be able to communicate successfully
with classmates and teachers. A significant portion of
coursework is made up of group-based activities, such as
group presentations. The ability to work as an effective
member of a group extends beyond school. In the work-
place, one needs to be able to successfully work with
colleagues. A person needs to be able to listen to what
other group members say and understand why they are
taking on a specific perspective, especially if it differs from
oneself, as is often the case. This requires ToM because the
person needs to be able to place him/herself in the other
person’s mental state to understand why they are making a
specific suggestion. Additionally, ToM ability is necessary
during job interviews and interaction with supervisors, as it
is very important to take the perspective of the interviewer
or supervisor as well as recognize a socially-inappropriate
response. Another area that requires successful ToM abil-
ities is in friendships. Humans are social creatures and need
social interaction. When establishing friendships, one
needs ToM abilities in order to understand others. This
becomes much more important when searching for a sig-
nificant other. Because everyday living needs successful
social interactions, any deficits in ToM abilities can sig-
nificantly impact one’s life. The inability to interact with
others can impede success at school, work, and finding/
maintaining friends. This may lead to a lack of positive
social relationships, which can lead to feelings of isolation,
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anxiety, and depression. Impairments have been found in
some clinical populations. For example, individuals with
autism spectrum disorders, dementia, and bipolar disorder
have demonstrated poor ToM skills (Baron-Cohen et al.
1985; Baron-Cohen et al. 1997; Bora et al. 2005; Brüne and
Brüne-Cohrs 2005; Cuerva et al. 2001; Gottlieb 2005;
Gregory et al. 2002; Happé 1994; Kaland et al. 2002; Kerr
et al. 2003).
Executive Function
EF refers to higher-order cognitive processes required for
individuals to complete goal driven tasks (Lezak et al. 2004
p. 35). Examples include the ability to inhibit behavior, shift
cognitive sets, plan how to solve a problem, and generate
behaviors with categorical or phonemic constrictions
(Anderson 2002; Delis et al. 2001). The prefrontal cortex
may control EF because of its ability to incorporate multiple
types of information needed for a task (Royall et al. 2002).
Of note, there is still no agreement of what constitutes all of
the components of EF, and many models exist to explain EF
domains (for a review, see Stuss and Knight 2002).
Although there is a discrepancy on defining the exact
components of EF, all models agree that EF constitutes the
steps necessary to solve a complex task (Zelazo and Frye
1998). One approach in particular, the Cognitive-Process
approach, avoids separating out distinct domains of EF and
instead focuses on the skills necessary to complete tradi-
tional EF tests (Homack et al. 2005; Delis et al. 2001).
Executive Function and Theory of Mind
A number of studies have examined the EF-ToM rela-
tionship, and results have been variable. For example, a
case study of an adult who sustained amygdala damage and
was diagnosed with both Asperger’s Disorder and schizo-
phrenia found EF deficits but normal ToM functioning
(Fine et al. 2001). Another case study of an adult with
impaired orbitofrontal capacity also reported no relation-
ship between EF and ToM (Bach et al. 2005). However,
most studies have found a relationship between EF and
ToM. In a comprehensive review, Hughes and Graham
(2002) concluded that in addition to EF and ToM deficits in
autism spectrum disorders, the two domains are related to
one another. In a study of children with autism, it was
found that performance on ToM was significantly and
positively related to working memory and inhibition
(Joseph and Tager-Flusberg 2004). Fisher and Happé
(2005) examined the clinical implications of the EF-ToM
relationship and trained two groups of children in either
ToM skills or EF skills. They found that better performance
J Autism Dev Disord (2011) 41:667–678
in EF skills was positively associated with better perfor-
mance in ToM, suggesting an association between EF and
ToM in the autism spectrum disorders (Fisher and Happé
2005).
This EF-ToM association has also been found outside
this group. In children with attentional and behavioral
problems, ToM and working memory were found to be
significantly and positively related (Fahie and Symons
2003). In a similar sample, Hughes et al. (1998) found that
EF and ToM were positively correlated. This relationship
has been found in non-clinical populations as well. In a
study of preschoolers by Gordon and Olson (1998), results
indicated better ToM performance as a function of better
performance of EF. Cole and Mitchell (2000) found similar
conclusions in three to five-year-old children. A longitu-
dinal study by Hughes (1998) demonstrated that EF pre-
dicted ToM performance over time, but ToM did not
predict EF. The EF-ToM relationship has also been dem-
onstrated in a non-Western culture. In a study that exam-
ined preschoolers from China and the United States,
researchers found that planning, cognitive flexibility, and
inhibition were positively correlated with ToM (Sabbagh
et al. 2006). This relationship is not specific to children,
either. Saltzman et al. (2000) found that design fluency,
problem solving, and verbal fluency were positively cor-
related with ToM in an elder population.
Of note, there has also been research examining whether
specific EFs drive ToM or if they simply share a basic
general processing domain. McKinnon and Moscovitch
(2007) found that on measures of social cognition (ToM
and deontic reasoning), performance relied on a general
central processing component. This study was followed by
Bull et al. (2008), in which a dual-task interference task
was added to ToM measures. The interference tasks were
differing types of general EF domains (inhibition, switch-
ing, updating). The dual-task conditions significantly
affected ToM performance and the authors suggested that
this occurred because both ToM and EFs share global
attentional reserves (Bull et al. 2008). Thus far, there
appear to be only a few studies have attempted to identify
the specific EF domains which share the most variance
with ToM. Limited research examining this question have
noted that both inhibition and working memory appear to
have the strongest association with ToM, and that this
relationship emerges at 39 months of age (Carlson et al.
2002, 2004a, b). Further, most of these studies have only
examined children (Carlson et al. 2002, 2004a, b; Cole and
Mitchell 2000; Fahie and Symons 2003; Fisher and Happé
2005; Joseph and Tager-Flusberg 2004; Perner and Lang
1999; Sabbagh et al. 2006). The limitation of this is that
children are still in the developing stages of ToM (Brüne
and Brüne-Cohrs 2005), and, EF is not fully developed
until after childhood (Anderson et al. 2002). Therefore, it
669
becomes more difficult to draw conclusions. Additionally,
Apperly et al. (2009) emphasized that it is important to
examine the role of EF in ToM in adults, as it can give
insights about the importance of EF in the development
and/or maintenance of ToM in adulthood. The authors
stated that without studying ToM in adults, it is difficult to
pinpoint the role of EF. They noted that EF may be crucial
in the development of ToM but may not be necessary in
adulthood, or, that EF may also be an important process in
the fully-developed ToM of adults. This question cannot be
answered by studying children alone, but needs to be
coupled with research on adults as well (Apperly et al.
2009). This, therefore, is another reason that it is important
to examine the EF-ToM relationship in a typically-devel-
oping adult population.
Aims
To avoid the complication among the effects of cognitive
development when examining the ToM-EF relationship as
well as further examine the role of EF in the fully-devel-
oped ToM, this study used a sample of typically developing
adults because they should have fully developed their ToM
abilities (Brüne and Brüne-Cohrs 2005). By using a typi-
cally-developing population, it can be easier to infer the
relationship between EF and ToM. Based on the results of
Hughes (1998), in which EF was found to predict ToM but
not the other way around, this study will examine the
predictive ability of EF on ToM using a comprehensive set
of EF domains. Furthermore, to our knowledge, there has
not been a study that examines the relationship among a
wide range of EF components and ToM. Previous studies
only compared a limited number of EF domains, such as
inhibition and working memory (Carlson et al. 2002,
2004a, b). This study utilizes multiple EF measures and
multiple levels of ToM tests to obtain a comprehensive
assessment of the EF-ToM relationship.
The specific aims of this study were (a) to evaluate the
relationship between ToM tests with one another; and (b)
to identify which domains of EF best predict ToM, as
obtained from a non-clinical adult population. By con-
ducting this study, we hope to provide further insight into
the cognitive mechanisms that drive the complex process
of ToM. As aforementioned, there are multiple clinical
populations who have shown deficits in ToM and thus
suffer from unsuccessful social interaction (Baron-Cohen
et al. 1985, 1997; Bora et al. 2005; Brüne and Brüne-Cohrs
2005; Cuerva et al. 2001; Gottlieb 2005; Gregory et al.
2002; Happé 1994; Kaland et al. 2002; Kerr et al. 2003).
Therefore, we hope to contribute to the ongoing ToM
research on clinical populations by further describing the
underlying skills necessary for successful ToM.
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Method
Participants
One hundred and thirty-five research participants from the
University of Georgia Research Participant Pool were
recruited to participate in this study. Participants were
excluded from the study based on the presence of ongoing
psychosis, depression, current psychiatric medication, or
poor effort. To screen for psychosis, the Psychotic Screen
from the Structured Clinical Interview for DSM-IV Axis I
Disorders (First et al. 1996) was used as a measure of gross
psychological impairment. Endorsement of any of these
items (e.g., visual or auditory hallucinations, persecutory or
grandiose delusions, etc.) excluded the participant’s data
from this study. To screen for depression, participants were
administered the Beck Depression Inventory (BDI; The
Psychological Corporation 1996), which indicates current
depressive symptoms. Data from participants who obtained
a BDI score of C20 (i.e., moderate depression) or more
were excluded from the study. The Medical Symptom
Validity Test (MSVT), an empirically-supported, quantita-
tive measure of effort, was administered to screen for poor
effort (Richman et al. 2006; Merten et al. 2005). Five par-
ticipants were excluded from this study due to endorsing
symptoms of current psychosis. Three participants were
excluded due to self report of significant depressive symp-
toms, and current use of psychiatric medication excluded
four participants. No participants were excluded due to poor
performance on the MSVT. The final number of participants
included in this study was 123. Participants ranged in age
from 18 to 27 years (M = 19.04, SD = 1.30).
Procedure
Each participant was tested in a single session in the
Neuropsychology and Memory Assessment Laboratory at
the University of Georgia. Informed consent was obtained
by a written form approved by the University’s Institu-
tional Review Board. Participants also received verbal
explanation of their rights as well as course credit.
Demographic information was obtained and participants
were administered the Wechsler Test of Adult Reading
(WTAR; The Psychological Corporation 2001) in order to
obtain an estimated Full Scale IQ (FSIQ) score. This was
calculated to ensure IQ equivalence among participants.
Next, participants were administered the D-KEFS and
three well-known ToM tests (Reading the Mind in the Eyes
test (RMET; Baron-Cohen et al. 2001), Strange Stories
Test (Brent et al. 2004; Happé 1994), and Faux Pas Test
(Gregory et al. 2002; Stone et al. 1998). The order of these
tests (EF battery first or ToM battery first) were counter-
balanced. The order of the ToM tests were as follows:
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J Autism Dev Disord (2011) 41:667–678
RMET, Strange Stories test, and Faux Pas test. The Strange
Stories test included six randomized sets that were cycled
through every six participants. Tests were administered and
scored according to standard protocol (Baron-Cohen et al.
2001; Delis et al. 2001; Gregory et al. 2002; Happé 1994;
Stone et al. 1998).
After the completion of testing, participants received a
written and verbal debriefing of the study’s aims.
Measures
Delis-Kaplan Executive Function System
The Delis-Kaplan Executive Function System (D-KEFS) is
a battery of nine subtests that measure components of EF.
This battery is based on several traditional neuropsycho-
logical tests that have been updated and normed on the
same sample. This is the first battery of EF tests that has
been normed on such a large sample (1,750 adults and
children) and can be administered to individuals between 8
and 89 years. There are nine subtests, including (a) Word
Context Test, (b) Sorting Test, (c) Twenty Questions Test,
(d) Tower Test, (e) Color-Word Interference, (f) Verbal
Fluency Test, (g) Design Fluency Test, (h) Trail Making
Test, and (i) Proverb Test. They each yield multiple scores;
however one EF domain score can be pulled from each test,
which are (a) cognitive flexibility, (b) verbal fluency, (c)
design fluency, (d) inhibition, (e) problem solving, (f)
categorical processing, (g) deductive reasoning, (h) spatial
planning, and (i) verbal abstraction (Delis et al. 2001).
Cognitive flexibility is postulated as the capacity to adapt
to new rules. Verbal and design fluency constitute the
ability to quickly make unique words or designs. Inhibition
requires one to resist a prepotent response. Problem solving
refers to the capacity to successfully solve a problem. In
categorical processing, one has to be able to systematically
organize information. In order to have adequate deductive
reasoning skills, one has to be able to use clues in order to
solve a puzzle. Verbal abstraction refers to the capacity to
not literally comprehend all statements (Delis et al. 2001).
Because of the large age range of the D-KEFS, it has low
floors and high ceilings. Furthermore, there is moderate
reliability and validity. Test–retest reliability across subtest
scores is between .06 and .90. The internal consistency
across subtests is between .33 and .90 (Delis et al. 2001).
The D-KEFS tests were administered and scored
according to standard protocol (Delis et al. 2001).
Reading the Mind in the Eyes Test
The Reading the Mind in the Eyes Test (RMET) has been
developed as a subtle measure of ToM assessing a funda-
mental skill needed for ToM: emotion recognition. The
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RMET has been able to to identify ToM deficits in both
healthy controls and individuals with high-functioning
Autism and Asperger’s Disorder (Baron-Cohen et al.
1997). This test is made up of 36 photos of actors’ eyes and
requires the participant to identify the emotion that the
actor is portraying (Baron-Cohen et al. 2001).
This study used a revised version of the test that is
designed for adults. It has been shown to have better psy-
chometric qualities than the original version, primarily in
reducing normal performance to below ceiling compared to
the original (Baron-Cohen et al. 2001). Validity has been
good. Scores on the Autism Quotient and the RMET were
inversely correlated (r = -.53, p \ .01), with increasing
severity of Autism associated with poorer scores on the
RMET (Baron-Cohen et al. 2001). As previously noted, the
amount of literature regarding variance among ToM mea-
sures is limited. The RMET was administered and scored
according to standard protocol (Baron-Cohen et al. 2001).
Strange Stories Test
The Strange Stories test is another subtle test of ToM
(Happé 1994; Jolliffe and Baron-Cohen 1999). It is sensi-
tive in detecting ToM deficits in individuals who generally
pass other simpler measures (Happé 1994). This test
assesses more advanced concepts such as double bluff,
white lies, and persuasion. Participants are presented with a
series of vignettes and are asked to explain why the main
character acted in a particular manner.
A revised shorter version has also been found to be a
sensitive measure of ToM in adults (Happé 1994; Jolliffe
and Baron-Cohen 1999; Happé et al. 1998; Maylor et al.
2002; Sullivan and Ruffman 2004). A different revised
version was used in this study (with permission from the
test developer) which contains 16 items (8 control and 8
experimental) and developed specifically for younger and
older participants. To the best of our knowledge, this par-
ticular subset of stories has not been used though the var-
ious individual stories have all been used (Brent et al.
2004; Happé 1994). Therefore, specific data of the reli-
ability and validity of the exact set of stories used for this
study are unknown.
The Strange Stories test scores has been found to have
strong interrater reliability (87%) (Happé et al. 1998).
Validity has also been good. Specifically, it has consis-
tently shown poorer performance in participants with
Autism Spectrum Disorders compared to typically devel-
oping controls, thus demonstrating a deficient ToM ability
in those with Autism Spectrum Disorders. Additionally,
the Strange Stories test has demonstrated subtle differences
in test performance between severely autistic participants
and higher-functioning autistic participants (Happé 1994;
Kaland et al. 2002; Gottlieb 2005).
671
Administration of the Strange Stories test adhered to the
standard protocol which consisted of reading the vignettes
aloud to the participants while the participants were pro-
vided with a written version of the vignettes as well (Happé
1994) except for nine participants who read the stories
themselves. An independent samples t-test indicated no
differences between those who had the stories read to them
and followed along versus those who only read the stories
themselves (t (121) = .367, p [ .05). The majority of the
Strange Stories tests were scored by two raters, and inter-
rater reliability was established (q = .87, p \ .01).
Therefore, an average variable was calculated for the
majority of participants. The remainder of the tests were
scored by the first author alone, and interrater reliability
was established among the first author and the two raters
from a subset of the data (q = .89, q = .89, p \ .01). This
yielded a test variable that consisted of either the average
score of the two raters or the sole score rated by the first
author.
Faux Pas Test
The Faux Pas test is another subtle measure of ToM. A
faux pas is defined as an interaction in which one person
inadvertently makes an inappropriate comment that results
in negative feelings from the other person (Gregory et al.
2002; Stone et al. 1998).
The Faux Pas test has been shown to have good inter-
rater reliability (r = .98; Gregory et al. 2002). Research
also indicates that it is a valid measure of understated ToM
impairment, as children with Asperger’s Disorder were
unable to correctly detect a faux pas but were able to pass
simple false-belief tasks (Baron-Cohen et al. 1999).
Additionally, research on adults found that those with
damage to the orbitofrontal cortex were unable to detect a
faux pas but were able to pass false belief tasks (Stone et al.
1998). To the knowledge of the authors, concordance
between the Faux Pas test and other ToM tests has not
generally been reported in studies using this test (Shaw
et al. 2004).
Administration of the Faux Pas test adhered to the
standard protocol which consisted of reading the vignettes
aloud to the participants while the participants were pro-
vided with a written version of the vignettes as well
(Gregory et al. 2002; Stone et al. 1998). As with the
Strange Stories, the same nine participants read the stories
to themselves and analyses similarly found no differences
between the groups (t (121) = -1.56, p [ .05). Interrater
reliability was similarly established as with the Strange
Stories Test (q = .91, p \ .01) and an average variable
calculated for those with two raters. Remaining scores were
singularly scored by the first author following adequate
interrater reliability of a subset of the data (q = .96,
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q = .89, p \ .01). This yielded a test variable that con-
sisted of either the average score of the two raters or the
sole score rated by the first author.
Of note, none of the three ToM measures used were
false belief tasks. These three tasks were utilized in this
study because they are considered higher-order tasks that
are designed for people who do not generally fail false
belief tasks (Baron-Cohen et al. 1999). According to Happé
(1994), it is common for individuals with higher-func-
tioning status on the autism spectrum to pass first-order
false belief tasks. Since this study examined typically-
developing adults, it appeared appropriate to use these
measures.
Variables
Though various ToM tests are commonly aggregated into
one score (Saltzman et al. 2000; Fahie and Symons 2003;
Yirmiya et al. 1998), earlier pilot data suggested a potential
lack of correlation (Ahmed et al. 2007). Thus we first
examined whether the ToM scores were correlated before
considering aggregating them. For the ToM tests, variables
were derived from the total number correct from the
RMET, total score of the Strange Stories test, and the total
items correct from the Faux Pas test. Each of the nine
D-KEFS EF domains yielded a single scaled score from
one representative task as a predictor variable. Condition 4
of the Trail-Making Test referred to cognitive flexibility.
The Letter Fluency condition of the Verbal Fluency Test
indicated verbal fluency, and design fluency was repre-
sented by Condition 1 of the Design Fluency Test. Con-
dition 3 of the Color-Word Interference Test designated
inhibition, problem solving was indicated by the confirmed
correct sorts of the Free Sort condition of the Sorting Test,
and the total weighted achievement of the Twenty Ques-
tions Test represented categorical processing. Deductive
reasoning was indicated by the total number consecutively
correct of the Word Context Test, total achievement of the
Tower Test represented spatial planning, and the cumula-
tive percentile rank from the Multiple Choice condition of
the Proverb Test indicated verbal abstraction (Delis et al.
2001).
Results
Demographic information for the 123 participants is sum-
marized in Table 1.
Descriptive data on the D-KEFS and ToM scores are
summarized in Table 2.

Table 1 Demographic data

Frequency Percent Minimum Maximum Mean Standard
deviation

Agea 18 27 19.04 1.30

Gender
Male 53 42.7
Female 70 56.5
Ethnicity
White/non hispanic 96 78.0
African American/Black 6 4.9
Hispanic/Latino 5 4.1
Asian/Pacific Islander 14 11.4
Other 2 1.6
Family income
Below $10,000 1 .8
$10,001–$30,000 7 5.7
$30,001–$60,000 23 18.7
$60,001–$90,000 37 30.1
$90,001 and above 55 44.7
Geographical region raised
South 106 86.2
North Central 1 .8
N = 123 West 3 2.4
a
In years Northeast 6 4.9
b
WTAR-predicted Other 6 4.9
FSIQ = Wechsler test of adult b
WTAR-predicted FSIQ 86 122 108.91 6.90
reading-predicted full scale IQ

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Table 2 Descriptive statistics of D-KEFSa and ToMb variables Correlational analyses were used to evaluate the rela-
Minimum Maximum Mean Standard
tionship among ToM tests. As all three ToM tests were in
deviation violation of normality based on the Kolmogorov–Smirnov
statistic (all p’s \ .01), rank-order correlations were con-
D-KEFS: cognitive 4 14 10.78 1.87
ducted. None of the three ToM tests were significantly
flexibility
correlated with each other (see Table 3).
D-KEFS: verbal fluency 5 19 12.19 3.48
A correlation matrix was also calculated for the D-KEFS
D-KEFS: design fluency 4 19 11.98 3.05
and ToM variables (see Table 3).
D-KEFS: inhibition 6 19 11.51 2.25
Since the ToM tests were not correlated with one
D-KEFS: problem solving 1 15 9.13 2.62
another, three separate regression analyses were conducted
D-KEFS: categorical 5 15 11.54 2.34
processing
with each of the three variables from the ToM tests as
single dependent variables. D-KEFS variables that were
D-KEFS: deductive 6 16 11.71 2.11
reasoning correlated with each ToM measure were entered as inde-
D-KEFS: spatial planning 4 17 11.17 2.18 pendent variables (see Table 3). Hierarchical regression
D-KEFS: verbal 5 100 87.49 28.63 analyses were employed by entering any significantly
abstraction correlated demographic variables in the first step of the
RMETc 8 34 27.28 3.75 model and then adding D-KEFS variables into the second
Strange stories 22 32 27.41 2.23 step of the model. Outlier analyses were also calculated
Faux Pas 76 121 112.94 8.58 separately for each regression. All results from regression
analyses were in a positive direction.
N = 123
a
D-KEFS Delis-Kaplan Executive Function System. D-KEFS scores
based on M = 10, SD = 3. D-KEFS verbal abstraction based on Executive Function and Performance on the RMET
percent correct
b
ToM Theory of Mind. ToM scores based on total correct (RMET To determine whether any of the demographic variables
ranges from 0 to 36; Strange Stories Test ranges from 0 to 32; Faux (i.e., age, gender, ethnicity, family income, geographical
Pas Test ranges from 0 to 121) region raised, and WTAR-predicted FSIQ) significantly
c
RMET Reading the Mind in the Eyes Test accounted for variance in the RMET scores, they were

Table 3 Correlation Matrix of D-KEFSa and ToMb variables

CF VF DF I PS CP DR SP VA RMET Strange stories Faux Pas

CF 1.00 .25** .26** .28** .28** .07 .15 .09 .05 .03 -.01 .07
VF 1.00 .29** .44** .22* .18* .29** .02 .11 .23* .22* .22*
DF 1.00 .26** .10 .12 .15 .04 -.020 .24** .19* .10
I 1.00 .26** .02 .28** .04 .16 .22* -.00 .06
PS 1.00 .19* .23* .07 .21* -.09 -.05 .21*
CP 1.00 .04 .06 .10 .06 .01 .19*
DR 1.00 .13 .17 .21* .18* .14
SP 1.00 -.04 -.03 .18* .04
VA 1.00 .120 .08 .13
RMETc 1.000 .14 .13
Strange stories 1.00 .11
Faux Pas 1.00
N = 123. Spearman’s Rank-Order Correlations were used for Correlations among ToM tests. All other correlations used Pearson’s correlations
* p \ .05; ** p \ .01
a
D-KEFS Delis-Kaplan Executive Function System, D-KEFS variables: CF cognitive flexibility, VF verbal fluency, DF design fluency,
I inhibition, PS problem solving, CP categorical processing, DR deductive reasoning, SP spatial planning, VA verbal abstraction
b
ToM Theory of Mind
c
RMET Reading the Mind in the Eyes Test

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Table 4 Multiple regression analysis for prediction of RMETa by R = .42, R2 = .17 Adj. R2 = .14, R2 change = .05, Standard Error
D-KEFSb testsc,d Step 1: R = .36, R2 = .13, Adj. R2 = .12, Standard of Estimate = 3.07, F (4,115) = 4.84, p \ .01
Error of Estimate = 3.11, F (1,119) = 17.22, p \ .01 Step 2:
Step Beta t Sig. (p) Correlations
Zero-order Partial Part

1 WTAR-predicted .17 4.15 \.01 .36 .36 .36

FSIQ
2 WTAR-predicted .13 2.82 \.01 .36 .25 .24
FSIQ
Verbal fluency .04 .36 [.05 .23 .03 .03
Design fluency .14 1.39 [.05 .22 .13 .12
Inhibition .13 .83 [.05 .26 .08 .07
Deductive reasoning .15 1.10 [.05 .22 .10 .09

N = 121. The dependent variable is the RMET total raw score (range = 0–36)
a
RMET Reading the Mind in the Eyes Test
b
D-KEFS Delis-Kaplan Executive Function System
c
Only D-KEFS variables that were significantly correlated with the RMET were entered in the model
d
D-KEFS-RMET significant correlations: a verbal fluency (r = .23, p \ .05), b design fluency (r = .24, p \ .01), c inhibition (r = .22,
p \ .05), and d deductive reasoning (r = .21, p \ .05)

regressed on the RMET variable. The only significant Verbal fluency (r = .22, p \ .05), design fluency
variable was WTAR-predicted FSIQ scores (b = .39, (r = .19, p \ .05), deductive reasoning (r = .18, p \ .05),
t (115) = 4.49, p \ .01), so it was entered into the first step and spatial planning (r = .18, p \ .05) were all signifi-
of the model. cantly correlated with Strange Stories performance (see
The D-KEFS variables that correlated with RMET per- Table 3) so they were simultaneously entered into the
formance were entered into the second step of the model regression model, with the Strange Stories test as the
(see Table 3). Verbal fluency (r = .23, p \ .05), design dependent variable. A Cook’s D analysis (value of 4/123
fluency (r = .24, p \ .01), inhibition (r = .22, p \ .05), [.0325]) identified seven outliers. After removing these
and deductive reasoning (r = .21, p \ .05) were the only outliers from the data set, the regression analysis was
significantly correlated variables. Next, a Cook’s D anal- re-run (see Table 5).
ysis (value of 4/123 [.0325]) identified two outliers. After
removing these two participants from the data set, the
Table 5 Multiple regression analysis for prediction of strange stories
regression analysis was re-run (see Table 4).
testa by D-KEFSa testsc,d
The first step of the model significantly predicted vari-
ance in RMET (R2 = .126, F (1, 119 = 17.22, p \ .01) Beta t Sig. (p) Correlations
and WTAR-predicted FSIQ scores significantly predicted Zero-order Partial Part
performance on the RMET (b = .17, t (119) = 4.15,
Verbal fluency .14 2.44 \.05 .32 .23 .21
p \ .01). The overall model also accounted for a signifi-
Design fluency .10 1.58 [.05 .25 .15 .13
cant amount of variance in RMET scores (R2 = .17,
Deductive reasoning .21 2.33 \.05 .31 .22 .20
R2 = .05, F (5, 115) = 4.84, p \ .01). However, this
Spatial planning .17 1.97 [.05 .20 .18 .17
continued to be driven by WTAR-predicted FSIQ
2 2
(b = .13, t (115) = 2.82, p \ .05) and none of the R = .45, R = .21, Adjusted R = .18 Standard Error of Esti-
D-KEFS variables were significant. mate = 1.88, F (4, 111) = 7.14; p \ .01
N = 116
a
Executive Function and Performance on the Strange The dependent variable is the Strange Stories Test total raw score
Stories Test (range = 0–32)
b
D-KEFS Delis-Kaplan Executive Function System
c
As above, demographic variables were initially entered in a Only D-KEFS variables that were significantly correlated with the
regression analysis to determine whether they accounted Strange Stories Test were entered in the model
d
for a significant amount of variance in Strange Stories test D-KEFS-Strange Stories Test significant correlations: a verbal
fluency (r = .22, p \ .05), b design fluency (r = .19, p \ .05),
scores. None were significant, so they were left out of c deductive reasoning (r = .18, p \ .05), and d spatial planning
further analysis. (r = .18, p \ .05)

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J Autism Dev Disord (2011) 41:667–678 675

The model accounted for a significant proportion of continued to account for a significant portion of variance
variance in Strange Stories performance (R2 = .21, F (4, (b = 4.99, t (111) = 5.04, p \ .01). Of the D-KEFS vari-
111) = 7.139, p \ .01; see Table 5). Verbal fluency ables, verbal fluency (b = .32, t (111) = 2.22, p \ .05) and
(b = .14, t (111) = 2.44, p \ .05) and deductive reasoning problem solving (b = .50, t (111) = 2.45, p \ .05)
(b = .21, t (111) = 2.33, p \ .05) predicted a significant explained a statistically significant amount of variance in
amount of variance in Strange Stories scores. Design flu- Faux Past test performance. Categorical processing was
ency and spatial planning were nonsignificant. nonsignificant. In order to examine the gender effect, an
independent-samples t-test was used. Because Levene’s test
Executive Function and Performance on the Faux Pas for equality of variance was significant, a Brown-Forsyth
Test test was used (Brown-Forsyth test statistic = 16.442,
p \ .01), which indicated that females performed modestly,
The amount of variance accounted for by demographic though significantly, better than males (mean score
variables was again calculated. Gender significantly pre- females = 116, mean scores males = 112).
dicted performance on the Faux Pas test (b = .34,
t (116) = 3.90, p \ .01) so it was entered into the first step
of the regression analysis. Verbal fluency (r = .22, Discussion
p \ .05), problem solving (r = .21, p \ .05), and cate-
gorical processing (r = .19, p \ .05) were significantly Our first aim was to evaluate the relationship between the
correlated with the Faux Pas test (see Table 3) and were three ToM measures. The lack of correlations among the
entered into the second step of the regression model. three ToM tests suggest that although all were designed to
A Cook’s D analysis (value of 4/123 [.0325]) identified measure ToM (Baron-Cohen et al. 2001, 1997; Gottlieb
seven outliers. After removing these participants from the 2005; Gregory et al. 2002; Happé 1994; Happé et al. 1998;
data set, the regression analysis was re-run (see Table 6). Jolliffe and Baron-Cohen 1999; Kaland et al. 2002; Maylor
The first step of the model accounted for a significant et al. 2002; Stone et al. 1998; Sullivan and Ruffman 2004),
portion of variance (R2 = .14, F (1, 114) = 18.75, p \ .01) they may be each tapping into very different domains. This
and gender was significant (b = 4.47, t (114) = 4.33, supports and expands preliminary research from this lab-
p \ .01). The overall model was also significant (R2 = .26, oratory that also suggested each of these ToM tasks may
R2 change = .11, F (4, 111) = 9.48, p \ .01). Gender utilize different cognitive processes (Ahmed et al. 2007).
Research by Brent et al. (2004) also suggested that various
Table 6 Multiple regression analysis for prediction of Faux Pas Testa higher-order ToM tasks may be related to differing infor-
by D-KEFSa Testsc,d mation-processing components. Furthermore, different EF
Step Beta t Sig. Correlations
patterns were found for each ToM test, which suggests that
(p) there may be differing cognitive processes that are asso-
Zero- Partial Part ciated with the apparent different domains of ToM mea-
order
sured by each test. It is not rare for ToM tests to be
1 Gender 4.47 4.33 \.01 .38 .38 .38 aggregated into a composite score (Salztman et al. 2000;
2 Gender 4.99 5.04 \.01 .38 .43 .41 Fahie and Symons 2003; Yirmiya et al. 1998). These
Verbal fluency .32 2.22 \.05 .24 .21 .18 results, however, suggest that this practice may not be the
Problem solving .50 2.45 \.05 .19 .23 .20 best manner in which to analyze one’s data.
Categorical .20 .92 [.05 .15 .09 .08 The RMET requires a participant to study the expres-
processing sions of actors’ eyes and determine which emotion they are
Step 1: R = .38, R2 = .14, Adjusted R2 = .13, Standard Error of conveying from four possible choices (Baron-Cohen et al.
Estimate = 5.49, F (1,114) = 18.75, p \ .01 Step 2: R = .51, 2001). None of the EF variables accounted for a significant
R2 = .26, Adjusted R2 = .23, R2 change = .11, Standard Error of proportion of variance in RMET performance. A measure
Estimate = 5.18 F (4,111) = 9.48, p \ .01
of word-reading ability, however, was predictive of RMET
N = 116 performance. The RMET has been conceptualized as a
a
The dependent variable is the Faux Pas Test total raw score ToM task due to the concept that emotion recognition is the
(range = 0–121)
b foundation of ToM abilities (Baron-Cohen et al. 2001). The
D-KEFS Delis-Kaplan Executive Function System
c
results found in this study suggest that the EF domains
Only D-KEFS variables that were significantly correlated with the
Faux Pas Test were entered in the model
measured in this study did not drive this particular task of
d
D-KEFS-Faux Pas Test significant correlations: a verbal fluency
emotion recognition. It may be that the aspect of ToM
(r = .22, p \ .05), b problem solving (r = .21, p \ .05), and c cate- measured in the RMET, emotion recognition, is so differ-
gorical processing (r = .19, p \ .05) ent from the areas of ToM measured by the Strange Stories

123
676
and Faux Pas tests that it does not include a significant EF
mechanism. It should be noted that the Strange Stories and
Faux Pas tests both require one to be able to clearly express
their responses in a verbal format, whereas the RMET
requires one to choose an appropriate word from a choice
of four options (Baron-Cohen et al. 2001; Gregory et al.
2002; Happé 1994; Stone et al. 1998). Successful perfor-
mance on the RMET may only require a basic under-
standing of emotion words. Emotion recognition has been
referred to as the first step in ToM without the more
complicated task of deciphering the beliefs of the charac-
ters (Baron-Cohen et al. 2001). In fact, it has been argued
that the ability to recognize an emotional state develops as
early as infancy (Nelson 2001).
Of domains of EF variables entered into the regression
model for predicting Strange Stories performance, verbal
fluency and deductive reasoning were significant. The
Strange Stories test uses a series of vignettes in which
participants have to identify the intentions of the stories’
characters (Happé 1994). Verbal and design fluency require
a person to quickly form words according to a rule (Delis
et al. 2001). This can be conceptualized as the ability to
flexibly initiate responses. A person does not memorize one
type of social interaction. Instead, one needs to generalize
basic concepts of social interaction to a variety of unique
situations, thus utilizing ToM through successful applica-
tion of flexible initiation of behavior. Deductive reasoning
relies on the ability to solve a puzzle from clues (Delis
et al. 2001). Since the Strange Stories test requires a person
to figure out the intentions of the characters (Happé 1994),
one has to deduce why a character behaved the way he or
she did.
For the Faux Pas test, verbal fluency and problem
solving significantly accounted for performance on that
test. The problem-solving variable came from the D-KEFS
Sorting Test’s confirmed correct sorts, in which partici-
pants have to sort a set of cards in multiple ways (Delis
et al. 2001). This appears to be a more complicated task
than the measure of deductive reasoning, which requires
one to solve a nonsense word using contextual cues (Delis
et al. 2001). The Faux Pas test measures a person’s ability
to simultaneously understand the beliefs of two characters
(Gregory et al. 2002; Stone et al. 1998), whereas the
Strange Stories test measures a person’s ability to under-
stand the beliefs of one character (Happé 1994). Perhaps
this increased complication in demands on the Faux Pas
test explains why the more complex D-KEFS measure of
problem-solving accounted for a significant amount of
variance than the somewhat simpler measure of deductive
reasoning.
Compared to the EF variables, however, gender
accounted for much more variance in Faux Pas perfor-
mance. Our findings supported previous literature of
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J Autism Dev Disord (2011) 41:667–678
gender differences finding females performing better than
males (Baron-Cohen and Wheelwright 2004; Baron-Cohen
et al. 1997, 1999) in general as well as specific to the Faux
Pas test (Baron-Cohen et al. 1999).
A strength of this study was the use of a typically-
developing population in regards to expected ToM func-
tioning. As previously mentioned, much of the ToM
research has been conducted on populations in which there
are deficiencies in ToM, by either studying children or
clinical populations with difficulties in ToM (Brüne and
Brüne-Cohrs 2005; Carlson et al. 2002, 2004a, b; Cole and
Mitchell 2000; Fahie and Symons 2003; Fisher and Happé
2005; Joseph and Tager-Flusberg 2004; Perner and Lang
1999; Sabbagh et al. 2006). It makes it more difficult to
draw conclusion about an EF-ToM relationship when ToM
is not intact. Therefore, this study attempted to control for
this problem by assessing a large sample of adults with
typically-developed ToM. Additionally, this study utilized
a broad range of EF variables, which to our knowledge has
not been done before. However, a related limitation of this
study was the rather homogenous sample. There was a
limited range of age, predicted IQ, and ethnicity. This may
have restricted the amount of variance in the test results
and one should be cautious about generalizing these results
beyond this limited sample group. A further limitation was
that, while gross psychological screening was conducted,
we did not specifically exclude persons with a history of
autism spectrum disorder or attention deficit disorder.
Although several studies have found links between
working memory and inhibition on ToM (Carlson et al.
2002; 2004a; b; Mckinnon and Moscovitch 2007), results
from this study did not find significant links between them.
In young adults, working memory interfered with perfor-
mance of tests of social reasoning (Mckinnon and Mos-
covitch 2007). This study did not specifically test for
working memory, as the D-KEFS measures do not give a
working memory score (Delis et al. 2001). Therefore, the
results of the current study neither support nor deny the
impact of working memory on ToM. It should be noted,
however, that the nature of the D-KEFS measures requires
one to be able to hold and manipulate information men-
tally. Participants need to hold different instructional sets
as they carry out the tasks of each test, such as the changing
instructions of the Trail Making Test (Delis et al. 2001).
Regarding inhibition, the results of this project did not find
inhibition to significantly predict ToM performance,
although it was significantly correlated with the RMET
(r = .22, p \ .05). As previously mentioned, working
memory and inhibition were found to be significant pre-
dictors of ToM in children (Carlson et al. 2002, 2004a, b).
Perhaps inhibition plays a more crucial role in the devel-
opment of ToM but plays a more minor role in the
developed ToM. According to Apperly et al. (2009), it is
J Autism Dev Disord (2011) 41:667–678
possible that EFs, or certain EFs, are more necessary in the
development of ToM but not for its maintenance. However,
it is still too early to make this claim, as it is possible that
inhibition was simply not a necessary EF for the ToM tests
used in this study.
This study supported previous preliminary research that
suggested that the RMET, Strange Stories test, and Faux
Pas tests utilized differing cognitive mechanisms. Except
for the RMET, some EF domains significantly accounted
for variance in ToM performance. It is possible that inci-
dental task demands of ToM tests are similar to EF mea-
sures. Specifically, these tests may be sharing a general
attentional capacity (Bull et al. 2008; McKinnon and
Moscovitch 2007). A follow-up to this study may be able to
address this question by partitioning the skills necessary to
successfully complete the EF measures that significantly
predicted ToM performance (i.e., verbal fluency, deductive
reasoning, and problem solving). Finally, these results were
observed in a non-clinical sample. It may be useful to
replicate this study using a population that does not have
fully-developed ToM abilities. It is unknown whether these
same results would reappear, as clinical populations would
likely have a larger range of demographic variables and,
perhaps, test scores. With this increased variability, the
results may be different. To be able to establish an EF-ToM
relationship, there has to be further research in both clinical
and nonclinical populations using the most comprehensive
batteries possible.
Acknowledgments We would like to thank Francesca Happé and
Anita Marsden for their permission and provision of the Strange
Stories test as well as Simon Baron-Cohen and the Autism Research
Centre for allowing the use of the Reading the Mind in the Eyes and
the Faux Pas tests. Finally, we thank LaShonda Abner, Cami Godsey,
Amy Kasian, and Gemma Patel for their help in the data collection
process.
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