Hot and cool executive function and its relation to theory of mind in children with and without autism spectrum disorder

Previous research has clearly demonstrated that Autism Spectrum Disorder (ASD) involves deficits in multiple neuropsychological functions, such as Executive Function (EF) and Theory of Mind (ToM). A conceptual distinction is commonly made between cool and hot EF. In ASD, continued attention has been paid to the cool areas of executive dysfunction. Cool EF has been strongly related to ToM but research has not taken into account the association between hot EF and ToM in ASD. The present study investigates the associations between hot and cool EF and ToM in 56 school-aged children with ASD and 69 controls on tasks tapping cool EF (i.e. working memory, inhibition, planning), hot EF (i.e. affective decision making, delay discounting), and ToM (i.e. mental state/ emotion recognition and false belief). Significant group differences in each EF measure support an executive dysfunction in both domains in ASD. Strong associations between delay discounting and ToM mental state/ emotion recognition are reported suggesting that hot EF makes a unique contribution to ToM above and beyond cool EF in typical development and ASD. This study improves understanding of the profile of higher-order cognitive deficits in children with ASD, which may inform diagnosis and intervention