Evelyne Clement

Cognitive Flexibility


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of dimension is explicitly announced.

      The common feature of the above tests is that they require flexible switching from one rule to another on a set of items. Other tasks, on the other hand, require a change in stimulus processing, not between several blocks of items, but from one item to another. One example is the “plus minus” task (Jersild 1927), which compares the performance obtained when performing simple operations (addition or subtraction) without the need to switch to those obtained when performing a series of operations involving a systematic switch between these two simple operations.

      This procedure can be seen as the basis of the task switching paradigm, which is used in a great deal of research on processing flexibility in adults (Mayr 2001; Monsell 2003; Schuch and Koch 2003; Mayr and Bell 2006).

      Other tasks built on this task switching format can be cited as classic cognitive flexibility tasks and are still widely used, such as the number-letter task (Rogers and Monsell 1995). In this task, pairs of numbers and letters (e.g. 4F) are presented either at the top or bottom of a screen. Depending on the location of the number-letter pair on the screen (top or bottom), a question has to be answered about the number (even or odd?), or about the letter (consonant or vowel?).

      The local-global task (Miyake et al. 2000) presents a geometric figure (often referred to as a “Navon figure”; Navon (1977)), in which the shape of a global figure (e.g. a triangle) is composed of other figures, local figures this time, which are much smaller (e.g. squares). A cue (e.g. the color of the figure) tells participants whether to give the number of lines used to compose the figure (e.g. 1 for a circle, 2 for an X, 3 for a triangle, or 4 for a square) for either the global figure or the local figure.

      In the TMT (Reitan and Wolfson 1993), the participant must switch from processing a sequence of letters in alphabetical order (A, B, C, etc.) to processing a sequence of numbers in ascending order (1, 2, 3, etc.), alternating between the two processes from one item to the next. Several numbers and letters are placed on a sheet of paper and the participant has to connect the elements with a pencil, going from the first letter (A), to the first number (1), to the second letter (B), and so on (A, 1, B, 2, C, 3, etc.).

      A simplified version of this test exists to make it accessible to preschoolers, the TMT for preschoolers (Espy and Cwik 2004). In this test, a sheet of paper shows dogs and bones of different sizes. The child is asked to stamp dogs in order of size (smallest to largest), while stamping the bones corresponding to the size of the dog as they go. The child must stamp the smallest dog, then the smallest bone, then the second dog, the second bone, etc. However, this version for children does not seem quite satisfactory, at least if it is to be used in conjunction with the adult version, because it does not allow for the same type of change to be assessed. The adult version requires switching from one task to another (connecting numbers and connecting letters), whereas the child version only proposes switching between two identical tasks: connecting according to size, certainly by alternating dog and bone, but the task remains identical.

      Another adult version with a version for children exists: the Color Trail Test (CTT) (D’Elia et al. 1996) and the Children’s Color Trail Test (CCTT) (Williams et al. 1995), this time being more similar to the adult version. In both cases, the test consists of alternating between two series of numbers, one in pink circles, the other in yellow circles. These versions are simpler than the original version, proposing to alternate between two identical tasks (connecting the sequence of numbers, although alternating according to the color of the items). However, they are still useful in some cases and have the advantage of proposing two equivalent versions, allowing for a comparison of the results of children and adults.

      1.3.1.1.2. Executive function assessment batteries

      Direct assessments are often less used by practitioners than by researchers, due to the greater material and temporal cost than for indirect assessments. However, there are several batteries of executive function assessments that include measures that can be likened to measures of cognitive flexibility, which have the advantage of providing useful calibrations for practitioners.

      The Test of Everyday Attention for Children (TEA-Ch) (Manly et al. 2001), which assesses the attentional abilities of children aged 6 to 12 years, includes the Creature Counting subtest, which can be used to assess cognitive flexibility. In this test, the task is to switch from counting up to the creature to counting down based on explicit visual cues (arrows indicating the counting direction). If the arrow points up, count upwards, but if the arrow points down, count backwards. This test involves flexibly switching from one process to another several times during the test.

      Another battery that includes possible flexibility assessments is the developmental neuropsychological assessment, second edition (NEPSY II) (Korkman et al. 2012), intended for children aged 5 to 16 years and 11 months. This battery includes the drawing fluency subtest (also usable for children aged 5 to 16 years and 11 months), in which the child is asked to connect dots in different ways by drawing lines in a limited time. Flexibility is assessed here by the child’s ability to produce different “drawings” for each item and to produce as many as possible within the time limit. As the name implies, this task is also often not considered a flexibility task, but a fluency task.

      A second subtest of the NEPSY II could be related to a measure of flexibility: it is the categorization subtest that can be used for children aged 7 to 16 years and 11 months. In this subtest, the child must produce categories to sort cards showing pictures that can be grouped in different ways. For example, the cards show animals of different sizes (large versus small), on different colored backgrounds (blue versus yellow), etc. The child is given an initial categorization by the adult and is then asked to produce others. This subtest can be used to assess cognitive flexibility, as it involves producing several different sorting actions for the same material.

      These four subtests could therefore all be considered as assessing, or at least partly involving, cognitive flexibility, but none of the four are explicitly described as such, and to our knowledge, there is no cognitive or executive test battery that includes an assessment of cognitive flexibility named as such.

      1.3.1.1.3. More playful