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Young Children’s Ability to Complete CBT Tasks:

Investigating the Relationship with Age, IQ, Theory of Mind

Development and Mental Health
Lyndsay Noble, Dr Charlotte Wilson & Professor Shirley Reynolds
University of East Anglia

Introduce Need for early intervention for childhood mental health difficulties - There is evidence to suggest that children age seven years
and younger can complete basic cognitive behaviour therapy (CBT) related tasks (Doherr et al., 2005; Quakley et al. 2004 & Reynolds et al.,
2006). Sentence about Piaget’s Theory of cognitive development. Sentence about Theory of mind and CBT – Sentence about importance of
adapting CBT for children to make it accessible and enjoyable for this population. The aim of the study was to broaden current
understanding of the factors related to enhancing young children’s performance in CBT related tasks.

Method Findings and Feedback

Design and Sample Main Findings
• Cross-sectional design The results of the study suggest that level of theory of mind
• A community sample of 98 children aged 54 to 84 months development is a more reliable predictor of young children’s
participated in the study ability to successfully complete CBT related tasks than
• 42% of participants were boys and the average age of chronological age.
participants was 67.3 months
  Participant Feedback
Measures Children said that the tasks ‘fun’ to do and some children asked to
• Participants completed four tasks: do more when they had completed testing. None of the children
o Thought-feeling-behaviour discrimination task with visual cues became distressed or asked to stop testing indicating that children
(TFB: see Quakley et al., 2004) of this age group found the tasks engaging and enjoyable.
o Linking own thoughts and feelings task (OWN: task adapted
from Doherr et al., 2005) Clinical and Theoretical Implications
o Shortened form of a standardised intelligence test (WPPSI-IIIUK ) The results support the view that children should not be excluded
o Battery of false belief tasks (TOM: see Hughes et al., 2000) from CBT based on their age. It is recommended that clinicians
• In addition, parents of participants completed: consider level of theory of mind development when assessing
o Strengths and Difficulties Questionnaire (SDQ) younger children’s suitability for CBT.
Results provide further support for suggestion that Piaget’s theory
of cognitive development underestimates the cognitive ability of
children in the preoperational stage.
Results Evaluation
Analyses Strengths of the study
Brief description of analyses Large sample of children studied using reliable, valid measures to
investigate skills and abilities, which have clear clinical implications.
Main Results
Multiple regression analysis revealed that IQ, ToM and age were Limitations of the study
significant Community Sample
predictors of performance on TFB task. Further analyses revealed Single informant measure of mental health
that ToM Cross-sectional design – no causality or direction of influence
mediated the relationship between age and performance in TFB
task. In addition, Suggestions for Future Research
ToM partially mediated the relationship between IQ and Repeat using different sample (e.g. older children, adults, clinical
performance in TFB task. group)
put more detail in here stats pertaining to multiple regression Longitudinal design
Include measure of parent mental health

Doherr, L., Reynolds, S., Wetherly, J., & Evans, E. H. (2005). Young children’s ability to engage in cognitive behavioural tasks: Associations with age and educational experience. Behavioural and Cognitive
Psychotherapy, 33, 201-215.

Reynolds, S., Girling, E., Coker, S., & Eastwood, L. (2006). The relationship between mental health problems and children’s ability to discriminate amongst thoughts, feelings and behaviours. Cognitive Therapy
Research, 30, 599-607.

Hughes, C., Adlam, A., Happé, F., Jackson, J., Taylor, A., & Caspi, A. (2000). Good test-retest reliability for standard and advanced false-belief tasks across a wide range of abilities. Journal of Child Psychology and
Psychiatry, 41, 483-490.
Contact Details:
Quakley, S., Reynolds, S., & Coker, S. (2004). The effect of cues on young children’s abilities to discriminate among thoughts, feelings and behaviours. Behaviour and Research Therapy, 42, 343-356.