Protocol - Cognitive Flexibility (Dimensional Change Card Sort) - Young Children

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The Dimensional Change Card Sort (DCCS) Standard Version is an interviewer-administered task that measures the flexible use of rules to govern behavior as a means of providing an index of executive function in young children. In this task, the assessor asks the participant to sort bivalent test cards according to one dimension (e.g., color) and then the other (e.g., shape).

The Dimensional Change Card Sort task is a freely available, simplified version of the Wisconsin Card Sort test. For more information about the Wisconsin Card Sort test, please refer to the Cognitive Atlas Interpretation.

Specific Instructions





Summary of the Dimensional Change Card Sort (DCCS) Standard Version

The Dimensional Change Card Sort (DCCS) Standard Version makes use of two different styles of bivalent cards, displaying for example a red boat and blue rabbit.

The protocol consists of the following four steps:

1. The assessor decides which dimension (e.g., color or shape) on the bivalent cards will be used for the pre-switch phase of sorting.

2. The assessor sets up two sorting trays displaying target cards representing the two different styles of card. The participant is then given instructions for sorting a set of test cards, which displays the same images as the target cards, based on the dimension decided upon in step 1. The assessor guides the participant through the process of appropriately sorting one of each style of card.

3. The pre-switch phase of testing is carried out. The assessor instructs the participant to sort six randomly selected test cards based on the dimension selected in step 1.

4. The post-switch phase of testing is carried out. The assessor instructs the participant to sort six randomly selected test cards based on the other dimension.


Typically, post-switch performance is only evaluated for participants who correctly sort five or more of the six pre-switch cards. Participants are scored as having passed or failed the task as scores are usually bimodally distributed between being all correct or all incorrect on post-switch trials. Participants who correctly sort five or more of the six post-switch cards are considered to have passed the task.

Most healthy three-year-old children fail the post-switch phase of the standard version of the DCCS, exhibiting inflexibility, while most healthy four- and five-year-old children pass as their flexibility increases.

Personnel and Training Required

The assessor should be trained to respond in a neutral, nonevaluative, noncorrective manner during the task. The assessor should be trained in how to respond to hesitant or resistant behavior by the participant.

Equipment Needs

The assessor will need two sorting trays with panels for displaying target cards, two styles of bivalent target cards (e.g., one card displaying a red boat and the other a blue rabbit), and 14 standard test cards (7 of each style of target card).

Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Interviewer-administered evaluation


Infant, Toddler


Children aged 2.5-7 years

Selection Rationale

This Dimensional Change Card Sort (DCCS) Standard Version is a well validated measure of one aspect of executive control-cognitive flexibility-which can be used with preschoolers.



Human Phenotype Ontology Cognitive impairment HP:0100543 HPO
Human Phenotype Ontology Addictive behavior HP:0030858 HPO
caDSR Form PhenX PX530102 - Cognitive Flexibility Dimensional Change Card Sort You 6227128 caDSR Form
Derived Variables


Process and Review

The Expert Review Panel #3 (ERP 3) reviewed the measures in Alcohol, Tobacco and Other Substances, and Substance Abuse and Addiction domains.

Guidance from ERP 3 includes:

• No significant changes to measure

Back-compatible: NA no changes to Data Dictionary

Protocol Name from Source

Dimensional Change Card Sort (DCCS), Standard Version


Zelazo, P. D. (2006). The dimensional change card sort (DCCS): A method of assessing executive function in children. Nature Protocols, 1(1), 297-301.

General References

Errico, A. L., King, A. C., Lovallo, W. R., & Parsons, O. A. (2002). Cortisol dysregulation and cognitive impairments in abstinent male alcoholics. Alcoholism: Clinical and Experimental Research, 26(8), 1198-1204.

Klüber, A., Murphy, K., & Garavan, H. (2005). Cocaine dependence and attention switching within and between verbal and visuospatial working memory. European Journal of Neuroscience, 21, 1984-1992.

van der Plas, E. A., Crone, E. A., van den Wildenberg, W. P., Tranel, D., & Bechara, A. (2009). Executive control deficits in substance-dependent individuals: A comparison of alcohol, cocaine, and methamphetamine and of men and women. Journal of Clinical and Experimental Neuropsychology, 31(6), 706-719.

Verejo-García, A., Bechara, A., Recknor, E. C., & Pérez-García, M. (2006). Executive dysfunction in substance dependent individuals during drug use and abstinence: An examination of the behavioral, cognitive and emotional correlates of addiction. Journal of International Neuropsychological Society, 12, 405-415.

Protocol ID


Export Variables
Variable Name Variable IDVariable DescriptiondbGaP Mapping
PX530102010000 Dimension used for pre-switch phase of sorting. N/A
PX530102030000 Number of post-switch cards correctly more
sorted: __________ show less
PX530102020000 Number of pre-switch cards correctly sorted: more
__________ show less
Substance Use-related Neurobehavioral and Cognitive Risk Factors
Measure Name

Cognitive Flexibility

Release Date

February 24, 2012


This measure assesses flexibility in detection and use of rules that govern behavior.


Cognitive flexibility is one component of the multidimensional construct "executive function." This measure provides a marker of the development of executive function. Substance use has been shown to correlate with deficits in both cognitive flexibility and other aspects of executive functioning.


Child, Cognitive Flexibility, DCCS, Dimensional Change Card Sort Border Version, Dimensional Change Card Sort Standard Version, Drug Abuse, drug use, Executive Function, Neuropsychiatry, NIH Toolbox, substance abuse, substance use, SAA, Substance Use-related Neurobehavioral and Cognitive Risk Factors

Measure Protocols
Protocol ID Protocol Name
530101 Cognitive Flexibility (Dimensional Change Card Sort) - Children, Adolescents, and Adults
530102 Cognitive Flexibility (Dimensional Change Card Sort) - Young Children

There are no publications listed for this protocol.