Protocol - Cognitive Flexibility (Dimensional Change Card Sort) - Children, Adolescents, and Adults

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Protocol Name from Source:

Dimensional Change Card Sort (DCCS) Border Version


Publicly available


The Dimensional Change Card Sort (DCCS) Border Version is an iPad-administered task (by a research assistant) that measures the flexible use of rules to govern behavior as a means of providing an index of executive function development. DCCS is a measure of cognitive flexibility. Two target pictures are presented that vary along two dimensions (e.g., shape and color). Participants are asked to match a series of bivalent test pictures (e.g., yellow balls and blue trucks) to the target pictures, first according to one dimension (e.g., color) and then, after a number of trials, according to the other dimension (e.g., shape). “Switch” trials are also employed, in which the participant must change the dimension being matched. For example, after four straight trials matching on shape, the participant may be asked to match on color on the next trial and then go back to shape, thus requiring the cognitive flexibility to quickly choose the correct stimulus. Scoring is based on a combination of accuracy and reaction time. The DCCS task is a simplified version of the Wisconsin Card Sorting Test (WCST) that is available on the National Institutes of Health (NIH) Toolbox, where investigators will need to pay a licensing fee. The DCCS is suitable for testing subjects between the ages of 3 and 85. This task has demonstrated superior test-retest reliability in adult populations Zelazo et al. (2014).


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

The DCCS Border Version makes use of two different styles of bivalent cards, displaying, for example, a red boat and blue rabbit. The test cards additionally have either no border or a black border.

The protocol consists of the research assistant preparing the administration on an iPad, where data are transmitted via the Internet to the Apple iCloud for download by the investigator.

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 iPad Air or iPad Air2 with Wi-Fi capacity that is running iOS version 8.4 or later.


Requirement CategoryRequired
Average time of greater than 15 minutes in an unaffected individualNo
Major equipmentYes
Specialized requirements for biospecimen collectionNo
Specialized trainingNo

Mode of Administration


Life Stage:

Child, Adolescent, Adult

Specific Instructions:


Research Domain Information

Release Date:

November 21, 2016


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.

Selection Rationale

The Dimensional Change Card Sort (DCCS) is an easily administered and widely used measure of executive function.




Common Data Elements (CDE)Person Cognitive Flexibility Questionnaire Assessment Score3371717CDE Browser

Process and Review

The [link[phenx.org/node/101|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

Previous version in Toolkit archive ([link[www.phenxtoolkit.org/index.php?pageLink=resources.archive|link]])


Zelazo, P. D. (2006). The Dimensional Change Card Sort (DCCS): A method of assessing executive function in children. Nature Protocols, 1(1), 297-301. www.nihtoolbox.org

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 NameVariable IDVariable DescriptionVersiondbGaP Mapping
PX530101_Dimension_Sorting_Border_CardsPX530101010000Dimension used for sorting border cards.4N/A
PX530101_Number_Cards_Correctly_SortedPX530101020000Number of cards correctly sorted: __________4N/A
PX530101_Standard_Border_Version_AdministeredPX530101030000Standard and Border version administered?4N/A
PX530101_Combined_ScorePX530101040000Combined (Standard and Border version) score.4N/A