Theory of Mind Profile of School-Aged Children with Autism Spectrum Disorder

Impairments in social functioning in autism spectrum disorder (ASD) are theoretically linked to an underlying deficit in theory of mind (ToM)—the social-cognitive ability to take another’s perspective. Previous research has consistently documented ToM impairments in preschoolers with ASD, but investigations of ToM in school-aged children with ASD and average IQ have produced mixed results. The present study examined the pattern of individual differences in ToM in school-aged children with ASD. Children with ASD between the ages of 7-11 years underwent several procedures as part of a larger protocol examining effects of an executive functioning intervention. All children had an ASD diagnosis and Full Scale IQ of 80 or higher. The ToM battery included tasks measuring: (1) emotion recognition, (2) first-order false belief, (3) second-order false belief, and (4) naturalistic social attributions. In addition to exploring ToM as a theoretical construct, this study addressed the relative contribution of various ToM measures to the heterogeneity in social symptoms and social functioning in ASD using multiple regression analyses. Results showed that the battery of ToM measures captured both cognitive and affective components of ToM, with unique relevance to naturalistic social attribution ability. Furthermore, affective ToM and naturalistic social attribution uniquely predicted variation in ASD social symptom severity, above and beyond the influence of age and IQ. Overall, this research has important implications for understanding task-related differences in ToM and elucidating the heterogeneity in social functioning and social cognition in school-aged children with ASD