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Measuring Individual Differences in Cognitive, Affective, and Spontaneous Theory of Mind Among School-Aged Children with Autism Spectrum Disorder

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Abstract

The present study examined individual differences in theory of mind (ToM) among a group of 60 children (7–11 years-old) with autism spectrum disorder (ASD) and average intelligence. Using open-ended and structured tasks to measure affective ToM, cognitive ToM, and spontaneous social attribution, we explored the nature of ToM and assessed whether ToM predicts the phenotypic heterogeneity in ASD through structural equation modeling. Affective ToM uniquely predicted social symptom severity, whereas no ToM types predicted parent reported social functioning. Our findings suggest that differentiating among theoretical components is crucial for future ToM research in ASD, and ToM challenges related to reasoning about others’ emotions may be particularly useful in distinguishing children with worse social symptoms of ASD.

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Notes

  1. All indices were identical to Klin (2000) except the animation index, which was not included in the present study because pilot coding revealed insufficient agreement between coders.

  2. A proposition, defined as a verb plus its complement, served as the narrative unit for scoring all index scores obtained from narratives 1 through 7.

  3. The Monte Carlo simulation routines are available from the second author upon request.

  4. For a critical value of 3.84 Chi square units.

  5. For a critical value of 30.144 Chi square units.

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Acknowledgments

Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under Award Number K99/R00HD071966. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors would like to thank Dr. Ami Klin for helping us learn the SAT coding scheme, Dr. Kate White for her comments and advice on previous drafts of the manuscript, the staff and students who assisted with collecting and scoring these measures, and to particularly thank the children and families who participated in this study. This work represents the honors thesis of the first author, which was conducted at Bates College and supported by the Bates Student Research Fund, Summer Research Fellowship, and Hoffman Research Support Grant. Preliminary results were first presented at the International Meeting for Autism Research in San Francisco, CA in May 2017.

Funding

This study was funded by K99/R00HD071966, Bates Student Research Fund, Bates Summer Research Fellowship, and Bates Hoffman Research Support Grant.

Author information

Authors and Affiliations

  1. Yale School of Medicine, Yale Child Study Center, New Haven, CT, USA

    Melody Altschuler & Rebecca Burger-Caplan

  2. Division of Developmental Medicine, Boston Children’s Hospital, Boston, MA, USA

    Georgios Sideridis, Rachel Gilbert, Devon Carroll & Susan Faja

  3. Harvard Medical School, Boston, MA, USA

    Georgios Sideridis & Susan Faja

  4. Dartmouth College, Hanover, NH, USA

    Shashwat Kala

  5. Tufts University, Medford, MA, USA

    Megan Warshawsky

  6. Department of Psychiatry, Boston Children’s Hospital, Boston, MA, USA

    Devon Carroll & Susan Faja

  7. Laboratories of Cognitive Neuroscience, Boston Children’s Hospital, 1 Autumn Street, BCH3178, Boston, MA, 02215, USA

    Susan Faja

Authors
  1. Melody Altschuler
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  2. Georgios Sideridis
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  3. Shashwat Kala
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  4. Megan Warshawsky
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  5. Rachel Gilbert
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  6. Devon Carroll
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  7. Rebecca Burger-Caplan
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  8. Susan Faja
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Contributions

MA contributed to the design of the study, contributed to the analyses and interpretation of results, participated in the acquisition and coding of the data, helped to develop the SAT coding manual, and drafted the manuscript; GS conducted the analyses and contributed to interpretation of results; SK and MW participated in the acquisition and coding of the data; RG participated in the design and coordination of the study and acquisition of the data; DC and RB helped to develop the SAT coding manual and provided consultation to clarify coding issues; SF conceived of the study, participated in its design and coordination, contributed to data acquisition and analysis, helped to develop the SAT coding manual, and helped to draft the manuscript. All authors read, reviewed, and approved the final manuscript.

Corresponding author

Correspondence to Susan Faja.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from parents of all individual participants included in the study and all children provided their assent.

Appendices

Appendix 1: First-Order False Belief (FOFB) Videos Task

Location Change False Belief Video

Script from TED Talk by Saxe (2009)

Here is a pirate. His name is Ivan. And you know what pirates really like? Pirates really like cheeseburgers. So, Ivan has this cheeseburger, and he says, “Yum yum yum yum yum! I really love cheeseburgers.” And Ivan puts his burger over here, on top of the pirate chest. And Ivan says, “You know what? I need a drink with my lunch.” And so, Ivan goes to get a drink. And while Ivan is away, the wind comes, and it blows the burger down onto the grass. And now, here comes the other pirate. This pirate is called Trevor. And Trevor also really loves cheeseburgers. So, Trevor has a cheeseburger and he says, “Yum yum yum yum yum! I love cheeseburgers.” And he puts his cheeseburger over here on top of the pirate chest.

Which cheeseburger is Trevor’s? (Comprehension Question 1).

And which cheeseburger is Ivan’s? (Comprehension Question 2).

So now Trevor goes off to get a drink. Ivan comes back and he says, “I want my cheeseburger.”

Which one do you think Ivan is going to take? (Test Question 1).

Let’s see. [Ivan is shown taking Trevor’s cheeseburger].

Why did he take that one? (Test Question 2).

Is Ivan being mean and naughty for taking Trevor’s sandwich? (Test Question 3).

Why do you think that? (Test Question 4).

Unexpected Contents False Belief Video

What do you think is in this box? (Comprehension Question 1).

If we asked your parents, what do you think they would say is in here? (Comprehension Question 2).

If we asked your friend, what do you think they would say is in the box? (Comprehension Question 3).

[Contents are revealed and explicitly labeled].

What’s inside the box? (Comprehension Question 4).

Now, if I asked you again, what would you say is in there? (Test Question 1).

If your parent came in now, and we asked what they think is in the box, what would they say? (Test Question 2).

If we asked your friend, what do you think they would say is in the box? (Test Question 3).

Appendix 2: Additional Fit Indices

Several more fit indices were utilized in order to test model fit using three recommended corrections for small sample sizes (i.e., Bartlett’s, Yuan’s, and Swain’s). As shown above, RMSEA values were close to zero, the Chi square to D.F. ratio was well below the recommended cutoff of 2.0 units, all descriptive fit indices had values greater than 0.90 generally, and 0.95 specifically, and all parsimonious fit indices had values greater than 0.50. Consequently, model fit for the 2-factor correlated model was adequate using all available means. Supplemental fit statistics were estimated using an R-function we developed for that purpose. For detailed analyses of more than 20 fit indices, please contact the second author.

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Altschuler, M., Sideridis, G., Kala, S. et al. Measuring Individual Differences in Cognitive, Affective, and Spontaneous Theory of Mind Among School-Aged Children with Autism Spectrum Disorder. J Autism Dev Disord 48, 3945–3957 (2018). https://doi.org/10.1007/s10803-018-3663-1

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