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Theory of Mind Predicts Social Interaction in Children with Autism Spectrum Disorder: A Two-Year Follow-Up Study

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Abstract

This two-year follow-up study examined the predictive relationships of theory of mind (ToM) to social interaction by reciprocal social behaviors (RSBs) and social functioning (SF) in 106 children with ASD. The results of the path analysis showed that the earlier ToM predicted children’s current component RSBs (B = 3.53, SE = 1.86, p = 0.039) and the current SF (B = 1.79–1.87, SE = 0.03–0.34, p < 0.001). The aloof and passive social interaction styles predicted fewer turn-taking of RSBs (B =  − 48.77 to − 111.17, p < 0.001) and fewer components of RSBs (B =  − 36.30 to − 81.41, p < 0.001). This finding provides empirical evidence that ToM predicts social interaction in children with ASD.

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Data and/or Code Availability

Data not available due to ethical considerations. Based on the signed informed consent, participants of this study did not agree their data could be shared to the public. No software application or custom code was applied in this study.

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Acknowledgments

We thank all the children and caregivers involved in this study, and the occupational therapists of Chi Mei Medical Center, Country Hospital, De Shang Clinic, Municipal Kai-Syuan Psychiatric Hospital, National Cheng Kung University Hospital, Xing Cheng Rehabilitation Clinic, Yong Cheng Rehabilitation Clinic, Yong Kang Clinic, and You Chang United Hospital for their assistance with recruiting participants. We specially thank to Dr. Yen-Ting Yu for her assistance in data analysis during revision.

Funding

This study was supported by grants awarded to the corresponding author by the Ministry of Science and Technology, R.O.C (MOST 103-2410-H-006-060, MOST 104-2410-H-006-065, and MOST 105-2410-H-006-047-MY2).

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Authors and Affiliations

  1. Department of Occupational Therapy, College of Medicine, National Cheng Kung University, No. 1 University Road, Tainan, 701, Taiwan R.O.C.

    Hsiu-Man Chiu & Kuan-Lin Chen

  2. Department of Occupational Therapy, Tai An Hospital, Shuang Shi Branch, Tai-chung, Taiwan R.O.C.

    Hsiu-Man Chiu

  3. Department of Educational Psychology and Counseling, National Tsing Hua University, Hsin-chu, Taiwan R.O.C.

    Cheng-Te Chen

  4. Department of Child and Adolescent Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kao-hsiung, Taiwan R.O.C.

    Ching-Hong Tsai & Hsing-Jung Li

  5. Department of Psychology, Kaohsiung Medical University, Kao-hsiung, Taiwan R.O.C.

    Chin-Chin Wu

  6. Department of Medical Research, Kaohsiung Medical University Hospital, Kao-hsiung, Taiwan R.O.C.

    Chin-Chin Wu

  7. Department of Occupational Therapy, College of Medicine, I-Shou University, Kao-hsiung, Taiwan R.O.C.

    Chien-Yu Huang

  8. School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan R.O.C.

    Chien-Yu Huang

  9. Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan R.O.C.

    Chien-Yu Huang

  10. Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan R.O.C.

    Kuan-Lin Chen

  11. Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan R.O.C.

    Kuan-Lin Chen

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  1. Hsiu-Man Chiu
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Contributions

H-MC, C-TC, C-CW, C-YH, and K-LC contributed to the study conception and design. Material preparation, data collection and data analysis were performed by H-MC and K-LC. The original draft was written by H-MC and K-LC, and all authors commented on of the manuscript. All authors read and agreed to the final manuscript.

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Correspondence to Kuan-Lin Chen.

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Ethical Approval

The study protocol was approved by the Institutional Review Boards of a medical center hospital and a psychiatric hospital in Taiwan.

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The manuscript has been read and agreed by all authors, and consent forms of all participants have been collected.

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Chiu, HM., Chen, CT., Tsai, CH. et al. Theory of Mind Predicts Social Interaction in Children with Autism Spectrum Disorder: A Two-Year Follow-Up Study. J Autism Dev Disord 53, 3659–3669 (2023). https://doi.org/10.1007/s10803-022-05662-4

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