Contribution of Theory of Mind, Executive Functioning, and Pragmatics to Socialization Behaviors of Children with High-Functioning Autism
Social difficulties are a key aspect of autism, but the intervening factors are still poorly understood. This study had two objectives: to compare the profile of ToM skills, executive functioning (EF), and pragmatic competence (PC) of children with high-functioning autism (HFA) and children with typical development (TD), and analyze their mediator role in social functioning. The participants were 52 children with HFA and 37 children with TD matched on age, intelligence quotient, and expressive vocabulary. Significant differences were found on measures of ToM, both explicit and applied, EF, and PC between children with HFA and TD. Multiple mediation analysis revealed that applied ToM skills and PC mediated the relations between autism symptoms and social functioning. Implications for social cognitive interventions to address these findings are discussed.
KeywordsHigh functioning autism Theory of mind Pragmatic competence Executive functioning Social domain
This work is supported by the Spanish project PSI2016-78109 (AEI/FEDER, UE) and the predoctoral fellowship University of Valencia UV-INV-PREDOC15-265889.
CB conceived the study, participated in its design, and coordination, interpretation of results and drafted the manuscript; AM conceived the study, participated in the design, coordination of the study, interpretation of the data and manuscript revisions; CC participated in the design and coordination of the study, and data collection; IB participated in the coordination of the study and data collection; BR participated in data analysis and interpretation of results. All authors read and approved the final manuscript.
Compliance with Ethical Standards
Conflict of interest
Authors declare no conflict of interest.
The study was approved by the Ethics Committee of the University of Valencia (Declaration of Helsinki in the European Council Agreement, 1964).
- Baixauli-Fortea, I., Roselló-Miranda, B., & Colomer-Diago, C. (2015). Relationships between language disorders and socio-emotional competence. Revista de Neurología, 60, 51–56.Google Scholar
- Baron-Cohen, S. (1995). Mindblindness. Cambridge, MA: MIT Press.Google Scholar
- Bishop, D. V. (2003). The children’s communication checklist: CCC-2. London: Harcourt Assessment.Google Scholar
- Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. New York: The Guilford Press.Google Scholar
- Helland, W. A. (2014). Differentiating children with specific language impairment and children with Asperger syndrome using parental reports. Annals of Psychiatry and Mental Health, 2, 1013.Google Scholar
- Helland, W. A., Biringer, E., Helland, T., & Heimann, M. (2009). The usability of a norwegian adaptation of the children’s communication checklist second edition (CCC-2) in differentiating between language impaired and non-language impaired 6-to 12-year-olds. Scandinavian Journal of Psychology, 50, 287–292.CrossRefPubMedGoogle Scholar
- Hughes, C., & Devine, R. T. (2015). A social perspective on theory of mind. In M. E. Lamb (Ed.), Handbook of child psychology and developmental science: Socioemotional processes (pp. 564–609). Hoboken, NJ: Wiley.Google Scholar
- Hutchins, T. L., Prelock, P. A., & Bonazinga, L. (2014). Technical manual for the theory of mind inventory and theory of mind task battery. Unpublished copyrighted manuscript. http://www.theoryofmindinventory.com.
- Kaufman, A. S., & Kaufman, N. I. (2000). K-BIT, Test breve de inteligencia de Kauffman [Kaufman brief intelligence test]. Madrid: Pearson.Google Scholar
- Klin, A., Saulnier, C. A., Sparrow, S. S., Cicchetti, D. V., Volkmar, F. R., & Lord, C. (2007). Social communication abilities and disabilities in higher functioning individuals with autism spectrum disorders: The Vineland and the ADOS. Journal of Autism and Developmental Disorders, 37, 748–759.CrossRefPubMedGoogle Scholar
- Korkman, M., Kirk, U., & Kemp, S. (2007). NEPSY-II: A developmental neuropsychological assessment. San Antonio, TX: The Psychological Corporation.Google Scholar
- Maldonado Belmonte, M. J. (2016). Adaptation of the behavior rating inventory of executive function (BRIEF) to the spanish population and its usefulness for the diagnosis of attention deficit hyperactivity disorder inattentive and combined subtypes. Doctoral dissertation, Universidad Complutense de Madrid, Spain.Google Scholar
- Miranda-Casas, A., Baixauli-Fortea, I., Colomer-Diago, C., & Roselló-Miranda, B. (2013). Autismo y trastorno por déficit de atención con hiperactividad. Convergencias y divergencias en funcionamiento ejecutivo y teoría de la mente [Autism and attention deficit hyperactivity disorder: Similarities and differences in executive functioning and theory of mind]. Revista de Neurología, 57, 177–184.Google Scholar
- Orinstein, A. J., Suh, J., Porter, K., De Yoe, K. A., Tyson, K. E., Troyb, E., et al. (2015). Social function and communication in optimal outcome children and adolescents with an autism history on structured test measures. Journal of Autism and Developmental Disorders, 45, 2443–2463.CrossRefPubMedPubMedCentralGoogle Scholar
- Pugliese, C. E., Anthony, L., Strang, J. F., Dudley, K., Wallace, G. L., & Kenworthy, L. (2015). Increasing adaptive behavior skill deficits from childhood to adolescence in autism spectrum disorder: Role of executive function. Journal of Autism and Developmental Disorders, 45, 1579–1587.CrossRefPubMedPubMedCentralGoogle Scholar
- Rutter, M., Bailey, A., & Lord, C. (2003a). Social communication questionnaire. Los Angeles: Western Psychological Services.Google Scholar
- Rutter, M., Le Couteur, A., & Lord, C. (2003b). ADI-R. Autism diagnostic interview revised. Manual. Los Angeles: Western Psychological Services.Google Scholar
- Snow, C., Cancino, H., Gonzalez, P., & Shriberg, E. (1989). Giving formal definitions: An oral language correlate of school literacy. In D. Bloome (Ed.), Classrooms and literacy (pp. 233–249). Norwood, NJ: Ablex.Google Scholar
- Sparrow, S. S., Cicchetti, D. V., & Balla, D. (2005). The vineland II adaptive behavior scales. Circle Pines, MN: American Guidance Service.Google Scholar
- Wallace, G. L., Yerys, B. E., Peng, C., Dlugi, E., Anthony, L. G., & Kenworthy, L. (2016). Chapter three-assessment and treatment of executive function impairments in autism spectrum disorder: An update. International Review of Research in Developmental Disabilities, 51, 85–122.CrossRefGoogle Scholar
- Wechsler, D. (2003). Wechsler intelligence scale for children, fourth edition (WISC-IV). San Antonio, TX: The Psychological Corporation.Google Scholar