Effects and Moderators of a Short Theory of Mind Intervention for Children with Autism Spectrum Disorder: A Randomized Controlled Trial

Abstract

Limited perspective taking or "Theory of Mind" (ToM) abilities are a core deficit of autism, and many interventions are aimed to improve ToM abilities. In this study, we investigated the effectiveness of a ToM treatment for children with autism spectrum disorders (ASD) and, for the first time, the moderating roles of social interaction style (SIS) and disruptive behavior (DB), to determine which children are most likely to respond to this intervention. The trial protocol is registered at www.trialregister.nl, trial number 2327 and published before the data collection was finished (www.trialsjournal.com). Children with autism aged 7-12 years (n = 97) were randomized over a waitlist control or a treatment condition. Outcome measures included ToM and emotion understanding, parent and teacher questionnaires on children's social skills, ToM-related social behavior, and autistic traits. Six-month follow-up parent reported data were collected for the treatment group. The treatment had a positive effect on ToM understanding, parent-reported ToM behavior, and autistic traits, but not on parent or teacher-reported social behavior. Passive SIS was associated with diminished treatment effects on autistic traits, but DB was unrelated to outcomes. The ToM intervention improved conceptual social understanding and ToM-related behavior of children with ASD. However, broader application of learned skills to other domains of functioning was limited. Individual differences with regard to treatment response are discussed.

Moderating Effects of Parental Characteristics on the Effectiveness of a Theory of Mind Training for Children with Autism: A Randomized Controlled Trial

“…Previous data from this randomized control trial (RCT) showed that training improved children’s knowledge of ToM; ToM-related behavior also increased and autistic features decreased (Begeer et al 2015). A larger sample of participants from the same RCT has since become available, allowing us to test the potential moderating effects of these parental characteristics.…”

Effectiveness of behavioral interventions for autism spectrum disorder: A systematic review

“…Communication-focused interventions was used in twenty one studies [15,21,26,31,46,50,51,54,55,66,67,75,76,82,91,[93][94][95]104]. Thirty-two studies used integrative programs [18,20,24,25,28,30,33,[35][36][37]40,52,58,60,62,63,71,74,[77][78][79]81,86,89,92,96,98,[100][101][102][103]107]. Also, thirty studies used social skills development interventions [16,17,…”

“…The results of the included studies were mainly based on observed data and only in fourteen studies, selfreported of participants' practices were used to evaluate the effects of interventions [23,34,40,45,58,61,64,65,70,72,77,79,100,101]. Of the included studies, only twelve (12.9%) used theories and models.…”

Systematic review and guide to management of core and psychiatric symptoms in youth with autism

“…Fifteen studies (Table a–c) met inclusion criteria for targeting impaired social communication in ASD [12 psychosocial , two biomedical and one mixed biomedical/psychosocial intervention ]. Most recently published psychosocial interventions provided single study data evaluating unique intervention approaches with the exception of parent‐mediated (three trials) and computer‐based (three trials) approaches.…”

“…Two small computer‐based interventions focused on ToM training failed to bring about treatment effects on social communication outcomes , while a third small study found positive effects on social symptoms following a computer‐based social skills intervention; however, bias across studies was rated as unclear to high . Single study data also showed positive results following a number of other interventions on outcomes related to impaired social interaction, including: ToM intervention vs. waitlist , pivotal response therapy vs. parent education , CBT vs. facilitated play , behavioural therapy with speech‐generating support vs. behavioural therapy alone and a monthly play intervention vs. education .…”