Relations between moral reasoning, theory of mind and executive functions in children with autism spectrum disorders

The link between impaired theory of mind and executive function in children with cerebral palsy

Objective: The present study examines the effectiveness of two psychomotor rehabilitation methods, Dosahu and Floortime, on the theory of mind in students with high-functioning autism. Methodology: This study is an applied research in terms of its objective and a quasi-experimental interventional study in terms of data collection, employing a single-group pretest-posttest design with a control group and follow-up. The statistical population consisted of all 6- to 10-year-old boys with high-functioning autism in Tehran who were enrolled in exceptional schools in the city during the 2023-2024 academic year. The sampling method used in this study was multi-stage cluster random sampling. Participants were selected from autistic children diagnosed by the Organization for Special Education and identified as having high-functioning autism based on the Autism Spectrum Screening Questionnaire (ASSQ). A total of 45 children were randomly assigned to three groups of 15 participants each. The first group underwent Dosahu intervention, the second group received Floortime intervention, and the third group served as the control group, receiving no intervention. Data analysis was conducted using paired t-tests and visual depiction or graphical analysis via SPSS. Findings: The Dosahu therapeutic method significantly affected the subscales of theory of mind in children with autism spectrum disorder. Furthermore, the effect size indicates that the Dosahu method was more effective in improving preliminary theory of mind in children with autism spectrum disorder and contributed more to its enhancement (p<0.01). Conclusion: The results of this study showed that Dosahu and Floortime psychomotor rehabilitation positively impact the improvement of theory of mind and motor imagery in children with high-functioning autism, enhancing their cognitive and motor skills.

This study aimed to investigate the development of Theory of Mind (ToM) in children with Autism Spectrum Disorder (ASD), Down syndrome, and typical development from Iran and Sweden. Participants between the ages of 6 to 12 were assessed using various ToM tasks. Additionally, the study explored the correlation between children's behavioral problems, as reported by teachers and parents, and their ToM performance. Furthermore, the influence of family socioeconomic status on children's ToM understanding was examined. The research revealed that cultural factors played a partial role in specific ToM tasks during childhood, but not across the entire ToM construct in the studied groups. Introduction: Theory of Mind (ToM) refers to the ability to understand and attribute mental states, such as beliefs, desires, and intentions, to oneself and others. It plays a crucial role in social interactions and is an essential aspect of cognitive development in children. This study aimed to explore the influence of cultural factors on ToM development in children with Autism Spectrum Disorder (ASD), Down syndrome, and typical development. Methodology: The participants consisted of 74 native speakers from Iran and 66 from Sweden, falling within the 6 to 12 age range. They were divided into three groups based on their developmental profiles: children with ASD, children with Down syndrome, and typically developing children. ToM tasks were administered to measure their ToM abilities across all orders of complexity. Results: The study found that cultural factors partially influenced specific ToM tasks that children developed during their childhood. However, this effect was not observed across the entire ToM construct for any of the studied groups. The findings suggest that cultural differences might impact certain aspects of ToM development, but they do not have a universal effect on ToM understanding in the studied populations. The results also revealed a strong correlation between children's behavioral problems, as reported by teachers, and their ToM performance. However, this correlation was not significant when considering parents' perspectives. This discrepancy highlights the importance of considering multiple informants when assessing children's behavior and social cognition. Furthermore, the study examined the relationship between family socioeconomic status and children's ToM understanding. Surprisingly, no clear link was found in any of the studied groups, suggesting that socioeconomic status may not be a determining factor in ToM development among these children. Conclusion: In conclusion, this cross-cultural analysis provides valuable insights into the development of ToM in children with Autism Spectrum Disorder, Down syndrome, and typical development from Iran and Sweden. Cultural factors were found to have a partial influence on specific ToM tasks developed during childhood, while family socioeconomic status did not appear to be significantly linked to ToM understanding in these groups. The study also underscores the importance of considering different perspectives when evaluating children's behavior and social cognition. Further research is warranted to explore other potential factors that may impact ToM development in diverse populations.

Children with autism spectrum disorders (ASD) struggle with impaired theory of mind. We aimed to evaluate the effect of remediation of theory of mind on theory of mind, face perception, and behavioral symptoms in children with ASD. Thirty children with ASD were randomly assigned to two equal groups of theory of mind training and active control group. Attentive remediation of theory of mind (ARTOM) and story-telling sessions were used for intervention in the groups. Theory of mind and facial emotion recognition tests as well as Gilliam autism rating scale (GARS) were used for assessment in three baseline, post-intervention, and follow-up sessions. Repeated measures ANOVAs were used for analysis. The results showed improvement in facial emotion recognition and theory of mind in intervention group. The behavioral symptoms, measured by GARS, were ameliorated in the intervention group. The training effects lasted until follow-up session. The results suggest remediation of basic components of theory of mind, without direct intervention on theory of mind, improves theory of mind skill. The results also suggest that the remediation of basic components of theory of mind improves social and communicational performance and ameliorates stereotypes symptoms in children with ASD.

Impaired executive function (EF), verbal comprehension, and theory of mind (ToM) may contribute to social difficulties in children with autism spectrum disorder (ASD). The linkage between cool (cognitive) EF and ToM has been widely investigated, but the relations between hot (affective) EF and ToM remain largely unknown. The roles of cool EF and verbal comprehension have not been previously explored together to address hot EF-ToM relations. This study applied mediation analysis to investigate the mediating effects of cool EF and verbal comprehension to further elaborate the link between hot EF and ToM in children with ASD and average intellectual abilities. A total of 97 children with ASD aged from 6 to 12 years participated in this study. Children's cool EF, hot EF, and verbal comprehension were, respectively, measured with the computerized Dimensional Change Card Sort task, Children's Gambling Task, and the verbal comprehension index of the Wechsler Intelligence Scale for Children-fourth edition. Children's ToM was assessed with the Theory of Mind Task Battery. Partial correlation coefficients indicated that hot EF was significantly related with ToM with age controlled for. The results of the mediation analysis showed that cool EF and verbal comprehension mediated the linkage between hot EF and ToM. These findings highlight not only the connections between hot EF and ToM but also the importance of cool EF and verbal comprehension on hot EF-ToM relations in clinical assessments and interventions for school-aged children with ASD and average intellectual abilities. LAY SUMMARY: Relatively few studies have investigated the hot (affective) executive function (EF)-theory of mind (ToM) relations in children with autism spectrum disorder (ASD). This study discovered that hot EF was significantly related to ToM, while cool (cognitive) EF and verbal comprehension mediated the relationship between hot EF and ToM. Therefore, the influence of cool EF and verbal comprehension on hot EF-ToM relations should be considered in studies involving children with ASD. Autism Res 2021, 14: 921-931. © 2020 International Society for Autism Research and Wiley Periodicals LLC.

Executive functioning and theory of mind in children clinically referred for attention and behavior problems

Introduction: Divorce is not only an event but also a process that has short-term and long-term effects on children. Aim: The present study was conducted to compare executive functions, sensory processing and theory of mind in children from divorced families and ordinary children. Method: This is causal-comparative research. The statistical population included 180 male and female students between 9 and 12 years old in Districts 5 and 18 of Tehran in the academic year 2021-2022 selected by convenience sampling method and divided in two groups of children from divorced families and ordinary children (n=90 in each group). For data collection, Executive Function System (D-KEFS) (Delis, Kaplan, & Kramer, 2001), Sensory Profile (Dunn, 1999) and Theory of Mind (Hutchins et al., 2012) were used. The research data was analyzed by independent t-test and SPSS 24. Results: The results showed a significant difference in working memory (t=6.08, P<0.05), mental flexibility (t=5.12, P<0.05), inhibitory control (t=7.16, P<0.05), sensory register (t=6.72, P<0.05), sensation-seeking (t=4.65, P<0.05) and sensory sensitivity (t=7.36, P<0.05), and theory of mind levels including level 1 (t=7.12, P<0.05), level 2 (t=7.14, P<0.05), and level 3 (t=9.32, P<0.05). The mean of ordinary children was higher than that of children from divorced families, but no significant difference was observed in the mean of sensory avoiding in both groups (P˃0.05). Conclusion: The status of executive functions, sensory processing and theory of mind in normal children was better than that of children from divorced families. Therefore, the use of educational programs to strengthen cognitive dimensions of the mind of children from divorced families with emphasis on executive functions, sensory processing and theory of mind can be effective on improving their cognitive performance.

The impact of visual-spatial abilities on theory of mind in children and adolescents with autism spectrum disorder

Background:Children with attention deficit hyperactivity disorder (ADHD) and specific learning disorder (SLD) generally have difficulties in social cognition and display impairments involving emotion and face and prosody perception and reduced empathy, indicating theory of mind (ToM) impairment. The objective of this work was to assess and compare the executive functions and ToM in children with ADHD and SLD.Methods:Twenty children diagnosed with ADHD, 20 children diagnosed with SLD, and 20 normal healthy children in the age group of 7 to 15 years, IQ between 90 and 110 (average intelligence) of any gender, were recruited. All participants were assessed using neuropsychological tests of executive functions and ToM.Results:Significant differences were found on early ToM, basic ToM, advanced ToM, and mean scores on ToM inventory between ADHD and control groups (P ≤ 0.001). Similarly, significant differences were found between ADHD and SLD groups on early, basic, advanced, and mean ToM inventory scores (P < 0.001). No significant differences were found between the control and SLD groups on ToM measures. Further, in the ToM task battery, on task D and task G, significant differences were found between the SLD and control groups at P = 0.04 and P = 0.03 respectively. Differences between ADHD and control groups were also statistically significant on task D and task G at P < 0.001 and P = 0.033. Executive functions in the form of set-shifting and response inhibition were significantly poor in the ADHD group and SLD group at P < 0.001 and P < 0.05 levels, respectively, when compared to the control group.Conclusion:Children with ADHD displayed more deficits in the ToM inventory and tasks than children having SLD and healthy children of their similar age and educational background. Executive functions (set-shifting and response inhibition) were poorer in children with ADHD and children with SLD when compared to healthy children of their similar age and educational background.

The aim of the current research was to investigate the effect of a psycho-motor rehabilitation on executive functions and theory of mind in children with autism spectrum disorder. The sample size was 50 children with an average age of 4–6 years. A quasi-experimental experiment was designed and implemented, specifically a pre test post test- control-group design with a quantitative approach, because the researcher want to established possible causes and effects between dependent and independent variables. After checking the normality of the data using the Shapiro-Wilk test, the covariance analysis test was used to test the hypotheses. All data were analyzed using SPSS software version 23, and the significance level was considered as p ≤ 0.05. The comparison of the scores in the two experimental and control groups indicates that the Dohsa-hou method was successful in improving the executive functions and theory of mind in children with autism spectrum disorder.

Neural responses to affective and cognitive theory of mind in children and adolescents with autism spectrum disorder

The goal of the present study was to examine the link between poor attention to social information and mindreading abilities in children with autism spectrum disorder (ASD). Results demonstrated that children with ASD tended to perform worse than neurotypical children on both social orienting and theory of mind tasks. Preference for human faces and motion tended to be related but only for the neurotypical children. These findings provide partial support for the social motivation theory.

Executive function (EF) in specific learning disorders (SLD) has been investigated using mainly cool EF tasks, whilst less is known about hot EF and theory of mind (ToM) in this population. The aim of this study was to examine group differences in hot and cool EF and ToM in school-aged children with SLD relative to typically developing peers. It also attempted to investigate whether EF measures are significant predictors of ToM in SLD and typical development. Cross-sectional data were collected from 135 school-aged children with and without SLD (8–10 years old), tested on measures of cool & hot EF and ToM. Significant group differences were observed in EFs inhibition (p= .04), working memory (p= .04) and delay of gratification (p < .001), as well as ToM mental state/emotion recognition (p = .019). Inhibition and planning contributed to 22% of the explained variance of ToM mental state/emotion recognition, but not false belief overall. Results suggest that cool EF may be a crucial predictor of ToM in children with and without SLD. Finally, stepwise logistic regression analysis identified specific hot EF and ToM measures contributing to group differentiation, specifically delay of gratification (odds ratio=.995, 95% CI [.993–.998]) and mental state/emotion recognition (odds ratio= .89, 95% CI [.796–.995]). This study contributes to our understanding of cognitive deficits and socio-cognitive impairment in children with SLD, which hold promise for informing interventions aimed at addressing these cognitive challenges.

ABSTRACTPrevious research has clearly demonstrated that autism spectrum disorder (ASD) involves deficits in multiple neuropsychological functions, such as executive function (EF) and theory of mind (ToM). A conceptual distinction is commonly made between cool and hot EF. In ASD, continued attention has been paid to the cool areas of executive dysfunction. Cool EF has been strongly related to ToM, but research has not taken into account the association between hot EF and ToM in ASD. The present study investigated the associations between hot and cool EF and ToM in 56 school-aged children with ASD and 69 controls on tasks tapping cool EF (i.e., working memory, inhibition, planning), hot EF (i.e., affective decision making, delay discounting), and ToM (i.e., mental state/emotion recognition and false belief). Significant group differences in each EF measure support an executive dysfunction in both domains in ASD. Strong associations between delay discounting and ToM mental state/emotion recognition were found, suggesting that hot EF makes a unique contribution to ToM above and beyond cool EF in typical development and ASD. This study improves understanding of the profile of higher-order cognitive deficits in children with ASD, which may inform diagnosis and intervention.

Motor imagery in mental rotation of hand pictures