The relationship of theory of mind and executive functions to symptom type and severity in children with autism

• Published in: Development and psychopathology 2004-03, Vol.16 (1), p.137-155
• Main Authors: JOSEPH, ROBERT M., TAGER–FLUSBERG, HELEN
• Format: Article
• Language: English
• Subjects: Adolescent; Autism; Autistic Disorder - complications; Behavior; Child; Child, Preschool; Children & youth; Cognition & reasoning; Cognition Disorders - diagnosis; Diagnostic and Statistical Manual of Mental Disorders; Female; Humans; Language; Male; Neuropsychological Tests; Nonverbal Communication; Psychological Theory; Severity of Illness Index; Studies
• ISSN: 0954-5794; 1469-2198
• DOI: 10.1017/S095457940404444X

Although neurocognitive impairments in theory of mind and in executive functions have both been hypothesized to play a causal role in autism, there has been little research investigating the explanatory power of these impairments with regard to autistic symptomatology. The present study examined the degree to which individual differences in theory of mind and executive functions could explain variations in the severity of autism symptoms. Participants included 31 verbal, school-aged children with autism who were administered a battery of tests assessing the understanding of mental states (knowledge and false belief) and executive control skills (working memory, combined working memory and inhibitory control, and planning) and who were behaviorally evaluated for autism severity in the three core symptom domains. Whereas theory of mind and executive control abilities explained the significant variance beyond that accounted for by language level in communication symptoms, neither explained the significant variance in reciprocal social interaction or repetitive behaviors symptoms. These findings are discussed in terms of a proposed distinction between higher level, cognitive–linguistic aspects of theory of mind and related executive control skills, and more fundamental social–perceptual processes involved in the apprehension of mental state information conveyed through eyes, faces, and voices, which may be more closely linked to autistic deficits in social reciprocity.This research was supported by grants from the National Institute on Child Health and Human Development (RO3 HD37898) to Robert Joseph and from the National Institute on Deafness and Other Communication Disorders (PO1 DC03610) to Helen Tager–Flusberg. In addition, this study was conducted as part of the NICHD/NIDCD Collaborative Programs of Excellence in Autism. We thank the following individuals for their assistance in collecting and preparing the data reported in this article: Susan Bacalman, Laura Becker, June Chu, Susan Folstein, Anne Gavin, Margaret Kjelgaard, Lauren McGrath, Echo Meyer, and Shelly Steele. We are especially grateful to the children and families who generously participated in this study.