Empathy, Theory of Mind, and Prosocial Behaviors in Autistic Children

Abstract

Background:Previous research has suggested that children with autism spectrum disorder (ASD) display fewer prosocial behaviors, and the role of empathy or Theory of Mind (ToM) in prosocial behaviors of autistic children remains unclear.MethodsData were obtained from an ongoing longitudinal study in Guangzhou, China. A total of 96 autistic children and 167 typically developing (TD) children were enrolled. Prosocial behaviors were assessed using a subscale of the Strength and Difficulties Questionnaire and Dictator Game (DG) paradigm with stickers as incentives. Empathic traits and ToM ability were measured using the children's Empathy Quotient and the Chinese version of ToM toolkit. Generalized linear models were used to assess the differences of prosocial behaviors and empathic traits, ToM ability between the two groups and the associations between empathic traits, ToM ability and prosocial behaviors in autistic children.ResultsCompared with TD children, autistic children exhibited worse ToM ability and performed less pro-socially in the DG paradigm, while there were no differences regarding empathic traits. In autistic children, empathic traits especially affective empathy, were positively associated with parent-reported prosocial behaviors [β = 0.17, 95% confidence interval (CI): 0.07–0.27; β = 0.47, 95%CI: 0.33–0.60]. ToM ability was associated with DG paradigm (β = 1.03, 95%CI: 0.16–1.89).ConclusionAutistic children showed less pro-sociality and ToM ability than TD children. In autistic children, empathic trait was associated with parent-reported prosocial behaviors while their ToM ability was associated with prosocial behaviors in experimental condition. Our findings indicated that better ToM ability and empathic trait might promote prosocial behaviors in autistic children.

Are prosocial tendencies relevant for developmental psychopathology? The relations of prosocial behavior and empathy-related responding to externalizing problems, internalizing problems, and autism spectrum disorder

“…If the limited longitudinal evidence based on parents' reports is fairly consistent in reporting low levels of general prosocial behavior and its social-emotional correlates (e.g., empathic concern, ToM) in young children with ASD, cross-sectional studies have obtained more mixed findings. For instance, in line with longitudinal findings, data obtained via parent reports mostly indicate a lower general level of prosocial behavior in children with ASD compared to those without ASD (e.g., Russell et al, 2013;Ziv et al, 2014; but see for different results, Wang et al, 2022). In a secondary data analysis of the Millenium Birth Cohort study (n >19,000), parents' report of (low) prosocial behavior was the best predictor of ASD diagnosis compared to the other SDQ subscales (Russell et al, 2013).…”

Using simple economic games to assess social orienting and prosocial behavior in adolescents with autism spectrum disorder

“…These mixed results might be partly due to the reliance on diverse paradigms to measure prosocial behavior. For example, Wang et al (2022) found that ASD and non‐ASD children did not differ on parent‐rated prosocial behavior, but did behave less altruistically in a dictator game. The study's use of a behavioral game can be regarded as a methodological strength, since prosocial behavior involving real resources was directly measured and did not just involve indirect reports.…”

Autism and Religion

“…The development of ToM is delayed in children with ASD, which appears to be specific to understanding mental states and prosocial behavior. Children with ASD show milder impairments in relationship recognition or understanding the animate-inanimate distinction [ 44 , 80 , 81 , 82 ]. Some higher-functioning children with ASD do develop a first-order ToM (the ability to attribute beliefs to others) but struggle with the second-order theory of mind (the ability to attribute beliefs about beliefs), although it depends on task complexity [ 83 , 84 ].…”