Individual differences in the efficacy of a short theory of mind intervention for children with autism spectrum disorder: a randomized controlled trial

Hoddenbach, Elske; Koot, Hans M.; Clifford, Pamela; Gevers, Carolien; Clauser, Cassandra; Boer, Frits; Begeer, Sander

doi:10.1186/1745-6215-13-206

Cited by 17 publications

(28 citation statements)

References 31 publications

(49 reference statements)

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“…2327) and published prior to completion of the data collection (Hoddenbach et al 2012). The relatively large sample also allowed for the analysis of parent characteristics potentially related to treatment success.…”

Section: Discussionmentioning

confidence: 99%

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

Veld

Howlin

Hoddenbach

et al. 2017

J Autism Dev Disord

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This RCT investigated whether the effect of a Theory of Mind (ToM) intervention for children with ASD was moderated by parental education level and employment, family structure, and parental ASD. Children with autism aged 8–13 years (n = 136) were randomized over a waitlist control or treatment condition. At posttest, children in the treatment condition had more ToM knowledge, showed fewer autistic features, and more ToM-related behavior than children in the control condition. Children who had one or two parents with at least a college degree, and children with parents not diagnosed with/suspected of having ASD themselves benefitted from the training. These findings provide valuable information about family variables that need to be taken into account in treatment design and implementation.

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Section: Discussionmentioning

confidence: 99%

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

Veld

Howlin

Hoddenbach

et al. 2017

J Autism Dev Disord

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“…In this RCT, we explored the impact of a shortened version of the ToM training program [Hoddenbach et al, ] for children with ASD and average intelligence quotient (IQ). While a variety of moderators can be studied, any treatment trial can only validly test one or two main hypotheses at a time [Kraemer, Wilson, Fairburn, & Agras, ].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2015

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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.

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“…Interventions targeting ToM abilities are highly prevalent among treatments for autism 2. However, there is no consensus on the efficacy of these treatments, and a wide variety of outcome measures are used 2…”

Section: What Is Already Known On This Topic?mentioning

confidence: 99%

Theory of mind interventions can be effective in treating autism, although long-term success remains unproven

Begeer

2014

Evid Based Mental Health

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WHAT IS ALREADY KNOWN ON THIS TOPIC? Limited theory of mind (ToM) skills are a key problem for individuals with autism. 1 Interventions targeting ToM abilities are highly prevalent among treatments for autism. 2 However, there is no consensus on the efficacy of these treatments, and a wide variety of outcome measures are used. 2 WHAT DOES THIS PAPER ADD? ▸ This is the first systematic review of interventions for ToM skills in individuals with autism. ▸ The inclusion of interventions on ToM, but also on related domains (eg, emotion recognition) or precursors of ToM (eg, joint attention), and the focus on a wide range of outcome measures provides relevant information for clinical practice. ▸ These is some evidence that ToM can be taught to individuals with autism spectrum disorder (ASD), but little evidence on maintenance and generalisation of ToM skills, or the effects of these skills to other domains of functioning. LIMITATIONS▸ The widely varied outcome measures used in the included papers complicate the comparative analysis of different studies. ▸ Blinding participants and personnel in intervention studies may not always be an option. Rather than emphasising possible performance bias, it would be practical to consider alternatives for this problem. For instance, individual differences approaches in larger samples may highlight both child and clinician features that are related to performance bias. WHAT NEXT IN RESEARCH?▸ The inclusion of long-term intervention effects of ToM treatment, to examine the accumulation of social skills during development.▸ The analysis of individual differences in treatment effects, including child features (eg, subtypes of autism, age, intelligence and gender), and also features of the delivery of the treatment (eg, clinician vs non-expert, participation of parents, individual vs groupbased, duration, use of computers or social media). This approach will improve our understanding of whether, why and for whom these interventions are effective. ▸ The development of a uniform battery of sensitive outcome measures, which allows the direct comparison between outcomes of different effect studies on ToM. Outcomes should include both conceptual abilities (ie, the level of ToM understanding) and practical abilities (ie, the use of ToM skills in daily life, as reflected by parent and teacher questionnaires and standardised observation scales). COULD THESE RESULTS CHANGE YOUR PRACTICES AND WHY?The results change clinical practice because they show that ToM interventions are effective. These results highlight the merit of interventions in older children and early adolescents. However, they also show the poor maintenance and generalisation of skills, which require specific attention in addition to the ToM intervention. REFERENCES 1. Lai MC, Lombardo MV, Baron-Cohen S. Autism. Lancet 2014;383:896-910. 2. Hoddenbach E, Koot HM, Clifford P, et al. Individual differences in the efficacy of a short theory of mind intervention for children with autism spectrum disorder: a randomized controlled trial. ...

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Individual differences in the efficacy of a short theory of mind intervention for children with autism spectrum disorder: a randomized controlled trial

Cited by 17 publications

References 31 publications

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

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

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

Theory of mind interventions can be effective in treating autism, although long-term success remains unproven

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