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

Abstract

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.Impairments in theory of mind and in executive functions have both been hypothesized to underlie the core, defining symptoms of autism. The theory of mind hypothesis (Baron-Cohen, Tager-Flusberg, & Cohen, 2000) posits that autism involves an impairment in the ability to conceive of mental states and to use mental state concepts to interpret and predict one's own and other people's behavior. Although efforts to specify the nature of the "mentalizing" impairment in autism have increasingly taken a developmental rather than a static, all or nothing approach (Tager-Flusberg, 2001), the bulk of the research on theory of mind in autism has nonetheless focused on the attainment of one key social-cognitive milestone, false belief understanding, in which individuals with autism have been found to be significantly impaired (Baron-Cohen, Leslie, & Frith, 1985; also see Baron-Cohen, 2000, for a review). The ability to impute false beliefs to oneself and others, which is normally acquired at around age 4, is considered a particularly important development in theory of mind in that it marks the emergence of a representational concept of mind, whereby children implicitly understand that mental states are subjective representations of the world that are independent of and not necessarily congruent with reality (Astington & Gopnik, 1991;Perner, 1991;Wellman, 1990). From the vantage point of the theory of mind hypothesis, an impaired ability to represent mental states, and the limited awareness of oneself and other people that this implies, provides a compellin...

Exploring links between language and cognition in autism spectrum disorders: Complement sentences, false belief, and executive functioning

“…Moreover, correlations between complement sentences and ToM also emerged despite this limitation, which suggests that EF abilities in ASD do not impact verbal ToM performance in the same way as specific complementation skills do. It is interesting to underline that recent studies that have found a relation between verbal theory of mind performance and executive control abilities in ASD have reported that associations between these components disappeared when the effects of non-verbal ability and language level on these variables were controlled (Joseph & Tager-Flusberg, 2004).…”

Executive Function in Preschoolers with Autism: Evidence Consistent with a Secondary Deficit

“…For example, when an individual participates in a group discussion, s/he must track multiple speakers' comments simultaneously, while generating and modifying his/her own contributions. Moreover, there is also a large literature, which will not be reviewed here, connecting 'theory of mind' deficits and EF (see Carlson, Moses, & Claxton, 2004;Hughes, 2001;Joseph & Tager-Flusberg, 2004 for recent developments in this area of research). Systematic research must be conducted to clarify the contribution of social experience throughout development on cognitive and neural mechanisms underlying EF, and how deviation from typical social experiences contributes to an emergent deficit as seen in autism.…”

Exploring ‘The autisms’ at a cognitive level

“…verbal tasks and tasks requiring inference of the experimenter's intentions) or because these two cognitive processes fundamentally rely on a common cognitive mechanism. Despite a lack of clarity as to the roots of this association, the past literature in ASD certainly supports the existence of such a relationship (Joseph & Tager-Flusberg, 2004;Ozonoff, Pennington, & Rogers, 1991;Zelazo, 2002). …”