Psychometric Evaluation of the Chinese Version of the Theory of Mind Inventory for Children With Autism Spectrum Disorder

PURPOSE: Theory of mind (ToM) is a social–cognitive ability to understand the mental states of others in order to interpret others’ behavior. The specific deficit of ToM in children with autism spectrum disorder (ASD) has been found to relate to their impairments in social interaction. Many assessments have been developed to measure ToM; however, three limitations exist in these ToM measures: They (1) do not cover the whole spectrum of ToM, (2) are limited by cognitive or language impairments, and (3) indicate only ToM capacity, which cannot represent ToM performance in real daily contexts. The Theory of Mind Inventory (ToMI; Hutchins, Prelock, & Bonazinga, 2012), may solve the above-mentioned limitations. However, the ToMI cannot be applied to Taiwanese children due to cultural differences. Therefore, this study had two purposes: (1) to develop a Chinese version of the ToMI (ToMI–C) and (2) to evaluate the psychometric properties, including internal consistency, test–retest reliability, dimensionality validity, convergent validity, and discriminative validity.

DESIGN: The study design was psychometric research. The ToMI–C was developed in five stages: (1) translation, (2) back translation, (3) synthesis of the original version and back translation, (4) expert consultation for content validity, and (5) pilot study. To examine the psychometric properties of the ToMI–C, children with ASD and typically developing (TD) children ages 3–12 yr were recruited from kindergartens, hospitals, clinics, and developmental centers in Tainan, Kaohsiung, Hsinchu, Taipei, and Hualien in Taiwan.

METHOD: The caregivers of the children with ASD filled out the ToMI–C, Social Responsiveness Scale–2 (SRS–2) school-age form, and the Vineland Adaptive Behavior Scale (VABS) and were interviewed with the Childhood Autism Rating Scale (CARS), while the caregivers of the TD children filled out only the ToMI–C. All children were assessed with the Theory of Mind Task Battery (ToMTB) and the verbal IQ of the Wechsler Intelligence Scale for Children–IV or the Wechsler Preschool and Primary Scale of Intelligence–IV. The data analysis included intraclass correlation coefficients (ICC), Cronbach’s α, exploratory factor analysis, Pearson’s correlation coefficients (r), and t tests.

RESULTS: One hundred thirty children with ASD and 54 children with TD ages 3–12 yr were recruited in this study. The ToMI–C showed high internal consistency (Cronbach’s α = .956) and test–retest reliability (ICC = 0.81). The ToMI–C could well discriminate ToM deficits relative to age-matched children with ASD and TD (t = 0.956, p < .01). In addition, the ToMI–C had significant mild correlation with the SRS–2 (r = .413, p < .01) and CARS (r = .436, p < .01) and was moderately correlated with the VABS (r = .536, p < .01) and ToMTB (r = .565, p < .01).

CONCLUSION: The completed ToMI–C is a comprehensive measure that can be applied to children with linguistic and cognitive impairments to measure the performance of ToM of children with ASD in real social contexts. The ToMI–C can be used by clinicians and researchers to evaluate the ToM of Taiwanese children with ASD without cultural barriers.

References

Hutchins, T. L., Prelock, P. A., & Bonazinga, L. (2012). Psychometric evaluation of the Theory of Mind Inventory (ToMI): A study of typically developing children and children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 42, 327–341. https://doi.org/10.1007/s10803-011-1244-7

Lerner, M. D., Hutchins, T. L., & Prelock, P. A. (2011). Brief report: Preliminary evaluation of the Theory of Mind Inventory and its relationship to measures of social skills. Journal of Autism and Developmental Disorders, 41, 512–517. https://doi.org/10.1007/s10803-010-1066-z