Date Presented 03/28/20
The results showed that children with normal verbal comprehension had better performance in ToM-related social interaction than those with delayed verbal comprehension. However, children’s symptom severities significantly predicted their ToM-related social interaction only in children who had normal verbal comprehension. This study highlighted the differential predictions of symptom severity to ToM-related social interaction by their verbal comprehension levels in children with ASD.
Primary Author and Speaker: Shih-Yao Mao
Contributing Authors: Yen-Ting Yu, Hsiu Man Chiu, Ching-Hong Tsai, Hsing-Jung Li, Kuan-Lin Chen
PURPOSE: Social interaction can be categorized as theory-of-mind-related (ToM-related) and not-related. ToM and symptom severity may explain the ToM-related social interaction impairment in children with autism spectrum disorder (ASD). Previous studies have showed that children’s verbal comprehension ability may play a key role in their social interaction. However, few studies have investigated the relation of verbal comprehension level to possible predictors of ToM-related social interaction in children with ASD. Therefore, considering the heterogeneity of ASD, this study aimed first to compare ToM-related social interaction in children with ASD with normal verbal comprehension and in those with delayed verbal comprehension. Second, this study aimed to identify the possible predictors of ToM-related social interaction according to verbal comprehension levels.
DESIGN: This was a quasi-experimental study. Children were recruited if they had a chronological age of 4–12 years and had received a diagnosis of autistic spectrum disorder, Asperger’s disorder, or Pervasive Developmental Disorder. Children were excluded if they had organic brain dysfunction or uncorrected hearing or visual impairments or were unable to follow orders and complete the procedures.
METHOD: Caregivers of children with ASD filled out the Interactive Scale of Social Skills Questionnaire–Parent form (SSQ-P) to evaluate children’s ToM-related social interaction. Participating children were assessed with the Verbal Comprehension Index (VCI) of the Wechsler Intelligence Scale for Children–Fourth Edition or Wechsler Preschool and Primary Scale of Intelligence–Fourth Edition, the Theory of Mind Task Battery (ToMTB), and the Childhood Autism Rating Scale (CARS), respectively to evaluate verbal comprehension, theory of mind performance and symptom severity. Children were divided into two groups according to their VCI scores (≥ 70 vs. < 70). Independent T-test was first applied to examine the differences of the SSQ-P between the two groups. Then regression analysis was applied to identify the possible predictors (i.e., VCI, ToMTB, and CARS) of the SSQ-P total scores in both groups (VCI ≥ 70 vs. VCI < 70).
RESULTS: A total of 100 children with ASD and their caregivers participated in this study. Significant group differences (VCI ≥ 70 vs. VCI < 70) were found in the SSQ-P total scores (40.5 ± 14.1 vs. 23.5 ± 10.6, t
(98) = 4.9, p < 0.001). These results indicated that children with normal verbal comprehension had significantly better performance on ToM-related social interaction than did children with delayed verbal comprehension. Moreover, the regression analysis showed that the CARS total score significantly predicted the SSQ-P total score (β = −1.4, p < 0.001) in children with normal verbal comprehension. However, no significant predictors of SSQ-P were found for children with delayed verbal comprehension.
CONCLUSION: The results indicated that in children with ASD, differences in ToM-related social interaction are related to verbal comprehension. In addition, symptom severity is a predictor of ToM-related social interaction in children with normal verbal comprehension, but not in those with delayed verbal comprehension. This study highlighted the importance of verbal comprehension in ToM-related social interaction. It is suggested that verbal comprehension and symptom severity both be considered in designing better assessment and intervention plans for social interaction in children with ASD.
References
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