The association between theory of mind, executive function, and the symptoms of autism spectrum disorder

Gender Difference in the Association Between Executive Function and Autistic Traits in Typically Developing Children

Autistic traits and executive function (EF) were assessed in 413 typically developing children aged 6-9 years. The children were divided into the high- autistic-trait (HAT) and low-autistic-trait (LAT) groups based on their total autistic traits. Results suggested that there were gender differences in specific autistic traits in children with LAT. There were gender-specific associations between EF and autistic traits in children with HAT: the set shifting of EF predicted difficulties in social awareness in boys; whereas all the EF components predicted difficulties in social communication and social cognition in girls. These findings may have implications for developing customized interventions that are targeted at specific autistic deficits in males and females.

Relationships between implicit and explicit uncertainty monitoring and mindreading: Evidence from autism spectrum disorder

We examined performance on implicit (non-verbal) and explicit (verbal) uncertainty-monitoring tasks among neurotypical participants and participants with autism, while also testing mindreading abilities in both groups. We found that: (i) performance of autistic participants was unimpaired on the implicit uncertainty-monitoring task, while being significantly impaired on the explicit task; (ii) performance on the explicit task was correlated with performance on mindreading tasks in both groups, whereas performance on the implicit uncertainty-monitoring task was not; and (iii) performance on implicit and explicit uncertainty-monitoring tasks was not correlated. The results support the view that (a) explicit uncertainty-monitoring draws on the same cognitive faculty as mindreading whereas (b) implicit uncertainty-monitoring only test first-order decision making. These findings support the theory that metacognition and mindreading are underpinned by the same meta-representational faculty/resources, and that the implicit uncertainty-monitoring tasks that are frequently used with non-human animals fail to demonstrate the presence of metacognitive abilities.

Executive Function in Autism Spectrum Disorder: History, Theoretical Models, Empirical Findings, and Potential as an Endophenotype

This review presents an outline of executive function (EF) and its application to autism spectrum disorder (ASD). The development of the EF construct, theoretical models of EF, and limitations in the study of EF are outlined. The potential of EF as a cognitive endophenotype for ASD is reviewed, and the Research Domain Criteria (RDoC) framework is discussed for researching EF in ASD given the multifaceted factors that influence EF performance. A number of executive-focused cognitive models have been proposed to explain the symptom clusters observed in ASD. Empirical studies suggest a broad impairment in EF, although there is significant inter-individual variability in EF performance. The observed heterogeneity of EF performance is considered a limiting factor in establishing EF as a cognitive endophenotype in ASD. We propose, however, that this variability in EF performance presents an opportunity for subtyping within the spectrum that can contribute to targeted diagnostic and intervention strategies. Enhanced understanding of the neurobiological basis that underpins EF performance, such as the excitation/inhibition hypothesis, will likely be important. Application of the RDoC framework could provide clarity on the nature of EF impairment in ASD with potential for greater understanding of, and improved interventions for, this disorder.

Measuring Individual Differences in Cognitive, Affective, and Spontaneous Theory of Mind Among School-Aged Children with Autism Spectrum Disorder

The present study examined individual differences in theory of mind (ToM) among a group of 60 children (7-11 years-old) with autism spectrum disorder (ASD) and average intelligence. Using open-ended and structured tasks to measure affective ToM, cognitive ToM, and spontaneous social attribution, we explored the nature of ToM and assessed whether ToM predicts the phenotypic heterogeneity in ASD through structural equation modeling. Affective ToM uniquely predicted social symptom severity, whereas no ToM types predicted parent reported social functioning. Our findings suggest that differentiating among theoretical components is crucial for future ToM research in ASD, and ToM challenges related to reasoning about others' emotions may be particularly useful in distinguishing children with worse social symptoms of ASD.

Novel four-session treatment intervention for anxiety and high-functioning autism: A single case report for Externalizing Metaphors Therapy

TOPIC

The Brief Services psychotherapy paradigm has evolved to produce cost-effective and clinically significant outcomes in children's mental health. Though its clinical evaluation is still in its infancy, it has been utilized to a much lesser degree with autism spectrum disorders, which typically require a longer-term approach to psychotherapy treatment.

PURPOSE

The current paper introduces a novel, four-session intervention that aims to decrease anxiety experienced by clients presenting with high-functioning autism. Externalizing Metaphors Therapy is based upon the externalization of problems, transformation of metaphoric imagery, shifting of maladaptive emotional schemas, and the generalization of problems. A case study is utilized to visually aid in the understanding of this new treatment intervention.

SOURCE

A composite literature review was conducted with regards to significant works in Narrative Therapy, treatment interventions for anxiety and high functioning autism, evidence-based treatments for anxiety, and practice based approaches in psychotherapy. Works were selected based on their relevance to the research filed of anxiety and autism.

CONCLUSIONS

This clinical research challenges the children's mental health field in addressing anxiety and high-functioning autism from a brief framework. Further clinical research is needed to clinically evaluate the current model.

Executive Function and Theory of Mind in Children with ADHD: a Systematic Review

In developmental research, the relationship between Executive Function (EF) and Theory of Mind (ToM) has been extensively assessed, and EF has been considered a condition for ToM. However, few researchers have studied the relationship between EF and ToM in clinical populations, especially that of Attention Deficit Hyperactivity Disorder (ADHD), a neurodevelopmental disorder characterized by symptoms of inattention and motor hyperactivity/impulsivity, in which EF is largely impaired. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) model, 201 English and Spanish articles evaluating EF and ToM in ADHD were chosen. Fifteen papers met the inclusion criteria and were selected for further analysis. The first study dates from 2001. Most of the studies' designs are cross-sectional, include mostly male children, have a small sample size, and were conducted in European countries. Unlike tasks assessing EF, tasks assessing ToM were heterogeneous across studies. The EFs most correlated with ToM were inhibitory control, working memory, cognitive flexibility, and attention. Interest in studying the relationship between EF and ToM in ADHD is recent,but increasing based on new findings and tuning of ToM instruments. However, while an association between EF and ToM is indicated in ADHD, the degree of prediction and predictability of one over the other cannot yet be established because of the studies' heterogeneity.

Executive function predicts theory of mind but not social verbal communication in school-aged children with autism spectrum disorder

BACKGROUND

The association between Executive Function (EF) and Theory of Mind (ToM) in autism spectrum disorder (ASD) has been mainly investigated using false belief tasks, whilst less is known about the EF effect on other ToM facets. Furthermore, the role EF plays in social communication in ASD is mainly assessed using parent-report EF ratings rather than direct assessment.

AIMS

The aim of this study was to shed more light on the effect of performance-based EF measures on ToM and social communication in middle childhood in ASD relative to neurotypical controls.

METHODS AND PROCEDURES

Cross-sectional data were collected from 64 matched, school-aged children with and without ASD (8-12 years old), tested on measures of EF (inhibition, working memory, cognitive flexibility), ToM mental state/emotion recognition and social verbal communication.

OUTCOMES AND RESULTS

Significant group differences were observed only in selective EF skills (inhibition &cognitive flexibility) and social verbal communication. EF working memory contributed to the explained variance of ToM but not social verbal communication in middle childhood.

CONCLUSIONS AND IMPLICATIONS

These findings suggest that EF and ToM are still associated in middle childhood and EF may be a crucial predictor of ToM across childhood in ASD. Implications are discussed regarding the social-cognitive impairment relationship in ASD.

Can you spot a liar? Deception, mindreading, and the case of autism spectrum disorder

Detection of deception is of fundamental importance for everyday social life and might require “mindreading” (the ability to represent others’ mental states). People with diminished mindreading, such as those with autism spectrum disorder (ASD), might be at risk of manipulation because of lie detection difficulties. In Experiment 1, performance among 216 neurotypical adults on a realistic lie detection paradigm was significantly negatively associated with number of ASD traits, but not with mindreading ability. Bayesian analyses complemented null hypothesis significance testing and suggested the data supported the alternative hypothesis in this key respect. Cross validation of results was achieved by randomly splitting the full sample into two subsamples of 108 and rerunning analyses. The association between lie detection and ASD traits held in both subsamples, showing the reliability of findings. In Experiment 2, lie detection was significantly impaired in 27 adults with a diagnosis of ASD relative to 27 matched comparison participants. Results suggest that people with ASD (or ASD traits) may be particularly vulnerable to manipulation and may benefit from lie detection training. Autism Res2018, 11: 1129–1137. © 2018 The Authors Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc.

Lay Summary

Detection of deception is of fundamental importance for everyday social life. People with diminished understanding of other minds, such as those with autism spectrum disorder (ASD), might be at risk of manipulation because of lie detection difficulties. We found that lie detection ability was related to how many ASD traits neurotypical people manifested and also was significantly diminished among adults with a full diagnosis of ASD.