The associations of theory of mind with both general and theory-of-mind-related social interaction in children with autism spectrum disorder

Background: Theory of mind (ToM) appears to be associated with social interaction impairment in children with autism spectrum disorder (ASD). However, limited studies have examined the relationship between ToM and social interaction in children with ASD by separating social interaction into general and ToM-related categories. Therefore, this study examined whether ToM was a predictor of general and ToM-related social interaction in children with ASD, controlling for symptom severity and verbal comprehension. Method: A total of 135 children with ASD (mean age: 8.41 ± 1.73 years old) and their caregivers participated. Children were assessed with the Theory of Mind Task Battery, Vineland Adaptive Behavior Scales–Socialization domain, and Interactive Scale of Social Skills Questionnaire–Parent form. Results: The correlational findings revealed moderate correlations of ToM with general and ToM-related social interaction (r = 0.557 and r = 0.464, p < .001). Symptom severity and verbal comprehension were also moderately correlated with general (r = −0.584 and r = 0.497, all p < .001) and ToM-related (r = −0.507 and r = 0.491, all p < .001) social interaction. The two hierarchical regression models further showed that ToM predicted both general (p = .002) and ToM-related social interaction (p = .038) when symptom severity and verbal comprehension were controlled for. Conclusions: Conclusively, ToM was found to be a significant predictor of both general social interaction and ToM-related social interaction. The findings of this study highlight the importance of ToM in planning assessment and intervention for general and ToM-related social interaction in children with ASD.