The Impact of Theory of Mind on Real-Time Social Interactions and Momentary Social Anxiety: A Comparison Between Young Autistic and Neurotypical Children

There is a growing need to examine how Theory of Mind (ToM) abilities impact real-time social engagement in autistic children. Caregivers of 45 young autistic children (70.7 ± 23.3 months) and those of 36 neurotypical peers (59.2 ± 11.8 months) carried a mobile device for 7 days to repeatedly record their child's social interactions and in-the-moment anxiety. They also completed the Social Responsiveness Scale-2 and the Theory of Mind Inventory-2 to evaluate their child's severity of autistic symptoms and ToM abilities. Multilevel analyses found that young autistic children with higher ToM abilities were more likely than those with lower abilities to interact with peers (OR = 1.12, 95% CI = 1.01–1.23) but also experienced more anxiety during interactions with both peers and adults (OR = 1.36, 1.28, 95% CI = 1.12–1.67, 1.01–1.63). In contrast, no significant associations between ToM and social interactions or anxiety were found in the neurotypical group. This study highlights the critical role of ToM abilities in the real-life social engagement of autistic children and emphasizes the importance of understanding real-time subjective social experiences.