The Relationships among Theory of Mind Pretend Play and Playfulness in Children with Autism Spectrum Disorder

Abstract

Autism spectrum disorder (ASD) is a lifelong neurodevelopmental disorder Children with ASD are found to have impaired theory of mind (ToM) which might cause their poor socialization and be associated with pretend play deficit and lower playfulness However previous findings on the relationship between ToM and pretend play have been inconsistent and no studies have directly examined the relationship between ToM and playfulness Therefore the main purpose of this study was to comprehensively examine the relationships among ToM pretend play and playfulness in children with ASD Furthermore one more purpose was to characterize ToM pretend play and playfulness in children with ASD as compared to children with developmental delay (DD) and typically developing (TD) children Twenty children with ASD 20 children with DD and 20 TD children aged between 3 and 7 11 were recruited for this study The three groups of children were matched for verbal ability Children were measured with the Receptive and Expressive Vocabulary Test-Second Edition and the Theory of Mind Test and they entered a free play condition and a pretend play condition for the Test of Playfulness and the Child-Initiated Pretend Play Assessment respectively The children’s caregivers were interviewed with the Childhood Autism Rating Scale Descriptive analysis one-way analysis of variance and Pearson’s correlation coefficient were used for the data analysis The results showed that children with ASD had deficits in ToM and pretend play and felt less playful as compared to children with DD and TD children The results of the correlational analysis confirmed that ToM was associated with imitated actions (r = - 481 p < 05) and the behaviors of object substitution (r = 479 p < 05) in pretend play However the results failed to show a significant relationship between ToM and playfulness The present study provides a complete understanding of the relationships among ToM pretend play and playfulness in children with ASD The findings support the idea that children with ASD who have better ToM may be able to develop more spontaneous pretend play behaviors and the behaviors of object substitution However the limitations of this study include the small sample size the underestimated ToM due to that considerately good verbal ability and long assessment time were required for the ToM test and the inability to generalize the results to children with lower-functioning and non-verbal ASD Further studies are warranted to include more participants apply a measurement of ToM that is less time-consuming and less verbally-demanding and recruit lower-functioning and non-verbal children with ASD to illustrate the relationships among ToM pretend play and playfulness

Date of Award	2015 Feb 2
Original language	English
Supervisor	Kuan-Lin Chen (Supervisor)