ToM² : Parental Perception of Theory of Mind Abilities in Autistic Children

Understanding how parents perceive their children's abilities is crucial for family dynamics and intervention strategies, particularly in autism, where accurate parental assessment of social-cognitive capabilities can influence support approaches and developmental outcomes. This study introduces ToM², a novel measure examining parents' ability to predict their autistic child's Theory of Mind (ToM) performance, representing a form of mentalization that requires parents to evaluate how their child understands others' mental states. We recruited 54 parent-child dyads (43 included in final analyses) from families with children diagnosed with autism (ages 42-70 months). Children completed a six-task ToM scale, while parents predicted their child's responses to each task. ToM² accuracy was calculated based on the match between parental predictions and child performance. We examined the relationships between ToM² accuracy and family accommodation for restricted and repetitive behaviors, autism symptom severity, and parental broader autism phenotype characteristics using logistic mixed-effects modeling. Results revealed that parents with higher levels of family accommodation demonstrated significantly lower ToM² accuracy (p = 0.030), suggesting that higher accommodation is associated with reduced accuracy in perceiving social-cognitive abilities, consistent with bidirectional parent-child interaction patterns. Greater autism symptom severity showed a trend toward reduced ToM² accuracy (p = 0.051), possibly suggesting that more pronounced autism characteristics may present greater challenges for parental mentalization. Parental broader autism phenotype was not associated with ToM² accuracy. These findings suggest that ToM² represents a useful framework for parental mentalization in autism and may inform family-centered interventions targeting both accommodation behaviors and parental perception accuracy.