Indirect Pathways to Social Functioning in Autistic Children: The Roles of Verbal Comprehension, Task-Based Theory of...

Mixed results exist regarding the relationships between theory of mind (ToM) and social functioning in children with autism. This inconsistency may stem from a predominant focus on explicit ToM knowledge, with insufficient consideration of applied ToM competence and verbal comprehension. Further research is needed to incorporate these factors into the understanding of social functioning. This study developed mediation models to examine the links among explicit ToM knowledge, caregiver-perceived applied ToM competence, verbal comprehension, and social functioning in children with autism.

A total of 202 children with autism (183 boys) and their caregivers participated in this study. The children completed standardized assessments of verbal comprehension and explicit ToM knowledge. Caregivers completed questionnaires assessing the children's applied ToM competence and social functioning, including subdomains of Interpersonal Relationships, Play and Leisure, and Coping Skills.

Verbal comprehension showed significantly direct effects across all social functioning subdomains (effects: 0.05-0.15, 95%CI: 0.01-0.25). Explicit ToM knowledge was associated with social functioning only through verbal comprehension and applied ToM competence, or both (effects: 0.20-0.78, 95%CI: 0.04-1.37).

The results suggest that verbal comprehension may play an important role in linking explicit ToM knowledge to social functioning, whereas explicit ToM knowledge alone may be insufficient to explain social functioning in children with autism. Caregiver-perceived applied ToM competence may represent an additional pathway to social functioning. These findings highlight the importance of considering verbal comprehension, explicit ToM knowledge, and caregiver-perceived applied ToM competence when understanding and improving social functioning in children with autism.