Theory of Mind and IQ in High Ability Youth with An ASD

Background:   Theory of mind has been found to be impaired in most high functioning youth with an autism spectrum disorder (ASD).  Some research suggests theory of mind is not impaired in most high functioning adults with an ASD, however they still have social difficulties.  Research indicates the development of theory of mind, both first-order (emotional/mental self-awareness) and second-order (understanding of other’s emotional/mental states), to be facilitated by language acquisition in children.    It is not clear what other factors may be influencing sophisticated theory of mind in high functioning youth and adolescents with an ASD (i.e., age, IQ, executive functioning).  Investigation of theory of mind, including emotional self-awareness, empathy, and social insight in high ability youth with an ASD may provide valuable information regarding the relationship between theory of mind and IQ.

Objectives:   This research provides some information regarding the relationship between IQ and theory of mind in high ability youth with an ASD.  The study encourages further investigation of sophisticated theory of mind development and related factors in individuals with an ASD, with clinical implications for the design of successful social skills interventions.

Methods:  Forty-two youth with high ability (defined as having an IQ verbal, nonverbal, or full scale standard score of >120) and an ASD (Autistic Disorder, Asperger’s Syndrome, Pervasive Developmental Disorder – Not Otherwise Specified; PDD-NOS) had measures gathered from the Wechsler Intelligence Scale for Children – Fourth Edition (WISC-IV) or Wechsler Adult Intelligence Scale – Third Edition (WAIS-III), as well as measures from the Autism Diagnostic Observation Schedule (ADOS) , as part of a Belin-Blank Center Javits Grant and from private clients evaluated at the Belin-Blank Center’s Assessment and Counseling Clinic.  Clinician rated ADOS codes of theory of mind (empathy, insight into social relationships, and emotional self-awareness) were analyzed with IQ Indices to determine correlations between ADOS theory of mind codes and IQ Indices (i.e., Verbal Comprehension Index, Perceptual Reasoning Index, Processing Speed Index, and Working Memory Index).

Results:   Nonparametric Spearman rank order correlation coefficients were calculated of WISC-IV/WAIS-III Indices and ADOS codes.  Results revealed Verbal Comprehension Index scores were positively correlated with the ADOS code of insight into social relationships (r_s = - .411, p = .007), and had trends towards significance with ADOS codes of emotional self-awareness (r_s = - .674, p = .067), and empathy (r_s = - .270, p = .084).  Conversely, Perceptual Reasoning Index scores were negatively correlated with ADOS codes of emotional self-awareness (r_s = .730, p = .040) and empathy (r_s = .428, p = .005). 

Conclusions:   High verbal ability is associated with sophisticated theory of mind abilities in youth with an ASD.  Language acquisition facilitates theory of mind development in children and may facilitate sophisticated theory of mind development in high ability youth with an ASD.  Further research is needed to better understand the relationship between language abilities and sophisticated theory of mind abilities in high functioning persons with an ASD.