Understanding the roles of theory of mind and executive function in reading comprehension among Chinese children with autism spectrum disorders

Abstract

The present study explored the profile of theory of mind (ToM), executive function (EF), and pragmatic comprehension, and examined how they contributed to the hyperlexia profile of Chinese school-aged children with autism spectrum disorders (ASD). 36 children with ASD and 36 typically developing (TD) controls aged 8 to 10 were tested on non-verbal intelligence, working memory, verbal ability, pragmatic comprehension, ToM, EF, word reading and reading comprehension. Children with ASD have more difficulties with advanced ToM, specific EF components (i.e. inhibition and planning), answering and explaining their answers of pragmatically complex questions. Furthermore, ToM skills are unique predictors to reading comprehension in ASD children, while shifting is a common predictor to reading comprehension in both groups. Additionally, only ToM and pragmatic comprehension are indicators that distinguished children with ASD from TD controls. These findings imply a new reading framework for children with ASD by highlighting the role of ToM skills and shifting ability in reading comprehension. Finally, these findings shed light on the incorporation of ToM and pragmatic comprehension in diagnosis of ASD in school-aged children.