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Published in: Trials 1/2012

Open Access 01-12-2012 | Study protocol

Individual differences in the efficacy of a short theory of mind intervention for children with autism spectrum disorder: a randomized controlled trial

Authors: Elske Hoddenbach, Hans M Koot, Pamela Clifford, Carolien Gevers, Cassandra Clauser, Frits Boer, Sander Begeer

Published in: Trials | Issue 1/2012

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Abstract

Background

Having a ‘theory of mind’, or having the ability to attribute mental states to oneself or others, is considered one of the most central domains of impairment among children with an autism spectrum disorder (ASD). Many interventions focus on improving theory of mind skills in children with ASD. Nonetheless, the empirical evidence for the effect of these interventions is limited. The main goal of this study is to examine the effectiveness of a short theory of mind intervention for children with ASD. A second objective is to determine which subgroups within the autism spectrum profit most from the intervention.

Methods

This study is a randomized controlled trial. One hundred children with ASD, aged 7 to 12 years will be randomly assigned to an intervention or a waiting list control group. Outcome measures include the completion of theory of mind and emotion understanding tasks, and parent and teacher questionnaires on children’s social skills. Follow-up data for the intervention group will be collected 6 months after the interventions.

Discussion

This study evaluates the efficacy of a theory of mind intervention for children with ASD. Hypotheses, strengths, and limitations of the study are discussed.

Trial registration

Netherlands Trial Register NTR2327
Appendix
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Literature
1.
go back to reference Centers for Disease Control and Prevention: Prevalence of autism spectrum disorders–Autism and Developmental Disabilities Monitoring Network, United States, 2008. MMWR. MMWR 2012, 61: 1-19. Centers for Disease Control and Prevention: Prevalence of autism spectrum disorders–Autism and Developmental Disabilities Monitoring Network, United States, 2008. MMWR. MMWR 2012, 61: 1-19.
2.
go back to reference American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. 2000, Washington DC, 4 American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. 2000, Washington DC, 4
3.
go back to reference Baron-Cohen S, Tager-Flusberg H, Cohen DJ: Understanding Other Minds: Perspectives From Developmental Cognitive Neuroscience. 2000, Oxford: Oxford University Press Baron-Cohen S, Tager-Flusberg H, Cohen DJ: Understanding Other Minds: Perspectives From Developmental Cognitive Neuroscience. 2000, Oxford: Oxford University Press
4.
go back to reference Baron-Cohen S, Leslie AM, Frith U: Does the autistic child have a ‘theory of mind’?. Cognition. 1985, 21: 37-46. 10.1016/0010-0277(85)90022-8.CrossRefPubMed Baron-Cohen S, Leslie AM, Frith U: Does the autistic child have a ‘theory of mind’?. Cognition. 1985, 21: 37-46. 10.1016/0010-0277(85)90022-8.CrossRefPubMed
5.
go back to reference Yirmiya N, Erel O, Shaked M, Solominica-Levi D: Meta-analyses comparing theory of mind abilities of individuals with autism, individuals with mental retardation, and normal developing individuals. Psychol Bull. 1998, 124: 283-307.CrossRefPubMed Yirmiya N, Erel O, Shaked M, Solominica-Levi D: Meta-analyses comparing theory of mind abilities of individuals with autism, individuals with mental retardation, and normal developing individuals. Psychol Bull. 1998, 124: 283-307.CrossRefPubMed
6.
go back to reference Scheeren AM, de Rosnay M, Koot HM, Begeer S: Rethinking theory of mind in children and adolescents with autism. J Child Psychol Psychiatry. 10.1111/jcpp.12007. Scheeren AM, de Rosnay M, Koot HM, Begeer S: Rethinking theory of mind in children and adolescents with autism. J Child Psychol Psychiatry. 10.1111/jcpp.12007.
7.
go back to reference Seida JK, Ospina MB, Karkhaneh M, Hartling L, Smith V, Clark B: Systematic reviews of psychosocial interventions for autism: an umbrella review. Dev Med Child Neurol. 2009, 51: 95-104. 10.1111/j.1469-8749.2008.03211.x.CrossRefPubMed Seida JK, Ospina MB, Karkhaneh M, Hartling L, Smith V, Clark B: Systematic reviews of psychosocial interventions for autism: an umbrella review. Dev Med Child Neurol. 2009, 51: 95-104. 10.1111/j.1469-8749.2008.03211.x.CrossRefPubMed
8.
go back to reference Gevers C, Clifford P, Mager M, Boer F: Brief report. A theory-of-mind based social cognition training program for school-aged children with pervasive developmental disorders: an open study of its effectiveness. J Autism Dev Disord. 2006, 36: 567-571. 10.1007/s10803-006-0095-0.CrossRefPubMed Gevers C, Clifford P, Mager M, Boer F: Brief report. A theory-of-mind based social cognition training program for school-aged children with pervasive developmental disorders: an open study of its effectiveness. J Autism Dev Disord. 2006, 36: 567-571. 10.1007/s10803-006-0095-0.CrossRefPubMed
9.
go back to reference Steerneman P, Jackson S, Pelzer H, Muris P: Children with social handicaps: an intervention programme using a theory of mind approach. Clin Child Psychol Psychiatry. 1996, 1: 251-263. 10.1177/1359104596012006.CrossRef Steerneman P, Jackson S, Pelzer H, Muris P: Children with social handicaps: an intervention programme using a theory of mind approach. Clin Child Psychol Psychiatry. 1996, 1: 251-263. 10.1177/1359104596012006.CrossRef
10.
go back to reference Swettenham J: Can children with autism be taught to understand false belief using computers?. J Child Psychol Psychiatry. 1996, 37: 157-165. 10.1111/j.1469-7610.1996.tb01387.x.CrossRefPubMed Swettenham J: Can children with autism be taught to understand false belief using computers?. J Child Psychol Psychiatry. 1996, 37: 157-165. 10.1111/j.1469-7610.1996.tb01387.x.CrossRefPubMed
11.
go back to reference Hess K, Morrier M, Heflin L, Ivey M: Autism treatment survey: services received by children with autism spectrum disorders in public school classrooms. J Autism Dev Disord. 2008, 38: 961-971. 10.1007/s10803-007-0470-5.CrossRefPubMed Hess K, Morrier M, Heflin L, Ivey M: Autism treatment survey: services received by children with autism spectrum disorders in public school classrooms. J Autism Dev Disord. 2008, 38: 961-971. 10.1007/s10803-007-0470-5.CrossRefPubMed
12.
go back to reference Begeer S, Gevers C, Clifford P, Verhoeve M, Kat K, Hoddenbach E, Boer F: Theory of mind training in children with autism: a randomized controlled trial. J Autism Dev Disord. 2011, 8: 997-1006.CrossRef Begeer S, Gevers C, Clifford P, Verhoeve M, Kat K, Hoddenbach E, Boer F: Theory of mind training in children with autism: a randomized controlled trial. J Autism Dev Disord. 2011, 8: 997-1006.CrossRef
13.
go back to reference Koenig K, De Los Reyes A, Cicchetti D, Scahill L, Klin A: Group intervention to promote social skills in school-age children with pervasive developmental disorders: reconsidering efficacy. J Autism Dev Disord. 2009, 39: 1163-1172. 10.1007/s10803-009-0728-1.CrossRefPubMed Koenig K, De Los Reyes A, Cicchetti D, Scahill L, Klin A: Group intervention to promote social skills in school-age children with pervasive developmental disorders: reconsidering efficacy. J Autism Dev Disord. 2009, 39: 1163-1172. 10.1007/s10803-009-0728-1.CrossRefPubMed
14.
go back to reference Lord C, Wagner A, Rogers S, Szatmari P, Aman M, Charman T, Dawson G, Durand VM, Grossman L, Guthrie D, Harris S, Kasari C, Marcus L, Murphy S, Odom S, Pickles A, Scahill L, Shaw E, Siegel B, Sigman M, Stone W, Smith T, Yoder P: Challenges in evaluating psychosocial interventions for autistic spectrum disorders. J Autism Dev Disord. 2005, 35: 695-708. 10.1007/s10803-005-0017-6.CrossRefPubMed Lord C, Wagner A, Rogers S, Szatmari P, Aman M, Charman T, Dawson G, Durand VM, Grossman L, Guthrie D, Harris S, Kasari C, Marcus L, Murphy S, Odom S, Pickles A, Scahill L, Shaw E, Siegel B, Sigman M, Stone W, Smith T, Yoder P: Challenges in evaluating psychosocial interventions for autistic spectrum disorders. J Autism Dev Disord. 2005, 35: 695-708. 10.1007/s10803-005-0017-6.CrossRefPubMed
15.
go back to reference Fisher N, Happé F: A training study of theory of mind and executive function in children with autistic spectrum disorders. J Autism Dev Disord. 2005, 35: 757-771. 10.1007/s10803-005-0022-9.CrossRefPubMed Fisher N, Happé F: A training study of theory of mind and executive function in children with autistic spectrum disorders. J Autism Dev Disord. 2005, 35: 757-771. 10.1007/s10803-005-0022-9.CrossRefPubMed
16.
go back to reference Jones W, Klin A: Heterogeneity and homogeneity across the autism spectrum: the role of development. J Am Acad Child Adolesc Psychiatry. 2009, 48: 471-473. 10.1097/CHI.0b013e31819f6c0d.CrossRefPubMed Jones W, Klin A: Heterogeneity and homogeneity across the autism spectrum: the role of development. J Am Acad Child Adolesc Psychiatry. 2009, 48: 471-473. 10.1097/CHI.0b013e31819f6c0d.CrossRefPubMed
17.
go back to reference Scheeren AM, Koot HM, Begeer S: Social interaction style of children and adolescents with high-functioning autism spectrum disorder. J Autism Dev Disord. in press Scheeren AM, Koot HM, Begeer S: Social interaction style of children and adolescents with high-functioning autism spectrum disorder. J Autism Dev Disord. in press
18.
go back to reference Kanne SM, Gerber AJ, Quirmbach LM, Sparrow SS, Cicchetti DV, Saulnier CA: The role of adaptive behavior in autism spectrum disorders: implications for functional outcome. J Autism Dev Disord. 2011, 41: 1007-1018. 10.1007/s10803-010-1126-4.CrossRefPubMed Kanne SM, Gerber AJ, Quirmbach LM, Sparrow SS, Cicchetti DV, Saulnier CA: The role of adaptive behavior in autism spectrum disorders: implications for functional outcome. J Autism Dev Disord. 2011, 41: 1007-1018. 10.1007/s10803-010-1126-4.CrossRefPubMed
19.
go back to reference Antshel KM, Polacek C, McMahon M, Dygert K, Spenceley L, Dygert L, Miller L, Faisal F: Comorbid ADHD and anxiety affect social skills group intervention treatment efficacy in children with autism spectrum disorders. J Dev Behav Pediatr. 2011, 32: 439-446. 10.1097/DBP.0b013e318222355d.CrossRefPubMed Antshel KM, Polacek C, McMahon M, Dygert K, Spenceley L, Dygert L, Miller L, Faisal F: Comorbid ADHD and anxiety affect social skills group intervention treatment efficacy in children with autism spectrum disorders. J Dev Behav Pediatr. 2011, 32: 439-446. 10.1097/DBP.0b013e318222355d.CrossRefPubMed
20.
go back to reference Hartman CA, Luteijn E, Serra M, Minderaa R: Refinement of the children’s social behavior questionnaire (CBSQ): an instrument that describes the diverse problems seen in milder forms of PDD. J Autism Dev Disord. 2006, 36: 325-342. 10.1007/s10803-005-0072-z.CrossRefPubMed Hartman CA, Luteijn E, Serra M, Minderaa R: Refinement of the children’s social behavior questionnaire (CBSQ): an instrument that describes the diverse problems seen in milder forms of PDD. J Autism Dev Disord. 2006, 36: 325-342. 10.1007/s10803-005-0072-z.CrossRefPubMed
21.
go back to reference Koegel LK, Koegel RL, Hurley C, Frea WD: Improving social skills and disruptive behaviour in children with autism through self-management. J Appl Behav Anal. 2008, 25: 341-353.CrossRef Koegel LK, Koegel RL, Hurley C, Frea WD: Improving social skills and disruptive behaviour in children with autism through self-management. J Appl Behav Anal. 2008, 25: 341-353.CrossRef
22.
go back to reference Constantino JN, Gruber CP: Social Responsiveness Scale. 2007, Los Angeles: Western Psychological Services Constantino JN, Gruber CP: Social Responsiveness Scale. 2007, Los Angeles: Western Psychological Services
23.
go back to reference Steerneman P: Leren denken over denken en leren begrijpen van emoties: Groepsbehandeling van kinderen [Learning to Think about Thinking and Learning to Understand Emotions: Group Treatment of Children]. 1994, Leuven: Garant Steerneman P: Leren denken over denken en leren begrijpen van emoties: Groepsbehandeling van kinderen [Learning to Think about Thinking and Learning to Understand Emotions: Group Treatment of Children]. 1994, Leuven: Garant
24.
go back to reference Rogers SJ, Vismara LA: Evidence-based comprehensive treatments for early autism. J Clin Child Adolesc Psychol. 2008, 37: 8-38. 10.1080/15374410701817808.CrossRefPubMedPubMedCentral Rogers SJ, Vismara LA: Evidence-based comprehensive treatments for early autism. J Clin Child Adolesc Psychol. 2008, 37: 8-38. 10.1080/15374410701817808.CrossRefPubMedPubMedCentral
25.
go back to reference Muris P, Steerneman P, Meesters C, Merckelbach H, Horselenberg R, van den Hogen T, van Dongen L: The ToM test: a new instrument for assessing theory of mind in normal children and children with pervasive developmental disorders. J Autism Dev Disord. 1999, 29: 67-80. 10.1023/A:1025922717020.CrossRefPubMed Muris P, Steerneman P, Meesters C, Merckelbach H, Horselenberg R, van den Hogen T, van Dongen L: The ToM test: a new instrument for assessing theory of mind in normal children and children with pervasive developmental disorders. J Autism Dev Disord. 1999, 29: 67-80. 10.1023/A:1025922717020.CrossRefPubMed
26.
go back to reference Sullivan K, Zaitchik D, Tager-Flusberg H: Preschoolers can attribute second-order beliefs. Dev Psychol. 1994, 30: 395-402.CrossRef Sullivan K, Zaitchik D, Tager-Flusberg H: Preschoolers can attribute second-order beliefs. Dev Psychol. 1994, 30: 395-402.CrossRef
27.
go back to reference Kaland N, Moller-Nielsen A, Callesen K, Mortensen EK, Gottlieb D, Smith L: A new ‘advanced’ test of theory of mind: evidence from children and adolescents with Asperger syndrome. J Child Psychol Psychiatry. 2002, 34: 517-528.CrossRef Kaland N, Moller-Nielsen A, Callesen K, Mortensen EK, Gottlieb D, Smith L: A new ‘advanced’ test of theory of mind: evidence from children and adolescents with Asperger syndrome. J Child Psychol Psychiatry. 2002, 34: 517-528.CrossRef
28.
go back to reference White S, Hill E, Happé F, Frith U: Revisiting the strange stories: revealing mentalizing impairments in autism. Child Dev. 2009, 80: 1097-1117. 10.1111/j.1467-8624.2009.01319.x.CrossRefPubMed White S, Hill E, Happé F, Frith U: Revisiting the strange stories: revealing mentalizing impairments in autism. Child Dev. 2009, 80: 1097-1117. 10.1111/j.1467-8624.2009.01319.x.CrossRefPubMed
29.
go back to reference Bajgar J, Ciarrochi J, Lane R, Deane FP: Development of the levels of emotional awareness scale for children (LEAS-C). Br J Dev Psychol. 2005, 23: 569-586. 10.1348/026151005X35417.CrossRefPubMed Bajgar J, Ciarrochi J, Lane R, Deane FP: Development of the levels of emotional awareness scale for children (LEAS-C). Br J Dev Psychol. 2005, 23: 569-586. 10.1348/026151005X35417.CrossRefPubMed
30.
go back to reference Spence SH: Social Skills Training: Enhancing Social Competence With Children And Adolescents. 1995, UK: NFER-Nelson, Windsor Spence SH: Social Skills Training: Enhancing Social Competence With Children And Adolescents. 1995, UK: NFER-Nelson, Windsor
31.
go back to reference Castelloe P, Dawson G: Subclassification of children with autism and pervasive developmental disorder: a questionnaire based on Wing’s subgrouping scheme. J Autism Dev Disord. 1993, 23: 229-241. 10.1007/BF01046217.CrossRefPubMed Castelloe P, Dawson G: Subclassification of children with autism and pervasive developmental disorder: a questionnaire based on Wing’s subgrouping scheme. J Autism Dev Disord. 1993, 23: 229-241. 10.1007/BF01046217.CrossRefPubMed
32.
go back to reference O’Brien SK: The validity and reliability of the Wing Subgroups Questionnaire. J Autism Dev Disord. 1996, 26: 321-335. 10.1007/BF02172477.CrossRefPubMed O’Brien SK: The validity and reliability of the Wing Subgroups Questionnaire. J Autism Dev Disord. 1996, 26: 321-335. 10.1007/BF02172477.CrossRefPubMed
33.
go back to reference Pelham WE, Gnagy EM, Greenslade KE, Milich R: Teacher ratings of DSM-III-R symptoms for the disruptive behavior disorders. J Am Acad Child Adolesc Psychiatry. 1992, 31: 210-218. 10.1097/00004583-199203000-00006.CrossRefPubMed Pelham WE, Gnagy EM, Greenslade KE, Milich R: Teacher ratings of DSM-III-R symptoms for the disruptive behavior disorders. J Am Acad Child Adolesc Psychiatry. 1992, 31: 210-218. 10.1097/00004583-199203000-00006.CrossRefPubMed
34.
go back to reference Dunn LM, Dunn LM: Peabody Picture Vocabulary Test (PPVT)-III-NL. 2004, Amsterdam: Hartcourt Test Publishers Dunn LM, Dunn LM: Peabody Picture Vocabulary Test (PPVT)-III-NL. 2004, Amsterdam: Hartcourt Test Publishers
35.
go back to reference Hodapp F, Gerken K: Correlations between scores for Peabody Picture Vocabulary Test-III and the Wechsler Intelligence Scale for Children-III. Psychol Rep. 1999, 84: 1139-1142.CrossRef Hodapp F, Gerken K: Correlations between scores for Peabody Picture Vocabulary Test-III and the Wechsler Intelligence Scale for Children-III. Psychol Rep. 1999, 84: 1139-1142.CrossRef
36.
go back to reference Dunn JM, Dunn JM: Examiner’s Manual for the PPVT-III Peabody Picture Vocabulary Test. 1997, Circle Pines, MN: American Guidance Service, 3 Dunn JM, Dunn JM: Examiner’s Manual for the PPVT-III Peabody Picture Vocabulary Test. 1997, Circle Pines, MN: American Guidance Service, 3
37.
go back to reference Lord C, Risi S, Lambrecht L, Cook EH, Leventhal BL, DiLavore PC, Pickles A, Rutter M: The autism diagnostic observation schedule-generic: a standard measure of social and communication deficits associated with the spectrum of autism. J Autism Dev Disord. 2000, 30: 205-223. 10.1023/A:1005592401947.CrossRefPubMed Lord C, Risi S, Lambrecht L, Cook EH, Leventhal BL, DiLavore PC, Pickles A, Rutter M: The autism diagnostic observation schedule-generic: a standard measure of social and communication deficits associated with the spectrum of autism. J Autism Dev Disord. 2000, 30: 205-223. 10.1023/A:1005592401947.CrossRefPubMed
38.
go back to reference Rutter M, Lecouteur A, Lord C: Autism Diagnostic Interview - Revised Manual. 2003, Los Angeles: Western Psychological Sevices Rutter M, Lecouteur A, Lord C: Autism Diagnostic Interview - Revised Manual. 2003, Los Angeles: Western Psychological Sevices
Metadata
Title
Individual differences in the efficacy of a short theory of mind intervention for children with autism spectrum disorder: a randomized controlled trial
Authors
Elske Hoddenbach
Hans M Koot
Pamela Clifford
Carolien Gevers
Cassandra Clauser
Frits Boer
Sander Begeer
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Trials / Issue 1/2012
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/1745-6215-13-206

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