There is a growing need to examine how Theory of Mind (ToM) abilities impact real-time social engagement in autistic children. Caregivers of 45 young autistic children (70.7 ± 23.3 months) and those of 36 neurotypical peers (59.2 ± 11.8 months) carried a mobile device for 7 days to repeatedly record their child's social interactions and in-the-moment anxiety. They also completed the Social Responsiveness Scale-2 and the Theory of Mind Inventory-2 to evaluate their child's severity of autistic symptoms and ToM abilities. Multilevel analyses found that young autistic children with higher ToM abilities were more likely than those with lower abilities to interact with peers (OR = 1.12, 95% CI = 1.01-1.23) but also experienced more anxiety during interactions with both peers and adults (OR = 1.36, 1.28, 95% CI = 1.12-1.67, 1.01-1.63). In contrast, no significant associations between ToM and social interactions or anxiety were found in the neurotypical group. This study highlights the critical role of ToM abilities in the real-life social engagement of autistic children and emphasizes the importance of understanding real-time subjective social experiences.
Keywords: autism; neurotypical; preschool children; real‐life social experience; social anxiety; theory of mind.
This study found that autistic children with better ToM abilities were more likely to engage with their peers, but they also experienced more anxiety during interactions with both peers and adults. For neurotypical children, there was no significant link between ToM and social interactions or anxiety. These findings show that ToM challenges are a key part of ASD and have an important impact on how autistic children experience social situations. The study suggests that helping autistic children enhance their ToM skills, manage anxiety, and feel more confident in social settings can better support them in navigating everyday social interactions.
© 2025 International Society for Autism Research and Wiley Periodicals LLC.