The impact of visual-spatial abilities on theory of mind in children and adolescents with autism spectrum disorder.

BACKGROUND: Children and adolescents with autism spectrum disorder (ASD) often experience impaired social cognition. AIMS: In the present study, we aimed to investigate the relation between visual-spatial abilities and theory of mind in children and adolescents with and without ASD. METHODS: Forty-five boys from the age of 7 to 17 years with ASD and thirty-one aged matched boys without ASD participated and completed the test of intrinsic stable visual-spatial ability (test of visual perceptual skill-revised), intrinsic dynamic visual-spatial ability (animal mental rotation test), and theory of mind test (TOMT). RESULTS: Results showed that relative to boys without ASD, boys with ASD had a lower performance in theory of mind and intrinsic visual-spatial abilities. Secondly, theory of mind correlated with visual-spatial abilities in boys with ASD. Theory of mind for first and second order beliefs was predicted by the intrinsic dynamic visual abilities, whereas the theory of mind ability of emotion recognition was predicted by visual-spatial static abilities. In children without ASD, theory of mind for emotion recognition was predicted by intrinsic visual-spatial ability and the theory of mind for first order beliefs. DISCUSSION: Theory of mind can be predicted by visual-spatial abilities in children and adolescents with ASD. Future studies should investigate the role of different types of intrinsic dynamic visual-spatial abilities (e.g., egocentric vs. object-based mental rotation tasks) in relation to different aspects of theory of mind in children and adolescents with autism.