Moderating Effects of Parental Characteristics on the Effectiveness of a Theory of Mind Training for Children with Autism: A Randomized Controlled Trial.
Danielle M J de Veld, Patricia Howlin, Elske Hoddenbach and 5 others
PMID 28391453WHAT IT FOUND
An eight-week group social-cognition training improved children's knowledge of others' minds, parent-reported social behaviors, and reduced autistic features.
Knowledge gains were smaller when a parent had or was suspected of having ASD.
Key findings
01Children in the treatment group had better theory-of-mind knowledge, more theory-of-mind-related behaviors, and fewer autistic features than waitlist controls.
02Parental education changed the treatment effect on theory-of-mind knowledge mainly because children in the waitlist control group showed smaller gains when more parents had a college degree.
03Children without a parent diagnosed with or suspected of having ASD showed a significant treatment effect on theory-of-mind knowledge, while children with at least one such parent did not.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The trial did not use detailed diagnostic instruments such as the Autism Diagnostic Interview-Revised or the Autism Diagnostic Observation Scale, so diagnosis relied on multiple assessments by psychologists and psychiatrists not involved in the study. The study used multiple primary outcome measures, which can make it harder to interpret which result should be taken as the main finding. Parental characteristics were measured with simple categories, such as number of college-educated parents, number of employed parents, family structure, and whether a parent had or was suspected of having ASD, rather than detailed trait, income, or hours-worked measures. Some moderator subgroups were small, including only 41 children who were not living with two biological parents, so findings for parental employment and family structure are preliminary. The parental ASD moderator was exploratory and based on parent report of diagnosis or suspicion, not confirmed assessment. No blinding of participants or assessors is described, and families learned their allocation from the study coordinator. Outcomes were measured immediately after the 8-week period, with no follow-up reported, so maintenance of effects is unknown. The training was delivered in a child psychiatric center by certified therapists who were licensed counseling psychologists, so the paper does not show whether the same results apply in other settings or with other professional groups.
Declared interests
The paper names ZonMw (NL) as the funder. No other conflict-of-interest statement is provided in the supplied text.
The easy way to misread this
Do not read the parental ASD subgroup result as proof that the training is ineffective for children whose parents have or are suspected of having ASD. The finding was exploratory, it applied to theory-of-mind knowledge rather than everyday behavior or autistic features, and the paper does not report a confirmed parental ASD assessment.