Theory of mind in Chinese autistic children: Evidence for a delayed and unexpectedly deviant pattern

Theory of Mind (ToM) development in autistic children is widely considered both delayed and deviant. However, such findings may be affected by methodological limitations related to high linguistic and executive burdens and the choice of scoring approaches. The present study employed an improved Low-Verbal ToM Scale With ExtEnded Trials (LV-ToM-SWEET) to assess ToM abilities in 46 Mandarin-speaking Chinese autistic children aged 4.0–12.3 years (Mean age = 7.3 yrs, SD = 1.8 yrs, 41 boys). Using the improved Exclude Coding Scheme (Sobel & Austerweil, 2016) in the Rasch analyses, we identified the following developmental sequence of ToM abilities: Diverse Desires (DD) < Diverse Beliefs (DB) < Content False Belief (CFB) < Knowledge Access (KA) < Explicit False Belief (EFB) < Hidden Emotion (HE). Results indicated that ToM development in autistic children was overall delayed, and with deviations in the later steps of ToM progression. These deviations, differing from those reported in previous autism studies, may reflect the impact of improved measurement approaches. Overall, the present study highlights the importance of improved tools and scoring approaches in capturing the delayed yet partially deviant ToM development in Mandarin-speaking Chinese autistic children. These tools offer promise for broader clinical application in the future. • Developed a Mandarin version of the Low-Verbal ToM Scale for autistic children. • Reduced linguistic and executive demands to improve ToM assessment in autism. • Identified delayed and partially deviant ToM development in Chinese autistic children. • Found a novel CFB-before-KA sequence linked to working memory demands. • Highlights the need for refined tools and scoring schemes in ToM research.