Impaired theory of mind and symptoms of Autism Spectrum Disorder in children with Prader-Willi syndrome.
Kids with Prader-Willi syndrome can show Theory-of-Mind delays twice as large as those seen in ASD plus a high rate of autism features—so screen both areas and teach social thinking at a much lower developmental level.
01Research in Context
What this study did
Ho et al. (2013) looked at kids with Prader-Willi syndrome. They wanted to know how far behind these kids were on Theory of Mind tasks.
The team gave standard false-belief tests to a small group. They also checked how many met cut-off for autism spectrum disorder.
What they found
Most kids with PWS scored four years below their age level on ToM tasks. One in three also met criteria for ASD, with big behavior problems.
The delay was larger than what is usually seen in ASD alone.
How this fits with other research
Shojaeian et al. (2022) tested Swedish kids with ASD and Down syndrome. They found ToM gaps too, but the PWS lag in Ting’s study is even bigger.
Chiu et al. (2023) followed kids with ASD for two years. Early ToM scores predicted later social skills. This warns us that the huge ToM gap in PWS likely drags down future social life.
Nejati et al. (2021) showed that weak visual-spatial skills partly explain ToM trouble in ASD. Maybe the same pathway hurts PWS kids; we should check blocks and puzzles, not just talk skills.
Why it matters
If you work with a child who has Prader-Willi, expect social thinking that looks years younger. Start perspective-taking lessons early and keep them concrete. Watch for ASD flags; one third will need autism-style supports. Pair social stories with hands-on spatial games to shore up the skills that feed ToM.
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02At a glance
03Original abstract
In order to evaluate the social cognitive functioning in children with Prader-Willi syndrome (PWS), Theory of Mind (ToM) and symptoms of Autism Spectrum Disorder were evaluated. Sixty-six children with PWS aged 7-17 years were tested using the Theory of Mind test-R and the Diagnostic Interview for Social Communication disorders. We tested the correlation between Total ToM Standard Deviation Score (Total ToM SDS) and genetic subtype of paternal deletion or maternal uniparental disomy, and total IQ, verbal IQ and performal IQ. Prevalence and symptoms of Autism Spectrum Disorder were assessed. Median (interquartile range) of total ToM SDS of those aged 7-17 years was -3.84 (-5.73, -1.57). Their Total ToM SDS correlated with total IQ (β=0.662, p<0.001, adj.R(2)=0.407), in particular with verbal IQ (β=0.502, p=0.001, adj.R(2)=0.409), but not with performal IQ (β=0.241, p>0.05, adj.R(2)=0.259). No difference in Total ToM SDS was found between children with deletion and maternal uniparental disomy (β=-0.143, p>0.05, adj.R(2)=-0.016). Compared to the reference group of healthy children aged 7-12 years, children with PWS in the same age group had a median ToM developmental delay of 4 (3-5) years. One third of children with PWS scored positive for Autism Spectrum Disorder. Most prominent aberrations in Autism Spectrum Disorder were focused on maladaptive behavior. Our findings demonstrate a markedly reduced level of social cognitive functioning, which has consequences for the approach of children with PWS, i.e. adjustment to the child's level of social cognitive functioning.
Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2013.05.024