Ins and Outs of Applied Behavior Analysis (ABA) Intervention in Promoting Social Communicative Abilities and Theory of Mind in Children and Adolescents with ASD: A Systematic Review.
ABA packages teach ToM skills, but you must program for long-term use across people and places.
01Research in Context
What this study did
Esposito et al. (2025) looked at 20 studies that used ABA to teach theory-of-mind skills to kids and teens with autism. They pulled every paper that mixed Behavioral Skills Training, derived relations, video modeling, and role play. The team asked: can these packages teach perspective-taking, emotion ID, and other social-communication skills?
What they found
The review says yes — ABA packages can teach ToM skills. Kids learned to read faces, take another’s point of view, and join peer chats. But most studies lost the gains after the program ended. Skills rarely moved to new places, people, or topics without extra help.
How this fits with other research
Camargo et al. (2014) and Menezes et al. (2021) already showed that behavior-based social skills work in real classrooms. Esposito adds the ToM lens and shows the same tools still leak without maintenance plans.
Bauminger (2002) ran a 7-month BST program and saw lasting peer gains. That single study looks brighter than the 2025 review average. The gap is method: Nirit kept teaching for months and added home practice. The 20 newer studies mostly stopped once mastery was hit.
Kleinert et al. (2007) warned that head-to-head trials were missing. Esposito confirms the field still relies on small, single-case bundles rather than big comparisons. In short, the new review updates the playlist but keeps the same weak spots.
Why it matters
You can keep using BST, video modeling, and role play to teach ToM skills — the evidence base is solid. Just don’t stop at mastery. Add weekly booster sessions, teach parents and teachers the same scripts, and probe in new settings for at least two months. Build generalization and maintenance into the behavior plan from day one, not as an afterthought.
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02At a glance
03Original abstract
Social-communicative abilities and theory of mind (ToM) are crucial for successful social interactions. The developmental trajectories of social and communicative skills characterizing individuals with Autism Spectrum Disorder (ASD) are rather complex and multidimensional, including components related to theory of mind. Due to its mentalistic nature, theory of mind has been rarely addressed as an outcome for Applied Behavior Analysis (ABA) intervention in children and adolescents with ASD. However, there is evidence that ABA intervention might be effective in promoting social abilities in individuals with ASD. Thus, this topic is worth investigating. We present a systematic review to explore the Ins and Outs of an ABA approach to promote social and communicative abilities and ToM in children and adolescents with ASD. We applied a PRISMA checklist to consider studies published up to December 2024. The keywords that we used were ToM, perspective-taking, false belief, social cognition, and mental states, in combination with ABA intervention and ASD (up to age 18). We searched for studies using Scopus, Google Scholar, and Medline. We included twenty studies on perspective-taking, identifying emotions, helping, detecting eye gazing, and social engagement, reviewing fifteen dedicated to teaching the interpretation of mental states (involving 49 children and 10 adolescents). The ToM was addressed with a multiple baseline design on target behaviors associated with ToM components such as identifying emotion, helping behaviors, and mental states. The intervention included a behavioral package consisting of Behavioral Skill Training, Derived Relations, video modeling, and role playing. The results indicated a significant number of participants who followed ABA intervention to promote social abilities and mastered the target behavior in ToM tasks; however, they showed maintenance and generalization issues across trials and settings. The role of predictors was highlighted. However, the studies are still rare and exhibit specific methodological limitations, as well as some clinical and ethical considerations. More research is needed to define best practices in ABA intervention to promote social abilities in individuals with ASD.
Behavioral Sciences, 2025 · doi:10.3390/bs15060814