Autism & Developmental

The Impact of Theory of Mind on Real-Time Social Interactions and Momentary Social Anxiety: A Comparison Between Young Autistic and Neurotypical Children.

Chen et al. (2026) · Autism research : official journal of the International Society for Autism Research 2026
★ The Verdict

Better Theory of Mind helps autistic kids join peers, but it also stirs momentary social anxiety—pair social training with calming supports.

✓ Read this if BCBAs running social-skills groups in elementary schools.
✗ Skip if Clinicians focused only on non-verbal or preschool populations.

01Research in Context

01

What this study did

Chen et al. (2026) watched autistic and neurotypical kids during real play. They asked: Does better Theory of Mind lead to more peer contact and to more on-the-spot social anxiety?

They tracked each child’s moment-to-moment feelings while kids played together at school.

02

What they found

For autistic kids, stronger Theory of Mind meant more peer talk and play. It also meant sharper spikes of social anxiety right then and there.

For neurotypical kids, Theory of Mind made no difference to either contact or anxiety.

03

How this fits with other research

Chiu et al. (2023) already showed that early ToM scores forecast better social skills two years later in autistic children. Ryan’s team adds the twist: the same skill can boost both interaction and real-time worry.

Mazza et al. (2017) found that poor ToM explained social problems in autism. Ryan flips the picture: when ToM is higher, kids engage more, yet feel more anxious. The difference is setting—Monica used lab tasks; Ryan watched live recess play.

Burnside et al. (2017) saw no link between social orienting and ToM in preschoolers with autism. Ryan finds a clear link in elementary years. Age and naturalistic measurement likely explain the gap.

04

Why it matters

If you teach ToM to autistic clients, expect them to jump into peer games faster. Plan ahead: add emotion-regulation tools like brief breaks, coping cards, or peer buddies so the new social spark does not turn into stress.

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After a ToM lesson, give the child a pocket card with three calm-down steps and a signal to use it during peer play.

02At a glance

Intervention
not applicable
Design
other
Sample size
81
Population
autism spectrum disorder, neurotypical
Finding
mixed
Magnitude
small

03Original abstract

There is a growing need to examine how Theory of Mind (ToM) abilities impact real-time social engagement in autistic children. Caregivers of 45 young autistic children (70.7 ± 23.3 months) and those of 36 neurotypical peers (59.2 ± 11.8 months) carried a mobile device for 7 days to repeatedly record their child's social interactions and in-the-moment anxiety. They also completed the Social Responsiveness Scale-2 and the Theory of Mind Inventory-2 to evaluate their child's severity of autistic symptoms and ToM abilities. Multilevel analyses found that young autistic children with higher ToM abilities were more likely than those with lower abilities to interact with peers (OR = 1.12, 95% CI = 1.01-1.23) but also experienced more anxiety during interactions with both peers and adults (OR = 1.36, 1.28, 95% CI = 1.12-1.67, 1.01-1.63). In contrast, no significant associations between ToM and social interactions or anxiety were found in the neurotypical group. This study highlights the critical role of ToM abilities in the real-life social engagement of autistic children and emphasizes the importance of understanding real-time subjective social experiences.

Autism research : official journal of the International Society for Autism Research, 2026 · doi:10.1002/aur.70158