Theory of mind in children with autism spectrum disorder: do siblings matter?
Older siblings act like built-in false-belief coaches for autistic kids.
01Research in Context
What this study did
Matson et al. (2013) asked if having older brothers or sisters helps autistic kids pass false-belief tasks. They compared autistic children who had at least one older sibling with those who did not. They also included typically developing kids as a baseline group.
What they found
Autistic kids with older siblings scored just as well on false-belief tests as typical kids. Autistic kids without older siblings scored much lower. The boost was big enough to close the usual gap.
How this fits with other research
Chiu et al. (2023) followed 106 autistic children for two years and showed that early false-belief scores predicted later social skills. This means the sibling boost seen in 2013 may keep paying off in real friendships.
Begeer et al. (2015) tried teaching false-belief lessons in a short class. Kids learned the test, but parents saw no extra social gains. The lesson: natural sibling play may do more than a quick lesson.
Burnside et al. (2017) looked at preschoolers and found no social-orienting or implicit false-belief edge, even with siblings. The gap closes later, so age and task type matter.
Why it matters
If your client has older siblings, lean into that resource. Invite siblings to therapy games or coach them to talk about thoughts and feelings during play. If the child is an only child, create peer sessions or small-group play that mimic sibling banter. The goal is daily back-and-forth about what others think, not just passing a test.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add a sibling or peer to the next false-belief role-play and prompt them to say, "I thought X, but you saw Y—what will happen?"
02At a glance
03Original abstract
Research indicates a positive relation between the sibling constellation and theory of mind (ToM) development in typically developing (TD) children. Less is known about this association in children with autism spectrum disorder (ASD). The current study examined the association among the presence and number of siblings, birth order, and false belief (FB) understanding in children with ASD and a TD comparison group. Two FB tasks (change of contents and change of location) and the Peabody Picture Vocabulary Test were administered to 57 children with ASD and 28 TD children during a home visit. One parent of each child reported on demographics and the sibling constellation. Separate hierarchical regressions controlled for age, receptive language ability, and scores on the Social Communication Questionnaire. In children with ASD, no association was observed between presence or number of siblings and ToM. However, the presence of older (but not younger) siblings was found to be positively associated with ToM. Children with ASD who had at least one older sibling performed similarly to the TD group, whereas children with ASD who had no older siblings performed significantly worse than the TD group. These findings indicate an advantage for FB performance in children with ASD who have an older sibling. They may bear on decisions to include older siblings or peers in intervention programs and may also contribute to a more complete understanding of the origins of individual differences in ToM ability in children with ASD.
Autism research : official journal of the International Society for Autism Research, 2013 · doi:10.1002/aur.1308