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Improving ToM in Children With ASD Through VPT Training: Behavioral and fNIRS Study

Not Applicable
Recruiting
Conditions
Autism Spectrum Disorder
Interventions
Behavioral: Thought-bubble training
Behavioral: Block building training
Behavioral: Visual perspective taking training
Behavioral: Treatment as usual
Registration Number
NCT06196060
Lead Sponsor
Nanjing Normal University
Brief Summary

This study aims to employ a longitudinal tracking research to investigate the effects of a visual perspective taking intervention on the development of theory of mind in children with autism. Additionally, the investigators seek to examine modifications in the neural mechanisms linked to facial emotion recognition in children both before and after intervention by using the functional Near-Infrared Spectroscopy (fNIRS) to record the relative changes in blood oxygen levels in the cerebral cortex with the oddball Face-Periodic Visual Stimulation (FPVS) paradigm.

Detailed Description

The deficiency or delayed development of Theory of Mind (ToM) stands as a significant contributing factor to social disorders observed in children with Autism Spectrum Disorder (ASD). Consequently, improving ToM ability is considered pivotal way to improve the development of social function of children with ASD. This study aims to improve ToM ability of children with ASD, and the purpose of this study are as follows:

1. Reveal the development mechanism of theory of mind of children with ASD, based on embodied cognition theory. Explore whether visual perspective taking training can improve the development of Theory of Mind in children with ASD, and if such enhancement exhibits long-term stability.

2. Undertake a longitudinal investigation to assess the stability of visual perspective taking training in improving the development of Theory of Mind in children with ASD. Additionally, the study aims to compare the differential effects and stability of various intervention programs in improving the Theory of Mind in children with ASD.

3. Explore potential disparities in the brain mechanisms of facial emotion recognition between children with ASD and typically developing children before and after the intervention. Specifically, the study seeks to discern whether the intervention can enhance facial emotion recognition abilities in children with ASD and assess the longevity of such enhancements.

The study consists of two parts. In Study 1, participants will be randomly assigned to distinct training groups based on baseline task performance, undergoing three sessions per week for a duration of 4 weeks. In Study 2, the investigators will mainly use the fNIRS with the oddball FPVS paradigm to test children's ability to distinguish facial emotion pictures before and after the intervention, assessing whether the intervention enhances facial emotion recognition ability and if effects vary across different training methods.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
100
Inclusion Criteria

ASD group:

  • With a diagnosis of ASD.
  • Age between 3 and 8 years old.
  • Monolinguals, Chinese native speakers.
  • Providing written informed consent sighed by parents.

Control group:

  • No diagnosis of ASD (including individuals who are typically developing, have attention deficit hyperactivity disorder, etc.)
  • Age between 3 and 8 years old.
  • Monolinguals, Chinese native speakers.
  • Providing written informed consent sighed by parents.
Exclusion Criteria
  • Language or motor impairments hindering participation in the study.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Thought-bubble trainingThought-bubble trainingParticipants will receive thought-bubble training in this arm.
Block building trainingBlock building trainingParticipants will receive block building training in this arm.
Visual perspective taking trainingVisual perspective taking trainingParticipants will receive visual perspective taking training in this arm.
Treatment as usualTreatment as usualParticipants will continue to receive routine therapy in this arm.
Primary Outcome Measures
NameTimeMethod
The Chinese version of Theory of Mind Task Battery (ToMTB)The test will be measured before, after immediately and three months after the intervention.

The ToMTB encompasses nine tasks, including an emotion recognition task, a desire-based emotion task, a seeing-leads-to-knowing task and so forth.

Visual perspective takingThe test will be measured before, after immediately and three months after the intervention.

A small toy will be placed on a square turntable, which has distinct colored sides. The child will be presented with a laminated card representing four images of the toy, each captured from the front, back, left, and right perspectives. The experimenter will randomly place a small doll in different positions (left, right, or the distant side). The child will be asked, 'This is a little seahorse. When the seahorse is here, which view will the seahorse have?' The child's response will be recorded and scored.

Theory of Mind scaleThe test will be measured before, after immediately and three months after the intervention.

This scale comprises seven subtests reflecting the sequential development of these concepts throughout the preschool years, including diverse desires, diverse beliefs, knowledge-ignorance or access, contents false belief, explicit false belief, belief emotion and real-apparent emotion.

The Chinese version of Theory of Mind Inventory-2 (ToMI-2-C)The test will be measured before, after immediately and three months after the intervention.

The ToMI-2 is a questionnaire filled by parents or guardians. It encompasses 60 items, which are categorized into three empirically derived subscales-Early, Basic, and Advanced-to comprehensively measure ToM abilities.

Secondary Outcome Measures
NameTimeMethod
Mental rotationThe test will be measured before, after immediately and three months after the intervention.

A small toy will be placed on a square turntable, which has distinct colored sides. The child will be presented with a laminated card representing four images of the toy, each captured from the front, back, left, and right perspectives. After the child correctly identifies the starting direction of the toy, the toy will be covered with an opaque cup. Subsequently, the examiner will randomly rotate the turntable by 90 degrees. The child is then tasked with identifying what the toy will look like when the cup is unveiled. The child's response will be recorded and scored.

Facial emotion recognitionThe test will be measured before, after immediately and three months after the intervention.

fNIRS recordings of relative changes in blood oxygen levels in the cerebral cortex under the oddball FPVS paradigm were employed to assess the recognition of emotional facial images in children with ASD.

Spatial abilityThe test will be measured before, after immediately and three months after the intervention.

Spatial ability will be assessed using the Block Design subtest from the Wechsler Preschool and Primary Scale of Intelligence,4th ed. (WPPSI-IV)

Trial Locations

Locations (3)

The Second Affiliated Hospital of Guangxi Medical University

🇨🇳

Nanning, Guangxi, China

Nanjing Normal University

🇨🇳

Nanjing, Jiangsu, China

Zhuhai Fudan Innovation Institute

🇨🇳

Zhuhai, Guangdong, China

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