Enhancing Theory of Mind in Children with Autism Through Computer-Assisted Instruction and the Thought-Bubble Strategy

Children with autism spectrum disorder (ASD) have significant deficits in communication, emotional recognition, perspective-taking, and social skills. Evidence from existing studies has shown that the social interaction skills of children with ASD are closely related to their theory of mind (ToM) abilities. While prior research has explored the effect of single intervention modes such as computer-assisted instruction (CAI) and the thought-bubble strategy, the efficacy of combining CAI with the thought-bubble strategy remains unclear. This study investigates the effectiveness of this multifaceted approach in fostering ToM development in children with ASD. Using a single-case design, the intervention for two children with ASD involved implementing CAI combined with the thought-bubble strategy to teach ToM skills to children with ASD, including basic beliefs, first-order beliefs and first-order false beliefs. Results indicated that both children showed an increase in their ToM abilities, evidenced by their increased tendency to use “I think/I feel” statements in everyday life, enhanced understanding of false beliefs, and a decrease in negative emotions. The thought-bubble strategy can be embedded in CAI, and the combination of these two methods facilitates the enhancement of the ToM abilities among children with ASD with good maintenance and generalization effects.