The relationship between theory of mind, executive functioning, and repetitive behavior in high functioning autism spectrum disorder

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterised by social communication impairments, and restricted and repetitive behaviors (RRB). Difficulties in Theory of Mind (ToM) abilities in ASD as well as deficits in Executive Functions (EF) are reported in the literature. To date, few studies have investigated the influence of deficits in ToM and EF on ASD symptom severity, including RRB. Thus, the aim of this clinical study is to investigate the relationship between EF, ToM, and RRB in ASD. Our sample consisted of 50 ASD participants divided in two groups: 34 adolescents (mean age = 15.65; SD = 1.68) and 16 adults (mean age = 23.19; SD = 10.08). A mediation analysis evaluated whether the relationship between ToM and EF can be mediated by RRB for each group. Our results demonstrate that RRB plays a key role in the promote the correct relationship between ToM and EF. During development, the structuring of rehabilitation interventions focusing on these aspects can improve abilities to achieve important goals that promote independence and quality of life.