Enhancing theory of mind through language and executive function training: Evidence from bilingual and monolingual autistic children

The current study has investigated whether targeted language or executive function (EF) training can enhance Theory of Mind (ToM) in autistic children, and whether bilingualism would modulate training effects on the autistic children’s ToM performance. Forty autistic children (20 monolingual, 20 bilingual) were randomly assigned to language- or EF-based training groups, while an additional monolingual group received no training. Verbal and non-verbal ToM were assessed pre- and post-training. Both group and case-series analyses were conducted. At the group level, monolingual autistic children did not demonstrate significant pre–post improvements in either ToM modality, regardless of training type. In contrast, pre- to post-training comparisons in the bilingual autistic groups demonstrated significant verbal and non-verbal ToM gains following both language and EF training. No baseline differences were observed across groups in non-verbal IQ, vocabulary, syntactic comprehension, or working memory. Individual-level analyses further showed improvements primarily after language training, with heterogeneous improvements in verbal and non-verbal ToM across the bilingual autistic cases. The overall findings suggest that bilingual experience may strengthen improvement for both verbal and non-verbal ToM functions, further supporting the hypothesis that improvement in domain-specific functions, like language or EF, may lead to improvement in socio-cognitive functions as well. While preliminary, these results highlight the importance of including bilingual autistic populations in language and EF training research, and contribute to ongoing debates regarding the relations between language, EF and ToM in autism. • Language and EF training significantly enhanced Theory of Mind in ASD. • Bilingual children showed greater ToM gains across training conditions. • Bilingualism modulated responsiveness to cognitive and linguistic training.