The Role of Nice and Nasty Theory of Mind in Teacher-Selected Peer Models for Adolescents With Autism Spectrum Disorders

Abstract

The study aimed at verifying if nice and nasty theory of mind behaviors, in association with teachers’ peer buddy nomination, could be used to correctly select peer models for adolescents with autism spectrum disorder. Mentalizing abilities and emotional and behavioral characteristics of 601 adolescents were assessed. Results suggest that teachers recognize how students socially use their mind-reading ability, and employ such knowledge to select peers as intervention agents.

Keywords

autism spectrum disorder peer-mediated intervention teacher nominations mental abilities

Autism spectrum disorders (ASDs) are neurodevelopmental disorders resulting in lifelong qualitative impairments in social communication, as well as the presence of repetitive and stereotyped patterns of behavior (American Psychiatric Association, 2013; Wilson, 2013). Although the degree of impairment in each of these areas may be different in individuals with ASD, social difficulties are the most pervasive and troubling (Chung et al., 2007).

The difficulty to interpret social issues, engage in age-appropriate relationships and share emotional experiences by children and adolescents with ASD is wrongly mistaken for the will to avoid social interaction. Indeed, children and adolescents with ASD may desire to engage in social relationships but they are not naturally equipped to interact with others appropriately. Furthermore, their severe inability to handle social demands through shared verbal and nonverbal patterns leads them to find alternative ways to communicate, which are not always understood and socially accepted by others. Self- and other-oriented aggressive behavior and social rejection, sometimes shown by some individuals with ASD, may be an extreme solution adopted by them to communicate their needs after milder but failed attempts (Baumgartner & Strayer, 2008; Bifulco, Schimmenti, Jacobs, Bunn, & Rusu, 2014; Caretto & Lonigro, 2006). Such behaviors, in turn, discourage typically developing peers to engage in and maintain social interaction with students with ASD (Banda, Hart, & Liu-Gitz, 2010).

Moreover, the lack of positive social life exposes children and adolescents with ASD toward a greater likelihood to develop depressive symptoms and high levels of social anxiety than nondisabled peers (Flynn & Healy, 2012; Wood & Gadwo, 2010). Hence, efficient intervention programs aimed at enhancing social and communicative skills in individual with ASD are crucial to contrast the engagement in problematic behavior and the experience of social rejection (Cappadocia & Weiss, 2010; Cotugno, 2009).

Inclusive classroom environments may produce positive benefits to social development and adjustment of adolescents with ASD. However, the simple exposure to peers interactions is not sufficient to promote social skills in adolescents with ASD, but highly structured training programs with systematic procedures are required (Owen-DeSchryver, Carr, Cale, & Blakeley-Smith, 2008; Wilson, 2013).

In the literature, peer-mediated intervention (PMI), a treatment approach in which classmates are trained to act as the intervention agents, has been demonstrated to be useful to promote social behavior and enhance scholastic achievement (Bellini, Peters, Benner, & Hopf, 2007; Chan et al., 2009). PMI may be advantageous for adolescents with ASD because peers may take on several functions, such as reinforcing target behaviors and modeling appropriate behaviors. According to Chan et al. (2009), there are many potential benefits related to PMI as promoting inclusion in school settings: Students with ASD can make relationships with typically developing peers and increase the opportunities to practice social skills. Adolescents with ASD could learn basic social rules through observation of peer behavior and they could have the possibility to generalize in the future the acquired skills in new contests.

Much of the literature on PMI has focused on interventions with younger children with ASD. Chan et al. (2009) provided a systematic review concerning the use of PMI in the treatment of ASDs and they reported positive outcomes, although the treatment ﬁdelity was only rarely assessed. As summarized in the review, there is not a clear understanding about the behavioral/cognitive/social characteristics typically developing peers should have. The beneﬁts to peer models for participation in these programs have rarely been explored. Additionally, although typically developing peers in early elementary school showed willingness, in adolescence they gradually showed lack of involvement and negative attitudes toward adolescents with ASD (Locke, Rotheram-Fuller, & Kasari, 2012).

It must be said that the benefits of PMI also depend by the strategies used to peer chosen. Previous research has provided some support for the use of sociometric status, but some risks need to be understood (Jackson & Campbell, 2009). If on the one hand teachers and peers’ ratings of social status and popularity often overlap, on the other hand differences may come into view. First, teachers are not completely aware of social relationships and dynamics into the classroom. Second, adolescents who engage in antisocial behavior may be popular in the classroom because of their social influence on peers. Finally, teachers are more likely to select classmates with good scholastic performances but with little social influence (Newman & Murray, 2005; Renk & Phares, 2004; Rodkin & Hodges, 2003). Hence, new strategies to identify peer buddies are needed.

Going beyond popularity and social influence, characteristics that remain important, mind-reading abilities and their use in a prosocial way might be useful to peer chosen. Theory of mind (ToM) is the everyday ability to attribute independent mental states to self and others in order to predict and explain behaviors (Bellagamba, Laghi, Lonigro, Pace, 2012; Laghi, Pallini, D’Alessio, & Baiocco, 2011; Pace, Zavattini, & D’Alessio, 2012; Shakoor et al., 2012). ToM becomes more advanced during childhood and adolescence, and it continues to develop also in adulthood (Baron-Cohen, 2002,2003; Happè,1994; Pardini & Nichelli, 2009). This developmental trend is also confirmed by research in the field of neuropsychology, which demonstrates how a progressive maturation of neuronal connections in the prefrontal area, an area involved in the control and management of future actions, still occurs in late adolescence (Dumontheil, Apperly, & Blakemore, 2010).

Children’s understanding of others’ mental states has been positively linked to social competence in the classroom, popularity among peers, and engagement in connected communication with friends. Children with more advanced ToM abilities receive lower peers’ negative behavioral and teachers’ aggressiveness evaluations and they show better social abilities in the classroom (Diesendruck & Ben-Eliyahu, 2006). Furthermore, children who perform better on standard ToM tests have positive peer interactions, thus gaining their peers’ liking and preference (Slaughter, Dennis, & Pritchard, 2002). They are more able to adapt to the school context, showing higher levels of cooperation both with pupils and teachers (Denham, 2006). However, mastery of mind-reading abilities is not a guarantee of prosocial behavior. High levels of ToM abilities may at times lead to negative outcomes (Badenes, Estevan, & Bacete, 2000; Happé & Frith, 1996; Lonigro, Laghi, Baiocco, & Baumgartner, 2013). Children may use their mind-reading abilities to manipulate, outwit, tease, or trick their peers (Astington, 2003). Thus, ToM seems to be rather a neutral tool, which can be used for prosocial and antisocial purposes (Arefi, 2010). The expressions Nice Theory of Mind and Nasty Theory of Mind are used to differentiate behaviors requiring a prosocial use and an antisocial use of ToM abilities, respectively (Ronald, Happé, Hughes, & Plomin, 2005). Ronald et al. (2005) suggested the relevance to distinguish prosocial and antisocial ToM abilities, identifying nice ToM behaviors, such as cooperating, comforting, considering others’ feelings, and nasty ToM behaviors, lying, cheating, blaming, or teasing in preschool children. Their findings pointed out how preschool children are able to engage in both prosocial or antisocial behaviors that necessitating ToM and not necessitating ToM, suggesting that children’s conduct is complex and the ability to understand others’ inner states may be used for different purposes.

Purposes of the Study

The study aimed at verifying if nice and nasty ToM behaviors, in association with teachers’ peer buddy nomination, could be used to correctly select peer models. Considering ToM as a neutral tool, it is hypothesized that students’ performance on ToM task could be not appropriate to alone identifying intervention agents.

Conversely, nice and nasty ToM behaviors may be a direct expression of the social use of ToM, thus allowing to discriminate students who use their own mind-reading ability to help and collaborate with others spontaneously from students who use their mind-reading ability in order to achieve their own goals, even encompassing others’ feelings and needs. Hence, it is hypothesized that although students held same ToM abilities, only students with nice ToM behavior were more likely to be selected by teachers as peer models than students with nasty ToM behavior.

Method

Participants and Procedure

The sample consisted of 601 adolescents (409 boys and 192 girls; M age = 15.68, SD = 0.28; range = 14–16) from 38 classrooms within the public high schools in center of Italy (Lazio) and 38 teachers (25 females and 13 males), one for each classroom.

Recruitment began by contacting the schools with letters that described the purpose of the study. The schools were selected on the basis of their willingness to participate in the study as part of a project for PMI in supporting adolescents with autism in regular education settings. The voluntary nature of participation was ensured, and anonymity of the results was guaranteed.

Application consisted of the students completing the questionnaire quietly in a classroom at school, after informed consent was acquired from both students and their parents. The questionnaires were administered in the classroom by a team of interviewers who were trained advanced PhD students in psychology. Instructions stated that the questionnaires were voluntary and that responses were anonymous and confidential. All students responded to the same questionnaire packet, with measures administered in counterbalanced order to each group of subjects. After administering the questionnaires, the experimenters explained to participants that they were interested in ‘‘learning what they thought about the possibility to help a peer with ASD in their classroom’’ participating as a peer model. During student data collection, teachers completed peer buddy nominations.

The whole research project was coordinated by the first author. This survey was reviewed and approved by the Ethics Commission of Department of Developmental and Social Psychology, Sapienza, University of Rome.

Measures

Strength and Difficulties Questionnaire

The Italian version of Strengths and Difficulties Questionnaire (SDQ) 11–17 (Goodman, Meltzer, & Bailey, 1998) consists of 25 items, divided into five subscales of 5 items covering emotional problems, conduct problems, hyperactivity problems, peer problems, and prosocial behavior. Each item uses an ordered categorical response format (0 = not true, 1 = somewhat true, or 2 = certainly true). Responses can be rated 0 to 2 for negatively worded items and rated inversely 2 to 0 for positively worded items. Subscores are generated for each subscale (range = 0–10). All subscores, except the prosocial score, are added up to a total difficulties score (range = 0–40). The prosocial subscale measures the adolescent’s ability to act prosocially, independent of the difficulties measured by the other subscales. These scores have exhibited good levels of internal consistency (Cronbach’s α = .71 for emotional problems; Cronbach’s α = .75 for conduct problems; Cronbach’s α = .79 for hyperactivity problems; Cronbach’s α = .70 for peer problems; Cronbach’s α = .83 for prosocial behavior). The scales and total score of the SDQ version are good psychometric indicators of psychological problems. The syntaxes are available for download at http://www.sdqinfo.org website, where normative data from different countries can be found.

Children’s Version of the Reading the Mind in the Eyes Test

The Italian adaptation of the Reading the Mind in the Eyes Test (RMET-Children) was courtesy of the Autism Research Centre (Cambridge, United Kingdom). The RMET–Children (RMET-C; Baron-Cohen, Wheelwright, Spong, Scahill, & Lawson, 2001) is a standard test of advanced “ToM” which measures the ability to decipher mental states from 28 photographs of the eye region alone. Participants are required to select which of four complex mental state descriptors (one target word and three foil words) best describes the thoughts or feelings expressed by different individuals. This is not simply a complex test of emotion recognition because the mental state words included both affective and nonaffective (cognitive) mental state terms. The Eyes task included a control for nonmentalistic social intelligence: Participants were asked to judge the person in the photo’s gender, from their eyes alone. The RMET-C stimuli were displayed on a large screen; each stimulus was presented for 25 seconds and was followed by a blank slide for 5 seconds. Participants were provided with the answer sheet and with a glossary of the mental state terms, they were asked to read through the glossary and to indicate any word meanings they were unsure of, and they were told that they could return to the glossary at any point during the testing. Percentages of ‘‘correct’’ answers out of 28 items were calculated. At present, the RMET-C has also been repeatedly employed with adolescents in both clinical and nonclinical studies (e.g., Hallerbäck, Lugnegård, Hjärthag, & Gillberg, 2009).

Teacher Peer Buddy Nominations

According to Jackson and Campbell (2009), teachers also nominated three peer buddies and a “best” peer buddy for the adolescents with autism. Teachers also nominated three students they would not choose as peer buddies (Not Selected).

Analytic Strategy

The analyses were conducted using SPSS 18.0. To examine gender differences in emotional and behavioral characteristics, multivariate analysis of variance (MANOVA) was carried out. A factor analysis using varimax rotation was used to analyze nice and nasty behaviors which involve ToM.

The analysis of covariance (ANCOVA) was carried out using ToM behavior groups as the between-subjects factor, and RMET-C scores as the dependent variable, and gender as the covariate. A chi-square analysis was used to verify ToM behavior groups differences across teacher buddy selections.

Results

Preliminary Analyses

Preliminary analyses revealed no univariate outliers. The skewness and kurtosis indices were judged sufficient to meet the assumptions for the analysis (Curran, West, & Finch, 1996). To examine gender differences in emotional and behavioral characteristics, MANOVA was carried out and the scores in the subscales of SDQ were used as the dependent variables. MANOVA revealed an overall group effect on the dependent variables, λ =.84, F(5, 595) = 22.54, p < .001, η²_p = .16. Results from the univariate tests revealed that the two groups differed for emotional problems, F(1, 599) = 46.16, p < .001, η²_p = .07, and for prosocial subscale, F(1, 599) = 33.43, p < .001, η²_p = .03, where girls obtained higher scores (M = 3.96, SD = 2.39; M = 7.89, SD = 1.86, respectively) than boys (M = 2.65, SD = 2.10; M = 6.84, SD = 2.14, respectively), and for conduct problems, F(1, 599) = 4.56, p < .01, η²_p = .03, and peer problems, F(1, 599) = 6.67, p < .01, η²_p = .01, where boys obtained higher scores (M = 2.33, SD = 1.84; M = 2.40, SD = 1.95, respectively) than girls (M = 2.00, SD = 1.62; M = 1.97, SD = 1.67, respectively). Additionally, an analysis of variance using sex as between-subjects factor was conducted for the RMET-C scores. The analysis of variance revealed an effect for sex, F(1, 599) = 59.69, p < .001, η²_p = .09. Females obtained higher scores (M = 71.80, SD = 10.43) than males (M = 63.37, SD = 13.07).

Nice and Nasty Theory of Mind

To distinguish adolescents who use ToM in a prosocial way from adolescents who use ToM in an antisocial way, two steps were carried out. The first one was to identify prosocial behavior necessitating ToM (nice ToM) and antisocial behavior necessitating ToM (nasty ToM). Following the same procedure adopted by Ronald et al. (2005,) and by Lonigro et al. (2013), a factor analysis was carried out. Only behaviors which require mind-reading abilities were considered in the analyses. For this reason, nice and nasty behaviors which did not involve ToM were excluded. Items were selected from the SDQ. A factor analysis using varimax rotation was used to analyze data. The scree-plot suggested that two factors should be extracted, termed nice ToM and nasty ToM, explaining 28.18% and 14.25% of the variance, respectively. All the items of each dimension were loaded on the same factor with a correlation of at least .30. Example items are “I try to be nice to other people. I care about their feeling” (nice ToM) and “I am often accused of lying or cheating” (nasty ToM). The ToM questions were taken to represent socially insightful behavior and not a measure of false belief understanding (see Table 1).

Table 1.

Sorted Rotated Factor Loading Matrix for the Nine Items in Three Scales of Strength and Difficulties Questionnaire (Maximum Likelihood Analysis With Varimax Rotation).

Item	Factor 1	Factor 2
I often volunteer to help others (parents, teachers, children)	.71
I am helpful if someone is hurt, upset, or feeling ill	.70
I am kind to younger children	.64
I try to be nice to other people. I care about their feelings	.56
I usually share with others (food, games, pens, etc.)	.49
I am often accused of lying or cheating		.72
I get on better with adults than with people of my own age	.29	.60
I fight a lot. I can make other people do what I want		.58
I take things that are not mine from home, school, or elsewhere		.51
Eigenvalues	2.53	1.28
% Explained variance	28.18	14.25
Alpha	.70	.71

Note. Coefficients less than .25 are omitted from the table.

The second step aimed at identifying adolescent groups differentiated on social behaviors which require ToM. In particular, adolescents were divided into four groups on their standardized nice and nasty factor scores: (a) adolescents with low social ToM behavior (n = 86; 14.2%), those with 2 standard deviations below the mean on both factors; (b) adolescents with nice ToM behavior (n = 332; 55.2%), those with 2 deviations above the mean on the nice ToM score and with 2 standard deviations below the mean on the nasty ToM score; (c) adolescents with nasty ToM behavior (n = 99; 16.5%), those with 2 standard deviations below the mean on the nice ToM score and with 2 standard deviations above the mean on the nasty ToM score; (d) adolescents with contradictory ToM behavior (n = 85; 14%), those with 2 standard deviations above the mean on both scores.

Chi-square analysis pointed out gender differences, χ²₍₃₎ = 7.98, p < .05, among the ToM behavior groups. Females were more likely to report higher nice ToM scores and lower nasty ToM scores than males (60.4% vs. 42%).

Nice and Nasty ToM Behavior and Mentalizing Abilities

The ANCOVA was carried out assuming ToM behavior groups as the between-subjects factor, and RMET-C scores as the dependent variable, and gender as the covariate. Gender, F(1, 178) = .33, p = .25, was not significant. ANCOVA pointed out the differences between ToM groups on the ToM task, F(3, 597) = 3.01, p < .01, η²_p = .02. Results from the univariate tests ANCOVA and post hoc (Tukey test, p < .001) showed differences on adolescents with nice ToM behavior and adolescents with nasty ToM behavior who obtained higher mean scores than adolescents with contradictory ToM. Adolescents with low social ToM behavior obtained the lowest score, as reported in Table 2.

Table 2.

Descriptive Statistics and Significant ToM Group Effects on Reading the Mind in the Eyes Test (RMET-C) Scores.

	Adolescents With Low ToM Behavior (N = 86)	Adolescents With Nice ToM Behavior (N = 332)	Adolescents With Nasty ToM Behavior (N = 99)	Adolescents With Contradictory ToM Behavior (N = 85)
RMET-R total score	62.55^c (16.06)	67.20^a (12.30)	66.13^a (13.92)	64.93^b (11.08)

Note. ToM = theory of mind. Standard deviations are reported in parentheses. Post hoc comparisons (Tukey test; p < .001): Different letters indicate mean differences between groups.

Teacher-Selected Buddies and Nice and Nasty ToM Behaviors

Regarding the three teacher buddy selection groups, 104 adolescents were selected as peer models (17.3%), 85 were classified as inappropriate peer buddies (14.1%), and 412 were not nominated (68.6%). A chi-square analysis revealed significant gender difference across teacher buddy selections, χ²₍₂₎ = 9.53, p < .001. Boys were represented in the Not Selected group more frequently than girls (16.9% vs. 8.3%).

A chi-square analysis of peer buddy selection and ToM behavior groups revealed significant differences, χ²₍₂₎ = 49.93, p < .001. Adolescents with nasty ToM behavior were represented in the Not Selected group more frequently than adolescents with nice ToM behavior (25% vs. 11 %).

Discussion

Adolescents with ASD show pervasive difficulties with socioemotional reciprocity and nonverbal communication that largely affect social life (Tajmirriyahi, Nejati, Pouretemad, & Sepehr, 2013). The inability to begin and sustain social conversation, and share new activities with peers by adolescents with ASD lead them to experience social rejection and avoidance by nondisabled counterparts, with negative consequences on their social adjustment, scholastic achievement, and personal well-being (Chung et al., 2007). Hence, successful intervention programs need to be identified to enhance adaptive behavior, social skills, and acceptance (Banda et al., 2010). The classroom may be a fertile ground where adolescents with autism may experience social interactions in a positive way if structured procedures and training are provided to peers and teachers (Wilson, 2013). In particular, PMI is shown to be an efficacious treatment approach to improve social and communicative skills among adolescents with ASD (Chan et al., 2009). However, questions about the methods used to choose peers are still open. Teachers and peers’ ratings of social status and popularity are mainly used, but some problems may occur (Jackson & Campbell, 2009).

The present study aimed at verifying if nice and nasty ToM behaviors could be used to correctly select peer models. Accordingly with the hypothesis, adolescents who engage in nice ToM behavior and adolescents with nasty ToM behavior performed higher than other ToM groups on the advanced mind-reading task. Such finding confirms that ToM is a neutral tool that adolescents may employ for prosocial or antisocial purposes (Astington, 2003). The performance on ToM task is not sufficient to select peer as intervention models because it does not add information about the social use of mind-reading abilities. Conversely, nice and nasty ToM behaviors allowed us to identify adolescents who use their sensitivity to others’ mental states, to help and cooperate with peers from adolescents who encompass others’ needs and consider only their own personal goals.

Interestingly, teachers inserted into the Not Selected group adolescents with nasty ToM behavior more frequently than adolescents with nice ToM behavior. The overlap between teachers’ and students’ behavioral evaluation for identifying peer models seems to suggest that teachers recognize how students socially use their mind-reading ability, and employ such knowledge to select intervention agents. The social use of ToM appears crucial for peer selection.

Moreover, we do not know if the specific profiles translate into better implementation of PMI, or most importantly, if they are related to the outcomes for students with ASD. While the study allows to understand what skills should peer models have, we do not have information on how these characteristics translate into their roles as peer partners. For future research, it could be useful to select a subgroup of peer models to implement a PMI and to link their mind-reading skills verifying the impact on adolescents with ASD’s outcomes.

Additionally, the process of recruitment of buddies based on the analysis of important construct as ToM and emotional and social behavior with the use of multiple informants (teachers, peers, and adolescents with ASD) could have important implications for future empirical investigation and also for psychoeducational intervention for adolescents with ASD.

Our study is a preliminary attempt to overcome the problems linked to methods commonly used to select peers (Jackson & Campbell, 2009). Verifying our suggestions in longitudinal design is the challenge for future research.

Despite promising findings of the present study, the lack of longitudinal data on the effect of PMI on increases of social skills among adolescents with ASD does not allow to surely claim that peer selection based on nice and nasty ToM behaviors is better than the use of social status.

Footnotes

Acknowledgements

Special thanks to the adolescents who were involved in this study and to the principals and the teachers of the high schools in Rome where participants were recruited. The authors also thank Prof. Franco Sapia (ITAS G. Garibaldi) and Dr. Ilaria Marchetti (Provincia di Roma) for invaluable assistance, providing various research supports for the intervention.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Author Biographies

Fiorenzo Laghi is Associate Professor of Developmental Psychology at Sapienza, University of Rome. His primary research interests focus on prevention of risk behaviors and promotion of positive outcomes for at-risk child and adolescent populations. He is Director of Master in Autism Spectrum Disorders at Sapienza, University of Rome.

Antonia Lonigro is clinical psychologist and PhD in Developmental Psychology at Sapienza, University of Rome.

Simona Levanto is the Coordinator of specialized assistants for adolescents with ASD at ITA G. Garibaldi.

Maurizio Ferraro is the President of Cooperativa G. Garibaldi that is composed by adolescents with ASD and their parents.

Emma Baumgartner is Full Professor of Developmental Psychology. Her primary research interests focus on child and adolescence social competence.

Roberto Baiocco is Professor of Developmental Psychology at Sapienza, University of Rome. He is Director of the Center for the Study of Sexual Orientation and Gender Identity at the Sapienza University of Rome.

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