Language, theory of mind and cognitive skills in Arabic-speaking children with and without autism: Evidence from network and cluster analyses

Introduction: Autism spectrum disorder (ASD) is characterized by impairments in social interactions, social communication, and repetitive and stereotyped patterns of behavior. Previous studies have reported mixed findings regarding the links between language (i.e., phonology, morphosyntax, lexicon, and pragmatics), theory of mind (ToM), executive functions (EFs), and central coherence measures in children with ASD. Methods: A total of 163 Palestinian-Arabic-speaking children aged 4–11 participated: 76 with ASD and 87 with typical language development (TLD). The children`s phonological, morphosyntactic, lexical, and pragmatic skills, along with verbal and non-verbal ToM abilities were evaluated. Additionally, cognitive assessments included non-verbal IQ, EF, and central coherence processing. Results: Group-level results showed that children with ASD scored lower than their TLD peers in all measures. Network analysis revealed robust interconnections between language, ToM, and cognitive skills in both groups. In autistic children, language was a central node, with pragmatics prevailing over morphosyntax and lexicon, while age was central in the TLD group. Cluster analysis identified four language clusters within the ASD group, demonstrating dissociations between language domains: (1) high performance across all domains, (2) moderate performance in phonology and morphosyntax with low pragmatic abilities, (3) moderate performance in phonology and lexicon with low morphosyntax and pragmatics, and (4) moderate phonology and lexicon with extremely poor morphosyntax and pragmatics. Autistic children with enhanced language abilities performed better in verbal and non-verbal ToM and EF tasks. Conclusions: Our findings underscore the variability in language, ToM, and cognitive profiles of autistic children, showing dissociation within and between different domains in some autistic children. These results offer insights for applied interventions.