Theory of mind (ToM) refers to the ability to understand the state of mind of the self and others, and to properly explain the behavior of self and others. The theory of mind deficit is prevalent in children with autism spectrum disorder (ASD) and is a key factor in social impairment. Previous studies have shown that it is effective to intervene in the theory of mind of autistic children. Interventions for theory of mind in children with ASD have been divided into three main categories: direct intervention for false belief cognition, multi-component intervention for theory of mind based on the sequence of children's psychological development, and intervention that combine theory of mind and social skills. These three types of interventions have certain effects on improving children's simple interaction and dialogue skills, emotional understanding, belief understanding and pretend play, theory of mind, social communication, and empathy. However, there are the following shortcomings. Firstly, the intervention sample size is small, the content is large, the cycle is long, and it does not focus on thinking from the other person's point of view. Secondly, it is limited to a certain component or specific ability, such as "false belief understanding" "emotional understanding" "perspective taking" and so on. Focusing solely on one component or specific ability limits the effectiveness of the intervention. Thirdly, there was confusion between intervention content and effect assessment. Therefore, theory of mind intervention with ASD children should focus on developing time-saving, cost-effective group interventions and pay attention to the correlation between different stages of theory of mind and comprehensively intervening in various components.
Moreover, moderate separation between intervention content and effect assessment was emphasized. Bird and Viding proposed the self to other model of empathy (SOME), which includes five subsystems: Theory of Mind System, Affective Representation System, Situational Understanding System, Affective Cue Classification System, and Mirror Neuron System. As a crucial element of the model, the Self/Others Switch corrects the bias of the processing information of the input system to ensure that the Situational Understanding System and the Affective Cue Classification System process the situational and emotional cues of ‘other’ rather than ‘self’. Compared to Typically Developing Children (TD), children with ASD develop abnormalities in many aspects, such as the distinction between self and others' information, memory of self-related materials, self-statement and self-evaluation, and the ability to integrate social situation cues. Some researchers believe that when TD individuals process input information, they will shift their affective state of ‘self’ to ‘other’, but ASD individuals are difficult to activate this conversion system. This study utilized the SOME as a reference and self-others transformation as the breakthrough point. The research designed a transposition social group intervention program suitable for improving the symptoms of children with autism according to the sequence of children's psychological development, and evaluated the immediate and short-term maintenance effects. Through a step-by-step curriculum, ASD children learn to distinguish between self and others' wishes, beliefs, and other psychological components. In the curriculum design, through transposition (swapping positions) - repositioning (returning to the original position), children with ASD are consciously converted from the perspective of "self" to the perspective of "others", and the goal of speculating on the psychological state and intentions of others is achieved. The ultimate goal of the curriculum is to improve their autism symptoms and improve their ability to think differently.
Forty-one children with autism aged four to twelve were randomly divided into intervention and control groups. Both groups received routine rehabilitation intervention. The intervention group also received transposition social group training. The Autism Treatment Evaluation Checklist and the Interpersonal Reactivity Index were used to evaluate the effect of the intervention. It turned out that after the group intervention, the total score of autism symptoms, sensory/cognitive, health/physical/behavior, the total score of empathy, and perspective taking in the intervention group were significantly improved, and the effect remained during the follow-up period. Therefore, it is concluded that transposition social group intervention can effectively improve the overall symptoms and empathy ability of autistic children by using self-other-to-others as the starting point.