Two Kinds of Thinking, Trained Together

What the research found

This paper is a perspective article in the journal Frontiers in Psychiatry, published in 2022 by Hajri and colleagues. That label matters. A perspective article is a considered argument built from other people’s studies. It is not a new experiment, and it does not report a single group of children tested by the authors. It gathers existing work and proposes a direction. Read it as a well-reasoned case, not as fresh evidence.

The case begins with a distinction. Researchers often split thinking into two families. Non-social cognition covers the general-purpose machinery: memory, processing speed, planning, and what psychologists call executive function, which is the mind’s ability to hold a goal and organise steps toward it. Social cognition covers reading other people: recognising emotions, and theory of mind, which is the capacity to grasp that another person holds beliefs and intentions different from your own. Historically, autism research and autism therapy have treated these two families separately.

The authors draw on a large systematic review of 75 studies to show that both families are affected in autism. That review found impairments across every domain of non-social and social cognition, with the largest deficits in social cognition, specifically theory of mind and the perception of emotion. The paper does not report the effect sizes from that review, so we cannot say here how large “largest” is in numerical terms. The point being made is narrower: the difficulties are broad, not confined to the social side alone.

The paper then examines what happens when you train just one family. It cites a study of a cognitive remediation programme, a structured course of pencil-and-paper tasks, given to 25 children and adolescents with autism, of whom 16 completed it. The gains were real and specific. Intellectual ability improved (p less than 0.001), as did phonemic flexibility (p = 0.027), working memory on both forward and backward digit-span tasks (both p = 0.003), clinical symptoms (p less than 0.001), and school results (p = 0.001). But the authors flag a limitation candidly: social cognition was not measured at all. So we do not know whether training non-social thinking carried over into social understanding. Any suggestion that it might is inference, not finding.

Finally the paper points to two studies by Eack and colleagues, both eighteen-month programmes combining neurocognitive and social training in adults. Here the honest signal is mixed. Neurocognition improved relative to a comparison therapy. Social cognition showed a significant advantage at nine months, but that advantage was no longer significant at eighteen months. The authors do not report sample sizes for these trials in the passages available, which is itself a reason for caution.

What it means for you and your child

The central proposal is simple and sensible. Because the difficulties in autism span both families of thinking, training one in isolation may not be enough, since gains in a narrow skill often fail to generalise to daily life. The authors argue that therapy should address non-social and social cognition together, and they suggest, borrowing from research on schizophrenia, that executive function may need to come first as a foundation for social understanding. It is a reasonable hypothesis. It is not, on the evidence assembled here, an established fact.

Be clear-eyed about what this paper can and cannot support. It cannot tell you that any particular programme works, because it runs no trial of its own. It cannot establish cause and effect. The combined-training studies it leans on are few, and one of them showed a social benefit that faded by the eighteen-month mark. The paper’s own authors say the field is young, that studies targeting both domains together are scarce, and that larger samples are needed. When the people making the argument list this many caveats, a parent should hold the conclusion loosely.

What is genuinely useful here is the framing. If your child is receiving cognitive support, it is fair to ask what it targets. A programme built only around social skills may leave the underlying machinery of attention and planning untouched. A programme built only around memory and planning, like the one described above, may improve schoolwork and symptoms without touching how your child reads other people. This paper’s contribution is to name that gap and to ask whether bridging it would help.

Note also the population. The remediation programme with clear results studied children and adolescents; the combined-training studies studied adults. Findings do not transfer automatically across ages, and what helps a nineteen-year-old need not help a nine-year-old. The strongest numbers in this paper concern non-social skills, memory, flexibility, school performance, in a small, incomplete sample of 25 children reduced to 16.

For a family, the practical takeaway is modest and worth holding onto. First, cognitive gains in autism are measurable and specific, and a well-structured programme produced real improvement in working memory and school results in the study cited. Second, whether such gains reach into social understanding is genuinely unknown, because the study that showed them did not measure it. Third, the idea of training both kinds of thinking together is promising and untested at scale. Treat it as a good question the field is still working on, and treat anyone who sells it as settled science with the scepticism they have earned.