Advanced ToM Tests Which Consist of Visual and Auditory Modalities

Background: High functioning (HF) adolescents and adults with autism spectrum disorder (ASD) can recognize others’ simple mental states and pass the basic theory of mind (ToM) task, such as the first and second-order false belief tasks. Basic ToM tasks are not sensitive enough to detect ToM deficits in individuals with HF-ASD.  Therefore, various advanced ToM tasks have been constructed to measure those deficits.  Also, recently there has been a concern about which is the predominant perception for the individuals with ASD to understand the mental states of others (Golan et al., 2006) .

Objectives: We constructed new advanced Visual and Auditory ToM tasks which could provide evidence of subtle social cognitive deficits in the individuals with HF-ASD.  Moreover, our tasks were complex because they included many non-literal scenes with incongruent dialogue and mental states. This study was an attempt to understand the real mental state from only the visual modality (facial expression) or only the auditory modality (non-verbal aspects of speech: pitch/intonation/tone) independent of each other.  Our other objective was to identify which modality, visual or auditory, was useful for individuals with ASD to understand the mental states of others.

Methods: The participants consisted of 21 adolescent and adult males with ASD (mean age = 24.5 years, mean VIQ = 104.5, PIQ = 98.4, FIQ = 101.8, mean Autism-Spectrum Quotient (AQ) = 33.4) and a control group of 50 male students recruited from Chiba University (mean age = 21.2).  The advanced ToM Tests that were constructed for this research consisted of 41 video clips (3 seconds ~ 11 seconds in length) from the TV drama “Shiroi Kyotou”, a story about malpractice in a famous Japanese medical school. One Visual task and one Auditory task were made for each corresponding clip. For the Visual tasks, the sound of the 41 scenes was deleted. For the Auditory tasks, the pictures of the 41 scenes were deleted.  A word or a phrase which expressed the various and complex mental state was shown along with each video and sound clip.  The participants were asked to judge if each word or phrase was appropriate or not for each scene.

Results: Comparing the correct answer rate, there were significant differences between the ASD group and the control group in the Auditory tasks (p < .01), but not in the Visual tasks.  Also our results showed that the AQ score was negatively correlated with the performance in the Auditory task(r = -0.46, p < .05).

Conclusions: Our Auditory tasks are useful to identify individuals with ASD.  Also, mind-reading ability could be predicted from AQ.  The results suggest that the visual modality is useful for the individuals with HF-ASD to understand the mental states of others in complex situations.