Understanding of the perception-knowledge relationship is one key component of ToM, thought to be diminished in ASD. However, previous studies have failed to unambiguously demonstrate such a diminution. For example, Baron-Cohen and Goodhart (1994) implemented a “see-know” task in which participants observed one doll lifting a closed box and another doll opening the box and looking inside. Participants were subsequently asked, “Who knows what’s in the box?” (a correct answer being that only the doll who has had the relevant visual access will know what is inside). Children with ASD gave fewer correct responses than comparison children. However, a correct response requires not only an appreciation of the perception-knowledge relationship (i.e., ToM) but also the ability to (a) recall an action (e.g., Doll A opened the box and looked inside), (b) make an inference based on that action (e.g., Doll A must, therefore, know what is inside the box), whilst (c) reasoning about unobservable variables. Thus, children may fail this task for a number of reasons.
Objectives: The current study aimed to establish whether children with ASD have difficulties with see-know tasks because of diminished ToM competence or difficulties with extraneous task factors. We adopted Baron-Cohen and Goodhart’s (1994) see-know procedure and designed a control task with cognitive demands that closely mirrored those of the see-know task except with respect to the key variable of interest – i.e. ToM.
Methods: Participants were 40 children with ASD and 40 comparison children who were individually matched on chronological age (M ≈ 10.5 years) and verbal mental age (M ≈ 6.7). Each participant completed five test questions (e.g., “John lifts up the box and Fiona opens the box and has a look. Who knows what’s in the box?”) and six control questions (e.g., “John and Fiona go to the beach. John lies down in the sun while Fiona goes swimming. Who gets hot?”).
Results: Participants with ASD performed significantly less well on the control questions than comparison participants, Χ² (1, N = 80) = 5.54, p = .04, Φ = .26. After excluding children who failed the control task (ASD n = 11; comparison n = 3), it was found that children with ASD also performed significantly less well on the see-know test questions, Fisher’s exact probability test, p = .02, Φ = .31.
Conclusions: Although ToM competence is diminished in ASD, this is not the only reason individuals with ASD fail ToM tasks. Hence, previous research, which has not included adequate control tasks, may have overestimated the extent to which ToM competence is diminished in ASD. We recommend that future research on ToM includes carefully designed control tasks to rule out non-ToM sources of task difficulty.