A Continuous False Belief Task Reveals Egocentric Biases In Adolescents with Autism

Background:

The false belief task is widely used to determine Theory of Mind in autism. However, the task lacks sensitivity to false belief reasoning after childhood, especially in high functioning (normal IQ) individuals with autism (HFASD).

Objectives:

This study reports on a more sensitive false belief measure that allows for direct comparison between individuals with and without autism.

Methods:

In the classic false belief paradigm, the participant witnesses an object being relocated from one container to the next, in the absence of a protagonist, after which the child is asked to predict in which container the ignorant protagonist will look for the object. The same paradigm is used in the current Sandbox task, but the object is buried in a sandbox. This enables participants to predict where the protagonist will look for the object on a continuum between the original and the new location.

Results:

Most participants (n=124) aged 6-20 years showed an egocentric bias, based on their inclination to reason from their own privileged knowledge of the object’s location, rather than taking the protagonist’s false belief into account. Compared to typically developing individuals (n=62), those with HFASD (n=62) were found to be impaired on the Sandbox task, but not on a selection of second order Theory of Mind tasks. The egocentric bias in the HFASD group correlated with their verbal skills. However, group differences on the sandbox task remained after controlling for verbal skills.

Conclusions:

Despite their adequate ability to infer second order mental states, individuals with HFASD still showed an egocentric bias on a continuous measure of first order false belief reasoning. This indicates that sensitive measures can be used to show subtle first order Theory of Mind impairments in HFASD individuals. This may approach may provide more valid measure of autism related problems with Theory of Mind than the assessment of complex conceptual reasoning about mental states.