Critical Evaluation of Commonly Used Assessments of Theory of Mind Abilities

Background:  

Individuals with High Functioning Autism (HFA) and Asperger Syndrome (AS) are characterized by deficits in social competence. Many of the social difficulties observed in HFA/AS are related to deficits in social perspective taking. However, researchers have postulated that assessments commonly used to evaluate social perspective taking (Theory of Mind; ToM) do not effectively evaluate these abilities and are confounded by other variables (e.g., language ability). There is a paucity of research examining the efficacy of measures evaluating ToM abilities and as a means to monitor progress; therefore leading many to question the validity of these assessment tools. It is essential that the field critically examine commonly used measures to identify intervention efficacy. 

Objectives:  

This study examined the performance of elementary aged children (both HFA/AS and typically developing peers) on common assessments of ToM in order to evaluate the relationship between social perspective taking abilities, cognitive abilities (e.g., IQ, reading skills). This study also evaluated the utility of commonly used ToM assessments to monitor progress in the area of social perspective taking within the context of a social competency intervention. 

Methods:  

19 children, ages 6-10 participated in this study (10 HFA/AS, 9 typically developing). HFA/AS students were enrolled in the Social Competency Intervention for Elementary students (SCI-E; Stichter, et al., 2011). Standardized assessments were administered pre/post intervention to evaluate the impact of SCI-E on: Social Behavior, Theory of Mind, Executive Function and Emotion Recognition. Within this battery are common measures of ToM: false belief tasks and social vignettes (Strange Stories, Faux Pas). Additionally a parent rating, Theory of Mind Inventory (ToMi) was utilized. Measures of IQ and reading ability were conducted to analyze possible relationships with ToM scores. Within initial analyses the pre-assessment ToM scores of the 10 children with HFA/AS was compared to 9 typically developing children. Following the SCI-E intervention, outcome measures for participants with HFA/AS were analyzed to interpret intervention effectiveness. 

Results:  

The results indicated that 65% of the variance in ToM scores were associated with other variables (p<.01), IQ approximately 40% of the variance (p<.001) and reading recall 24% of the variance (p<.01). When the participant groups were analyzed separately only the HFA/AS group had significant results with 60% of the variance in their ToM abilities associated with their recall reading assessments (p<.001). Results of intervention efficacy for students with HFA/AS identified that the common measures of ToM did not demonstrate any post intervention changes, although the majority of other measures did, including the ToMi. 

Conclusions:  

Over half of the variance associated with ToM performance for participants with HFA/AS was related to reading recall abilities. These results indicate that ToM assessments may be in actuality evaluating working memory instead of interpreting social situations. The results also provide indications that the commonly used ToM assessments may be confounded by the large emphasis on reading abilities and requirements to retain verbal information and may not be sensitive to intervention change. The results support that the field needs to identify and utilize measures that more effectively evaluate ToM abilities.