Studies utilizing measures of more advanced ToM, including Happé’s Strange Stories (Happé, 1994), the faux pas test (Baron-Cohen et al., 1999), and Eyes test (Baron-Cohen, 1999) do not consistently find ToM impairments in higher functioning individuals with ASD (e.g., Speck et al., 2010). Given that higher functioning adolescents with ASD, however, have difficulties with social situations and relationships, as demonstrated by their lack of quality friendships and greater risk for social marginalization and victimization, it is important to develop advanced theory of mind measures that properly characterize their true ToM impairments. Some researchers argue that children with ASD do not acquire a genuine ToM, but rather they learn compensatory skills to mask their deficits (e.g., Happé, 1995). To examine this hypothesis, it is necessary to develop more sophisticated measures of ToM that involve novel social contexts for individuals with ASD so they will not have had the opportunity to develop compensatory strategies to handle the situations. Such measures would allow researchers to evaluate whether higher functioning children and adults with ASD are truly impaired in ToM or whether they can actually out-grow their impairments in ToM.
Objectives:
The objective of the current study was to develop a valid measure of advanced ToM that would be sensitive enough to detect subtle theory of mind impairments in higher functioning individuals with ASD.
Methods:
Participants consisted of 16 typically developing controls (10 males; 6 females) and 17 higher functioning individuals with ASD (11 males; 6 females) ranging in age from 10.2 – 17.9 years (M = 14.64, SD = 2.06). The newly designed paradigm consists of 16 vignettes, representing one of the following ToM concepts: evasion, backhanded compliment, indirect request, and hinting one is being insensitive. These stories involve two primary characters engaged in a complex social interaction. The participant must employ sophisticated ToM reasoning in order to understand the subtle nuances of the social interactions. Following each story are two questions that prompt first-order and second-order ToM reasoning and two questions that assess comprehension of important details that provide the building blocks for understanding the psychological reasons for the characters’ behaviors. ToM was also measured using Happe’s Strange Stories.
Results:
Regarding the new advanced ToM paradigm, preliminary results based on a univariate analyses of variance (ANOVA), controlling for composite IQ and age, revealed a main effect of group, such that the ASD group (M = 52.53, SD = 14.56) demonstrated worse ToM performance than the TD group (M = 69.72, SD = 6.14), F(1, 27) = 17.76, p < .001. As expected there was no significant group difference in story comprehension, p = .91. Confirming the validity of this new measure, Happe’s Strange Stories correlated well with this new advanced ToM paradigm, r(27) = 0.46, p = .02.
Conclusions:
These findings indicate that the newly designed advanced ToM paradigm is a valid measure of sophisticated ToM which can be used to detect more subtle theory of mind deficits in higher functioning older children and adolescents with ASD.
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