A Clinical Assessment Tool for Advanced Theory of Mind Performance in 5 to 12 Year Olds

Assessing Theory of Mind in Children: A Tablet-Based Adaptation of a Classic Picture Sequencing Task

Correctly assessing children's theory of mind (TOM) is essential to clinical practice. Yet, most tasks heavily rely on language, which is an obstacle for several populations. Langdon and Coltheart's (Cognition 71(1):43-71, 1999) Picture Sequencing Task (PST), developed for research purposes, avoids this limitation through a minimally-verbal procedure. We thus developed a tablet adaptation of this task for individual application, engaging children's motivation and allowing response times collection. To assess this tablet-PST, we first tested a large sample of neurotypical children (6-11 years-old, N = 248), whose results confirmed the task's structural and content validity, and permitted the construction of three standardized clinical indices. In a second experiment, we applied those to previously diagnosed autistic children (N = 23), who were expected to show atypical TOM performance. Children's outcomes were consistent with what was hypothesized and confirmed the task's external validity and moderate clinical sensitivity. The tablet-PST thus appears as a suitable tool, providing detailed profiles to inform clinical decisions.

Persuasion ability in children from 6 to 12 years old: Relations to cognitive and affective theory of mind

This study analyzes the relation between cognitive and affective components of theory of mind (ToM) in school-aged children and persuasion abilities. One-hundred forty-three normotypical school children aged 6 to 12 were administered cognitive and affective ToM tasks and one persuasion production task. A set of regression models showed that only the affective ToM component can predict both the persuasion total scores and all its indicators' scores. Children with a greater ability to attribute emotional mental states do not only produce a wider variety of persuasive arguments but also arguments focused on the persuadee and those with mental-related content. Both Hidden Emotion and Belief-Emotion (negative) tasks have been predictive of persuasion total scores. This study provides data on specific contribution of cognitive ToM and affective ToM on indicators of variety and quality of persuasive arguments independently.

A Review of the Nature and Development of Lying and Deception and Considerations for Teaching Prosocial Lying to Autistic Persons

Compared with their neurotypical (NT) counterparts, persons with autism appear to be less inclined to tell lies and less skilled in delivering sophisticated forms of deception. At the same time, some forms of deception like white lies and prosocial lies are frequent in human interaction because they are important for social success. This article challenges the reader to evaluate the therapeutic potential for prosocial deception and teaching white-lie telling to autistic persons. The nature and development of antisocial and prosocial lying in NT development and autism are reviewed. Considerations for when to (and when not to) teach the skill of empathic lying are discussed and recommendations for how to teach the comprehension and production of prosocial lies are offered.

Development and Psychometric Properties of a Culturally Adapted Video Version of Strange Stories as a Measure of Advanced Theory of Mind in Youths

This study described the development of a culturally adapted video version of Strange Stories test as a measure of advanced theory of mind for youths in an Asian country (i.e. Singapore), the Y-ToM, and to provide preliminary psychometric properties. Participants were 170 youths (82 male, 88 female) aged from 13 to 16 years old (M = 14.77, SD = 1.16) in Singapore. The youths completed the Y-ToM, an abbreviated IQ test and the Happé’s Strange Stories in a counterbalanced order while their parents completed the Child Behavior Checklist (CBCL). A two-factor structure consisting of social and physical subscales was suggested. Concurrent, convergent, divergent and diagnostic validity of the Y-ToM was examined. Internal consistency of the Y-ToM social subscale was acceptable though it was not satisfactory for the Y-ToM physical subscale. Inter-rater reliability was good while test-retest reliability was lower.

Executive function moderates the relationship between temperament and psychological difficulties in middle childhood

The current study examined the possible moderating influence of hot and cool executive function (EF) on the relationship between temperament and psychological difficulties in middle childhood. One hundred and twenty-six children and their parents (n = 105) participated. Children aged between 5 and 12 years completed three hot (motivational decision-making on the Cambridge Gambling Task (CGT), delayed gratification, and Theory of Mind [ToM]) and three cool EF (working memory, inhibition, and attentional set shifting) measures. Children's parents completed the Behavioral Inhibition Sensitivity (BIS) and Behavioral Approach Sensitivity (BAS) Scale and the Strengths and Difficulties Questionnaire. Hot EF (CGT, ToM) exacerbated the relationship between BAS and externalizing problems. Neither hot nor cool EF moderated the relationship between BIS and internalizing problems. The current findings provide further evidence of a hot-cool distinction in EF in middle childhood, suggesting that these constructs should be investigated separately when assessing EF. In addition, by considering potential interactions between temperament and EF, clinicians/researchers may be able to predict broad categories of psychological problems in middle childhood.

Measuring advanced theory of mind: Do story-based tasks work?

INTRODUCTION

Although much is known about theory of mind (ToM) development during childhood, data on how these skills develop in adolescence is scarce. This cavity is due in part to the limited knowledge about measures of advanced theory of mind.

METHODS

The study examined the relation among six common story-based tasks designed to measure advanced ToM in two age groups of Polish adolescents: early (13-year-olds; 78 girls) and late (16-year-olds; 143 girls) adolescents.

RESULTS

Factor models for individual tasks were constructed, followed by an examination of the underlying structure that explained the variability of factor scores. Only in half of the tasks, the results revealed an age-related increase in advanced ToM. Contrary to expectation, results showed a lack of correlations among story-based advanced ToM tasks in the two adolescent groups.

CONCLUSIONS

The results suggest a lack of coherence among advanced story-based ToM tasks and the need for further development of reliable and valid advanced ToM measures which are sensitive enough to show increasingly complex social reasoning abilities in adolescence.

Relations between Executive Functions, Theory of Mind, and Functional Outcomes in Middle Childhood

This study examined whether hot and cool executive functions (EFs) differentially predicted functional outcomes and the independent and mediating roles of theory of mind (ToM). 126 children completed tests of hot and cool EF, ToM, intelligence, and academic achievement. Parents completed questionnaires of peer problems and prosocial behavior. Hot and cool EFs differentially predicted intelligence and academic achievement, supporting a hot-cool distinction. ToM predicted word reading and prosocial behavior but did not mediate any associations between EF and functional outcomes. Findings contribute to current understandings of EF and its relationship with functional outcomes in middle childhood.

White Matter Correlates of Theory of Mind in Patients With First-Episode Psychosis

Deficits in theory of mind (ToM) are considered as a distinctive feature of schizophrenia. Functional magnetic resonance imaging (fMRI) studies have suggested that aberrant activity among the regions comprising the mentalizing network is related to observed ToM deficits. However, the white matter structures underlying the ToM functional network in schizophrenia remain unclear. To investigate the relationship between white matter integrity and ToM impairment, 35 patients with first-episode psychosis (FEP) and 29 matched healthy controls (HCs) underwent diffusion tensor imaging (DTI). Using tract-based spatial statistics (TBSS), fractional anisotropy (FA) values of the two regions of interest (ROI)-the cingulum and superior longitudinal fasciculus (SLF)-were acquired, and correlational analysis with ToM task scores was performed. Among the patients with FEP, ToM strange story scores were positively correlated with the FA values of the left cingulum and left SLF. There was no significant correlation between FA and ToM task scores in HCs. These results suggest that the left cingulum and SLF constitute a possible neural basis for ToM deficits in schizophrenia. Our study is the first to demonstrate the white matter connectivity underlying the mentalizing network, as well as its relation to ToM ability in patients with FEP.

A Distinction Between Linguistic and Social Pragmatics Helps the Precise Characterization of Pragmatic Challenges in Children With Autism Spectrum Disorders and Developmental Language Disorder

Purpose Children with autism spectrum disorders (ASDs) and children with developmental language disorder (DLD) face challenges with pragmatics, but the nature and sources of these difficulties are not fully understood yet. The purpose of this study was to compare the competence of children with ASD and children with DLD in two pragmatics tasks that place different demands on theory of mind (ToM) and structural language. Method Twenty Spanish-speaking children with ASD, 20 with DLD, and 40 age- and language-matched children with neurotypical development were assessed using two pragmatics tasks: a linguistic pragmatics task, which requires competence with structural language, and a social pragmatics task, which requires competence with ToM as well. Results For linguistic pragmatics, the ASD group performed similarly to the DLD and language-matched groups, and performance was predicted by structural language. For social pragmatics, the ASD group performed lower than the DLD and language-matched groups, and performance was predicted both by structural language and ToM. Conclusions Children with ASD and children with DLD face difficulties in linguistic pragmatics tasks, in keeping with their structural language. Children with ASD face exceptional difficulties with social pragmatics tasks, due to their difficulties with ToM. The distinction between linguistic and social pragmatic competences can inform assessment and intervention for pragmatic difficulties in different populations.

Children struggle beyond preschool-age in a continuous version of the ambiguous figures task

Children until the age of five are only able to reverse an ambiguous figure when they are informed about the second interpretation. In two experiments, we examined whether children’s difficulties would extend to a continuous version of the ambiguous figures task. Children (Experiment 1: 66 3- to 5-year olds; Experiment 2: 54 4- to 9-year olds) and adult controls saw line drawings of animals gradually morph—through well-known ambiguous figures—into other animals. Results show a relatively late developing ability to recognize the target animal, with difficulties extending beyond preschool-age. This delay can neither be explained with improvements in theory of mind, inhibitory control, nor individual differences in eye movements. Even the best achieving children only started to approach adult level performance at the age of 9, suggesting a fundamentally different processing style in children and adults.

What Do You Have in Mind? Measures to Assess Mental State Reasoning in Neuropsychiatric Populations

Social interaction is closely associated with both functional capacity and well-being. Previous research has not only revealed evidence of social dysfunction in individuals with a wide range of psychiatric and neurological disorders but also generated an abundance of potential measures for assessing social cognition. This review explores the most popular measures used within neuropsychiatric populations to investigate the ability to recognize or reason about the mental states of others. Measures are also critically analyzed in terms of strengths and limitations to aid task selection in future clinical studies. The most frequently applied assessment tools use verbal, visual or audiovisual forms of presentation and assess recognition of mental states from facial features, self-rated empathy, the understanding of other's cognitive mental states such as beliefs and intentions, or the ability to combine knowledge of other's thoughts and emotions in order to understand subtle communications or socially inappropriate behavior. Key weaknesses of previous research include limited investigation of relationships with clinical symptoms, and underutilization of measures of everyday social functioning that offer a useful counterpart to traditional "lab" tasks. Future studies should aim to carefully select measures not only based on the range of skills to be assessed but also taking into account potential difficulties with interpretation and the need to gain insight into the application of social cognitive skills as well as ability per se. Some of the best measures include those with well-matched control trials (e.g., Yoni Task) or those that restrict the influence of verbal deficits (e.g., intentions comic strip task), elicit spontaneous mentalizing (e.g., Animations Task), and possess greater ecological validity (e.g., Movie for the Assessment of Social Cognition). Social cognitive research within psychiatric populations will be further enhanced through the development of more closely matched control tasks, and the exploration of relationships between task performance, medication, strategy use, and broader emotional and motor functions.

Theory of Mind Test for Children: Content Validity

Resumo No contexto nacional, há uma escassez de instrumentos para avaliação de Teoria da Mente, especialmente com estudos de suas propriedades psicométricas. O presente estudo teve por objetivo investigar evidências de validade de conteúdo do Teste de Teoria da Mente para Crianças - TMEC. Foram descritas as etapas de elaboração, análise por juízes especialistas e verificação da aplicabilidade do instrumento em crianças entre 4 e 6 anos. O TMEC foi composto por quatro subtestes, seguindo o modelo de tarefas já descritas na literatura. Após, cinco juízes investigaram a clareza das instruções, da forma de registro e pontuação, nível de dificuldade dos itens e necessidade de mudanças. Foram reformulados itens conforme elencado pelos juízes, seguindo o critério de pelo menos 80% de concordância. Foi verificada a aplicabilidade do instrumento em um grupo de seis crianças pré-escolares, que indicou necessidade de reformulações em poucos itens para melhor compreensão do aplicador e da criança.

Normative data and psychometric properties of a farsi translation of the strange stories test

BACKGROUND AND OBJECTIVE

The Strange Stories test is one of the most commonly used tests to evaluate advanced "theory of mind," i.e. attribution of mental states. Normative data and psychometric properties of a new Farsi translation of this test were evaluated in a large community-based sample of Iranian school-aged children.

METHODS

Through randomized cluster sampling, 398 children aged 9-11 years studying at 20 elementary schools were recruited from 4 central regions of Tehran, Iran. The mean age of the students was 9.96 years (SD = 0.92), and 51% were girls (n = 202). The Child Behavior Checklist (CBCL) was completed by parents. The Strange Stories test was completed by all children and repeated for 20% of them after 2-4 weeks to assess the test-retest reliability.

FINDINGS

Students in upper grades had higher scores (P < .01); age predicted 2% of variance on the mental state score. Girls had significantly higher mentalizing scores than boys (P = .003). The split-half internal reliability coefficient was good (0.73). The test-retest reliability was fair to good. Item-scale score correlations were all significant (P < .01).

CONCLUSION

This new translation of the Strange Stories test is a reliable and valid instrument to evaluate higher level theory of mind abilities in community samples of Farsi speaking children. Autism Res 2017, 10: 1960-1967. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: "Mentalizing" or "theory of mind," the ability to recognize others' mental states, is a key aspect of social understanding. Mentalizing problems are characteristic of some clinical conditions such as autism. The Strange Stories is a test evaluating mentalizing in every day social situations. It was translated into Farsi language and administered to a group of Iranian school-aged children. The instrument was useful in assessing children's mind reading. Older children and girls were better in mentalizing ability.

Delay of gratification in middle childhood: Extending the utility and sensitivity of the standard task

The ability to delay gratification is an important aspect of the development of self-regulation and executive functioning. Standard tasks to assess delay of gratification are typically only useful up to age 5 years. A modified task was developed and administered to a sample of 126 (59 males and 67 females) typically developing Australian children aged 5-12 years. Results showed that 7-year-olds were significantly more likely to delay than 5-year-olds. A ceiling effect was observed from age 7 onwards. Performance on the modified task correlated significantly with other executive functioning tasks, demonstrating the convergent validity of the task. This study was successful in extending the usefulness of the standard delay of gratification task to age 7. Suggestions for further development of this task are discussed.

Non-linearities in Theory-of-Mind Development

Research on Theory-of-Mind (ToM) has mainly focused on ages of core ToM development. This article follows a quantitative approach focusing on the level of ToM understanding on a measurement scale, the ToM Storybooks, in 324 typically developing children between 3 and 11 years of age. It deals with the eventual occurrence of developmental non-linearities in ToM functioning, using smoothing techniques, dynamic growth model building and additional indicators, namely moving skewness, moving growth rate changes and moving variability. The ToM sum-scores showed an overall developmental trend that leveled off toward the age of 10 years. Within this overall trend two non-linearities in the group-based change pattern were found: a plateau at the age of around 56 months and a dip at the age of 72–78 months. These temporary regressions in ToM sum-score were accompanied by a decrease in growth rate and variability, and a change in skewness of the ToM data, all suggesting a developmental shift in ToM understanding. The temporary decreases also occurred in the different ToM sub-scores and most clearly so in the core ToM component of beliefs. It was also found that girls had an earlier growth spurt than boys and that the underlying developmental path was more salient in girls than in boys. The consequences of these findings are discussed from various theoretical points of view, with an emphasis on a dynamic systems interpretation of the underlying developmental paths.

The level of social relations comprehension and its impact on text comprehension in individuals with autistic spectrum disorder

<B>Background</b><br /> The study was carried out within the research “Reading comprehension – typical development and its risks”. The article contains data from a component study focused on 4th grade students with autism spectrum disorder (ASD) who were incorporated into a group of readers with reading comprehension development risks. The main aim was to establish whether variable results in children’s reading and comprehension tests relate to the level of understanding of social relations.<br /> <br /> <B>Participants and procedure</b><br /> We tested 20 students with ASD in two phases: T1 and T2. Each phase consisted of 2 individual sessions. Under the leadership of a research assistant, during each of these sessions a student would carry out the test focused on general intellectual skills, language skills, reading, and reading comprehension. For students with autistic spectrum disorder the Strange Stories test was added in order to ascertain the level of social relations understanding.<br /> <br /> <B>Results</b><br /> The results in reading and reading comprehension tests among students with ASD varied significantly. Based on a correlation analysis it was found that the Strange Stories results substantially correlate with tests focused on reading, text comprehension and language skill levels.<br /> <br /> <B>Conclusions</b><br /> Our research proved the following: the Strange Stories test results show that the level to which an individual is able to understand social relations and social behavior is significantly related to his/her ability to comprehend a text. Consequently, this can influence his/her learning skills as well as the quality of life in society. Cultivation of social abilities, social communication and understanding of social situations and relations is therefore necessary for compensation of autistic spectrum disorder expressions.

Predictors and Moderators of Spontaneous Pretend Play in Children with and without Autism Spectrum Disorder

Although pretend play has long been linked to children's normative cognitive development, inconsistent findings call for greater rigor in examining this relation (Lillard et al., 2013). Spontaneous pretend play is often impacted in atypical development, notably in autism spectrum disorder (ASD). Since ASD traits exist along a continuum in the general population, investigating how pretend play varies across the range of ASD symptoms by indexing variations in ASD traits in both typically developing and ASD populations may provide insight into how ASD symptoms may influence the relation between pretend play and associated processes in cognitive development. This study used rigorous observational methods to assess spontaneous pretend play. Specifically, 5-min free-play sessions with two discrete toy sets were double-coded by blinded coders (coder assignment counterbalanced). Key facets of pretense development [attribution of pretend properties (APP), object substitution (OS), imaginary objects] were examined. These facets of pretend play production were then analyzed in relation to ASD symptoms, as well as plausible, long-theorized correlates [theory of mind (ToM), verbal ability, familiarity, and interest in specific toys]. Forty children (M_age = 6;5, SD_age = 1.45; 29 males), six of whom met the threshold for ASD diagnosis via parent-reported ASD symptoms, participated in play sessions and completed measures of verbal IQ and ToM. Besides the measure of child ASD symptoms, parents completed a survey of their child's interest in and familiarity with the play session toys. Overall, greater ToM predicted more APP, and more interest in the toys presented predicted more OS. In terms of overall pretend play production, two results were counterintuitive. First, among children with more ASD symptoms, verbal ability marginally negatively predicted pretend play production. Second, among children with fewer ASD symptoms, ToM negatively predicted pretend play production. Further probing revealed that the negative effect of ASD symptoms on pretend play was simultaneously moderated by both variables: low ToM and high verbal ability both related to less pretend play production among children with more ASD symptoms. Implications for assessment and subsequent treatment for pretend ability among children with varying degrees of ASD symptoms, as well as for future research, are discussed.

An experimental investigation of mentalization ability in borderline personality disorder

OBJECTIVE

Deficits in mentalization ability have been theorized to underlie borderline personality disorder (BPD) and have led to mentalization-based treatments. Yet there has been little empirical investigation into whether mentalization deficits do differentiate the BPD population from healthy controls, and the specific nature of these differences.

METHOD

Five pre-existing Theory of Mind (ToM) tasks that assessed simple to complex mentalization capacity in both the affective and cognitive domains were administered to the same groups of age and gender matched patients with BPD and controls. Self-report measures assessed cognitive and affective empathy and childhood trauma and abuse.

RESULTS

The BPD group did not differ significantly from the healthy control group on basic cognitive false-belief picture-sequencing tasks, or on overall accuracy when discriminating mental states from viewing images of eyes, and attributing emotions based on social events. They were, however, significantly less accurate in identifying positive mental states on the Reading the Mind in the Eyes (RME) task and showed significantly more mentalization errors on affective and cognitive understanding of faux pas (faux pas total score p<.01) and on a Joke Appreciation task (p=.01), that required integration of multiple perspectives. They also self-reported less empathic perspective taking (p<.01). Observation of patterns of performance hinted at specific underlying biases (e.g. a default tendency to use superficial black-and-white attributions to others, such as, "he is mean", when explaining behavior). It was also found that as childhood experiences of punishment increased, adulthood mentalization ability decreased on all affective ToM tasks and on the cognitive and affective components of understanding faux pas.

CONCLUSIONS

The BPD group was as capable as controls in undertaking simple mentalization. However, deficits in mentalization capacity became evident when mentalization tasks became more complex and required the integration of multiple perspectives. Increasing childhood experiences of punishment were related to decreasing mentalization ability in adulthood. Findings support the use of treatments to improve mentalization skills in BPD, however, further research is needed to better specify the nature of underlying mentalizing biases in this population.

Performance of children with social communication disorder on the Happé Strange Stories: Physical and mental state responses and relationship to language ability

This study investigated whether a modified scoring method was useful for examining the ability of children with social communication disorder (CwSCD) to understand non-literal language and use mental state responses on the Happé Strange Stories (HSS) task. CwSCD and a control group of children with typical language development (CwTLD) completed 10 of the original HSS. CwSCD scored significantly lower on the HSS task than did CwTLD and were much less likely to produce mental state responses. There was a high level of inter-rater reliability (Weighted Kappa=0.907) across data from both groups. HSS performance and language ability correlated significantly for CwSCD. A regression model with age, nonverbal intelligence, receptive and expressive language as predictors explained 55.2% of the variance in HSS ability for CwSCD. The results suggest that the HSS have potential to be used as a clinical assessment to investigate high-level language and ability to infer intent in CwSCD.

LEARNING OUTCOMES

Readers will be able to describe a modified scoring method for the Happé Strange Stories task. Readers will be able to identify areas of impairment for children with social communication disorder. Readers will identify how these areas of impairment have an effect on ability to understand non-literal language and produce mental state responses on the Happé Strange Stories task.

Evaluation of the theory of mind in autism spectrum disorders with the Strange Stories test

OBJECTIVE

To evaluate the theory of mind in autism spectrum disorders (ASD) and control individuals by applying the Strange Stories test that was translated and adapted to the Portuguese language.

METHOD

Twenty-eight children with ASD and 56 controls who were all male and aged between 6 and 12 years participated in the study.

RESULTS

There were significant differences between the median scores of the groups for each of the 12 stories of the test and for the sum total of all the median scores. The median scores for all stories were significantly greater in the control group than those in the experimental group (children with ASD). In addition, the protocol had excellent internal consistency.

CONCLUSION

The theory of mind skills assessed with the Strange Stories test indicated alterations in children with ASD compared with children in the control group.

Theory-of-mind in adolescents and young adults with Alström syndrome

OBJECTIVE

The study focuses on theory-of-mind in adolescents and young adults with Alström syndrome (ALMS). ALMS, an autosomal recessive syndrome causes juvenile blindness, sensorineural hearing loss, cardiomyopathy, endocrinological disorders and metabolic dysfunction. Theory-of-mind (ToM) refers to the ability to impute mental states to one self and to others. Clinical observations have revealed an increased occurrence of deviances in mental state understanding in ALMS. In the present study ToM will be examined and related to working memory (WM), verbal ability and sensory loss.

METHODS

Twelve young individuals (16-37 years) with ALMS and 24 nondisabled individuals matched on age, gender and educational level participated. ToM was assessed by means of a multiple task that taxes the ability to understand thoughts and feelings of story characters'. WM was examined by means of a reading span task and verbal ability by means of a vocabulary test.

RESULTS

The ALMS group performed at significantly lower levels in ToM tasks and displayed a higher variability in performance than the control group. Individuals with ALMS and a relatively poor level performance provided fewer correct mental state inferences in ToM tasks than ALMS individuals with relatively higher performance levels. ALMS individuals with relatively high performance levels made as many correct inferences in ToM tasks as the control group, but their inferences were more often incomplete. Vocabulary skills and educational level, but not WM-capacity predicted ToM performance. Degree of deafblindness did not have an impact on ToM. Age of onset of visual loss but not hearing loss related to ToM.

CONCLUSIONS

The individuals with ALMS display a high degree of heterogeneity in terms of ToM, where some individuals reached performance levels comparable to nondisabled individuals. The results are discussed with respect to how cognitive and verbal abilities and factors related to the disability affect ToM.

Idiom, syntax, and advanced theory of mind abilities in children with autism spectrum disorders

PURPOSE

When researchers investigate figurative language abilities (including idioms) in children with autism spectrum disorder (ASD), syntax abilities may be more important than once considered. In addition, there are limitations to the overreliance on false-belief tasks to measure theory of mind (TOM) abilities. In the current study, the authors investigated idiom, syntax, and advanced TOM abilities in children with ASD compared to children with typical development (TD).

METHOD

Twenty-six children with ASD, ages 5 to 12 years, were compared to individuals in each of 2 control groups of children with TD: 1 matched on chronological age and nonverbal IQ, and 1 matched on syntax age-equivalence and raw scores. Idiom comprehension, syntax, vocabulary, and 2 measures of advanced TOM abilities were examined.

RESULTS

Although children with ASD performed worse on idiom comprehension compared to the age-matched group with TD, they exhibited comparable idiom performance to the syntax-matched group with TD. Advanced TOM abilities were related to idiom comprehension for children with ASD, but not for children with TD, above the contributions of basic language abilities.

CONCLUSION

Syntax abilities should be used as a matching variable when examining figurative or other late-developing language skills.

Theory of Mind Deficit versus Faulty Procedural Memory in Autism Spectrum Disorders

Individuals with autism spectrum disorders (ASD) have impairments in social interaction, communicative capacity, and behavioral flexibility (core triad). Three major cognitive theories (theory of mind deficit, weak central coherence, and executive dysfunction) seem to explain many of these impairments. Currently, however, the empathizing-systemizing (a newer version of the theory of mind deficit account) and mnesic imbalance theories are the only ones that attempt to explain all these core triadic symptoms of ASD On the other hand, theory of mind deficit in empathizing-systemizing theory is the most influential account for ASD, but its counterpart in the mnesic imbalance theory, faulty procedural memory, seems to occur earlier in development; consequently, this might be a better solution to the problem of the etiology of ASD, if it truly meets the precedence criterion. Hence, in the present paper I review the reasoning in favor of the theory of mind deficit but with a new interpretation based on the mnesic imbalance theory, which posits that faulty procedural memory causes deficits in several cognitive skills, resulting in poor performance in theory of mind tasks.

Pragmatic abilities in children with congenital visual impairment: an exploration of non-literal language and advanced theory of mind understanding

Children with congenital visual impairment have been reported to be delayed in theory of mind development. So far, research focused on first-order theory of mind, and included mainly blind children, whereas the majority of visually impaired children is not totally blind. The present study set out to explore whether children with a broader range of congenital visual impairments have a delay in more advanced theory of mind understanding, in particular second-order theory of mind (i.e. awareness that other people have beliefs about beliefs) and non-literal language (e.g. irony or figure of speech). Twenty-four children with congenital visual impairment and 24 typically developing sighted children aged between 6 and 13 were included. All children were presented with a series of stories involving understanding of theory of mind and non-literal language. When compared with sighted children of similar age and verbal intelligence, performance of children with congenital visual impairment on advanced theory of mind and non-literal stories was alike. The ability to understand the motivations behind non-literal language was associated with age, verbal intelligence and theory of mind skills, but was not associated with visual ability.

Beyond False Belief: Theory of Mind in Young, Young-Old, and Old-Old Adults

Theory of mind (ToM) refers to humans' ability to recognize the existence of mental states, such as beliefs, emotions, and desires. The literature on ToM in aging and on the relationship between ToM and other cognitive functions, like executive functions, is not homogenous. The aim of the present study was to explore the course of ToM and to investigate the role of working memory, inhibition, and language on the possible age differences in ToM. To address these issues, we examined ToM using the Strange Stories task and executive function task in three age groups. Results showed that young adults outperform both old groups on the ToM stories. This difference remains significant also when controlling for working memory and inhibitory control. Our findings suggest a specific impairment in inferring mental states starting from 60 years of age that seems to be independent of changes in executive functions.

Ongoing development of social cognition in adolescence

Age differences in social cognition between adolescents and young adults were investigated. Two large groups of adolescents and young adults were given tasks of theory of mind and emotion recognition. In addition, to control for possibly related basic cognitive development, working memory, speed of processing, and verbal ability were assessed. A strong age effect was revealed across both measures of social cognition. Adolescents performed with a lower accuracy than adults. Further analyses indicated that those age differences remained significant even after controlling for basic cognitive abilities. Exploratory analyses indicated no influence of pubertal phase on social cognition. Results suggest ongoing development of social cognition across adolescence, independent of individual differences in more basic cognitive abilities.

Theory of Mind in patients at clinical high risk for psychosis

BACKGROUND

Patients with schizophrenia have a decreased ability to interpret the intentions of other individuals, called Theory of Mind (ToM). As capacity for ToM normally advances with brain maturation, research on ToM in individuals at heightened clinical risk for psychosis may reveal developmental differences independent of disease based differences.

METHODS

We examined ToM in at clinical high risk and schizophrenia patients as well as healthy controls: 1) 63 clinical high risk (CHR) patients and 24 normal youths ascertained by a CHR program; and 2) in 13 schizophrenia cases and 14 normal adults recruited through a schizophrenia program. ToM measures included first- and second-order false belief cartoon tasks (FBT) and two "higher order" tasks ("Strange Stories Task" (SST) and the "Reading the Mind in the Eyes" task). In the first study, CHR patients and normal youths were also assessed for cognition, "prodromal" symptoms and social function.

RESULTS

Errors on first- and second-order false belief tasks were made primarily by patients. CHR patients and their young comparison group had equivalent performance on higher order ToM, which was not significantly different from the worse ToM performance of schizophrenia patients and the higher performance of normal adult controls. In the combined dataset from both studies, all levels of ToM were associated with IQ, controlling for age and sex. ToM bore no relation to explicit memory, prodromal symptoms, social function, or later transition to psychosis.

CONCLUSIONS

Higher order ToM capacity was equally undeveloped in high risk cases and younger controls, suggesting that performance on these tasks is not fully achieved until adulthood. This study also replicates the association of IQ with ToM performance described in previous studies of schizophrenia.

Do deaf adults with limited language have advanced theory of mind?

Previous studies show that deaf children have deficits in false belief understanding due to their language impairment. However, it is not clear whether deaf adults still have problems in advanced theory of mind (ToM). The present study examined deaf adults' performance on three aspects of advanced ToM. All of the deaf groups lacking mental state language tended to perform worse than the hearing group on explicit mental state understanding. Deaf groups with either vocabulary skill or interpersonal experience from early years were similar to the hearing group in implicit mental state reasoning. Individuals frequently using syntactic complements or having interpersonal experience with hearing people from early years tended to use ToM better. Moreover, language ability was the only predictor for explicit rather than implicit mental state understanding. Sufficient language is not necessary for all aspects of advanced ToM. Rich interpersonal experience as a substitute for language may facilitate deaf adults' advanced ToM.