Counterfactual and mental state reasoning in children with autism

Creating a diagnostic assessment model for autism spectrum disorder by differentiating lexicogrammatical choices through machine learning

This study explores the challenge of differentiating autism spectrum (AS) from non-AS conditions in adolescents and adults, particularly considering the heterogeneity of AS and the limitations ofssss diagnostic tools like the ADOS-2. In response, we advocate a multidimensional approach and highlight lexicogrammatical analysis as a key component to improve diagnostic accuracy. From a corpus of spoken language we developed, interviews and story-recounting texts were extracted for 64 individuals diagnosed with AS and 71 non-AS individuals, all aged 14 and above. Utilizing machine learning techniques, we analyzed the lexicogrammatical choices in both interviews and story-recounting tasks. Our approach led to the formulation of two diagnostic models: the first based on annotated linguistic tags, and the second combining these tags with textual analysis. The combined model demonstrated high diagnostic effectiveness, achieving an accuracy of 80%, precision of 82%, sensitivity of 73%, and specificity of 87%. Notably, our analysis revealed that interview-based texts were more diagnostically effective than story-recounting texts. This underscores the altered social language use in individuals with AS, a crucial aspect in distinguishing AS from non-AS conditions. Our findings demonstrate that lexicogrammatical analysis is a promising addition to traditional AS diagnostic methods. This approach suggests the possibility of using natural language processing to detect distinctive linguistic patterns in AS, aiming to enhance diagnostic accuracy for differentiating AS from non-AS in adolescents and adults.

Extended difficulties with counterfactuals persist in reasoning with false beliefs: Evidence for teleology-in-perspective

Increasing evidence suggests that counterfactual reasoning is involved in false belief reasoning. Because existing work is correlational, we developed a manipulation that revealed a signature of counterfactual reasoning in participants' answers to false belief questions. In two experiments, we tested 3- to 14-year-olds and found high positive correlations (r = .56 and r = .73) between counterfactual and false belief questions. Children were very likely to respond to both questions with the same answer, also committing the same type of error. We discuss different theories and their ability to account for each aspect of our findings and conclude that reasoning about others' beliefs and actions requires similar cognitive processes as using counterfactual suppositions. Our findings question the explanatory power of the traditional frameworks, theory theory and simulation theory, in favor of views that explicitly provide for a relationship between false belief reasoning and counterfactual reasoning.

Autistic Adults are Not Impaired at Maintaining or Switching Between Counterfactual and Factual Worlds: An ERP Study

We report an event-related brain potential (ERP) experiment that tests whether autistic adults are able to maintain and switch between counterfactual and factual worlds. Participants (N = 48) read scenarios that set up a factual or counterfactual scenario, then either maintained the counterfactual world or switched back to the factual world. When the context maintained the world, participants showed appropriate detection of the inconsistent critical word. In contrast, when participants had to switch from a counterfactual to factual world, they initially experienced interference from the counterfactual context, then favoured the factual interpretation of events. None of these effects were modulated by group, despite group-level impairments in Theory of Mind and cognitive flexibility among the autistic adults. These results demonstrate that autistic adults can appropriately use complex contextual cues to maintain and/or update mental representations of counterfactual and factual events.

Thinking about other's mistakes: contrasting patterns of performance in groups high or low in autistic or psychopathic traits

Introduction: Counterfactual thinking refers to thoughts such as, "What if … ?" or "If only … " that hypothesise about how past events might have turned out differently. It is a functional process, allowing us to reflect upon and solve problems, and to evoke appropriate responses. It is thought to involve both cognitive and emotional processes, and is linked to the development of false belief and moral emotions. Methods: The present study compared responses to a novel task, "Counterfactual Judgments", in students who scored high or low on self-report measures of autistic or psychopathic traits, two conditions putatively associated with deficits in empathy. Results: Contrasting patterns of performance were revealed: those with high versus low autistic traits gave harsher ratings of blame for others' mistakes and showed reduced sensitivity to punitive counterfactual alternatives, whereas those with high versus low psychopathic traits gave lower ratings for moral judgments of regret and guilt. A self-report questionnaire measure of empathy also provided some evidence of reduced empathic processing in both the high trait groups. Conclusions: The findings are considered in the light of the possible contributions of cognitive versus emotional processes to counterfactual thinking. The possible implications for managing social dysfunction in clinical populations are also discussed.

Intact counterfactual emotion processing in autism spectrum disorder: Evidence from eye-tracking

Counterfactual emotions, such as regret and relief, require an awareness of how things could have been different. We report a preregistered experiment that examines how adults with and without ASD process counterfactual emotions in real-time, based on research showing that the developmental trajectory of counterfactual thinking may be disrupted in people with ASD. Participants were eye-tracked as they read narratives in which a character made an explicit decision then subsequently experienced either a mildly negative or positive outcome. The final sentence in each story included an explicit remark about the character's mood that was either consistent or inconsistent with the character's expected feelings of regret or relief (e.g., "… she feels happy/annoyed about her decision."). Results showed that adults with ASD are unimpaired in processing emotions based on counterfactual reasoning, and in fact showed earlier sensitivity to inconsistencies within relief contexts compared to TD participants. This finding highlights a previously unknown strength in empathy and emotion processing in adults with ASD, which may have been masked in previous research that has typically relied on explicit, response-based measures to record emotional inferences, which are likely to be susceptible to demand characteristics and response biases. Therefore, this study highlights the value of employing implicit measures that provide insights on peoples' immediate responses to emotional content without disrupting ongoing processing. Autism Res 2019, 12: 422-444 © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Despite known difficulties with empathy and perspective-taking, we found that adults with autism are unimpaired at inferring complex emotions (regret and relief) in others. This finding extends existing evidence showing dysfunctional counterfactual thinking in children with autism. We highlight the value of using implicit measures to identify strengths and abilities in ASD that may be masked by explicit tasks that require participants to interact socially or report their own thoughts.

Belief and Counterfactuality: A Teleological Theory of Belief Attribution

The development and relation of counterfactual reasoning and false belief understanding were examined in 3- to 7-year-old children (N = 75) and adult controls (N = 14). The key question was whether false belief understanding engages counterfactual reasoning to infer what somebody else falsely believes. Findings revealed a strong correlation between false belief and counterfactual questions even in conditions in which children could commit errors other than the reality bias (r p  = .51). The data suggest that mastery of belief attribution and counterfactual reasoning is not limited to one point in development but rather develops over a longer period. Moreover, the rare occurrence of reality errors calls into question whether young children's errors in the classic false belief task are indeed the result of a failure to inhibit what they know to be actually the case. The data speak in favor of a teleological theory of belief attribution and challenges established theories of belief attribution.

Pragmatic skills predict online counterfactual comprehension: Evidence from the N400

Counterfactual thought allows people to consider alternative worlds they know to be false. Communicating these thoughts through language poses a social-communicative challenge because listeners typically expect a speaker to produce true utterances, but counterfactuals per definition convey information that is false. Listeners must therefore incorporate overt linguistic cues (subjunctive mood, such as in If I loved you then) in a rapid way to infer the intended counterfactual meaning. The present EEG study focused on the comprehension of such counterfactual antecedents and investigated if pragmatic ability—the ability to apply knowledge of the social-communicative use of language in daily life—predicts the online generation of counterfactual worlds. This yielded two novel findings: (1) Words that are consistent with factual knowledge incur a semantic processing cost, as reflected in larger N400 amplitude, in counterfactual antecedents compared to hypothetical antecedents (If sweets were/are made of sugar). We take this to suggest that counterfactuality is quickly incorporated during language comprehension and reduces online expectations based on factual knowledge. (2) Individual scores on the Autism Quotient Communication subscale modulated this effect, suggesting that individuals who are better at understanding the communicative intentions of other people are more likely to reduce knowledge-based expectations in counterfactuals. These results are the first demonstration of the real-time pragmatic processes involved in creating possible worlds.

How Children with Autism Reason about Other's Intentions: False-Belief and Counterfactual Inferences

We examine false belief and counterfactual reasoning in children with autism with a new change-of-intentions task. Children listened to stories, for example, Anne is picking up toys and John hears her say she wants to find her ball. John goes away and the reason for Anne's action changes-Anne's mother tells her to tidy her bedroom. We asked, 'What will John believe is the reason that Anne is picking up toys?' which requires a false-belief inference, and 'If Anne's mother hadn't asked Anne to tidy her room, what would have been the reason she was picking up toys?' which requires a counterfactual inference. We tested children aged 6, 8 and 10 years. Children with autism made fewer correct inferences than typically developing children at 8 years, but by 10 years there was no difference. Children with autism made fewer correct false-belief than counterfactual inferences, just like typically developing children.

Understanding Counterfactuality: A Review of Experimental Evidence for the Dual Meaning of Counterfactuals

Cognitive and linguistic theories of counterfactual language comprehension assume that counterfactuals convey a dual meaning. Subjunctive-counterfactual conditionals (e.g., 'If Tom had studied hard, he would have passed the test') express a supposition while implying the factual state of affairs (Tom has not studied hard and failed). The question of how counterfactual dual meaning plays out during language processing is currently gaining interest in psycholinguistics. Whereas numerous studies using offline measures of language processing consistently support counterfactual dual meaning, evidence coming from online studies is less conclusive. Here, we review the available studies that examine online counterfactual language comprehension through behavioural measurement (self-paced reading times, eye-tracking) and neuroimaging (electroencephalography, functional magnetic resonance imaging). While we argue that these studies do not offer direct evidence for the online computation of counterfactual dual meaning, they provide valuable information about the way counterfactual meaning unfolds in time and influences successive information processing. Further advances in research on counterfactual comprehension require more specific predictions about how counterfactual dual meaning impacts incremental sentence processing.

Brief Report: Theory of Mind, Relational Reasoning, and Social Responsiveness in Children With and Without Autism: Demonstration of Feasibility for a Larger-Scale Study

Understanding the underpinnings of social responsiveness and theory of mind (ToM) will enhance our knowledge of autism spectrum disorder (ASD). We hypothesize that higher-order relational reasoning (higher-order RR: reasoning necessitating integration of relationships among multiple variables) is necessary but not sufficient for ToM, and that social responsiveness varies independently of higher-order RR. A pilot experiment tested these hypotheses in n = 17 children, 3-14, with and without ASD. No child failing 2nd-order RR passed a false belief ToM test. Contrary to prediction, Social Responsiveness Scale scores did correlate with 2nd-order RR performance, likely due to sample characteristics. It is feasible to translate this comparative cognition-inspired line of inquiry for full-scale studies of ToM, higher-order RR, and social responsiveness in ASD.

Counterfactual Reasoning: Sharpening Conceptual Distinctions in Developmental Studies

Counterfactual reasoning (CFR)—mentally representing what the world would be like now if things had been different in the past—is an important aspect of human cognition and the focus of research in areas such as philosophy, social psychology, and clinical psychology. More recently, it has also gained broad interest in cognitive developmental psychology, mainly focusing on the question of how this kind of reasoning can be characterized. Studies have been inconsistent in identifying when children can use CFR. In this article, we present theoretical positions that may account for this inconsistency and evaluate them in the light of research on counterfactual emotions.

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.

Counterfactual reasoning: from childhood to adulthood

The objective of this study was to describe the developmental progression of counterfactual reasoning from childhood to adulthood. In contrast to the traditional view, it was recently reported by Rafetseder and colleagues that even a majority of 6-year-old children do not engage in counterfactual reasoning when asked counterfactual questions (Child Development, 2010, Vol. 81, pp. 376–389). By continuing to use the same method, the main result of the current Study 1 was that performance of the 9- to 11-year-olds was comparable to that of the 6-year-olds, whereas the 12- to 14-year-olds approximated adult performance. Study 2, using an intuitively simpler task based on Harris and colleagues (Cognition, 1996, Vol. 61, pp. 233–259), resulted in a similar conclusion, specifically that the ability to apply counterfactual reasoning is not fully developed in all children before 12 years of age. We conclude that children who failed our tasks seem to lack an understanding of what needs to be changed (events that are causally dependent on the counterfactual assumption) and what needs to be left unchanged and so needs to be kept as it actually happened. Alternative explanations, particularly executive functioning, are discussed in detail.

Understanding of emotions based on counterfactual reasoning in children with autism spectrum disorders

The understanding of emotions based on counterfactual reasoning was studied in children with high-functioning autism spectrum disorders (n = 71) and in typically developing children (n = 71), aged 6-12 years. Children were presented with eight stories about two protagonists who experienced the same positive or negative outcome, either due to their own action or by default. Relative to the comparison group, children with high-functioning autism spectrum disorder were poor at explaining emotions based on downward counterfactual reasoning (i.e. contentment and relief). There were no group differences in upward counterfactual reasoning (i.e. disappointment and regret). In the comparison group, second-order false-belief reasoning was related to children's understanding of second-order counterfactual emotions (i.e. regret and relief), while children in the high-functioning autism spectrum disorder group relied more on their general intellectual skills. Results are discussed in terms of the different functions of counterfactual reasoning about emotion and the cognitive style of children with high-functioning autism spectrum disorder.

Putting theory of mind in its place: psychological explanations of the socio-emotional-communicative impairments in autistic spectrum disorder

In this review, the history of the theory of mind (ToM) theory of autistic spectrum disorder (ASD) is outlined (in which ToM is indexed by success on false belief tasks), and the explanatory power and psychological causes of impaired ToM in ASD are critically discussed. It is concluded that impaired ToM by itself has only limited explanatory power, but that explorations of the psychological precursors of impaired ToM have been fruitful in increasing understanding of mindreading impairments in ASD (where 'mindreading' refers those abilities that underlie triadic interaction as well as ToM). It is argued that early explanations of impaired mindreading are untenable for various reasons, but that impairments of dyadic interaction in ASD that could lead to impaired ability to represent others' mental states may be the critical psychological cause, or causes, of impaired ToM. The complexity of causal routes to impaired ToM is emphasized.

Counterfactual reasoning: developing a sense of "nearest possible world"

This study investigated at what point in development 3- to 6-year-old children begin to demonstrate counterfactual reasoning by controlling for fortuitously correct answers that result from basic conditional reasoning. Basic conditional reasoning occurs when one applies typical regularities (such as "If 'whenever' it doesn't rain the street is dry") to counterfactual questions (such as "If it had not rained, would the street be wet or dry?") without regard to actual events (e.g., if street cleaners had just been washing the street). In counterfactual reasoning, however, the conditional reasoning must be constrained by actual events (according to the "nearest possible world"). In situations when counterfactual reasoning and basic conditional reasoning would yield the same answers, even the youngest children gave mostly correct answers. However, tasks in which the 2 reasoning strategies resulted in different answers proved unusually difficult even for the older children.

Brief report: additive and subtractive counterfactual reasoning of children with high-functioning autism spectrum disorders

The development of additive (‘If only I had done…’) and subtractive (‘If only I had not done….’) counterfactual reasoning was examined in children with High Functioning Autism Spectrum Disorders (HFASD) (n = 72) and typically developing controls (n = 71), aged 6–12 years. Children were presented four stories where they could generate counterfactuals based on a given consequent (e.g., ‘you left muddy footprints in the kitchen. How could that have been prevented?’). Children with HFASD increasingly used subtractive counterfactuals as they got older, but controls showed an increase in additive counterfactuals, which may be linked to their growing adaptive and flexible skills. Children with HFASD likely develop different strategies for their counterfactual reasoning. The role of IQ and ideational fluency will be discussed.

Mnesic imbalance: a cognitive theory about autism spectrum disorders

Autism is characterized by impairments in social interaction, communicative capacity and behavioral flexibility. Some cognitive theories can be useful for finding a relationship between these irregularities and the biological mechanisms that may give rise to this disorder. Among such theories are mentalizing deficit, weak central coherence and executive dysfunction, but none of them has been able to explain all three diagnostic symptoms of autism. These cognitive disorders may be related among themselves by faulty learning, since several research studies have shown that the brains of autistic individuals have abnormalities in the cerebellum, which plays a role in procedural learning. In keeping with this view, one may postulate the possibility that declarative memory replaces faulty procedural memory in some of its functions, which implies making conscious efforts in order to perform actions that are normally automatic. This may disturb cognitive development, resulting in autism symptoms. Furthermore, this mnesic imbalance is probably involved in all autism spectrum disorders. In the present work, this theory is expounded, including preliminary supporting evidence.