The autistic child's theory of mind: a case of specific developmental delay

Prosodic Focus Effects on Covert "Only" Reading of Scalar Quantifiers in Autistic and Non-autistic Children Under Tonal Language Background

Previous research on prosodic focus comprehension in non-autistic children has yielded inconsistent results, often attributing their difficulties to the presence of the word "only". However, studies on autistic children's understanding of focus are limited and often methodologically rigid. This study builds on previous work by investigating how prosodic focus influences the covert "only" interpretation of scalar quantifiers among Mandarin-speaking children aged 3-8, both autistic and non-autistic, using engaging and dynamic tasks. The present study combined a computer-based Picture-Sentence Judgment and a computer-based Selection Task. Samples included 25 autistic (3 F, 22 M) and 29 non-autistic children (17 F, 12 M) for the judgment task, and 20 autistic (3 F, 17 M) and 25 non-autistic (13 F, 12 M) for the selection task. Results indicated that non-autistic children showed prosodic focus sensitivity, requiring ToM and EF skills but not fully eliciting covert "only" inferences. Prosody enhanced clarity, reducing reliance on advanced reasoning, though vocabulary mattered. Autistic children's comprehension was unaffected by prosody, even with basic ToM and EF skills. Individual traits' influences on their interpretation were minimally affected by focus, highlighting reduced sensitivity. These findings suggest that non-autistic challenges may stem from cognitive capacities, not mere inclusion of "only". Autistic children's diminished sensitivity reflects autism's intrinsic aspects, likely linked to information integration impairments or decreased social motivation.

Effects of Individual Differences and Prosodic Focus on the Interpretation of Quantity Scalar Terms in Mandarin-Speaking 3- to 8-Year-Olds

PURPOSE

This study focuses on examining how individual differences, including biological, linguistic, and cognitive traits, and prosodic focus affect the computation biases and reaction time (RT) associated with quantity scalar terms in Mandarin-speaking children aged 3-8 years.

METHOD

The participants of this study were 27 Mandarin-speaking children aged 3-8 years. They completed a computer-based sentence evaluation task, and their receptive vocabulary, nonverbal IQ, and theory of mind (ToM) skills were assessed. Additionally, parents provided insights into their children's executive functions, including working memory, planning, regulation, and inhibition abilities, through a questionnaire reflecting daily performance.

RESULTS

Mandarin-speaking 3- to 8-year-olds showed pervasive quantifier semantic biases versus bimodally distributed ad hoc semantic/pragmatic biases. Their quantifier pragmatic bias increased with age, working memory, and planning abilities but decreased with first-order ToM. In contrast, their ad hoc pragmatic bias improved with second-order ToM, working memory, planning, and inhibition abilities but decreased with age and receptive vocabulary. Prosodic focus reduced the number of hesitators and minimized the RT differences between hesitators and pragmatic/semantic responders.

CONCLUSIONS

Children show a higher overall pragmatic bias in ad hoc compared to quantifier scalar terms, alongside notable individual differences. Quantifier and ad hoc scalar terms appear to have different initial interpretations, with the former leaning toward a semantic interpretation and the latter toward a pragmatic one. Prosodic focus reduced hesitation and encouraged further processing, although it did not significantly alter interpretation biases. Future studies should employ larger sample sizes and implicit measures to further explore these findings.

Disentangling the perceptual underpinnings of autism: Evidence from a face aftereffects experiment

Existing literature has documented diminished norm-based adaptation (aftereffects) across several perceptual domains in autism. However, the exact underlying mechanisms, such as sensory dominance possibly caused by imprecise priors and/or increased sensory precision, remain elusive. The "Bayesian brain" framework offers refined methods to investigate these mechanisms. This study utilized both model-free (frequentist statistics) and model-based (hierarchical Drift Diffusion Modeling) analytical approaches to compare gender face aftereffects in male adolescents with autism (n = 29) to neurotypical controls (n = 39) using a behavioral choice experiment. Contrary to our initial hypotheses, our analyses did not find support for imprecise priors or increased sensory precision within the autistic group. Instead, we observed generally decreased drift rates towards male but not female stimuli in the autistic group. Thus, our findings suggest a lack of own-gender bias in face processing among the autistic participants. These findings align with more recent behavioral and neurophysiological research observing intact priors in individuals with autism, suggesting that other mechanisms may better explain the perceptual challenges in autism. Our study contributes to the ongoing discourse on perceptual processing in autism, emphasizing the necessity for more nuanced analytical approaches in order to unravel the complexity of this condition.

The Dynamicity of the Oxytocin Receptor in the Brain May Trigger Sensory Deficits in Autism Spectrum Disorder

Sensory processing abnormalities have been noted since the first clinical description of autism in 1940. However, it was not until the release of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013 that sensory challenges were considered as symptoms of autism spectrum disorder (ASD). Multisensory processing is of paramount importance in building a perceptual and cognitive representation of reality. For this reason, deficits in multisensory integration may be a characteristic of ASD. The neurohormone oxytocin (Oxt) is involved in the etiology of ASD, and there are several ongoing clinical trials regarding Oxt administration in ASD patients. Recent studies indicate that Oxt triggers muscle contraction modulating thermogenesis, while abnormal thermoregulation results in sensory deficits, as in ASD. Activation of the Oxt system through exposure to cold stress regulates the expression of oxytocin receptor (Oxtr) in the brain and circulating Oxt, and if this mechanism is pathologically disrupted, it can lead to sensory processing abnormalities since Oxt acts as a master gene that regulates thermogenesis. This review will describe the sensory deficits characteristic of ASD together with the recent theories regarding how the modulation of Oxt/Oxtr in the brain influences sensory processing in ASD.

Time efficiency in mental state reasoning of people with multiple sclerosis: The double-sided affective and cognitive Theory of Mind disturbances

Objective: Theory of Mind (ToM) disturbances are recognized as a hallmark of several neurological conditions including multiple sclerosis (MS). People with MS show lower ToM competencies compared to healthy controls (HC) from the earliest stages of the disease. However, the nature of this disturbance is still under investigation. The aims of this study were 1) to explore ToM competencies in people with MS using a single task (the Yoni-48) considering both accuracy and time efficiency according to a multi-level (first- and second-order) and multi-component (affective and cognitive) approach, and 2) to investigate the relationship between ToM and other neurocognitive functions in people with MS. Method: Seventy-seven participants underwent an individual evaluation session to investigate their ToM profile and associated neurocognitive domains (short-term and working memory, and executive functioning). Results: As expected, the comparison between the two groups (MS vs HC) on ToM performance showed a selective decline of accuracy for the second-order level (Cohen's d = 0.46) and the affective (Cohen's d = 0.57) components of ToM, and a pathological reduction in ToM time efficiency in people with MS (Cohen's d > 0.50). Moreover, a link between executive function, memory, and ToM was found. Our results highlight a double-sided selective decline of high levels and affective components of ToM in people with MS, and a broad involvement of time efficiency. Conclusions: These findings provide insights into the contribution of efficiency and automaticity of mental state reasoning in this pathology, suggesting the role of compensation strategies in maintaining adequate performance during social interactions.

Scene construction ability in neurotypical and autistic adults

LAY ABSTRACT

People with autism spectrum conditions (ASC) have difficulties imagining events, which might result from difficulty mentally generating and maintaining a coherent spatial scene. This study compared this scene construction ability between autistic (N = 55) and neurotypical (N = 63) adults. Results showed that scene construction was diminished in autistic compared to neurotypical participants, and participants with fewer autistic traits had better scene construction ability. ASC diagnosis did not influence the frequency of mentions of the self or of sensory experiences. Exploratory analysis suggests that scene construction ability is associated with the ability to understand our own and other people's mental states, and that these individual-level preferences/cognitive styles can overrule typical group-level characteristics.

Prosodic and Visual Cues Facilitate Irony Comprehension by Mandarin-Speaking Children With Cochlear Implants

PURPOSE

This study investigated irony comprehension by Mandarin-speaking children with cochlear implants, focusing on how prosodic and visual cues contribute to their comprehension, and whether second-order Theory of Mind is required for using these cues.

METHOD

We tested 52 Mandarin-speaking children with cochlear implants (aged 3-7 years) and 52 age- and gender-matched children with normal hearing. All children completed a Theory of Mind test and a story comprehension test. Ironic stories were presented in three conditions, each providing different cues: (a) context-only, (b) context and prosody, and (c) context, prosody, and visual cues. Comparisons were conducted on the accuracy of story understanding across the three conditions to examine the role of prosodic and visual cues.

RESULTS

The results showed that, compared to the context-only condition, the additional prosodic and visual cues both improved the accuracy of irony comprehension for children with cochlear implants, similar to their normal-hearing peers. Furthermore, such improvements were observed for all children, regardless of whether they passed the second-order Theory of Mind test or not.

CONCLUSIONS

This study is the first to demonstrate the benefits of prosodic and visual cues in irony comprehension, without reliance on second-order Theory of Mind, for Mandarin-speaking children with cochlear implants. It implies potential insights for utilizing prosodic and visual cues in intervention strategies to promote irony comprehension.

Measuring mindreading in preschoolers: The perspective battery (PERBAT)

OBJECTIVE

The capacity to take another person's visual perspective is pivotal for solving mindreading tests, such as Theory of Mind (ToM) tasks, but most of them heavily rely on domain-general abilities (e.g., language, executive functions). Here we present a novel battery of visual perspective-taking tests for child neuropsychological assessment, the Perspective Battery (PERBAT), which poses a limited load on domain-general abilities.

METHODS

The battery includes four tests: i) Block Building; ii) Hide and Seek; iii) Deceptive Figures; iv) Double-Sided Shelf. We administered the PERBAT to 126 typically developing preschoolers (65 males; 3-6-year-old); the participants also performed classical tests of social cognition, language, and nonverbal abstract reasoning.

RESULTS

The scores of all the PERBAT tests were significantly and positively related with age and scores of the classical social cognition tests, but not with scores of the language and nonverbal abstract reasoning tests.

CONCLUSIONS

The PERBAT could represent a useful neuropsychological tool providing a comprehensive assessment of visual perspective-taking skills in preschool children. Future investigation is needed to examine the validity of the PERBAT with neurotypical samples across countries, race, ethnicity, and language as well as with clinical populations. Longitudinal studies are also encouraged to examine whether early visual perspective-taking weaknesses are associated with later development of mindreading skills.

Normative values and diagnostic optimisation of three social cognition measures for autism and schizophrenia diagnosis in a healthy adolescent and adult sample

Awareness of the importance of assessing social cognition skills under conditions showing atypical social behaviours has increased over the years. However, the evaluation of the psychometric properties of the measures and the availability of normative values for the clinical context are still limited. This study aims to revise, provide normative values, and evaluate the clinical validity of the Italian version of three social cognition measures: Advanced Theory of Mind (A-ToM) task, the Emotion Attribution Task (EAT), and the Social Situation Task (SST). Measures were administered to 580 adolescents and adult healthy controls (age range 14-50). We performed differential item functioning and Rasch analysis to revise each task, so normative data of the revised measures were calculated. Moreover, the revised measures were administered to 38 individuals with autism spectrum disorder (ASD) and 35 individuals with schizophrenia spectrum disorders (SSD): ASD and SSD were matched by age, gender, and IQ with a control sample to evaluate clinical validity. ROC analysis showed that the SST is the best measure differentiating between healthy and clinical groups, compared to the A-ToM (AUCASD = 0.70; AUCSSD = 0.65) and EAT (AUCASD = 0.67; AUCSSD = 0.50), which showed poorer performance. For SSD diagnosis, two SST subscales (Violation and Gravity score) indicated the best accuracy (AUCs of 0.88 and 0.84, respectively); for the ASD diagnosis, we propose a combined score between the SST subscale and A-ToM (AUC = 0.86). The results suggest that the proposed measures can be used to support the diagnostic process and clinical practice.

Profiles of theory of mind impairments and personality in clinical and community samples: integrating the alternative DSM-5 model for personality disorders

Introduction

Deficits in theory of mind (ToM)-the ability to infer the mental states of others-have been linked to antagonistic traits in community samples. ToM deficits have also been identified in people with personality disorders (PD), although with conflicting evidence, partly due to the use of categorical diagnoses. The DSM-5 Alternative Model for Personality Disorders (AMPD) provides an opportunity for a more precise understanding of the interplay between ToM abilities and personality pathology. Therefore, the study aims to determine whether and how individuals with diverse ToM profiles differ regarding personality impairment (AMPD Criterion A) and pathological facets (AMPD Criterion B).

Method

Adults with PD (n = 39) and from the community (n = 42) completed tests assessing ToM skills and self-reported questionnaires assessing AMPD Criteria A and B. Hierarchical agglomerative and TwoStep cluster analyses were consecutively computed using scores and subscores from ToM tests as clustering variables. Multivariate analyses of variance were subsequently performed to compare the clusters on both AMPD Criteria. Five clinically and conceptually meaningful clusters were found. The most notable differences across clusters were observed for Intimacy and Empathy dysfunctions (Criterion A), as well as for the Deceitfulness, Callousness, and Hostility facets from the Antagonism domain and the Restricted affectivity facet from the Detachment domain (Criterion B).

Discussion

The results support the association between antagonistic personality facets and ToM deficits. However, clusters showing impairments in ToM abilities did not necessarily exhibit high levels of personality dysfunction or pathological facets, emphasizing that both constructs are not isomorphic. Nevertheless, specific profiles can help refine existing interventions to make them more sensitive and specific to the nature of ToM dysfunctions while considering personality functioning and facets.

Effects of Ziprasidone or Haloperidol on Theory of Mind in Patients With Schizophrenia: A 16-week Pilot Trial

OBJECTIVES

Schizophrenia is associated with impairment in theory of mind (ToM), which is defined as the ability to make judgments about mental states and is related to medial prefrontal cortical activity. Ziprasidone, but not haloperidol, is known to have a protective effect in the medial prefrontal cortex. Thus, we hypothesized that these 2 drugs would have different efficacy in improving ToM task performance in patients with schizophrenia.

METHODS

Patients with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnosis of schizophrenia matched for sex, duration of illness, and education were randomized to receive ziprasidone (n=30) or haloperidol (n=30). All patients were assessed using the Positive and Negative Syndrome Scale and the Personal and Social Functioning Scale. ToM was assessed using a first-order false belief task, a second-order false belief task, the faux-pas task, and the Reading the Mind in the Eyes Task, in order of developmental complexity and difficulty. The primary outcome was change in ToM performance from baseline to 16 weeks of treatment.

RESULTS

For the first-order false belief task, there were no significant differences between the groups (P>0.05). For the second-order false belief task, the interaction effect was significant (P<0.05), and the simple effect of time showed a significant difference only in the ziprasidone group (P<0.001). For the faux-pas task, the interaction effect was not significant (P>0.05). For the Reading the Mind in the Eyes Task, the interaction effect was significant (P<0.05), and the simple effect of time showed a significant difference only in the ziprasidone group (P<0.001). The Positive and Negative Syndrome Scale results were similar between the groups. The ziprasidone group performed better than the haloperidol group on the Personal and Social Functioning Scale. There were no major safety concerns or adverse events.

CONCLUSIONS

The findings of this study suggest that ziprasidone could improve ToM and might be superior to haloperidol for improving complex ToM as well as personal and social functioning in patients with schizophrenia.

TRIAL REGISTRATION CHINESE CLINICAL TRIAL REGISTER

ChiCTR2200060542.

Empathy and Violence in Schizophrenia and Antisocial Personality Disorder

A paucity of cognitive and affective features of empathy can be correlated with violent behavior. We aimed to identify differences in empathy among four groups in a sample of 100 male participants: (1) 27 violent offenders with schizophrenia, (2) 23 nonviolent patients with schizophrenia, (3) 25 patients with antisocial personality disorder, and (4) 25 subjects from the general population, who formed the control group. Schizophrenia symptoms were quantified with the Positive and Negative Syndrome Scale. Empathy was measured with the empathy quotient. Theory of mind was evaluated using (a) the first-order false-belief task, (b) the hinting task, (c) the faux pas recognition test and (d) the "reading the mind in the eyes" test (revised). Differences noted among the groups were age (controls were younger) and educational status (antisocials were less educated). The empathy quotient scoring (p < 0.001) and theory-of-mind tests (p < 0.001) were distinct between the control group and the three other groups of participants, but not among the three patient groups. Patients with antisocial personality disorder, violent psychotic offenders and psychotic nonviolent patients show no remarkable differences in affective or cognitive empathy tests, but they all present deficits in empathy and theory of mind when compared to controls.

Autism as a Disorder of Affective Empathy

Since the first description by Leo Kanner, individuals with autism spectrum disorder (ASD) have been attributed a reduced empathy. However, it has not yet been clarified how empathy is specifically impaired in autism. Typically, scholars distinguish between the affective and the cognitive dimensions of empathy. The latter largely overlaps with the concept of the theory of mind (ToM), according to which we need internal inferences or simulations for gaining access to the hidden mental states of others. Since a deficit in ToM is a widely accepted explanation for difficulties of individuals with ASD in social interactions, limitations in cognitive empathy are accordingly assumed. Regarding affective empathy, there are contradictory results using various methods, showing an impaired affective empathy. The main aim of the paper is to present ASD primarily as a disorder of shared interpersonal and interaffective experiences and thus of affective empathy by means of a phenomenological analysis considering empirical studies. In this framework, a deficit of the ToM is accepted but criticized as a central explanatory approach for ASD since (1) it assumes a fundamental inaccessibility of other people, which does not correspond to our everyday social situations, and (2) it manifests developmentally long after the first signs of ASD, which means that its deficit cannot explain the basic autistic difficulties in social interactions.

No evidence for high inflexible precision of prediction errors in autism during lexical processing

Research has shown that information processing differences associated with autism could impact on language and literacy development. This study tested an approach to autistic cognition that suggests learning occurs via prediction errors, and autistic people have very precise and inflexible predictions that result in more sensitivity to meaningless signal errors than non-autistic readers. We used this theoretical background to investigate whether differences in prediction coding influence how orthographic (Experiment 1) and semantic information (Experiment 2) is processed by autistic readers. Experiment 1 used a lexical decision task to test whether letter position information was processed less flexibly by autistic than non-autistic readers. Three types of letter strings: words, transposed letter and substituted letters nonwords were presented. Experiment 2 used a semantic relatedness task to test whether autistic readers processed words with high and low semantic diversity differently to non-autistic readers. Results showed similar transposed letter and semantic diversity effects for all readers; indicating that orthographic and semantic information are processed similarly by autistic and non-autistic readers; and therefore, differences in prediction coding were not evident for these lexical processing tasks.

Teaching Children with Autism to Identify Known and Unknown Information across Self and Others

This study evaluated procedures for teaching three children diagnosed with autism spectrum disorder the perspective-taking skill of identifying known and unknown information by others based on what they were sensing across all five senses: see, taste, feel, hear, and smell. Using a multiple baseline across participants design, this study evaluated a training package consisting of rules, multiple exemplar training, error correction, and reinforcement. The treatment package successfully taught participants to identify known/unknown information based on what individuals sensed. Generalization across untrained stimuli and people was observed from baseline to posttraining for all participants.

Contrasting social knowledge and theory of mind patterns in adults with personality disorders, schizophrenia spectrum disorders, and healthy controls

INTRODUCTION

Personality disorders (PD) and schizophrenia spectrum disorders (SSD) are distinct conditions displaying common symptoms, like impairments in social cognition, that make them hard to distinguish, especially in severe cases. To date, few studies have compared theory of mind skills in these two disorders, and none have compared social knowledge skills. This study aims to compare the social cognitive abilities of patients with these conditions.

METHOD

Non-parametric analyses of covariance were used to compare severe PD patients (n = 37), SSD patients (n = 44), and healthy controls (HC; n = 49) on the Social Knowledge Test and two measures of theory of mind: the Reading the Mind in the Eyes Test and the Combined Stories Test, which incorporates items from various widely used tests.

RESULTS

While no significant group differences were found on the Social Knowledge Test, SSD patients performed lower than the HC group on both theory of mind tests. PD patients only had lower performance than the HC group on specific items from the Combined Stories Test.

CONCLUSIONS

PD and SSD patients demonstrated distinctive patterns of social cognitive impairments, with items of greater complexity or with an affective orientation being the most discriminant for PD.

Social Knowledge & Performance in Autism: A Critical Review & Recommendations

Autistic social challenges have long been assumed to arise from a lack of social knowledge ("not knowing what to do"), which has undergirded theory and practice in assessment, treatment, and education. However, emerging evidence suggests these differences may be better accounted for by difficulties with social performance ("doing what they may know"). This distinction has important implications for research, practice, policy, and community support of autistic people. This review examines the theoretical and clinical implications and empirical status of the knowledge-performance distinction in autism. Current evidence suggests that social knowledge deficits are neither definitional nor reliably related to outcomes in autism. Prioritizing social knowledge, then, may produce unanticipated, problematic consequences in terms of accuracy of assessment, intervention effectiveness, and promotion of stigma. It may also yield unrealistic expectations around the value of knowledge for autistic people and their families, yielding important ethical considerations. Conversely, recent evidence highlights performance-related factors as being especially promising for better modeling and addressing social challenges in autism. Prioritizing performance, then, may offer new directions for assessment, substantially different intervention opportunities, and novel methods of inclusion and affirmation. This review touches upon each of these domains and implications, integrates these developments with broader models of social competence in youth, and provides direction for future research and practice regarding social competence in autism.

Social cognition in first-episode schizophrenia/schizoaffective disorder patients

INTRODUCTION

People with schizophrenia have neurocognitive as well as social cognition deficits. Numerous studies have shown impairment in these domains in patients with chronic schizophrenia. However, these disturbances during the early phase of the disease have been less studied.

OBJECTIVE

The aim of the study is to explore the theory of mind (ToM) and emotional processing in first-episode patients, compared to healthy subjects.

METHOD

Forty patients with a first psychotic episode of less than 5 years' duration, and 40 healthy control subjects matched by age and years of schooling were assessed. The measures of social cognition included four stories of false belief, the Reading the Mind in the Eyes Test (RMET) and the Pictures Of Facial Affect (POFA) series.

RESULTS

The patients with a first psychotic episode performed significantly worse in all tasks of social cognition, compared to the healthy controls. The second-order ToM was impaired whereas the first-order ToM was preserved in the patients. Happiness was the emotion most easily identified by both patients and controls. Fear was most difficult for the patients, while for the controls it was disgust.

CONCLUSIONS

Deficits in ToM and emotional processing are present in patients with a first psychotic episode.

Toward an integrative socio-cognitive approach in autism spectrum disorder: NEAR method adaptation-study protocol

Background

The cognitive impairments exhibited by people with ASD, threaten the development of social skills that are essential for establishing and maintaining harmonious social relationships. Cognitive remediation and social skills training are now considered as crucial therapeutic approaches in the management of these disorders. Several programs have already been validated and have shown improvements in social skills or cognitive performance. However, the effects of these training methods seem to be difficult to generalize to other everyday life. The aim of our study is to alleviate cognitive and social deficiencies by using a socio-cognitive framework to adapt the Neuropsychological Educational Approach to Remediation (NEAR) method for adolescents with ASD.

Methods/design

Adolescents meeting the DSM-5 criteria for ASD, older than 13 years, and following a regular school curriculum will be recruited from clinical population at the Child and Adolescent Psychiatry in Razi University Hospital-Manouba- Tunisia. Our study is an open and non-randomized controlled trial including 30 patients: NEAR group / control group. The NEAR method combines computerized cognitive exercises and bridging groups inspired from cognitive behavioral therapy. NEAR group will be divided into three groups of five patients each. The duration of the sessions will vary according to the capacities of the participants and the exchanges between them (about 60–120 min). In our study, bridging groups will be amended by adding other tasks including planning role plays and scenarios of problematic social situations in autism, taking into account cultural particularities in order to promote social skills. Computerized exercises will be enriched by adding other tasks aiming to improve the recognition and expression of facial emotions by using digital videos and photographs expressing the six basic emotions. The duration of the program will be about 6 months. All selected patients will have an assessment of cognitive function: social cognition, neurocognition and pragmatic skills, social skills, self-esteem and global functioning at baseline, 1 week after the end of the NEAR program and 6 months later.

Conclusion

This adaptive program is a promising socio-cognitive intervention that create new perspectives for adolescents with autism spectrum disorder.

Assessing the construct validity of a theory of mind battery adapted to Tunisian school-aged children

Background

Theory of mind (ToM) refers to the ability to understand others' states of mind, desires, emotions, beliefs, and intentions to predict the content of their mental representations. Two major dimensions within ToM have been studied. The first is the type of inferred mental state, which can be cognitive or affective. The second comprises the types of processes involved according to their degree of complexity (first- and second-order false belief and advanced ToM). ToM acquisition is fundamental-a key component in the development of everyday human social interactions. ToM deficits have been reported in various neurodevelopmental disorders through various tools assessing disparate facets of social cognition. Nevertheless, Tunisian practitioners and researchers lack a linguistically and culturally appropriate psychometric tool for ToM assessment among school-aged children.

Objective

To assess the construct validity of a translated and adapted French ToM Battery for Arabic-speaking Tunisian school-aged children.

Methods

The focal ToM Battery was designed with neuropsychological and neurodevelopmental theory and composed of 10 subtests distributed evenly in three parts: Pre-conceptual, cognitive, and affective ToM. Translated and adapted to the Tunisian sociocultural context, this ToM battery was individually administered to 179 neurotypical Tunisian children (90 girls and 89 boys) aged 7-12 years.

Results

After controlling for the age effect, construct validity was empirically confirmed on two dimensions (cognitive and affective) via structural equation modeling (SEM) analysis, demonstrating that this solution has a good fit. The results confirmed that the age affected differentially the performance obtained on ToM tasks based on the two components of the battery.

Conclusion

Our findings confirm that the Tunisian version of the ToM Battery has robust construct validity for the assessment of cognitive and affective ToM in Tunisian school-aged children; hence, it could be adopted in clinical and research settings.

The robotic mentalist – On the influences of robots’ mentalizing abilities and external manipulative intent on people’s credibility attributions

Robots are used in various social interactions that require them to be perceived as credible agents (e.g., as product recommenders in shopping malls). To be rated credible (i.e., competent, trustworthy, and caring) a robot’s mentalizing abilities have shown to be beneficial because they allow a robot to infer users’ inner states, thus serving as a prerequisite for understanding their beliefs and attitudes. However, social robots are often deployed by private and thus profit-oriented companies. In such cases where an organization’s implied manipulative intent is salient, the effect of robots’ mentalizing abilities might be reversed. The reason for this is that mentalizing abilities could pose a persuasive threat to users rather than a feature for better understanding, thereby decreasing credibility attributions. These assumptions were tested in a three (robot’s mentalizing abilities) by two (external manipulative intent) between-subjects, pre-registered, laboratory experiment during which participants interacted with a social robot that recommended experience vouchers as potential gifts for participants’ target persons. Contrary to our assumptions, inferential statistical results revealed no significant differences in explicit or indirect credibility attributions caused by the experimental manipulation. The external manipulative intent of an organization using the robot caused no differences in participants’ behavioral intentions or evaluations of it. Furthermore, only participants’ attribution of empathic understanding to the robot varied significantly between the three mentalizing conditions. Our results suggest that people focus more on the robot than on the organization using it, causing potential opportunities for such organizations to hide their economic interests from the users.

Second-Order False Beliefs and Linguistic Recursion in Autism Spectrum Disorder

This study investigates the role of recursive language and working memory (WM) in second-order false belief skills in Danish-speaking children with autism spectrum disorder (ASD; n = 62; 8 females) and typical development (n = 41; 15 females), ages 6-16. Second-order false belief skills correlated with receptive grammar, vocabulary, and age; sentential complement production predicted second-order false beliefs, controlling for age, receptive grammar and WM. Regressions showed that second-order false belief was associated with age across groups, but with sentential complements in the ASD group only. Second-order false belief skills improved in children who received training in either recursive phrases (d = 0.21) or WM (d = 0.74), compared to an active control group. Results suggest that false belief skills are entwined with both linguistic and executive functions.

Measuring Theory of Mind in Adolescents With Language and Communication Problems: An Ecological Perspective

We tested if the newly designed ToMotion task reflects a single construct and if the atypical groups differ in their performance compared to typically developing peers. Furthermore, we were interested if ToMotion maps a developmental sequence in a Theory of Mind (ToM) performance as exemplified by increasing difficulty of the questions asked in every item. The sample consisted of 13 adolescents that have been diagnosed with a developmental language disorder (DLD) and 14 adolescents that are deaf or hard of hearing (DHH). All of these adolescents were in special schools for secondary vocational education. The control group existed of 34 typical developing adolescents (TD) who were in regular intermediate vocational education, ranging from level 2 to 4. The ToMotion, available in a spoken Dutch version and in a version in Sign Language of the Netherlands (SLN), was used to map ToM abilities. An attempt has been made to fill the gap of missing studies of ToM in adolescents by developing a new measuring instrument. In conclusion, assessing ToM with the ToMotion results in a picture that DHH adolescents score lower than TD peers. However, their scores are as consistent as those of the TD peers. The picture of DLD adolescents is the reverse. They show no differences in ToM scores, but seem to be somewhat more inconsistent compared to TD peers. We provide a discussion on those results and its implications for future research. What this paper adds? The current study introduces a new visual Theory of Mind (ToM) task, ToMotion, designed specifically to assess ToM in adolescents in an ecologically valid way and adapted to the needs of adolescents with language and communication difficulties.

Functional connectivity patterns of trait empathy are associated with age

Empathy is the capacity to feel and understand others' mental states. In some individuals, there is an imbalance between the affective and cognitive components of empathy, which can lead to deficits. This study investigated the functional connectivity of the anterior insula (AI) and dorsomedial prefrontal cortex (dmPFC), which play key roles in empathy, in covariation with the affective and cognitive subscales of the Interpersonal Reactivity Index (IRI), as a function of age and sex, as an exploratory analysis. Seed-based functional connectivity analyses were performed on 33 healthy participants that were subdivided according to their age (16 adults and 17 adolescents) and sex (16 women and 17 men). Adolescents reported lower cognitive empathy than adults and men less affective empathy than women. The connectivity of the dmPFC and AI, in covariation with the cognitive and affective subscales of empathy, respectively, differed between adolescents and adults, but was similar in men and women. Adolescents had patterns of negative covariations between the regions of interest and many brain regions associated with the default-mode and salience networks. These findings support that lower self-report levels of empathy in certain individuals could be reflected in the functional connectivity patterns of the dmPFC and AI.

Theory of Mind Among Swedish Children with ASD, Down Syndrome and Typically Developing Group

The present study examined the role of IQ and the Theory of Mind understanding in children with an autism spectrum disorder and down syndrome. Sixty-six Swedish children with ASD (n = 26), DS (n = 18), and typically developed group (n = 22) ranged between 6 and 12 years old were compared on ToM tasks consisted of standard ToM and IQ tasks. SPSS 25 program was used to analyze data. The results indicated that individuals with ASD reach a better understanding of first-order ToM tasks than children with DS. This picture was the same in the TD group to show better ability than children with ASD and DS on first-order tasks, except one task which was not found significant differences. To employ second-order TD performed better than clinical groups, while, there was no significant difference between ASD and DS. The scores for the third-order task in children with ASD were significantly better than children with DS.

Comparing Theory of Mind Development in Children with Autism Spectrum Disorder, Developmental Language Disorder, and Typical Development

BACKGROUND

Theory of mind (ToM) is the ability to recognize, comprehend, and consider oneself's and others' mental states and perspectives to predict and explain behaviors and motivations. It is widely accepted that children with autism spectrum disorder (ASD) experience difficulties with ToM. However, there are also findings suggesting that ToM abilities might also be compromised in children with Developmental Language Disorders (DLD).

PURPOSE

To assess ToM abilities in three groups of children: 1. ASD with no language difficulties; 2. DLD, known for their language disorder; and 3. TD with no language issues.

MATERIALS AND METHODS

A total of 41 preschool children aged 5-to-6 were examined and assigned to one of the three groups based on previous clinical reports and a standardized Hebrew language assessment tool. Nonverbal IQ was established with a standardized test to verify within average range placement (>75 IQ). ToM skills were examined with a Hebrew version of the ToM Task Battery and parent's questionnaire (ToMI).

RESULTS

Children with ASD had significantly lower ToM scores compared to the children with DLD, and TD. The ToM scores of the children with DLD were similar to the scores of the TD children. According to the parents' questionnaires, both the ASD children and the DLD children had less developed ToM skills compared to their TD peers.

CONCLUSION

The present findings suggest that children with ASD have a fundamental difficulty in ToM that is independent of their language abilities. Children with DLD show difficulties in everyday social interactions that involve ToM. It is possible that both ASD and language disorders influence ToM development, suggesting that different developmental routes affect the acquisition of ToM.

Sources of variation in search and foraging: A theoretical perspective

Search-the problem of exploring a space of alternatives to identify target goals-is a fundamental behaviour for many species. Although its foundation lies in foraging, most studies of human search behaviour have been directed towards understanding the attentional mechanisms that underlie the efficient visual exploration of two-dimensional (2D) scenes. With this review, we aim to characterise how search behaviour can be explained across a wide range of contexts, environments, spatial scales, and populations, both typical and atypical. We first consider the generality of search processes across psychological domains. We then review studies of interspecies differences in search. Finally, we explore in detail the individual and contextual variables that affect visual search and related behaviours in established experimental psychology paradigms. Despite the heterogeneity of the findings discussed, we identify that variations in control processes, along with the ability to regulate behaviour as a function of the structure of search space and the sampling processes adopted, to be central to explanations of variations in search behaviour. We propose a tentative theoretical model aimed at integrating these notions and close by exploring questions that remain unaddressed.

The relationship between alexithymia and theory of mind: A systematic review

Theory of Mind (ToM), the ability to represent the mental states of oneself and others, is an essential social skill disrupted across many psychiatric conditions. The transdiagnostic nature of ToM impairment means it is plausible that ToM impairment is related to alexithymia (difficulties identifying and describing one's own emotions), as alexithymia is seen across psychiatric conditions. Whilst many studies have examined links between alexithymia and ToM, results are mixed. Therefore, the purpose of this systematic review is to provide a taxonomy of ToM tests and assess their relationship with alexithymia. Tests are grouped according to whether they assess propensity to engage spontaneously in ToM or accuracy of ToM inferences, with tests further subdivided into those that do, and do not, require emotion recognition. A review of 63 suitable studies suggests that alexithymia is often associated with reduced ToM, and inaccurate ToM when tasks require emotion recognition. This latter finding appears due to impaired emotion recognition, rather than ToM impairment per se. Further directions and considerations for future research are discussed.

Group and sex differences in social cognition in bipolar disorder, schizophrenia/schizoaffective disorder and healthy people

BACKGROUND

Impairment of social cognition is documented in bipolar disorder (BD) and schizophrenia/schizoaffective disorder (SCH). In healthy individuals, women perform better than men in some of its sub-domains. However, in BD and SCH the results are mixed. Our aim was to compare emotion recognition, affective Theory of Mind (ToM) and first- and second-order cognitive ToM in BD, SCH and healthy subjects, and to investigate sex-related differences.

METHODS

120 patients (BD = 60, SCH = 60) and 40 healthy subjects were recruited. Emotion recognition was assessed by the Pictures of Facial Affect (POFA) test, affective ToM by the Reading the Mind in the Eyes Test (RMET) and cognitive ToM by several false-belief stories. Group and sex differences were analyzed using parametric (POFA, RMET) and non-parametric (false-belief stories) tests. The impact of age, intelligence quotient (IQ) and clinical variables on patient performance was examined using a series of linear/logistic regressions.

RESULTS

Both groups of patients performed worse than healthy subjects on POFA, RMET and second-order false-belief (p < 0.001), but no differences were found between them. Instead, their deficits were related to older age and/or lower IQ (p < 0.01). Subthreshold depression was associated with a 6-fold increased risk of first-order false-belief failure (p < 0.001). Sex differences were only found in healthy subjects, with women outperforming men on POFA and RMET (p ≤ 0.012), but not on first/second-order false-belief.

LIMITATIONS

The cross-sectional design does not allow for causal inferences.

CONCLUSION

BD and SCH patients had deficits in emotion recognition, affective ToM, and second-order cognitive ToM, but their performance was comparable to each other, highlighting that the differences between them may be subtler than previously thought. First-order cognitive ToM remained intact, but subthreshold depression altered their normal functioning. Our results suggest that the advantage of healthy women in the emotional and affective aspects of social cognition would not be maintained in BD and SCH.

Empathy influences how listeners interpret intonation and meaning when words are ambiguous

This study examines how individual pragmatic skills, and more specifically, empathy, influences language processing when a temporary lexical ambiguity can be resolved via intonation. We designed a visual-world eye-tracking experiment in which participants could anticipate a referent before disambiguating lexical information became available, by inferring either a contrast meaning or a confirmatory meaning from the intonation contour alone. Our results show that individual empathy skills determine how listeners deal with the meaning alternatives of an ambiguous referent, and the way they use intonational meaning to disambiguate the referent. Listeners with better pragmatic skills (higher empathy) were sensitive to intonation cues when forming sound-meaning associations during the unfolding of an ambiguous referent, and showed higher sensitivity to all the alternative interpretations of that ambiguous referent. Less pragmatically skilled listeners showed weaker processing of intonational meaning because they needed subsequent disambiguating material to select a referent and showed less sensitivity to the set of alternative interpretations. Overall, our results call for taking into account individual pragmatic differences in the study of intonational meaning processing and sentence comprehension in general.

Preserved Perspective Taking in Free Indirect Discourse in Autism Spectrum Disorder

Perspective taking has been proposed to be impaired in persons with autism spectrum disorder (ASD), especially when implicit processing is required. In narrative texts, language perception and interpretation is fundamentally guided by taking the perspective of a narrator. We studied perspective taking in the linguistic domain of so-called Free Indirect Discourse (FID), during which certain text segments have to be interpreted as the thoughts or utterances of a protagonist without explicitly being marked as thought or speech representations of that protagonist (as in direct or indirect discourse). Crucially, the correct interpretation of text segments as FID depends on the ability to detect which of the protagonists "stands out" against the others and is therefore identifiable as implicit thinker or speaker. This so-called "prominence" status of a protagonist is based on linguistic properties (e.g., grammatical function, referential expression), in other words, the perspective is "hidden" and has to be inferred from the text material. In order to test whether this implicit perspective taking ability that is required for the interpretation of FID is preserved in persons with ASD, we presented short texts with three sentences to adults with and without ASD. In the last sentence, the perspective was switched either to the more or the less prominent of two protagonists. Participants were asked to rate the texts regarding their naturalness. Both diagnostic groups rated sentences with FID anchored to the less prominent protagonist as less natural than sentences with FID anchored to the more prominent protagonist. Our results that the high-level perspective taking ability in written language that is required for the interpretation of FID is well preserved in persons with ASD supports the conclusion that language skills are highly elaborated in ASD so that even the challenging attribution of utterances to protagonists is possible if they are only implicitly given. We discuss the implications in the context of claims of impaired perspective taking in ASD as well as with regard to the underlying processing of FID.

A Systematic Review of the Current Measures of Theory of Mind in Adults with Schizophrenia

Adults with schizophrenia usually have impairments in theory of mind (ToM), which subsequently cause them problems in social interaction. Therefore, it is important for healthcare providers to assess their ToM using adequate measures. This systematic review evaluated current ToM measures (or ToM tasks) for adults with schizophrenia and summarized their specific characteristics, including the concept and construct, administration, and psychometric properties. From a review of 117 articles, 13 types of ToM tasks were identified, and the findings from these articles were qualitatively synthesized. The results showed that ToM tasks are diverse in their presentation modalities, answer modes, strategies of controlling cognitive confounders, and scoring. Most tasks employ cognitive and affective dimensions and target a specific, single ToM concept. The present systematic review found that psychometric evidence supporting the ToM tasks, such as internal consistency, test–retest reliability, unidimensionality, and convergent, criterion, and ecological validities, is insufficient. Based on the results, we propose several principles for selecting appropriate ToM tasks in practice, e.g., selecting a task with multiple ToM concepts, or an exclusive ToM construct containing the cognitive and affective dimensions. Moreover, future studies are needed to provide more psychometric evidence on each type of ToM task applied in people with schizophrenia.

The impact of visual-spatial abilities on theory of mind in children and adolescents with autism spectrum disorder

BACKGROUND

Children and adolescents with autism spectrum disorder (ASD) often experience impaired social cognition.

AIMS

In the present study, we aimed to investigate the relation between visual-spatial abilities and theory of mind in children and adolescents with and without ASD.

METHODS

Forty-five boys from the age of 7 to 17 years with ASD and thirty-one aged matched boys without ASD participated and completed the test of intrinsic stable visual-spatial ability (test of visual perceptual skill-revised), intrinsic dynamic visual-spatial ability (animal mental rotation test), and theory of mind test (TOMT).

RESULTS

Results showed that relative to boys without ASD, boys with ASD had a lower performance in theory of mind and intrinsic visual-spatial abilities. Secondly, theory of mind correlated with visual-spatial abilities in boys with ASD. Theory of mind for first and second order beliefs was predicted by the intrinsic dynamic visual abilities, whereas the theory of mind ability of emotion recognition was predicted by visual-spatial static abilities. In children without ASD, theory of mind for emotion recognition was predicted by intrinsic visual-spatial ability and the theory of mind for first order beliefs.

DISCUSSION

Theory of mind can be predicted by visual-spatial abilities in children and adolescents with ASD. Future studies should investigate the role of different types of intrinsic dynamic visual-spatial abilities (e.g., egocentric vs. object-based mental rotation tasks) in relation to different aspects of theory of mind in children and adolescents with autism.

Two Faces of a Coin? A Systematic Review of Source Monitoring and Its Relationship with Memory in Autism

The ability to discriminate the origin of stimuli, known as source monitoring, is crucial for self–other distinction and the integration of internally generated and externally generated experiences. Despite its valence, evidence on source monitoring in autism is yet scarce and unclear. We systematically reviewed literature concerning source monitoring in autism and its relationship with other constructs, such as memory type, encoding effects, social cognition, general intelligence, and clinical factors. Source-monitoring performance (operationalized as error or accuracy) was reduced in autistic participants in 9 of the 15 studies that met the inclusion criteria. When explicitly investigated, free-recall memory impairments in autism were shown to influence source monitoring deficits. General intelligence was another important factor linked to source-monitoring performance. Conversely, other memory types or encoding effects were not impaired in autism, and no univocal association could be found with source monitoring. Social cognition and clinical symptoms were rarely assessed in spite of their possible involvement in source monitoring. The heterogeneity of the task design, outcome measures and demographical factors limited study comparability. As a research framework on source monitoring as a construct of primary interest in autism is still lacking, we propose preliminary indications for future investigations based on the collected findings.

A conceptual framework for the study of demonstrative reference

Language allows us to efficiently communicate about the things in the world around us. Seemingly simple words like this and that are a cornerstone of our capability to refer, as they contribute to guiding the attention of our addressee to the specific entity we are talking about. Such demonstratives are acquired early in life, ubiquitous in everyday talk, often closely tied to our gestural communicative abilities, and present in all spoken languages of the world. Based on a review of recent experimental work, here we introduce a new conceptual framework of demonstrative reference. In the context of this framework, we argue that several physical, psychological, and referent-intrinsic factors dynamically interact to influence whether a speaker will use one demonstrative form (e.g., this) or another (e.g., that) in a given setting. However, the relative influence of these factors themselves is argued to be a function of the cultural language setting at hand, the theory-of-mind capacities of the speaker, and the affordances of the specific context in which the speech event takes place. It is demonstrated that the framework has the potential to reconcile findings in the literature that previously seemed irreconcilable. We show that the framework may to a large extent generalize to instances of endophoric reference (e.g., anaphora) and speculate that it may also describe the specific form and kinematics a speaker's pointing gesture takes. Testable predictions and novel research questions derived from the framework are presented and discussed.

Paliperidone Compared with Haloperidol on the Theory of Mind Tasks in Schizophrenia: A Pilot Trial

PURPOSE

Theory of mind (ToM) is an important part of social cognitive function and is associated with medial prefrontal cortical (mPFC) activity. This study aimed to evaluate the efficacy of paliperidone in improving ToM task performance in patients with schizophrenia compared with haloperidol.

PATIENTS AND METHODS

This study was a single-center, single-blinded (assessor), parallel-group randomized clinical trial of patients with schizophrenia randomized to paliperidone or haloperidol. ToM was assessed at weeks 0, 8, 12, and 16 using the first-order belief, higher-order belief, faux-pas, and Reading the Mind in the Eyes tests. The primary outcome was the change in the ToM performance scores from baseline to after 16 weeks of treatment.

RESULTS

The participants received paliperidone (n = 29) or haloperidol (n = 31). For the first-order belief task, there were no between-group differences (P > 0.05) but time differences in both groups (P < 0.05). For the higher-order belief task, there were no between-group differences (P > 0.05), but there were time differences in both groups (P < 0.05) and a time×group interaction in the paliperidone group only (P < 0.05). For the faux-pas task, there was a difference between groups at week 16 (P < 0.05), and the improvement in time was significant for the paliperidone group only (P < 0.05). For the Reading the Mind in the Eyes task, there was an improvement over time for the paliperidone group only (P < 0.05). Safety was manageable in both groups.

CONCLUSION

Paliperidone treatment might be more effective than haloperidol in improving ToM task performance in schizophrenia.

TRIAL REGISTRATION

chictr.org.cn_identifier ChiCTR-IPR-15007635.

Components of Executive Control in Autism Spectrum Disorder: A Functional Magnetic Resonance Imaging Examination of Dual-Mechanism Accounts

BACKGROUND

It remains unclear whether executive control (EC) deficits in autism spectrum disorder (ASD) represent a failure in proactive EC (engaged and maintained before a cognitively demanding event) or in reactive EC (engaged transiently as the event occurs). We addressed this question by administering a paradigm investigating components of EC in a sample of individuals with ASD and typically developing individuals during functional magnetic resonance imaging.

METHODS

During functional magnetic resonance imaging, 141 participants (64 ASD, 77 typically developing) completed a rapid preparing to overcome prepotency task that required participants to respond to an arrow probe based on the color of an initially presented cue. We examined functional recruitment and connectivity in the frontoparietal task control, cingulo-opercular task control, salience, and default mode networks during cue and probe phases of the task.

RESULTS

ASD participants showed evidence of behavioral EC impairment. Analyses of functional recruitment and connectivity revealed that ASD participants showed significantly greater activity during the cue in networks associated with proactive control processes, but on the less cognitively demanding trials. On the more cognitively demanding trials, cue activity was similar across groups. During the probe, connectivity between regions associated with reactive control processes was uniquely enhanced on more-demanding (relative to less-demanding) trials in individuals with ASD but not in typically developing individuals.

CONCLUSIONS

The current data suggest that rather than arising from a specific failure to engage proactive or reactive forms of EC, the deficits in EC commonly observed in ASD may be due to reduced proactive EC and a consequent overreliance on reactive EC on more cognitively demanding tasks.

Understanding the Influence of Social and Motor Context on the Co-occurring Frequency of Restricted and Repetitive Behaviors in Autism

The social and motor context in which restricted and repetitive behaviors (RRBs) occur in autism and their relationship to social traits are not well-understood. Participants with and without autism completed tasks that varied in social and motor engagement and RRB frequency was measured. Motor and verbal RRBs were most common, RRBs varied based on motor and social context for participants with autism, and social engagement was associated with lower motor and verbal RRBs. Significant correlations between RRBs and autism severity, social synchrony, and nonverbal mental age were also found. This research confirms the importance of context for understanding RRBs during on-going tasks and raises questions about whether the factors that elicit vocal and motor RRBs are unique for individual children.

Usability inquiry of a gamified behavior change app for increasing physical activity and reducing sedentary behavior in adults with and without autism spectrum disorder

The purpose of this study was to conduct the first usability inquiry of a gamified, behavior change theory-guided mobile app PuzzleWalk for increasing physical activity and reducing sedentary behavior in adults with and without autism spectrum disorder (ASD). Eighteen adults with and without ASD participated in a mixed-methods study that consisted of cognitive walkthrough, system usability assessment, and qualitative interviews. The results of the system usability testing indicated satisfactory quality of the PuzzleWalk system that can be readily applicable to both adults with and without ASD. Several notable issues were identified from the qualitative interviews that address critical insights into unique health and social needs in adults with ASD. Future work is warranted to examine the long-term effects of the PuzzleWalk system on increasing physical activity and reducing sedentary behavior in adults with and without ASD in real-world settings.

Associations and Dissociations among Phonological Processing Skills, Language Skills and Nonverbal Cognition in Individuals with Autism Spectrum Disorder

AIMS

The purpose of this study was to examine the nature of phonological processing in individuals with autism spectrum disorder (ASD) as it pertains to their nonverbal cognitive and linguistic abilities.

METHODS

Twenty-one participants between the ages of 9 and 21 years were administered a nonverbal cognitive assessment (Raven test), a language measure that requires receptive and expressive knowledge of semantics, syntax and morphology, as well as the integration across these language domains (CELF-4), and a measure of phonological processing (CTOPP).

RESULTS

Results show that performance on nonword repetition (NWR) that reflects an aspect of phonological memory was significantly low, whereas performance on phoneme reversal, phoneme elision, blending words and memory for digits was within the normal range. Hierarchical regressions with age, nonverbal intelligence (Raven test) and receptive language (CELF) as predictors showed that for NWR and phoneme elision the receptive part of the CELF was the main significant -predictor, after controlling for age. For phoneme reversal and memory for digits, however, the Raven score was the significant predictor, suggesting that cognitive nonverbal ability is the main factor explaining variability in these tasks.

CONCLUSIONS

A deficit in phonological memory characterizes individuals in the autistic population. This deficit may influence language acquisition in this population consistent with other populations of children with language impairments. Other tasks of phonological awareness, however, might be preserved especially when they do not involve memory for long phonological sequences and when the cognitive abilities are within the norm.

Partner Perceptions of Conversations with Individuals with Autism Spectrum Disorder

Pragmatic difficulties resulting in problems with reciprocal conversation are widely studied in individuals with autism spectrum disorder (ASD). There is some consensus on the conversation differences between individuals with autism compared to neurotypical groups and groups with other developmental delays. There is little information on whether conversation partners (neurotypical or with ASD) of individuals with ASD find these differences problematic. The results indicate that behaviors reported to be the most problematic were not necessarily behaviors commonly addressed in research. Further, some conversational capacities that have received less research focus were perceived as more problematic. Although conversation partners who had ASD themselves reported the frequency of behaviors similarly to the neurotypical group, they did not find the behaviors as problematic.

Different associations between intelligence and social cognition in children with and without autism spectrum disorders

Autism spectrum disorders (ASD) are characterized by impaired social cognition and communication. In addition to social impairment, individuals with ASD often have intellectual disability. Intelligence is known to influence the phenotypic presentation of ASD. Nevertheless, the relation between intelligence and social reciprocity in people with ASD remains unclear, especially in childhood. To elucidate this relation, we analyzed 56 typically developing children (35 male, 21 female, aged 60–91 months) and 46 children with ASD (35 male, 11 female, aged 60–98 months) from university and affiliated hospitals. Their cognitive function was evaluated using the Kaufman Assessment Battery for Children. Their social cognition was assessed using the Social Responsiveness Scale. We used linear regression models to ascertain whether the associations between intelligence and social cognition of typically developing children and children with ASD are significantly different. Among the children with ASD, scores on the Kaufman Assessment Battery for Children correlated significantly with social cognition, indicating that higher intelligence is associated with better social cognition. For typically developing children, however, no significant correlation was found. One explanation might be that children with ASD fully use general intelligence for successful learning in social cognition, although extensive use of intelligence might not be necessary for TD children. Alternatively, autistic impairment in social cognition can be compensated by intelligence despite a persistent deficit in social cognition. In either case, when using the SRS as a quantitative phenotype measure for ASD, the influence of intelligence must be considered.

Cognitive and Affective Aspects of Theory of Mind in Greek-Speaking Children with Autism Spectrum Disorders

Substantial research indicates that individuals with Autism Spectrum Disorder (ASD) have difficulties with Theory of Mind (ToM) abilities, but rarely have studies used a comprehensive battery to measure both the cognitive and affective aspects of ToM. The present study tested this ability in 24 Greek-speaking children with ASD (ages 7-14), and their performance was compared to 24 age-, gender- and language-matched typically developing controls. Results showed that ASD children's performance was selectively impaired in both ToM aspects, supporting the distinction between ToM components. This is the first study of ToM abilities among Greek-speaking children with ASD, and the findings confirm that children with ASD are experiencing difficulties with socio-emotional understanding across languages and cultures.

Strategic Deception in Adults with Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) is often associated with impaired perspective-taking skills. Deception is an important indicator of perspective-taking, and therefore may be thought to pose difficulties to people with ASD (e.g., Baron-Cohen in J Child Psychol Psychiatry 3:1141–1155, 1992). To test this hypothesis, we asked participants with and without ASD to play a computerised deception game. We found that participants with ASD were equally likely—and in complex cases of deception even more likely—to deceive and detect deception, and learned deception at a faster rate. However, participants with ASD initially deceived less frequently, and were slower at detecting deception. These results suggest that people with ASD readily engage in deception but may do so through conscious and effortful reasoning about other people’s perspective.

Should Autism Spectrum Conditions Be Characterised in a More Positive Way in Our Modern World?

In a special issue that focuses on complex presentations related to Autism, we ask the question in this editorial whether an Autism Spectrum Condition without complexity is a disorder, or whether it represents human diversity? Much research into Autism Spectrum Conditions (ASCs) over the years has focused on comparisons between neuro-typical people and people with Autism Spectrum Conditions. These comparisons have tended to draw attention to ‘deficits’ in cognitive abilities and descriptions of behaviours that are characterised as unwanted. Not surprisingly, this is reflected in the classification systems from the World Health Organisation and the American Psychiatric Association. Public opinion about ASC may be influenced by presentations in the media of those with ASC who also have intellectual disability. Given that diagnostic systems are intended to help us better understand conditions in order to seek improved outcomes, we propose a more constructive approach to descriptions that uses more positive language, and balances descriptions of deficits with research finding of strengths and differences. We propose that this will be more helpful to individuals on the Autism Spectrum, both in terms of individual self-view, but also in terms of how society views Autism Spectrum Conditions more positively. Commentary has also been made on guidance that has been adjusted for people with ASC in relation to the current COVID-19 pandemic.

The relationship between cognitive variables and offending behaviour in adults with intellectual disabilities: A systematic review

BACKGROUND

Interventions for offenders with intellectual disabilities (ID) have used cognitive variables as measures of treatment outcome. However, the relevance of cognitive variables to offending in people with intellectual disabilities is unclear. This review aimed to evaluate the evidence for a relationship between cognitive variables and offending in people with intellectual disabilities.

METHOD

A systematic search identified studies comparing offenders and non-offenders with intellectual disabilities on an aspect of cognition. Seven cognitive variables were found and compared across 15 studies. These were appraised for their quality using an adapted quality appraisal checklist. The reliability and validity of cognitive measures were also considered.

RESULTS AND CONCLUSIONS

Other than for cognitive distortions, the evidence for a relationship between cognitive variables and offending in people with intellectual disabilities is currently limited due to methodological weaknesses and the small number of studies assessing each variable. Clinicians are advised to focus on cognitive distortions until better evidence is available.