Another Advanced Test of Theory of Mind: Evidence from Very High Functioning Adults with Autism or Asperger Syndrome

TLDR

Previous research identified a subgroup of autistic individuals who pass second‑order theory‑of‑mind tests, yet these tests are limited by a developmental ceiling of about six years, making it unclear whether their theory‑of‑mind abilities are truly intact or impaired. The study examines how very high‑functioning adults with autism or Asperger Syndrome perform on an adult theory‑of‑mind test. Participants inferred mental states from photographs of eyes. Compared to age‑matched normal controls and a Tourette syndrome group, autistic adults performed significantly worse on the eye‑based theory‑of‑mind task and on Happé’s strange stories, but performed normally on gender recognition and basic emotion recognition, indicating subtle mind‑reading deficits in this population.

Abstract

Previous studies have found a subgroup of people with autism or Asperger Syndrome who pass second-order tests of theory of mind. However, such tests have a ceiling in developmental terms corresponding to a mental age of about 6 years. It is therefore impossible to say if such individuals are intact or impaired in their theory of mind skills. We report the performance of very high functioning adults with autism or Asperger Syndrome on an adult test of theory of mind ability. The task involved inferring the mental state of a person just from the information in photographs of a person's eyes. Relative to age-matched normal controls and a clinical control group (adults with Tourette Syndrome), the group with autism and Asperger Syndrome were significantly impaired on this task. The autism and Asperger Syndrome sample was also impaired on Happé's strange stories tasks. In contrast, they were unimpaired on two control tasks: recognising gender from the eye region of the face, and recognising basic emotions from the whole face. This provides evidence for subtle mindreading deficits in very high functioning individuals on the autistic continuum.