11.4.2 Theory of Mind

• Theory of mind (TOM - also popularly known as ‘mind-reading’) is the ability to understand that other people may have different thoughts, feelings, ideas, attitudes or knowledge to one’s own
• Autistic spectrum disorder (ASD) is a developmental disorder which is genetic and has a prevalence rate  of 1 in 59 children (Rylaarsdam & Guemez-Gamboa, 2019)
• Although ASD is highly heritable there are environmental risk factors which can increase the likelihood of giving birth to a child with ASD e.g. older parents, a difficult birth, or infections during pregnancy (Modabbernia et al. 2017)
• People with ASD are affected by what is known as the triad of impairments which entails difficulty understanding social relationships, reading facial expressions, lack of imagination, problems with communication and difficulty adjusting to new, unfamiliar situations
• Younger children and people with ASD (both adults and children) are thought to lack TOM; young children due to their age and people with ASD due to the triad of impairments
• One aspect of TOM is understanding intentionality in terms of another person’s behaviour e.g. I can predict that James is going to take his dog for a walk because he has come out of his house wearing his green ‘dog-walking’ coat’
• The ability to understand the intentions of other people shows an appreciation that people are motivated by their beliefs and attitudes, which is a precursor to the development of TOM (Dennett, 1987)
• TOM is thought to be fully developed by the age of 3 or 4 years old, depending on the child, although some researchers claim that infants as young as 7-9 months old understand intentionality to some extent (Baron-Cohen, 1991)
• TOM may be a specific skill which is processed in a specific brain region rather than a generalised cognitive disorder as people with ASD do not experience difficulty with other cognitive abilities such as language, memory and attention (Baron-Cohen, 1993)

A false-belief task: the child has failed the test because he (wrongly) believes that Jenny will know what he knows (that the box does not contain Smarties).

• A ‘false belief’ task is one in which involves the person being tested understanding that another person’s belief about the world/events may be different to what it actually is or what has occurred
• To pass a false belief task an individual must be able to predict the actions/thoughts/beliefs of another person and to understand what might motivate/influence another person’s behaviour
• False belief tasks tend to be conducted with toddlers and/or very young children to assess the extent of their TOM
• A classic false belief task is the ‘Smarties’ test (shown in the above image): 
  • A child is shown a box labelled ‘Smarties’
  • The child is asked what they expect to find in the box
  • The child answers ‘Smarties’ (or ‘chocolates’ which is equally correct)
  • The child is then asked to open the box - which actually contains pencils rather than Smarties
  • The child is then asked to say what they think their friend (e.g.Jenny/Tom/Maisie/Amir) would say is inside the box (if they were simply shown the box with the lid closed)
  • The child passes the false belief task if they answer that their friend would expect to find Smarties in the box (as their friend does not know about the pencils)
  • The child fails the false belief task if they answer that their friend would expect to find pencils in the box (as their friend cannot possibly know what the child knows - that the Smarties have been replaced by pencils)
• The Sally-Anne task draws from false belief research in that it tests an incorrect attribution of another person’s belief as to the location of a hidden object  i.e. it also tests understanding of the intention and motivation of another person
• The Sally-Anne task is as follows (there are variations to this task but the procedure remains essentially the same):
  • The child is presented with 2 dolls -  Sally and Anne 
  • The child is told that Sally and Anne are in the same room: Sally has a  basket and Anne has a box
  • Sally has a red ball which she puts inside her basket, after which action she leaves the room and Anne is alone
  • Anne takes the ball out of the basket and puts it in her box
  • Sally returns to the room and the child is asked where Sally will look for her ball
  • The child passes the task if they answer that Sally will look for her ball in her basket (this is where she placed it so Sally is unaware of what happened while she wasn’t in the room)
  • The child fails the task if they answer that Sally will look for her ball in Anne’s box (Sally cannot know that Anne has placed the ball in the box as Sally was not present at the time)
• The Sally-Anne task is not used to diagnose autism but to offer some insight as to why children with ASD have difficulty functioning in social situations

The Sally-Anne task.

Research which investigates theory of mind

• Baron-Cohen (1985) - The classic Sally-Anne task using child participants who had ASD, Down’s syndrome or were normal: 20% of the ASD group answered the question correctly compared to 85% of normal children and 86%l in the Down’s syndrome group 
• Harris (1989) - Children often imagine that they are someone else in pretend-play scenarios at the age of 4 which suggests that they are using TOM to put themselves in another person’s place and use imagination to create feelings, ideas and thoughts which are not their own 

• Tager-Flusberg (2007) - A review article which questions many of the preconceived assumptions about TOM and ASD e.g. why do some people with ASD pass TOM tests?

Evaluation of theory of mind

Strengths

• Understanding TOM could be applied to anti-bullying strategies: Sutton et al. (1999) found that bullies need to be skilled in social cognition and TOM in order to manipulate others hence this could be used in a positive way to address the bullying behaviour
• Research such as Baron-Cohen (1985) used children with Down’s syndrome to demonstrate that lack of TOM may be a specific cognitive deficit, unique to ASD i.e. not shared by people with other developmental disorders

Weaknesses

• The failure of children with ASD to pass TOM tests may actually be due to researcher bias i.e. the researchers are not able to recognise any relevant TOM behaviours if they fall outside of their scoring criteria (Korkiangas et al. 2016)
• There is no real consensus among researchers as to the age at which TOM fully develops in children which means that the concept may lack reliability

Link to Issues & Debates:

There are ethical implications involved in this type of socially sensitive research as any type of behaviour which is labelled a ‘disorder/disability/deficit’ can be used against people by the media, employers, health professionals etc. Researchers must be mindful as to how they present their findings so as not to perpetuate stereotypes or stigmatise those with ASD.