A New Look at Performance on Theory-of-Mind Tasks by Adolescents With Autism Spectrum Disorder.

PURPOSE A hallmark of autistic spectrum disorder (ASD) is disruption in theory-of-mind development, including the understanding of false beliefs. Previous studies have typically assessed the development of first- and second-order false belief concepts in ASD, with tasks primarily emphasizing physical causality and logical inferencing. The present study investigated how preadolescents and adolescents with ASD performed on false belief tasks that included social inferencing of psychological states as well as logical inferencing of physical states. METHOD Two categories of tasks were administered: four traditional logical inferencing tasks and four social inferencing tasks specifically developed for this study. In addition, a prompt hierarchy was included to ascertain if performance on both task types improved. Participants were 45 children and adolescents primarily selected from three urban school districts: 15 adolescents with a previous diagnosis of ASD (ASD group); 15 typically developing children matched for age, gender, and ethnicity (CA group); and 15 typically developing children matched for language age, gender, and ethnicity (LA group). RESULTS Three findings were pertinent. First, the CA group performed at higher levels than did the LA group and the ASD group on both task sets. Second, although the CA and the LA groups performed equally well on both the logical and the social inferencing tasks, the ASD group performed better on the social inferencing tasks. Finally, the prompt hierarchy significantly improved overall task performance for the ASD and LA groups. CLINICAL IMPLICATIONS These findings indicate that task type, variations in vocabulary ability, and the provision of support influenced performance on the false belief tasks.