Theory of mind in autism

Theory of mind is the ability to attribute mental states (thoughts, feelings, knowledge, etc.) to other people. In the 1980s and 1990s, it was believed that autistic children may lack theory of mind.
Subsequent research has challenged this idea. While some autistic children develop theory of mind more slowly, many autistic people are not impaired in this area.
Despite this, stereotypes about autistic people lacking theory of mind and empathy continue, even in the research field.Gernsbacher, Morton Ann (2006). Toward a Behavior of Reciprocity. The Journal of Developmental Processes 1 (1): 139–152.Marocchini, Eleonora (2023-02-01). Impairment or difference? The case of Theory of Mind abilities and pragmatic competence in the Autism Spectrum. Applied Psycholinguistics 44 (3): 365–383. Autistic advocates have considered these stereotypes harmful, creating unfair stigma and wrongly portraying autistic people as uncaring.DeThorne, Laura S. (2020-03-01). Revealing the Double Empathy Problem. The ASHA Leader 25 (3): 58–65.(June 2013) A Critical Examination of Mindblindness as a Metaphor for Autism. Child Development Perspectives 7 (2): 110–114.Gernsbacher, Morton Ann (2017-08-06). Editorial Perspective: The use of person-first language in scholarly writing may accentuate stigma. Journal of Child Psychology and Psychiatry 58 (7): 859–861.(2022-11-24) "Autism research is in crisis": A mixed method study of researcher's constructions of autistic people and autism research. Frontiers in Psychology 13: 1050897. This theory may undermine their autonomy and credibility.Yergeau, Melanie (2018). Authoring autism: on rhetoric and neurological queerness, North Carolina, NC: Duke University Press.
In reality, both autistic and non-autistic people struggle to understand each other.Milton, Damian E. M. (October 2012). On the ontological status of autism: the 'double empathy problem'. Disability & Society 27 (6): 883–887. While society has historically placed all the blame for this on autistic people, improving understanding will require effort from non-autistic people too.
==History==
===Mind-blindness theory===
In the 1980s and 1990s, Simon Baron-Cohen led studies describing "mind-blindness" being a key trait of autistic people. Baron-Cohen suggested this explained why autistic people avoid eye contact.(1985-10-01) Does the autistic child have a "theory of mind" ?. Cognition 21 (1): 37–46.Baron-Cohen, Simon (1988-10-01). Social and pragmatic deficits in autism: Cognitive or affective?. Journal of Autism and Developmental Disorders 18 (3): 379–402.(November 1995) Are children with autism blind to the mentalistic significance of the eyes?. British Journal of Developmental Psychology 13 (4): 379–398. Autistic people would then have social difficulties because they cannot predict other people's behavior and do not see them as individual human beings.
This viewpoint became popular. It is taught in a wide range of psychology textbooks.Kellogg, Ronald Thomas (2007). Fundamentals of cognitive psychology, Los Angeles, CA: SAGE Publications.(2008) Educating exceptional children, 12th, Boston, MA: Houghton Mifflin.Myers, David G. (2010). Myers' psychology for AP, 1st, New York, NY: Worth Publishers.Myers, David G. (2011). Exploring psychology, 8th, New York, NY: Worth Publishers.(2016) Abnormal child psychology, 6th, Australia: Cengage Learning.(2018) Psychology : modules for active learning, 14th, Boston, MA: Cengage Learning.(2018) Life-span human development, 9th, Australia: Cengage Learning. Scholars in philosophy,Barnbaum, Deborah R. (2008). The ethics of autism : among them, but not of them, Bloomington, IN: Indiana University Press. sociology,(2015) The Mating Life of Geeks: Love, Neuroscience, and the New Autistic Subject. Signs: Journal of Women in Culture and Society 40 (2): 369–391. economics,(2005-04-01) The Neuroeconomics of Mind Reading and Empathy. American Economic Review 95 (2): 340–345. and more have promoted the idea.
===Issues with the theory===
Attempts to replicate the original studies have often failed to show any difference between autistic and non-autistic participants.(1991) Executive Function Deficits in High-Functioning Autistic Individuals: Relationship to Theory of Mind. Journal of Child Psychology and Psychiatry 32 (7): 1081–1105.(1989) Role taking and social competence in autism and [intellectual disability]. Journal of Autism and Developmental Disorders 19 (1): 119–127.(1994) A second look at second-order belief attribution in autism. Journal of Autism and Developmental Disorders 24 (5): 577–586.(2019) Empirical Failures of the Claim That Autistic People Lack a Theory of Mind. Archives of Scientific Psychology 7 (1): 102–118. A few successful replications have occurred,(2021-07-10) Further developing the Frith–Happé animations: A quicker, more objective, and web-based test of theory of mind for autistic and neurotypical adults. Autism Research 14 (9): 1905–1912.(February 2001) The "Reading the Mind in the Eyes" Test Revised Version: A Study with Normal Adults, and Adults with Asperger Syndrome or High-functioning Autism. Journal of Child Psychology and Psychiatry 42 (2): 241–251.Yeung, Michael K. (2022-02-01). A systematic review and meta-analysis of facial emotion recognition in autism spectrum disorder: The specificity of deficits and the role of task characteristics. Neuroscience & Biobehavioral Reviews 133: 104518. but some of these used methods (such as self-report questionnaires) that have been described as vague and imprecise.(2019-11-01) Autism and empathy: What are the real links?. Autism 24 (1): 3–6. These inconsistent findings call into the question the validity of the theory.(2007) Cognitive theories of autism. Developmental Review 27 (2): 224–260.
Baron-Cohen has revised his theories since then. His more recent studies have found diverse scores in autistic people, with around half of autistic people showing typical or above-average scores in some theory-of-mind and empathy measures.(2021-10-03) Social cognition in adults with autism spectrum disorders: Validation of the Edinburgh Social Cognition Test (ESCoT). The Clinical Neuropsychologist 35 (7): 1275–1293.(2018-11-27) Testing the Empathizing–Systemizing theory of sex differences and the Extreme Male Brain theory of autism in half a million people. Proceedings of the National Academy of Sciences 115 (48): 12152–12157.(2016-10-18) Unsupervised data-driven stratification of mentalizing heterogeneity in autism. Scientific Reports 6 (1): 35333. Other studies have found similar results.(April 2022) Heterogeneity of social cognitive performance in autism and schizophrenia. Autism Research 15 (8): 1522–1534. Traits like alexithymia, rather than autism itself, may influence whether someone has atypical empathy.(2013-07-23) Mixed emotions: the contribution of alexithymia to the emotional symptoms of autism. Translational Psychiatry 3 (7): e285.
===Double empathy problem===
Social understanding is a reciprocal process. New research has uncovered a "double empathy problem:" autistic people think differently from non-autistic people, which causes them both to misunderstand each other.Milton, Damian. The double empathy problem.(October 2022) The 'double empathy problem': Ten years on. Autism 26 (8): 1901–1903.
Autistic communicate more effectively with each other than they do with non-autistic people.(2020). Autistic peer-to-peer information transfer is highly effective. Autism 24 (7): 1704–1712.(2023-11-18) Mindreading beliefs in same- and cross-neurotype interactions. Autism.(2014-10-20) Autistic empathy toward autistic others. Social Cognitive and Affective Neuroscience 10 (2): 145–152.(2020). Outcomes of real-world social interaction for autistic adults paired with autistic compared to typically developing partners. Autism 24 (5): 1067–1080. They find it easier to befriend autistic people than non-autistic people and have positive impressions of other autistic people.(2020-10-26) Interpersonal similarity of autistic traits predicts friendship quality. Social Cognitive and Affective Neuroscience 16 (1–2): 222–231.(2021). Peer preferences and characteristics of same-group and cross-group social interactions among autistic and non-autistic adolescents. Autism 25 (7): 1885–1900.(2020). 'I never realised everybody felt as happy as I do when I am around autistic people': A thematic analysis of autistic adults' relationships with autistic and neurotypical friends and family. Autism 24 (6): 1438–1448.(2020-06-04) Atypical social communication is associated with positive initial impressions among peers with autism spectrum disorder. Autism 24 (7): 1841–1848.(2019-06-04) Do Individuals With Autism Spectrum Disorders Help Other People With Autism Spectrum Disorders? An Investigation of Empathy and Helping Motivation in Adults With Autism Spectrum Disorder. Frontiers in Psychiatry 10: 376. This suggests that autistic people are not socially deficient, but that communication struggles are more akin to a language barrier.Rozsa, Matthew. Being autistic may amount to a language difference — not an impairment.
Non-autistic people also show deficits in their interactions with autistic people.Heasman B, Gillespie A. Perspective-taking is two-sided: Misunderstandings between people with Asperger's syndrome and their family members. Autism. 2018 Aug;22(6):740-750. doi: 10.1177/1362361317708287. Epub 2017 Jul 7. PMID: 28683569; PMCID: PMC6055325. They are less willing to interact with autistic people(2017-02-01) Neurotypical Peers are Less Willing to Interact with Those with Autism based on Thin Slice Judgments. Scientific Reports 7 (1): 40700. and tend to judge them harshly and unfairly.Lim, A., Young, R.L. & Brewer, N. Autistic Adults May Be Erroneously Perceived as Deceptive and Lacking Credibility. J Autism Dev Disord 52, 490–507 (2022). https://doi.org/10.1007/s10803-021-04963-4 Autistic people often face bullying and other forms of victimization.Gernsbacher, Morton Ann (2006). Toward a Behavior of Reciprocity. The Journal of Developmental Processes 1 (1): 139–152.Libster, N., Knox, A., Engin, S. et al. Personal victimization experiences of autistic and non-autistic children. Molecular Autism 13, 51 (2022). https://doi.org/10.1186/s13229-022-00531-4Weiss JA, Fardella MA. Victimization and Perpetration Experiences of Adults With Autism. Front Psychiatry. 2018 May 25;9:203. doi: 10.3389/fpsyt.2018.00203. PMID: 29887806; PMCID: PMC5980973. However, education on autism may improve reciprocity in non-autistic people.Scheerer NE, Boucher TQ, Sasson NJ, Iarocci G. Effects of an Educational Presentation About Autism on High School Students' Perceptions of Autistic Adults. Autism Adulthood. 2022 Sep 1;4(3):203-213. doi: 10.1089/aut.2021.0046. Epub 2022 Aug 31. PMID: 36606156; PMCID: PMC9645669.Sasson, N. J., & Morrison, K. E. (2019). First impressions of adults with autism improve with diagnostic disclosure and increased autism knowledge of peers. Autism, 23(1), 50-59. https://doi.org/10.1177/1362361317729526
Resolving these difficulties could involve both empowering autistic people and educating non-autistic people.
== See also ==
* Autism
* Theory of Mind
== References ==
Category:1980s
Category:1990s
Category:Autism