Theory of Mind

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Theory of Mind and ASD

related brain structuresGenetics
Theory of Mindright medial prefrontal cortex
right anterior cingulate cortex
right middle frontal gyrus
right dorso-lateral prefrontal cortex
  • History

The idea that children with ASD lack a 'Theory of Mind' was first postulated by Baron-Cohen et. al.2 in 1985, on the basis that autistic children, regardless of IQ, do not engage in pretend play. It is this theory of mind, or the ability to understand that others have feelings and beliefs that may be different from your own, that is crucial for the emergence of pretend play in developing children. The theory of mind relates specifically to meta-representations of mental states. Baron-Cohen et. al. tested this hypothesis using a false-belief test. They found that while some ASD children were able to pass the test, the vast majority of the ASD group did not. These group results were significant when compared with control groups. They hypothesized that having this theory of mind was crucial in social behavior and communication, and that correspondingly the social deficits seen in ASD children are a result of their lack of a 'Theory of Mind'.2

  • Theory

The Theory of Mind is the ability for a person to connect emotional states to themselves and others. It is intimately connected with the development of a person's ability to analyze and interpret the intentions of others.These abilities are impaired in people with ASD and are central to social perception. 1

Some recent studies involving children with autism have shown that these children have rest functional abnormalities centered in the STS and the superior temporal gyrus using PET and SPECT. Additionally, significant negative correlation has been shown between regional rest cerebral blood flow and the scores of ASD children on the ADI-R. Furthermore, in theory of mind studies where subjects watched a virtual actor either look towards a checkerboard that appeared in her visual field vs. the empty space, typically developing subjects showed more activity in the STS when the actor looked at the empty space which signifies that the subjects had formulated an expectation about what the actor should do in that context, while subjects with ASD showed no difference in activity levels between the two trials. 1

Theory of Mind and Joint Attention

There is evidence that Joint Attention may be a precursor of Theory of mind.5

Theory of Mind and Social Competency

One study that sought to elucidate the relation between theory of mind and social competency found that theory of mind task performance was only associated with typically developing childrens' ability to solve social problems, as measured by peer-ratings. Theory of mind was not related to children's popularity (measured by peer likability ratings). The fundamental nature of this relation is unknown.7

Theory of Mind Interventions

Few studies which tested theory of mind interventions have shown effectiveness. Although many children who undergo these interventions show improvement in theory of mind skills, their empathic skills, elementary understanding, and social behavior did not improve. Generalization of theory of mind skills to social skills then is poor.8


Scores on Theory of Mind(TOM) tasks tend to vary greatly across cultures. Studies on Japanese children, for example, show that this population has poor performance on this task. It has been theorized that the differences in performance between cultures are attributed to difference in attribution styles between American/European and Asian cultures. People raised in Asian cultures tend to attribute behaviors to external and contextual causes while American/European cultures tend to attribute behaviors to internal causes.3

Many people also object to the Theory of Mind because they believe that it is a result of biases against those who are autistic. They argue that this theory is based on the assumption that those with autism are deficient, and that there is some unitary cause for autism. Critics believe that embedded in this theory is the assumption that everyone thinks the same, and has the same exact abilities.Low scores may be a result of an a capacity to recognize the individuality of others rather than a deficit.4

Other critics argue that some children who fail the theory of mind tasks may have a deficit in a lower level construct such as eye gaze or attention, rather than a deficit in a separate theory of mind module. Theory of mind is intact in autistic children, which explains their ability to pass false photograph tests. They do not have any impairments in the inputs required for these specific tests. This is further supported by many studies which report deficits in low level social deficits, such as face recognition, joint attention, and gaze direction processing.6

Tests for Theory of Mind

Brain MRI T1 movie.gifNeuroimaging

The amygdala, the striatum, the superior temporal suclcus and the orbitofrontal cortex have been theorized to play a major part in the development of social abilities. It has been proposed that the amygdala, striatum, and orbitofrontal cortex link sensory representations of stimuli to their motivational value while the superior temporal sulcus is involved in detailed perceptual processing.1

The superior temporal sulcus(STS) is activated more strongly when the person perceives a meaningful hand movement than non-meaningful ones, which suggest that the STS also analyzes how socially meaningful the movement is. Furthermore, activity in the STS is enhanced when subjects watch goal-directed behavior. These neuroimaging result are consistent with the hypothesis that Joint Attention is facilitated by networks involving the STS.1

The right medial prefrontal cortex, the right anterior cingulate cortex and the right middle frontal gyrus, and the right dorso-lateral prefrontal cortex all show robust activity in TOM tasks across cultures. 3

Anaphase IF.gifGenetics

Animal Models

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