Social impairment in childhood autism and theory of mind

Abstract

Objective: To investigate whether 'theory of mind' is impaired in autistic children. Materials and Methods: This is a cross sectional double blind study performed during years 2006 and 2007 in Nemmove day care center in Tehran, Iran. Thirtyone children in three groups participated in the study; an autistic group consisted of 10, a control group consisted of 7 Down's Syndrome and 14 normal children. The autistic children were from different day care centers and units specialized in autism. The autistic children were diagnosed by DSM-IV clinical criteria. Answering the "Belief Question" correctly meant that the children were able to predict the others' behavior on the basis of their belief. Although the Mental age (MA) of autistic children was higher than that of control group children, they failed to answer the 'False Belief' question. Two control questions (Reality Question) and (Memory Question) were also asked. Results: The results for Down's Syndrome and normal subjects were almost similar. Twelve out of 14 normal children and 6 out of 7 Down's Syndrome children passed the Belief Question (85% and 86% approximately). Eight of 10 autistic children (80%) failed the Belief Question. The difference between the groups was highly significant (p=0.006). Conclusion: The failure shown by autistic children constitutes a specific deficit, namely impaired Theory of Mind and cannot be attributed to the general effects of mental retardation, since Down's syndrome children performed well on our task.