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Wednesday 22 Nov 2017

Theory of Mind Training


Theory of mind (ToM) is our ability “to infer the full range of mental states (beliefs, desires, intentions, emotions, etc.) that cause action. In brief, having a theory of mind is to be able to reflect on the contents of one’s own and other’s minds.” (Baron-Cohen, 2001). Simon Baron-Cohen and his colleagues have found impairments in ToM in individuals with autism. Theory of mind impairments have been correlated to a person’s difficulties with social interactions based on their pragmatic skills (use of language appropriate to the social context) and adaptive and social behavior scores as determined via the Vineland (Baron-Cohen, 2001).

A ToM test has been devised which looks at 3 different aspects: “(a) precursors of theory of mind (e.g., recognition of emotions, pretense), (b) first manifestations of a real theory of mind (e.g., first-order belief, understanding of false belief), and (c) more advanced aspects of theory of mind (e.g., second-order belief, understanding of humor)” (Muris, et. al, 2009). These tests require an individual to look at a picture and/or listen to a story and answer questions such as “Who in this picture is happy?”, “Why is this person happy?”, and “What does he mean?”. While differences in abilities have been established in individuals with autism, there have been few research studies which have investigated interventions which may positively impact a person’s ability to demonstrate theory of mind and then apply this ability to natural social situations.

A study recently published in the Journal of Autism and Other Developmental Disabilities (JADD) by Sander Begeer and colleagues (October 2010) evaluated the efficacy of a ToM intervention on conceptual ToM skill and on generalized social abilities. The intervention consisted of 16 one and a half hour long group sessions focused on specific theory of mind concepts (i.e., thoughts and feelings of others, deceit and deception, and embedded mental states), and monthly parent training sessions focused on content of student training and how to promote social cognition through games and stories with their kids. They found the intervention increased individual scores on the ToM test but did not have a significant impact on generalized social skills.

The findings of this study are important because it highlights a few core issues with this type of intervention package. First of all, the group intervention methodology may not provide the necessary intensity of intervention. Each group consisted of 5-6 individuals which may have an impact on how much information was learned by each participant. Secondly, the information learned was all conceptual and theoretical which imparts inherent problems due to difficulties individuals with autism have in generalization of knowledge. With more hands-on training regarding application of these skills in the natural environment students may have made more progress in generalizing the skills learned. Thirdly, the parent training component was also all theoretical and discussion-based which does not ensure they were implementing the techniques discussed to facilitate social interactions with their kids. It has been shown that hands-on parent training is effective in helping individuals generalize and maintain skills (Relate to Autism, 2010).

Overall, it can not be conclude that interventions focused on teaching theory of mind skills are not effective, but the way in which these interventions are implemented may not be the most effective. There are a variety of resources available to help parents and interventionists teach theory of mind and social skills, but some attention needs to be paid to how these interventions are applied especially in terms of conceptual knowledge versus application and generalization of skills.

The Unwritten Rules of Social Relationships: Decoding Social Mysteries Through the Unique Perspectives of Autism

Teaching Children With Autism to Mind-Read : A Practical Guide for Teachers and Parents

The Hidden Curriculum: Practical Solutions for Understanding Unstated Rules in Social Situations

The New Social Story Book

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