Investigating Theory of Mind in autism Fulvia Castelli California Institute of Technology 2006

1. Investigating Theory of Mind in autism Fulvia Castelli California Institute of Technology 2006

2. Plan of the talk The concept of Theory of Mind Sherlock Holmes Investigating Theory of Mind “Off-line”language-based paradigms “On-line” non language-based paradigm A research model A Multi-layered Theory of Mind ability Theory of Mind tasks The Animation task: mental states attribution The Valley Task: intended goal-attribution

3. ToM & Sherlock Holmes In “A scandal in Bohemia”, Sherlock Holmes has been instructed by his client to find a photograph that a lady has safely concealed in her house. SH cunning plan is to make the lady think that her living room is on fire by tossing in a smoke rocket and raising a fire alarm. What happens afterwards is exactly what SH had predicted: the lady fears that the fire would destroy the photograph, and wants to secure it. She opens the secret hiding place, and doing so she revealed it to SH. Sherlock Holmes solved the case by attributing the correct mental states to the lady and predicting her actions

4. Physical states hold the property of having a material existence Mental states hold the property of pointingtowards objects or states of affairs

5. The concept of Intentionality Intentionalityis the feature that sets completely apart mental states from physical states: • Mental states ( beliefs, desires, intentions, thoughts, hopes, remembrances) point towards objects or states of affairs that do not exists “here and now”, that can be true or false, or even paradoxical. • Some examples: • “John believes that drinking water is safe, and that drinking H2O is poisonous” John has contrasting beliefs that point towards the same object • “John believes that the French Monarchy has a king” John has a false belief pointing towards a non-existing state of affair

6. The “classic” ToM Paradigm (False Belief): the Sally-Ann task (Baron-Cohen et al, 1985) Representation of the reality... Change of reality…

7. Reading Sally’s mind: “When she is back, where will she look for her marble?” Representation of a mental state that is different from reality: Sally has a false belief (out-of-date representation)

8. False belief test 4 years old typically developing children pass FB test 3 years old typically developing children do not pass FB test Children with autismwith a VMA above 4 yrs do not pass false belief tests Failure at attributing a false belief to others reflects some serious deficit in understanding mental states - a deficit in Theory of Mind -

9. What are we talking about? • Let’s take a step back…..how do we describe Autism? • When we talk about Theory of Mind, or “mentalizing” or “mindreading”, what are we describing exactly?

10. Autism: Diagnosis Diagnosis of autism is made on behavioural criteria. The necessary and sufficient features for the diagnosis are Qualitative impairment in: • social development • communicative development • restrictive and repetitive activities and interests

11. Wide variation = autistic spectrum • The variation in the clinical picture of the autistic disorder • is wide • between individuals • within one and the same individual over time The notion of autisticspectrum makes sense of the wide range of severity of the symptoms characterised by a triad of impairments

12. Multiple biological causes • Biological markers of autism are still not available. • However, • evidence for organic causes is overwhelming: • high incidence of epilepsy • incidence of autism increases with progressively lower IQ • Strong genetic contribution to autistic disorders has been demonstrated: • identical twins but not fraternal twins share the diagnosis of autism • risk for a sibling to be affected : 3%

13. Autism: explaining a single deficit Thequestion to be answered is then: “If there is no single origin nor any single kind of damage that can be used as criterion to set apart autism from other disorders, what then, justifiesthe application of a single label?” The explanation of autism at the cognitive level concerns a single cognitive deficit, namely, a ToM deficit (or a mentalizing deficit)

14. A research framework:causal modelling Causal modelling is a neutral framework which enables explicit comparison of different theories about developmental disorders. It allows to look at different levels of disorders within a unified model, and can be used to examine relationships across biological, cognitive, behavioral, and environmental factors

15. A causal modelling of autism E n v i r o n m e n t O O Biological Cognitive C Behavioral S S S This causal pattern shows a disorder with multiple biological causes, and several symptoms, but a single defining cognitive deficit

16. Cognitive level: explaining mental processes Biological level : origin of a developmental disorder Cognitive level: selective deficit Behavioral level: symptoms

17. Cognitive level: explaining mental processes Biological level E n v i r o n m e n t The level of cognitive processes makes the link to behavior as well as to the brain functions. Behavioral level

18. Good performance on mentalizing tests Autism: developmental DELAY in mentalizing Eventually, high functioning individuals with autism show a good performance on language based mentalising tasks Nevertheless, high-functioning individuals with autism show persistent social difficulties just as other individuals with autism

19. Good performance at the automatic level? How can the gap ToM good performance & persistent social impairment be explained? HF people with autism adopt language-based / off-line compensatory strategies to overcome their difficulties. However, it is possible that these strategies are not sufficiently fine-grained to compensate the impairment at an automatic level.

20. Off-line /On-line processing A challenge for creating mentalising tasks: To bypass learned strategies and tap real-life impairments by using non-verbal stimuli. How? Byinvestigating high-functioning people with autism during on-line processing, which has the advantage of engaging mentalizing at an automatic level, rather than off-line, which has the disadvantage of allowing time to work out the answer by logical inference.

21. A research modelThe tripartite theory of agency (Leslie, 1994) A multi-layered mechanism which has the competence to represent properties of an AGENT physical level represents only mechanical relations displayed “here and now” low-level ToM represents relations between agents and events that are at a distant time and places hi-level ToM represents an agent’s relations that are beyond spatio-temporal circumstances

22. Hi-level and low-level ToM physical level: no itentionality (no interaction) low-level ToM: intended -goals (future states of affair) hi-level ToM: beliefs and desires

23. Triggering inputs of mentalizing People have a pervasive tendency to infer what is in the minds of other people ... and moving shapes The perception of the movement patterns of simple shapes evokes either “behavioural” or “mentalistic” descriptions (Abell et al, 2000; Castelli et al, 2000, 2002)

24. Hi-level mentalizing The animation task • Random • Two triangles do not interact, they just float or bounce about • Goal-directed • Two triangles interact taking into account what each other “does” • (e.g. chasing, dancing) • Theory of Mind: • Two triangles interact taking into account what each other “thinks” • (e.g. bluffing, surprise)

28. Use of mental state terms People with autism used less mental states terms than controls to describe ToM animations

29. Appropriate descriptions People with autism described the Theory of Mind animations less appropriately than the controls. When they provided mentalistic descriptions, they often referred to inappropriate mental states.

30. What do these behavioural results tell us? Evidence for persistent mentalising deficit in high-functional individuals with autism who pass standard ToM tests The on-line mentalising task based on visual perception of kinetic patterns is sensitive enough to tap real-life difficulties in understanding complex social interactions

31. Investigating low-level mentalizing INTENDED GOAL “Minimal” Perceptual triggering inputs to attribute intentionality (Premack & Premack, 1994) 1- goal-directed motion 2- repeated motion (failing and trying again) 3) variable motion pattern

32. Developmental studies on intended-goal The “wall task”in pre-school children 3/5 year-olds (Montgomery and Montgomery, 1999) The red circle jumps a total of 3 times: Twice it bounces off the wall, the third time it: 1) overcomes the wall (goal-attained), lands next to the target 2) fails and lands next to the non-target (goal failed) 3) fails and lands equidistant to the target and non-target (neutral)

33. Montgomery & Montgomery’s (1999) paradigm Results: Children attribute an intended goal to an agent in the presence of a persistent movement when ignoring the agent’s final outcome. Kinetic patterns are highly important in inferring an agent’s goal. However, - The paradigm includes only the manipulation of the outcome variable, whereas the motion pattern of the agent is the same in all conditions - It is not clear whether motion is just a sufficient cue, or also a necessary one.

34. The Valley Task A novel paradigm was created using computer animated sequences with the aim of : a) Investigating the ability to attribute an agent’s intention in the presence of an agent’s persistent motion and improving attempts towards a goal in children with autism b) investigating developmental changes in the perception of an agent motion when it reaches a goal: is the perception of motion cue more salient than the perception of the outcome?

35. The Valley Task Naturalistic context: the target is visible to the agent, and it is plausible and obvious (agent is trying to overcome the force of gravity in order to get to the top of the valley)

36. Part 1: Goal attribution in the presence of constant goal-directed motion

37. Part 1: Goal attribution in the presence of constant goal-directed motion • Children with autism are able to attribute goal- directed intention to an abstract agent as well as normally developing children. • Motion pattern: The complex motion pattern induced more errors than the simple motion pattern • Errors: as predicted, children made errors by choosing the unsuccessful outcomes (Bottom and Midway) and did not choose the opposite side of the valley • Errors: contrary to prediction, there were no more errors associating the actual goal with the intended goal (e.g. click on Bottom when circle stops at Bottom)

38. Part 2: agent’s sudden change of direction Is the perception of motion cue more salient than the perception of the agent’s final outcome?

39. Part 2: Subjects

40. Part 2: agent’s sudden change of direction

41. Part 2: Goal-directed attribution to an agent:Outcome based representation or motion-based representation? • Indication that there is a “smooth” developmental change in the type of goal-directed representation between the age of 6 years and adulthood: • from an outcome-based representation to a persistent motion based representation

42. Conclusions • Investigating mentalizing abilitites implies the differentiation of multiple cognitive levels • The perception of moving abstract agents trigger the ability to attribute intentionality at an automatic level • It is possible to distinguish at least two levels of mentalising ability: • a “full-fledged” level involving the understanding of beliefs and desires (complex interactions) • a “minimal level” involving the understanding of goal-directed intentions (interaction not necessary) • Individuals with autism are good at understanding goal-directed intentions

43. Brain imaging: from cognition to brain Our main question: What brain system is underlying this ability? Brain imaging studies on mindreading What tasks have been used? What brain regions have been activated?

44. Understanding stories language based stimuli Example ToM story: “A burglar who has just robbed a shop is making his getaway. As he is running home, a policeman on his beat sees him drop his glove. He doesn't know the man is a burglar, he just wants to tell him he dropped his glove. But when the policeman shouts out to the burglar, "Hey, you! Stop!", the burglar turns round, sees the policeman and gives himself up. He puts his hands up and admits that he did the break-in at the local shop”. Why did the burglar do that?

45. Understanding stories language based stimuli Example Physical story: “A burglar is about to break into a jewellers’ shop. Carefully he crawls under the electronic detector beam. If he breaks this beam it will set off the alarm. Quietly he opens the door of the store-room and sees the gems glittering. As he reaches out, however, he steps on something soft. He hears a screech and something small and furry runs out past him, towards the shop door. Immediately the alarm sounds” Why did the alarm sound?

46. Reading the eyes visual and verbal stimuli