Assessing False-Belief Understanding in Children with Autism Using a Computer Application: A Pilot Study

Carlsson, Emilia; Miniscalco, Carmela; Gillberg, Christopher; Johnels, Jakob Åsberg

doi:10.1007/s10936-018-9579-2

Cited by 8 publications

(8 citation statements)

References 60 publications

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“…Our results suggest that children with ASD can understand others' false beliefs when cognitive demands are sufficiently reduced, but their false-belief processing unfolds more slowly than in TD children. Our findings are thus broadly consistent with recent evidence demonstrating that task demands impact false-belief performance (Rubio-Fernández and Geurts, 2013;Chevallier et al, 2014;Setoh et al, 2016;Carlsson et al, 2018;Bialecka-Pikul et al, 2019;Psouni et al, 2019;Salter and Breheny, 2019;Scott et al, 2020). More generally, this study offers a promising new paradigm exploring social cognitive processing in children with ASD.…”

Section: Discussionsupporting

confidence: 92%

Children With Autism Spectrum Disorder Can Attribute False Beliefs in a Spontaneous-Response Preferential-Looking Task

et al. 2021

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An established body of literature indicates that children with autism spectrum disorder (ASD) have difficulty understanding figurative language due to a deficit in theory of mind, or the ability to consider the beliefs of other people. Children with ASD tend to similarly fail traditional theory of mind tasks, which assess their ability to represent false beliefs. Our claim is, however, that these tasks involve cognitive processing demands that might mask false belief understanding because they require elicited responses. We examined whether children with ASD demonstrate false-belief understanding when tested with a spontaneous-response false belief task that measures children’s eye gaze durations. The two child participant groups were composed of 20 males with ASD (aged 3–9 years) and 20 typically developing males (aged 2–5 years) who were individually matched according to verbal mental age. Children with ASD and typically developing children listened to a change-of-location story accompanied by a book with matching and non-matching pictures. The final page showed the character searching for her object in a location that was either consistent or inconsistent with her belief. Both groups of children looked reliably longer at the belief-consistent picture, regardless of whether the character’s belief was true or false, though children with ASD were slower to do so. We suggest that a spontaneous-response assessment technique can potentially reveal figurative language comprehension in children with ASD in future research.

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Section: Discussionsupporting

confidence: 92%

Children With Autism Spectrum Disorder Can Attribute False Beliefs in a Spontaneous-Response Preferential-Looking Task

et al. 2021

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“…Studies demonstrated high levels of heterogeneity across tasks used to assess diagnostic discriminative ability, the type of technology used to implement them, primary metrics evaluated and developmental domains assessed. Tasks were presented on portable technologies, such as laptops ( H. Li & Leung, 2020 ; Lu et al, 2019 ), tablet computers ( Anzulewicz et al, 2016 ; Bovery et al, 2021 ; Campbell et al, 2019 ; Carlsson et al, 2018 ; Carpenter et al, 2021 ; Chen et al, 2019 ; Chetcuti et al, 2019 ; Dawson et al, 2018 ; Fleury et al, 2013 ; Gale et al, 2019 ; Jones et al, 2018 ; Mahmoudi-Nejad et al, 2017 ; Ruta et al, 2017 ), smartphones ( Mahmoudi-Nejad et al, 2017 ; Rafique et al, 2019 ; Zhao & Lu, 2020 ), intelligent toys ( Moradi et al, 2017 ) and digital audio recorders ( Nakai et al, 2014 ; Wijesinghe et al, 2019 ), and non-portable technologies, such as desktop computers ( Aresti-Bartolome et al, 2015 ; Borsos & Gyori, 2017 ; Chaminade et al, 2015 ; Crippa et al, 2013 ; Deschamps et al, 2014 ; Dowd et al, 2012 ; Gardiner et al, 2017 ; Gyori et al, 2018 ; Hetzroni et al, 2019 ; J. Li et al, 2020 ; P. Li et al, 2016 ; Lin et al, 2013 ; Martin et al, 2018 ; Veenstra et al, 2012 ) and VR platforms of varying sophistication ( Jung et al, 2006 ; Jyoti & Lahiri, 2020 ; Alcañiz Raya et al, 2020 ;…”

Section: Resultsmentioning

confidence: 99%

“…In total, 21 studies (55.3%) used gamified tasks ( Anzulewicz et al, 2016 ; Aresti-Bartolome et al, 2015 ; Carlsson et al, 2018 ; Chaminade et al, 2015 ; Chen et al, 2019 ; Chetcuti et al, 2019 ; Crippa et al, 2013 ; Deschamps et al, 2014 ; Dowd et al, 2012 ; Fleury et al, 2013 ; Gale et al, 2019 ; Gardiner et al, 2017 ; Hetzroni et al, 2019 ; Jones et al, 2018 ; P. Li et al, 2016 ; H. Li & Leung, 2020 ; Lu et al, 2019 ; Mahmoudi-Nejad et al, 2017 ; Rafique et al, 2019 ; Ruta et al, 2017 ; Veenstra et al, 2012 ), making these the most common type of performance-based tasks to detect autism risk in early childhood. Other types of assessments included video recording of children’s behaviours while they viewed or interacted with stimuli presented on a screen ( n = 9; 23.7%) ( Borsos & Gyori, 2017 ; Bovery et al, 2021 ; Campbell et al, 2019 ; Carpenter et al, 2021 ; Dawson et al, 2018 ; Gyori et al, 2018 ; J. Li et al, 2020 ; Martin et al, 2018 ; Zhao & Lu, 2020 ), tasks using VR platforms ( n = 4; 10.5%) ( Jung et al, 2006 ; Jyoti & Lahiri, 2020 ; Alcañiz Raya et al, 2020 ; Shahab et al, 2017 ) and audio recording of children’s speech ( n = 2; 5.2%) ( Nakai et al, 2014 ; Wijesinghe et al, 2019 ).…”

Section: Resultsmentioning

confidence: 99%

“…Tasks tapping the social and motor domains were particularly reliable, as discriminative ability was demonstrated by a total of 13 studies led by different study groups using a variety of tasks, metrics and devices. This included seven tasks tapping the social domain ( Bovery et al, 2021 ; Campbell et al, 2019 ; Carlsson et al, 2018 ; Gale et al, 2019 ; H. Li & Leung, 2020 ; Lu et al, 2019 ; Ruta et al, 2017 ) encompassing social versus non-social stimulus preference and theory-of-mind, and six tapping fine- and gross-motor domains ( Anzulewicz et al, 2016 ; Chetcuti et al, 2019 ; Dawson et al, 2018 ; Fleury et al, 2013 ; Mahmoudi-Nejad et al, 2017 ; Rafique et al, 2019 ). Also within the social domain, two studies assessed group differences in facial expressions in two ways – evoked expressions while watching animated videos ( Carpenter et al, 2021 ) versus imitating the facial expressions presented on the screen ( Zhao & Lu, 2020 ).…”

Section: Resultsmentioning

confidence: 99%

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Digital tools for direct assessment of autism risk during early childhood: A systematic review

Mukherjee

Bhavnani

Estrin

et al. 2022

Autism

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Current challenges in early identification of autism spectrum disorder lead to significant delays in starting interventions, thereby compromising outcomes. Digital tools can potentially address this barrier as they are accessible, can measure autism-relevant phenotypes and can be administered in children’s natural environments by non-specialists. The purpose of this systematic review is to identify and characterise potentially scalable digital tools for direct assessment of autism spectrum disorder risk in early childhood. In total, 51,953 titles, 6884 abstracts and 567 full-text articles from four databases were screened using predefined criteria. Of these, 38 met inclusion criteria. Tasks are presented on both portable and non-portable technologies, typically by researchers in laboratory or clinic settings. Gamified tasks, virtual-reality platforms and automated analysis of video or audio recordings of children’s behaviours and speech are used to assess autism spectrum disorder risk. Tasks tapping social communication/interaction and motor domains most reliably discriminate between autism spectrum disorder and typically developing groups. Digital tools employing objective data collection and analysis methods hold immense potential for early identification of autism spectrum disorder risk. Next steps should be to further validate these tools, evaluate their generalisability outside laboratory or clinic settings, and standardise derived measures across tasks. Furthermore, stakeholders from underserved communities should be involved in the research and development process. Lay abstract The challenge of finding autistic children, and finding them early enough to make a difference for them and their families, becomes all the greater in parts of the world where human and material resources are in short supply. Poverty of resources delays interventions, translating into a poverty of outcomes. Digital tools carry potential to lessen this delay because they can be administered by non-specialists in children’s homes, schools or other everyday environments, they can measure a wide range of autistic behaviours objectively and they can automate analysis without requiring an expert in computers or statistics. This literature review aimed to identify and describe digital tools for screening children who may be at risk for autism. These tools are predominantly at the ‘proof-of-concept’ stage. Both portable (laptops, mobile phones, smart toys) and fixed (desktop computers, virtual-reality platforms) technologies are used to present computerised games, or to record children’s behaviours or speech. Computerised analysis of children’s interactions with these technologies differentiates children with and without autism, with promising results. Tasks assessing social responses and hand and body movements are the most reliable in distinguishing autistic from typically developing children. Such digital tools hold immense potential for early identification of autism spectrum disorder risk at a large scale. Next steps should be to further validate these tools and to evaluate their applicability in a variety of settings. Crucially, stakeholders from underserved communities globally must be involved in this research, lest it fail to capture the issues that these stakeholders are facing.

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“…Although this might seem relatively uncomplicated in this example, in the context of a series of actions and mental state inferences, keeping track of who knows what and when might become quite complex. Some patients with neurological, psychiatric, or developmental disorders such as autism show significant impairments on such false belief tasks [29], and may therefore be particularly vulnerable during natural social interactions which require to identify and engage in appropriate social sequences.…”

Section: Early Work On Social Sequencingmentioning

confidence: 99%

The Involvement of the Posterior Cerebellum in Reconstructing and Predicting Social Action Sequences

Overwalle

et al. 2021

Cerebellum

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Recent advances in social neuroscience have highlighted the critical role of the cerebellum and especially the posterior cerebellar Crus in social mentalizing (i.e., theory of mind). Research in the past 5 years has provided growing evidence supporting the view that the posterior cerebellum builds internal action models of our social interactions to predict how other people's actions will be executed, and what our most likely responses to these actions will be. This paper presents an overview of a series of fMRI experiments on novel tasks involving a combination of (a) the learning or generation of chronological sequences of social actions either in an explicit or implicit manner, which (b) require social mentalizing on another person's mental state such as goals, beliefs, and implied traits. Together, the results strongly confirm the central role of the posterior cerebellar Crus in identifying and automatizing action sequencing during social mentalizing, and in predicting future action sequences based on social mentalizing inferences about others. This research program has important implications: It provides for the first time (a) fruitful starting points for diagnosing and investigating social sequencing dysfunctions in a variety of mental disorders which have also been related to cerebellar dysfunctions, (b) provides the necessary tools for testing whether non-invasive neurostimulation targeting the posterior cerebellum has a causal effect on social functioning, and (c) whether these stimulation techniques and training programs guided by novel cerebellar social sequencing insights, can be exploited to increase posterior cerebellar plasticity in order to alleviate social impairments in mental disorders.

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Assessing False-Belief Understanding in Children with Autism Using a Computer Application: A Pilot Study

Cited by 8 publications

References 60 publications

Children With Autism Spectrum Disorder Can Attribute False Beliefs in a Spontaneous-Response Preferential-Looking Task

Children With Autism Spectrum Disorder Can Attribute False Beliefs in a Spontaneous-Response Preferential-Looking Task

Digital tools for direct assessment of autism risk during early childhood: A systematic review

The Involvement of the Posterior Cerebellum in Reconstructing and Predicting Social Action Sequences

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