New test captures subtle social difficulties in adults with autism

A new test can assess theory of mind — the ability to understand others’ mental states — in adults with autism. In the test, people with the condition interpret scenes in a video for white lies, jokes and irony.

Many people with autism have difficulty grasping what others think or feel. But most tests of this ability are designed for children.

The new test is based on the Strange Stories Test, a collection of vignettes covering 12 everyday scenarios in which people tell jokes or say things they do not mean.

The Strange Stories Film Task, described 11 March in Autism Research, recreates more realistic versions of the same 12 scenarios in a video¹. It allows researchers to assess how well an individual can tap into social cues, such as facial expression and tone of voice, to understand what another person is thinking.

In one clip of the new task, characters named Max and Alice are sitting in a living room across from each other. Alice is holding a guitar and looks nervous. “I’ve been working on this for ages, and I think I have finally got it. I think my song’s going to end like this,” she says as she starts to play badly and sing out of tune.

Max, nodding and smiling, says, “Well done, Alice … that sounds really good.”

Viewers watch the clip and answer questions such as “Why did Max say that?” and “If you were in Alice’s situation, what would you say next?”

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Researchers gave the task to 20 adults with autism and 20 controls with an average age of 30. Scores ranged from 0 to 2 based on the responses to each scenario. For example, participants who said Max did not want to hurt Alice’s feelings earned a score of 2. Those who responded that Max is nice got a 1. Those who answered incorrectly received a 0.

Individuals with autism were worse than controls at guessing what the characters were thinking. They scored an average of 15.5 out of 24, compared with the controls’ 18.8.

The participants also took a series of standard tests of social cognition and emotion recognition, including the Reading the Mind in the Eyes Test — which gauges an individual’s ability to detect other people’s emotions by looking at their eyes. The Strange Stories Film Task was better able to distinguish between the autism group and the control group than the standard tests were.

The researchers plan to make the test freely available online. In the meantime, they say, they will send it to anyone who asks for it.