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Exploration of the Autistic Child's Theory of

Mind: Knowledge, Belief, and Communication

Josef Pemer
University of Sussex and Max-Planck Institute
for Psychological Research, Munich

Uta Frith and Alan M. Leslie


University of London

Susan R. Leekam
University of Sussex

PERNER, JOSEF; FRITH, UTA; LESLIE, ALAN M,; and LEEKAM, SUSAN R, Exploration ofthe Autistic
Child's Theory of Mind: Knowledge, Belief, and Communication. CHILD DEVELOPMENT, 1989, 60,
689-700, 26 autistic children with mental ages of 3-13 years were tested on 3 tasks that are within
the capability of 3- or 4-year-old nonnal children. The first task tested understanding ofa mistaken
belief. Children were shown a typical box of a certain brand of sweets, and they all thought that it
contained that kind of sweet. To their surprise, however, the box contained something else. Yet,
only 4 out ofthe 26 autistic children were able to anticipate that another child in the same situation
would make the same mistake. In contrast, all but 1 of 12 children with specific language impair-
ment, matched for mental age, understood that others would be as misled as they had been them-
selves. The autistic children were also tested for their ability to infer knowledge about the content of
a container from having or not having looked inside. All 4 children who had passed the belief task
and an additional 4 performed perfectly, but most failed. The third task assessed children's prag-
matic ability to adjust their answers to provide new rather than repeat old information. Here, too,
most autistic children seemed unable to reliably make the correct adjustment. These results confirm
the hypothesis that autistic children have profound difficulty in taking account of mental states.

Many of the known impairments of au- facial, bodily, and vocal expressions of feeling
tistic children become explicable if seen as a states (Hobson, 1986a, 1986b). They have also
consequence of an impaired understanding of been found not to use gestures that express
mental states (Frith, in press; Leslie, 1987; mental states such as embarrassment but to
Leslie & Frith, 1987). Having a theory of use gestures such as beckoning that aim at
mind implies being able to conceive of men- manipulating behavior (Attwood, Frith, &
tal states in oneself and others. This is of criti- Hermelin, in press). Autistic children have
cal importance in social, affective, and com- also been shown to have severe difficulties
municadve relationships. Thus emotional and with the pragmatics of language (e.g., Baltaxe,
behavioral reactions are often contingent 1977; Lord, 1985; Tager-Flusberg, in press).
upon knowledge or belief rather than upon Mundy, Sigman, Ungerer, and Sherman
the real state of the world. Likewise, com- (1986) and Sigman, Mundy, Sherman, and
munication, both verbal and nonverbal, is of- Ungerer (1986) have shown that from early
ten deliberately aimed at conveying or influ- childhood autistic children show profound
encing states of mind. problems with pragmatic-communicative
skills such as establishing joint attention, in-
Autistic children have been shown to forming, and initiating. Paul (1987) stresses
have difficulties in the appreciation of certain the difficulties that autistic children appesir to

The authors thank Mrs. Craves, head of Spring Hallow School for Autistic Children; Mr.
Connelly, head of Sybil Elgar School for Autistic Children in Ealing; Mrs. Cillies, head of John
Homiman School for Language Disordered Children in Worthing, West Sussex; and their staff and
students for their friendly cooperation, Josef Pemer also acknowledges financial assistance through a
Social Science Research Fellowship from the Nuffleld Foundation and a fellowship from the Alex-
ander-von-Humboldt Foundation. Requests for reprints should be directed to either Josef Pemer,
Experimental Psychology, University of Sussex, Brighton BNl 9QC, England, or to Uta Frith,
MRC—Cognitive Development Unit, 17 Cordon Street, London WCl, England.
[Child Development, 1989, 60, 689-700, © 1989 by the Society for Researeh in ChUd Development, Inc
AU rightsreserved,0009.3920/89/6003-0018$01,00]
690 Child Development
have with taking account of what is old and of that box. When shown the box, they all an-
new information for the listener. All these ob- swer "Smarties" and are surprised when the
servations are suggestive of a common under- box is opened and something quite different
lying factor involving difficulties with em- emerges. Their understanding of another
ploying a theory of mind. child's false belief is assessed by asking them
what another child would think (or say) was
Existing empirical evidence for autistic in the box when shown the box in the same
children's lack of a theory of mind is striking. deceptive way. This paradigm is a particularly
It includes evidence of their inability to at- compelling way of demonstrating difficulties
tribute false beliefs (Baron-Cohen, 1988; Ba- with false belief as the child experiences how
ron-Cohen, Leslie, & Frith, 1985), true knowl- the misleading situation creates a false belief
edge (Leslie & Frith, 1988), and to sort in him/herself before an attribution has to be
picture sequences involving surprise reac- made to the other person.
tions on the basis of a violated false belief
(Baron-Cohen, Leslie, & Frith, 1986). The One major objective of the present study
false-belief test of Baron-Cohen et al. (1985) was to replicate autistic children's problem
was modeled after the study by Wimmer and with belief attribution with this compelling
Pemer (1983). It involved a doll who put an paradigm. We also made an effort to control
object into one location and who was absent for linguistic difficulties that are frequent
when that object was unexpectedly trans- even in able autistic children (Paul, 1987) by
ferred to another location. Understanding the testing a group of language-delayed children,
doll's resulting false belief about the object's all attending a special school, matched for
location was indicated if subjects predicted verbal mental age with a subgroup of our au-
that on her return the doll would look for the tistic sample. If autistic children's difficulties
object in the original, now empty location. A with false-belief tasks are due to impaired lan-
control group of children with Down syn- guage development, then we would expect
drome performed like normal 4-year-olds on that children who are not autistic but who are
this task. They correctly indicated the empty impaired in the development of language
location as the one where the doll would look. comprehension should show similar difficul-
The group of autistic children, in contrast, ties.
wrongly pointed to the location where the ob-
ject really was, even though their mental ages The second objective of our study was to
were considerably higher than those of both explore autistic children's ability to attribute
the normal and Down syndrome children. mental states other than false beliefs. Al-
This failure revealed that the autistic children though understanding false belief may be a
had difficulty in taking the doll's belief into hallmark in children's acquisition of a theory
account. of mind at about the age of 4 years (e.g., see
chapters in Astington, Harris, & Olson, 1988),
the younger 3-year-old child cannot be char-
Both the false belief experiment (Baron- acterized as lacking an understanding of the
Cohen et al., 1985) and the picture-se- mind completely. In fact, from as young as 2
quencing task (Baron-Cohen et al., 1986) years old children rapidly acquire our mental
are based on understanding false belief that terminology (Bretherton, McNew, & Beeghly-
arises from an unexpected change in the Smith, 1981) and use it appropriately in the
world. As Pemer, Leekam, and Wimmer context of everyday life (Shatz, Wellman, &
(1987) argued, children's failure in this task Silber, 1983). Even in experimental contexts,
may reflect nothing more than a difference in surprisingly sophisticated understanding of
common-sense assumptions about what peo- mental phenomena has recently been demon-
ple normally expect to happen. By using a strated in these young children (Wellman,
"deceptive-appearance" paradigm, these au- 1988; Wellman & Estes, 1986).
thors were able to show that normal 3-year-
olds have a deeper conceptual difficulty with One of these tasks where young children
false-belief attribution. This paradigm avoids do better than on false belief is to distinguish
the mentioned shortcoming of the original what a person does know given that he has
false-belief task as children first experience seen something, and what the person does
how they themselves are misled by the ap- not know if he did not have access to relevant
pearance of a well-known European confec- information (Hogrefe, Wimmer, & Pemer,
tionery box ("Smarties")' about the contents 1986). This developmental lag between the

' Smarties are chocolate pastilles of difFerent colors known as M & Ms in the United States.
They are sold in tubular containers about 13 cm long and 2.5 cm in diameter that show a picture of
their contents on the outside.
Pemer et al. 691
ability to attribute knowledge and ignorance don. Their chronological age ranged from 7-5
and the ability to attribute false belief has im- to 18-10 (mean = 13-6). Their mental age, as-
portant theoretical implications, but although sessed by the British Picture Vocabulary Test,
it is a very reliable finding, the size of the lag ranged from 3-1 to 12-8 (mean = 6-2). Twelve
is not very large. It is, therefore, not clear children (two girls and 10 boys) from a special
whether the observed lag refiects an impor- school for linguistically impaired children in
tant conceptual development or just a transi- Worthing, West Sussex, served as a control
tional difficulty in the development of a the- group on the false-belief test. These children
ory of mind (Pemer & Wimmer, 1988). were admitted to the school on the basis
of their specific language impairment (SLI:
The findings reported by Leslie and Leonard, 1982, 1987) resulting in severe de-
Frith (1988) suggest that in autistic children lay in language comprehension. Their chron-
there is only a small and nonsignificant differ- ological ages ranged from 6-11 to 9-11 (mean
ence between their ability to attribute knowl- = 8-8), and their mental ages, as assessed by
edge and false belief It is therefore important the British Picture Vocabulary Test, ranged
further to clarify the relation between die two from 5-5 to 8-7 (mean = 6-9).
tasks.
Design
A third objective of the study was to in- Autistic children were tested on two oc-
vestigate the relation between these aspects casions about one-half year apart. At the first
of theory of mind and the pragmatic skill of meeting, they were tested on the "boxes"
making a communicative adjustment to the communication task, then on the false-belief
knowledge of the listener. Typically, lan- task, followed by the "bee" communication
guage is used to communicate new informa- task. For half the children (14, due to a coun-
tion to a listener and not merely to repeat terbalancing error), the boxes task involved a
what is already known. Pemer and Leekam partially ignorant, and the bee task a com-
(1986) examined the development of this abil- pletely ignorant, question asker. For the other
ity in the young child. They used two condi- half (only 12), the assignment of kind of igno-
tions. In the condition with a partially igno- rance and type of task was reversed.
rant partner, the child and the partner were
together shown that a toy bee can "fly" (i.e., For the second testing session, two of
flap its wings). Then the partner left and the these children were absent. The available 24
child was shown that the bee can also "nod" children were given the British Picture Vo-
its head. In the condition with a totally igno- cabulary Test and were assessed for their un-
rant partner, the partner was outside the room derstanding of visual access in knowledge for-
while both actions of the bee were demon- mation. This was assessed in two tasks. In one
strated to the child. In both conditions, the the subject was shown the selected object and
partner entered wondering about what the the other person was kept ignorant, while in
bee could do and asked the child, "What can the other task the subject was kept ignorant
the bee do?" Most children, as young as 3-31/2 and the other person was shown the object.
years, mentioned "nodding" first to the par- The order of these two tasks was counterbal-
tially ignorant partner (presumably because anced.
they realized that he had not seen that action The SLI children were tested on two
before), while no such preference for men- false-belief tasks. One of these tasks was the
tioning nodding first occurred when the part- same "deceptive-appearance" or "Smarties
ner was totally ignorant, as both actions were box" task used in this experiment on autistic
new to that partner. children. The other task was an adaptation of
the "unexpected-transfer" paradigm used on
We adopted this paradigm for our autistic autistic children by Baron-Cohen et al. (1985).
children to see whether their reported prag- The order of administering these two tasks
matic difficulties are specifically linked to tak- was counterbalanced.
ing another person's informational access or
knowledge into account (i.e., what the other Procedure
person was able to perceive). Children were tested individually in a
quiet room of the school. Each child was led
Method by the main experimenter to the testing room
where the child was introduced to the cooper-
Subjects ating experimenter, who, the child was told,
Subjects were 26 children (five girls and would join in for a hiding game. Child and
21 boys) diagnosed according to established main experimenter were seated at a small ta-
criteria (Rutter, 1978) as autistic from two ble facing each other, and the cooperating ex-
schools for autistic children in greater Lon- perimenter was seated at right angles on the
692 ChUd Development
side ofthe table. Subjects' responses were re- Reality Prompt: "What s in here? '
corded by the main experimenter, and a vid- Own-Response Prompt; "When I first asked you,
eorecording was made of both testing ses- what did you say?"
sions for all but one subject where no consent
was given. For SLI subjects, the experiment Then the subject was asked about the next
started directly with one of the two false- subject (who the other experimenter had gone
belief tasks. out to fetch): "Who will come after you?"
Communication test: Boxes.—The main (Subject names next person.) "S/he hasn't
experimenter produced two plastic containers seen this box. When s/he comes in, I'll show
(one about 8 cm, the other about 10 cm in her/him this box just like this and ask: [Name]
each dimension) and declared that she and what's in here?"
the subject would hide some things from the
other experimenter in those boxes. The other Prediction Test: "What will [Name] say?"
experimenter was sent out of the room. The Reality Check: "Is that what's really in the box?" (if
main experimenter produced a wax apple, answer is "No "): "What is really in the box?"
asked the child what it was, and put it into the Own-Response Check: "Do you remember, when I
slightly larger container. She then produced a took the box out of my bag [experimenter reenacts
piece of crumpled-up paper, asked the child that episode] and asked you what was in it, what
what it was, and put it into the other con- did you say?"
tainer. Then the child was asked to repeat the
contents of each box. Called back to find out The SLI subjects were also tested on an-
for himself, the cooperating experimenter dis- other false-belief test involving unexpected
played great interest in finding out the con- change. In this task, subjects watched the co-
tent of each box. He first tried the box with operating experimenter hide a coin in one of
the piece of paper: "Let's see what's in this three containers. In the cooperating experi-
box." However, unable to open it, he stated: menter's absence, the main experimenter and
"I can't open it" and turned to the other con- subject switched the coin to one of the other
tainer: "Now let's see what's in the other two containers. As a test for understanding
box." In the Total Ignorance condition, he false belief, subjects were asked where the
also failed to open the second container, stat- cooperating experimenter would look for the
ing: "I can't open it." In the Partial Ignorance coin when he came back. As a control for
condition, he managed to open that box and memory of actual events, subjects were asked
exclaimed: "Ah, there is an apple in here." where the coin actually is and where the
He closed the box, and as in the other condi- cooperating experimenter had put the coin
tion, put it next to the other container and, originally. For autistic children, the experi-
turning to the subject, asked the test question: ment continued with the second communica-
"What's in there?" An effort was made not to tion task.
look at or point to any ofthe two containers. If
the subject mentioned only one of the con- Communication test: Bee.—The cooper-
tents, memory for the other contents of the ating experimenter returned from the class-
other box was checked by asking: "What is in room without the next subject. The main
the other box?" experimenter asked him and the subject
whether they would like to play another game
False-belief test.—Subject and cooperat- and proceeded with the "bee" task described
ing experimenter were asked whether they by Pemer and Leekam (1986). The main dif-
would like to play another game. After an en- ference from the original study was that the
thusiastic response from the cooperating ex- person asking the question was not another
perimenter, he was told that it was time for child but the cooperating experimenter, who
him to fetch the next child from the class- left under the pretext of having lost his hand-
room. The subject was asked where that child kerchief outside the room. In the Total Igno-
was to be found, and the cooperating experi- rance condition, however, he left the room
menter left the room. The main experimenter before any of the bee's actions were demon-
produced a Smarties box from her bag and strated. In the Partial Ignorance condition, he
asked the child: "What's in here?" All chil- left after the demonstration of the bee "FLY-
dren answered with "Smarties" or "sweets." ing" by flapping its wings. After the second
The experimenter opened the box, and to the demonstration ofthe bee "NODding" its head,
subject's surprise, a pencil emerged; the ex- the other experimenter returned with his ker-
perimenter stated: "No, it's a pencil." She put chief and, when told that the demonstration
the pencil back into the box, closed the box, had already been carried out, asked the sub-
and asked two Prompt Questions: ject: "What can the bee do?"
Pemer et al. 693
Knowledge-formation task.—Subject and All subjects gave correct answers to
cooperating experimenter were shown a box prompt questions (i.e.. Reality and Own-Re-
with several objects. The main experimenter sponse Prompt). Answers to the prediction
checked whether the subject was familiar test were scored as correct if the answer was
with each object and explained that she "Smarties" (four children). All other answers
would choose one of these objects and put it were scored as incorrect, which consisted of
into a cup without anyone being able to see it. saying "pen(cil)" (17) or "I don't know" (2).
After the object had been put into the cup, All 23 children gave correct answers to the
the experimenter let the other experimenter Reality-Check question "Is that what's really
and the subject confirm that they could not in the box?" Answers consisted of either say-
see which object it was. ing "pen(cil)" (16) or "yes" after answer-
ing the previous question with "pencil" (7).
In the Other Ignorant condition, the ex- All correct answers to the Own-Response
perimenter then let the subject peek into the Check consisted of saying "Smarties" (13) or
cup, explaining: "I'll show you what I put "sweets" (1), and all incorrect answers of say-
into the cup, but I won't show it to [name of ing "pencil" (8). The data of one subject were
other experimenter]." In the Subject Ignorant missing on this question.
condition, the experimenter let the other ex-
perimenter peek into the box, emphasizing Responses to the prediction test closely
that she would not let the subject look into it. replicate the results by Baron-Cohen et al.
In both conditions, the following series of test (1985), where only four of 20 autistic children
questions was then asked: of comparable mental ages (mean M.A. =
5-5) were able to make correct predictions.
Other-Knows: "Does [name of experimenter] know In the present sample, only four of 23 chil-
which thing I put into the cup?" dren (mean M.A. = 4-11, or of 26 children, in-
cluding the three problem cases, mean M.A.
Justification: "Why does [name] not know that?" = 5-2) answered the prediction test correctly.
Other-Seen: "Did I let [name] look into the cup?"
(omitted if already answered by justification). The fact that the vast majority of autistic
Self-knows: "Do you know which object I put into children with mental ages well in excess of 3
the cup?" years were again incapable of understanding
false belief is the more remarkable as their
Justification: "Why do you know that?" task seemed easier in the present paradigm.
Self-Seen: "Did I let you look into the cup?" (omit- They should have been helped in predicting
ted if already answered by justification). others' response by having experienced mak-
ing exactly the same mistake themselves. Fur-
Results thermore, as their correct answers to the
Own-Response Prompt show, they were fully
Results are analyzed in four sections. In aware of their own mistake.
the first-section results from the false-belief
task are analyzed for autistic and SLI subjects. Table 1 shows the contingency between
The next two sections deal with autistic chil- answers to the prediction test and children's
dren's performance on the knowledge-forma- awareness of their own wrong response
tion and the communication tasks. Finally, (Own-Response Prompt). As these two ques-
there is a brief discussion of how all three tions are similar to the questions asked of nor-
types of tasks relate to children's mental and mal 3-year-oId children by Pemer et al. (1987,
chronological age. Experiment 2), the first and second columns
in Table 1 compare 3-year-olds with our sam-
False Belief ple of autistic children. The autistic children
Autistic children.—Three children fi-om were markedly worse in their ability to make
the lower end of the spectrum of mental ages correct belief attribution (first row), despite
(3-1, 3-8, and 4-1) needed so much prompting the fact that their average mental age was far
on questions that their responses became higher than 3 years and that they made fewer
meaningless as indicators of understanding. errors in answering the question about their
Responses by the remaining 23 subjects could own wrong response than 3-year-olds (last
be clearly interpreted. On four occasions, sub- row).
jects spontaneously corrected their wrong an-
swer (once on the Reality Prompt, two times For our autistic children, we could com-
on the Reality Check, and once on the Own- pare their belief attribution and their ability
Response Check). Since these subjects did to remember at the end of the experiment
not dither on any other questions, we ac- what they had wrongly predicted at the be-
cepted their spontaneous corrections. ginning (third column. Table 1). First of all, as
694 Child Development
TABLE 1
COMPARISON OF NORMAL 3-YEAR-OLDS" AND AUTISTIC CHILDREN OF VERBAL M.A. 6-2
ON THE MISLEADING-APPEARANCE TASK

NORMAL AUTISTIC CHILDREN


3-
CoRRECT RESPONSES 'Prompt) Prompt Memory Check*"
Fully correct 12 4 4
Incorrect 17 19 19
Pattern of correct responses:
Own response and attribution . . . . 12 4 4
Own response only 9 19 10
Attribution only 1 0 0
Neither 7 0 8
' Data from Pemer et al. (1987).
*• One case is missing.

a group they had noticeably more difficulty mance on the misleading-appearance task by
with this memory check than on the earlier the 12 SLI children with that by the 12 au-
Own-Response Prompt (binomial test [* = 0, tistic children highest in mental age. As
IV = 9], p < .01). This may be due to a diffi- Table 2 shows, the mean mental age of the
culty in remembering a response after re- autistic comparison group was higher than the
peated questions all concerning the same fact. mean of the SLI group. Yet our autistic chil-
Nevertheless, there were 10 subjects who still dren performed much worse on the false-
remembered their own response perfecdy belief test than the SLI children: x^(l, N =
well but had failed to predict that response for 24) = 13.6, p < .001.
the other person. Not one subject showed the
opposite response pattern: binomial (x = 0,N Knowledge Formation
= 10) = 10.0, p < .01. Each child was asked four difFerent ques-
tions in two tasks (Other and Self Ignorant).
SLI children.—In contrast to our autistic The correct answer to each question was
S£imple, the SLI group had little difficulty "yes" in one task and "no" in the other. Be-
with the false-belief task. All but one made sides this correct pattern of answers, there
correct predictions on both tasks. The one ex- were three other possibilities: to say "no" on
ception was probably due to some attentional both tasks (No-Bias), or "yes" (Yes-Bias), or to
lapse since this child made a correct predic- invert the correct pattern of responses (In-
tion on the unexpected-transfer task. verse). Very few responses could not be clas-
sified within these four categories. These re-
To provide a fair comparison of perfor- sponses consisted of blurting out with the
mance on the false-belief test between autis- known content or a guess, or not saying any-
tic and SLI children, we compared perfor- thing. Table 3 shows the frequency of these

TABLE 2 TABLE 3
COMPARISON OF SLI CHILDREN AND AUTISTIC
FREQUENCY OF RESPONSE PATTERNS IN
CHILDREN OF COMPARABLE MENTAL AGE
KNOWLEDGE-FORMATION TASK IN AUTISTIC
ON MISLEADING-APPEARANCE TASK
CHILDREN (n = 23)

DIAGNOSIS
KNOW SEE
RESPONSE
SLI Autistic PATTERN Other Self Other Self
Chronological age: Correct 10 13 17 16
Range 6-11 to 9-11 10-2 to 18-6 Wrong 13 10 6 7
Mean 8-8 15-2
Verbal mental age: Breakdown of
Range 5-5 to 8-7 5-9 to 12-8 wrong answers:
Mean 6-9 8-3 "No"-bias 3 0 2 0
False belief test: "Yes"-bias 7 7 2 4
Correct 11 2 Inverse 3 0 2 1
Incorrect 1 10 Unclassifiable... 0 3 0 2
Pemer et al. 695
response pattems for each of the four ques- subjects who gave adequate justifications for
tions. other and self on both tasks, we may conclude
that about 35% of the children tested have
Most autistic children evaluated visual made a clear connection between visual ac-
access correctly, both for themselves and for cess and knowledge. This compares favorably
the other experimenter, which was to be ex- with the 17.5% of the sample who passed on
pected from the findings by Hobson (1984) false-belief attribution, yet it is still lament-
and Leslie and Frith (1988) on visual perspec- ably low when the M.A. of the children is
tive-taking tasks. However, the number of taken into account.
failures in the present study was somewhat
higher (6/23) than in Leslie and Frith (1988): The contingency between belief and
0/14 and 0/18. This could be due to proce- knowledge attribution shows a clear picture,
dural differences between the two studies. though the data base is limited because only
Like the Leslie and Frith sample, our sample four children made correct false-belief attri-
of autistic children were much less able to butions. Nevertheless, the four children who
make correct knowledge attributions to them- did so were also able to attribute knowledge
selves or to the other person. There was a on the basis of visual access and justify their
strong contingency between knowledge attri- attribution to another person. All 12 children
bution and seeing judgments. All 10 children who failed on knowledge attribution also
who made correct knowledge attributions also failed on belief attribution. The resulting cor-
judged the other person's visual access cor- relation is positive ($ = .61) and statistically
recSy, and the six children who made an error significant (Fisher's test: p < .05). A very sim-
in their judgments of visual access also failed ilar result was found by Leslie and Frith
on knowledge attribution. This yielded a sig- (1988).
nificant positive correlation: <I> = .52 (Fisher's
test: p < .05). There is some indication that adequately
justified knowledge attribution may be
Of the remaining seven children, all slightly easier than understanding false be-
made correct judgments of visual access but lief, as the remaining four children could at-
failed to attribute knowledge correctly. Not a tribute knowledge and justify their attribution
single subject showed the opposite pattern but could not make a correct false-belief at-
(binomial test: x = 0, N = 7, p < .02). This tribution (binomial test: x = 0, N = 4, p =
finding that visual access is easier to judge .062, one-tailed). This difference in task diffi-
than knowledge is also typical of normal culty is also shown by normal 3- and 4-year-
3-year-old children (Pemer & Ogden, 1988; olds (Hogrefe et al., 1986).
Wimmer, Hogrefe, & Pemer, 1988a). Communication
The conclusion that a small but sizable In two cases, the experiment had to be
proportion of autistic children do understand terminated after the false-belief task. Conse-
the role of visual access in knowledge forma- quently, there were only 24 subjects with
tion can be fiirther strengthened by looking at complete data on both communication tasks.
children's justification of their knowledge There was no discernible difference between
judgment. We considered a "know" response the boxes and the bee task, and no difference
adequately justified if the child mentioned due to the order in which the partial and total
"seeing" or "looking" (e.g., "she saw it," "she ignorance tasks were presented.
could look inside," "she saw it put in there," The materials for these tasks had been
etc.). Insufficient justifications included "she chosen such that one response item in each
knows," "it's a peg," "don't know," "magic." task was interesting and salient ("apple" in
A "not know" answer was considered ade- box task and "flying" in bee task), while the
quately justified if the child mentioned the other was rather dull ("piece of paper" and
lack of visual access, for example, "couldn't "nodding," respectively). If salience has an
look," "haven't seen it," etc., or mentioned effect on children's communication, then this
the obstacle to seeing (e.g., "the hand's on it") should be most visible in the Total Ignorance
or experimenter's hiding intention (e.g., "it's a condition since the partner is equally ignorant
secret," "you hid it"). Most responses classi- about both items. In fact, children's prefer-
fied as insufficient justification consisted of ence to mention the salient item first was
"don't know" answers or silence. overwhelming in this condition (21 of 24).
The contingency between adequately In the Partial Ignorance condition, the
justified correct knowledge attributions to partner was ignorant of the dull item but
other and to self was almost perfect: <& = .91, knew about the interesting item. Children
Fisher's test: p < .001. As there were eight who understand that the purpose of their
696 Child Development
TABLE 4 justment was far from perfect, as correct men-
tion of the dull item to the partially ignorant
FREQUENCY OF RESPONSE PATTERNS COMBINED
partner occurred in only about one-third of
FOR THE Two COMMUNICATION TASKS (n = 24)
dmes.^ This small incidence of correct com-
RESPONSE PATTERN
municative adjustment can reflect two distinct
possibilities. One is that about one-third of
Partial Total our autistic sample are able to make this ad-
Ignorance Ignorance FREQUENCY justment reliably, and the rest cire incapable
of doing so. In this case, if children were
Salient 10 tested again, the one-third reliably correct re-
Dull Salient (correct).. 11 sponders should again make the correct ad-
Salient Dull 3 justment, while the rest should fail to do so.
Dull Dull 0 The other possibility is that most of our au-
tistic children have the ability to adjust their
responses but use this ability only occasion-
communication is to inform the other person ally (about one-third ofthe time). In this case,
of what that person has not yet seen should only about one-third of the children who
recognize the dull item as the more relevant mentioned the dull item to the partial igno-
one, and therefore mention it first, whereas rant partner on the first test would do so again
children who do not understand relevance in on a retest, while about one-third of those
this way should show the same bias for the who did not make the adjustment on the first
salient item in the Partial Ignorance condition test will make it on the retest.
as in the Total Ignorance condition.
To find out which of these two possibili-
Accordingly, if autistic children do not ties might be correct, we retested 20 subjects
understand this principle of relevance to oth- in the Partial Ignorance condition using dif-
ers, then we expect that most of them will ferent test material. About half the subjects,
prefer the salient item in both conditions (first all those who had the bee in the Partial Igno-
row in Table 4), and that very few will choose rance condition in the first test, were tested
the dull item in both conditions (last row). on the boxes task using as contents a calcu-
One would expect some intermediate fre- lator (salient) and a piece of wood (dull). The
quency for choosing the dull item on just one other half was shown a golden star (salient)
occasion, regardless of which of the two con- and a piece of paper (dull) going up a "Magic
ditions this happens in (equal frequencies in Stick" (Pemer & Leekam, 1986). Results
rows 2 and 3 of Table 4). If, however, some strongly favored the second possibility of gen-
autistic children are able to adjust their an- erally unreliable performance: only three
swers to the question-asker's ignorance, then subjects of those who had made the correct
the frequencies in the second row ("Correct") adjustment the first time mentioned the dull
in Table 4 should be boosted above the fre- item again, while seven of those who had not
quency of occasionally opting for the dull made the adjustment the first time did so on
item indicated by the frequency in the third the retest. This inconsistent performance con-
row. firms reports of autistic children's difficulty in
The frequencies in Table 4 indeed indi- using the pragmatic distinction between new
cate that the dull item was chosen for the ig- and old information (Baltaxe, 1977; Paul,
norant partner more often (second row) than 1987).
for the totally ignorant partner (third row); Yet, despite this inconsistency, there
McNemar's x^(l, N = 14) = 4.57, p < .05. were about two-thirds of our autistic sample
This result suggests that our able autistic who mentioned the nonsalient item first at
children may have some ability to adjust their least once in response to the partially ignorant
communicative response to another person's partner. However, these adjustments need
informational needs. Yet it also shows that not have been based on understanding that
their ability or willingness to make this ad- one's answer is to fill a gap in the other per-

^ Although there were 11 cases (somewhat more than one-third) in which the dull element was
preferred as an answer for the partially ignorant partner, these cases need not all reflect sensitivity to
that partner's informational needs. Rather, a certain number of these cases may he due to preference
for mentioning the dull item regardless of partner's informational state. The best estimate of that
incidence is the number mentioning the dull item to the totally ignorant partner, that is, three. On
the basis of this estimate, eight ofthe 11 mentions ofthe dull item to the partially ignorant partner
were genuine cases of communicative adjustment (8 of 24 = V3).
Pemer et al. 697
son's knowledge. This is actually suggested of mind. Furthennore, this impairment is not
by an almost total lack of correlation between a result of general mental retardation. The
choosing the nonsalient item in the communi- present investigation makes this point in com-
cation task and justified knowledge attribu- parison to language-impaired children with a
tion in the knowledge-formation task: $ = new range of tasks and thus confirms and ex-
.21,^ X^(l, N = 23) = 1.01, p > .30. In fact, tends previous findings.
correct communicative adjustment may not
even be based on the ability to judge the Indeed, the present results underline just
other person's informational access. Again, how poor autistic performance in understand-
there was no correlation between communi- ing false belief is: what normeJ children can
cative adjustment and judgment of visual ac- do with ease when they reach a mental age of
cess in the knowledge-formation task: <t> = 4, only a small minority of autistic children
.06, x^(l; N = 23) = 1.01, p > .10. Instead, can accomplish with a (verbal) mental age of
children's adjustment to old and new informa- up to almost 13 years.* We can rule out the
tion may be based on very rough environmen- possibility that general impairment in lan-
tal indicators. From the child's point of view, guage comprehension is responsible for fail-
it may be a question of verbally doing what ure because of the near-perfect performance
the other failed to do, that is, calling out the of nonautisdc children with specific language
name of the object in the box that the other impairment. Autistic children's difficulty in
did not open ("piece of paper"). attributing a false belief is not due to memory
failure. It exists even though they can remem-
Relation of task performance to mental ber their own erroneous response in the same
and chronological age.—We tested the rela- situation. Our data leave it open whether this
tion between performance on the three tasks difficulty arises from an inability to infer false
(belief, knowledge, and communication) and belief from the deceptive circumstances or
mental and chronological age by comparing fi-om an inability to use false belief for pre-
the mean age of children who gave correct dicting another person's response. In normal
answers on a particular task with the mean children, these two distinct possibilities seem
age of those who gave incorrect answers. We to concur developmentally (Harris, Johnson,
also checked whether the ability to correctly & Harris, personal communication; Pemer et
justify true knowledge attribution bore a rela- al., 1987), indicating that the common cause is
tion. In addition to mental and chronological a problem in conceptualizing mental repre-
age, we also included (verbal) IQ as defined sentation (Pemer, 1988a) or understanding
by Binet (IQ = [mental age -;- chronological how mental representations are causally re-
age] X 100). There was no indication in any lated to the world (Leslie, 1988; Wimmer et
of these comparisons that task performance al., 1988b).
bears any reliable relation to mental age,
chronological age, or IQ: all t values < 1.2, p Certain aspects of theory of mind are
> .20. more easily developed than others. This is
This lack of relation with mental age and tme for the normal as well as the autistic
IQ underscores again that autistic children's child. One aspect concerns understanding in-
problems with mental state attribution and formational access, for instance, understand-
communication are independent of their in- ing that one knows something because one
tellectual development otherwise. has seen it and, conversely, that one does not
know something because one has not seen it.
According to our results, we can expect that
Discussion about one-third of able autistic children will
The present study has succeeded in con- understand this relation and thus understand
firming and extending the conclusions drawn "knowing" in terms of visual access. This per-
on the basis of the experiments by Baron- formance is poor relative to mental age and is
Cohen et al. (1985,1986) and Leslie and Frith similar to that ofthe normal 3-year-old. There
(1988). It supports the claim that able autistic is some evidence that understanding knowing
children are severely impaired in their theory in this way is a component of understanding

^ That this insignificant hut positive correlation is hut error variation around a true correlation
of 0.0 is suggested hy the fact that the corresponding correlation hetween justified knowledge
attrihution and answers for the partially ignorant partner in the second communication test was
actually negative: = -.15.
* It should he home in mind that our use of verhal mental age is a conservative method given
that autistic children regularly show suhstantially higher nonverbal than verbal M.A.s, often hy as
much as 2 or 3 years.
698 ChUd Development
false belief since all four children who could (Leslie & Frith, 1988; Pemer, 1988a). Attribu-
understand false belief also demonstrated un- tion of knowledge is difficult because the
derstanding of the knowledge-ignorance dis- child has to understand how events in the real
tinction. However, there were another four world (i.e., looking at something) cause a
children who demonstrated understanding of mental state of knowing (Wimmer et al.,
the knowing/not-knowing distinction without 1988b). This understanding of how events in
understanding false belief, which indicates the real world cause a mental state is made
that autistic children, like normal 3-year-old particularly difficult if the content ofthe men-
children (Hogrefe et al., 1986), find this dis- tal state is nonreal, as in the case of a false
tinction slightly easier to understand than belief (Leslie, 1988). The attribution of sec-
false belief Leslie and Frith (1988) also found ond-order false beliefs is yet more difficult
a small group of autistic children who ap- again because of the recursive nature of such
peared to understand partial knowledge but attribution (Pemer, 1988b).
not false belief
Finally, the results from the communica-
Our results can be summarized descrip- tion task reinforce this rather bleak picture.
tively by saying that autistic children are Only a tiny proportion ofthe autistic children
grossly delayed in their acquisition ofa theory (12.5%) reliably took into account the listen-
of mind. Their degree of impaimient, how- er's knowledge in shaping a message, despite
ever, spreads over a wide range in the normal the fact that a larger number had shown them-
child's development. About one-fourth of our selves capable of working out what that
sample were unable to make consistent judg- knowledge might be. This raises the possibil-
ments of visual access, an ability that devel- ity that even where an autistic child has a
ops by the age of 2 years or even earlier in the certain level of facility in understanding men-
normal child (Flavell, Abrahams, Croft, & tal states, he or she may not use it to the full in
Flavell, 1981; Masangkay, McCluskey, Mcln- communication situations.
tyre, Sims-Knight, Vaughn, & Flavell, 1974).
It might be, however, that a difference in pro- The foregoing description of the autistic
cedure (e.g., use of a more difficult question, child's range of impairment in theory of mind
"Did I let someone look?" rather than "Can raises the question of whether there is a sin-
someone see?") has produced slighdy lower gle neurodevelopmental malfunction leading
performance on this task than in other studies to a single computational deficit with multiple
of autistic children (Hobson, 1984; Leslie & cognitive effects, as originally suggested by
Frith, 1988). Baron-Cohen et al. (1985) and Leslie (1987),
or whether there are a set of such malfunc-
About two-thirds of our sample had diffi- tions perhaps affecting different autistic chil-
culty making knowledge attributions and jus- dren in slightly different ways. Insight into
tifying them. In the normal child, this ability these questions depends pardy upon more ex-
develops between 3 and 4 years (Hogrefe plicit modeling of the computations underly-
et al., 1986; Marvin, Greenberg, & Mossier, ing such tasks, as well as further investigation
1976; Mossier, Marvin, & Greenberg, 1976; into the relation between the understanding
Wimmer et al. 1988a). Of the one-third who of knowledge (tme belief) and the under-
could make justified knowledge attributions, standing of false belief. In this, studies of
only half were also able to attribute a false childhood autism and normal development
belief, which most 4-year-old normal children will complement each other in important
can do (Pemer et al., 1987; Wimmer & Per- ways.
ner, 1983). Extrapolating from results by Ba-
ron-Cohen (1988), we may assume that even
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