Background: Some autistic individuals with good compensatory skills may circumvent diagnosis, but still struggle with mentalizing. This missed or delayed identification can deprive them of the opportunity to receive necessary support and interventions. Thus, more sensitive assessment techniques are needed that are not susceptible to compensation. One such promising assessment, Southgate et al. (2007)'s anticipatory looking paradigm, has presented exciting yet inconclusive evidence surrounding spontaneous mentalizing in autism. The present study therefore aimed to advance this paradigm by addressing some alternative explanations and scrutinizing the claims that have been made in the literature, through implementing a multi-trial design with shorter trials, matched true-belief conditions, and both high and low inhibitory demand false-belief conditions. We also sought to inspect if any group differences were related to group-specific patterns of attention on key events.
Methods: Seventeen autistic adults were compared with nineteen neurotypical adults on an adapted implicit mentalizing task and a well-established explicit mentalizing task. One-sample t -tests were used to compare performance to chance on the implicit task, a mixed-design ANOVA was conducted to examine main effects of group, time and belief and their interactions, and t -tests were used to further explore gaze patterns.
Results: The two groups were comparable in the explicit mentalizing task, indicating sophisticated mentalistic reasoning; however, the autism group did not show anticipatory looking behaviour in the implicit mentalizing task, indicating that they struggled to mentalize the protagonist's beliefs. Surprisingly, there was no group difference in attention distribution during any of the key event.
Limitations: Our true-belief conditions may also trigger mentalizing; future studies should therefore create a mentalizing-free baseline matched with the false-belief scenario.
Conclusions: Our findings further document that although many autistic individuals perform well in explicit tasks, they struggle to spontaneously mentalize in implicit tasks, consistent with their everyday social difficulties. We ruled out some alternative theoretical explanations for this pattern of performance, leading to a better understanding of mentalizing difficulties. We also presented evidence that autistic adults may process information from social cues in the same way as neurotypical adults, but this information is not then used to update mental representations.