Theory of mind training includes any form of instruction which is designed to teach people how to recognise mental states (such as thoughts, beliefs and emotions) in themselves and in other people.
Theory of mind training is based on the idea that some people have a poor theory of mind, that is, they struggle to recognise mental states in themselves and in other people. Because of this they may find it difficult to make sense of and predict actions. For example, they may not be able to recognise that they are getting angry or that someone else is sad.
There are a variety of programmes which are specifically designed to teach theory of mind. For example, the Thought Bubble Training programme teaches children to visualise other people’s thoughts and emotions by imagining those thoughts and emotions as pictures or thought bubbles.
There are also a number of programmes which are designed to teach the precursor skills of theory of mind (such as joint attention and imitation). However, this factsheet concentrates just on those programmes which are specifically designed to teach theory of mind.
It may be possible to teach theory of mind skills to some autistic people using a theory of mind training programme.
However, those skills rarely or never transfer to situations outside the situation in which the training took place. It is unclear whether any skills that have been learnt can be maintained and improved on in the long term.
Because of this, researchers might wish to study other interventions (such as comprehensive, multi-component approaches) which target a range of skills designed to improve social and communication skills in autistic individuals
It is worth noting that some autistic people have criticised the idea that it is only autistic people who have problems understanding how other people think. Many autistic people believe that non-autistic people have just as many problems trying to understand autistic people.
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Theory of mind training is designed to help anyone who has difficulties with theory of mind including autistic children and adults.
According to Gevers et al (2006), “Children with pervasive developmental disorders (PDD) are impaired by early onset difficulties in reciprocal social interaction. It has been proposed that this social impairment is the result of a lack of Theory of Mind (ToM): the ability to attribute mental states (e.g., beliefs, desires, intentions, and emotions) to others and to use these in predicting and explaining the behavior of others). Research has shown that this ability is seriously impaired in autistic children, and moderately impaired in children with Pervasive Developmental Disorders, Not Otherwise Specified (PDD-NOS). This impairment may limit PDD-NOS children in their understanding of humor and irony, and restrict their ability to take into account the interests and knowledge of a partner in social conversation.”
The aim of theory of mind training is teach people how to recognise mental states (such as thoughts, beliefs and emotions) in themselves and in other people. Some people think that this can lead to improvements in other areas, such as social communication and social interaction.
For example, Fletcher-Watson et al (2014) stated “The ToM model of autism suggests that the social and communication difficulties that are characteristic of the syndrome stem from a failure to develop an intact ToM. Certainly there is evidence that ToM is correlated with real-life social skills and symptomatology. Certain ToM precursor skills also have a direct relationship with symptoms. Therefore, training in ToM, or in the precursor or component skills of ToM, should alleviate the social and communication difficulties experienced by individuals with the disorder.”
There have been various claims made for theory of mind training. For example,
Theory of mind training includes any form of instruction designed to teach people how to recognise mental states (such as thoughts, beliefs and emotions) in themselves and in other people.
Theory of mind training is also known as ToM training, mind reading training and mental state training.
According to Fletcher-Watson et al (2014), “Having a ’theory of mind’ may depend on developing related basic skills, including joint attention (sharing a focus of interest with another person), recognising other people’s emotions from faces or stories, and imitating other people.”
There are a variety of programmes which are specially designed to teach theory of mind including
There are also a number of programmes which are designed to teach the precursor skills of theory of mind (such as joint attention and imitation).
The cost of the theory of mind training will depend to a certain extent on the type of theory of mind training, the length of training, the specific provider being used, and the needs of the individual participant. There may also be additional costs for the initial evaluation, travel and equipment. For example
The ‘Transporters’ programme “Home Pack – British English version”, a set of DVDs and other materials was available for sale at £39.99 in October 2015. The “Pro Pack – North American version” which contains materials for professionals was available for $129.99.
We have been unable to identify the costs of theory of mind training programmes delivered by professional trainers.
The length and frequency of theory of mind training may vary depending on the specific form of theory of mind training, the particular programme being followed, and the needs of the individual client.
For example, according to Beeger et al. (2011), “The Theory of Mind training is a manualized treatment program, that includes 16 weekly sessions of approximately 1,5 h each, provided to 5 or 6 children simultaneously, with a mutual age difference that does not exceed 3 years. All sessions [are] supervised by certified therapists, and every last 15 min, children are joined by their parents, who are informed about the meeting and briefed about the assignments for the next meeting. In addition, parents attend monthly trainings, where they are informed about the content of the training and about the progress of their children, and given suggestions on how to promote social cognition through playing games and story telling.“
There are no known hazards for theory of mind training.
There are no known contraindications (something which makes a particular treatment or procedure potentially inadvisable) for autistic people.
However some autistic people, such as Milton (2012), have criticised the idea that it is only autistic people who have problems understanding how other people think. For example, some autistic people believe that non-autistic people have just as many problems trying to understand autistic people.
We have been unable to identify any specific providers of theory of mind training, although we have identified a number of training resources (such as DVDs and manuals) which can be bought from the Internet. In practice, theory of mind skills are often taught alongside a range of other skills within comprehensive, multi-component programmes.
There are no specific credentials for the suppliers of theory of mind training, which is normally carried out by one or more professionals, such as teachers or clinical researches, each of whom will have their own credentials.
In 1978 Premack and Woodruff published a research paper that asked whether a chimpanzee could imagine what someone else was thinking and use this information to alter its behaviour. They called this ability to impute mental states to the self and to others “Theory of Mind.”
In 1985 Baron-Cohen, Leslie and Frith suggested that autistic children have difficulties with theory of mind including undertaking tasks that require the child to understand another person's beliefs.
In 1995 Ozonoff and Miller published the first study of a mind reading training programme for autistic children.
We have identified more than 20 scientific studies of theory of mind training programmes in peer-reviewed journals published in English.
The studies included a total of more than 600 autistic individuals aged from 4 years old to adult.
There are a number of limitations to all of the research studies on theory of mind training published to date. For example
For a comprehensive list of potential flaws in research studies, please see "Why some autism research studies are flawed."
We have been unable to identify any studies into theory of mind training that are currently underway. If you know of any other studies we should include please email info@researchautism.net with the details. Thank you.
There is an extremely limited amount of research evidence of a sufficiently high quality to suggest that theory of mind training may provide some limited benefits to some autistic individuals.
Fletcher-Watson et al (2014) reported that “... it may be possible to teach both Theory of Mind (ToM) and the precursor skills associated with the construct. However this teaching rarely or never generalises to novel contexts and it is unclear whether there is long-term maintenance of learnt skills, or developmental progression in learning.”
We have been unable to identify any personal anecdotes about the use of theory of mind training in autistic people.
According to Fletcher-Watson et al (2014), “Future reviewers should consider investigating the results of multi-modal interventions ... which teach a range of real-world social and communicative skills as well as academic learning. Given the problems with maintenance and generalisation of taught skills, multi-modal approaches may be more successful in improving social and communication outcomes in people with ASD.”
This section provides details of scientific studies into the effectiveness of this intervention for people with autism which have been published in English-language, peer-reviewed journals.
If you know of any other publications we should list on this page please email info@informationautism.org
Please note that we are unable to supply publications unless we are listed as the publisher. However, if you are a UK resident you may be able to obtain them from your local public library, your college library or direct from the publisher.
This section provides details of other publications on this topic.
You can find more publications on this topic in our publications database.
If you know of any other publications we should list on this page please email info@informationautism.org
Please note that we are unable to supply publications unless we are listed as the publisher. However, if you are a UK resident you may be able to obtain them from your local public library, your college library or direct from the publisher.