Adult Theory of Mind Test (AToM)
Background
The Adult Theory of Mind Test (AToM) is a formal assessment tool used to measure an adult's ability to understand the beliefs, intentions, and emotions of others ('Theory of Mind - ToM') using video scenarios of (scripted) real-life interactions. The test was developed by Neil Brewer and colleagues in 2017 to address missing standardized test procedures and provide reliable normative data to study adults with autism spectrum disorder (ASD). The test was simplified by Brewer and colleagues in 2022 by changing the response options from openended text input to multiple choice questions. The simplified test is referred to as AToM-Q.
Both tests consist of 12 scenarios that are largely based on the "Strange Story Tests" by Francesca G. E. Happé published in 1994. The former paper-pencil content of the selected "Strange" stories (plus four new stories designed by Brewer et al) was scripted and professionally filmed. Six of the 12 scenarios require a more "physical" interpretation of the scene (e.g. "why did he stop at the intersection?" -> "Because there was a Stop sign") and function as "control" items that should not be problematic for people with ASD. The remaining six scenarios address various social situations that traditionally prove to be more difficult for people with ASD, ranging from situations involving sarcasm, white lies, faux pas and others.
After each scenario is played, participants are asked to answer a scenario-specific question. The AToM and AToM-Q differ in how participant are asked to provide their answer. In the original AToM, participants get 1 minute to write down their answers in an open-ended testing format. The time limit is intentional to discourage participants from using slow, deliberate logic to solve social problems instead of processing the scenario intuitively and instantly. All answers are scored on a scale from 1 to 3 using the scoring criteria provided by Brewer et al (2017). Scoring the responses requires a trained test administer and is somewhat elaborate and potentially error-prone. For these reasons, the simplified ATom-Q uses a multiple-choice response format and provides 4 response options of which only one is the correct one (only this one receives a point).
Millisecond's original AToM script presents the videos (publicly accessible), asks the relevant questions, collects responses and enforces time-limits. However, response scoring must be done manually using the published guidelines; no automatic response scoring is implemented. The responses in the ATom-Q on the other hand are automatically scored by the script.
Task Procedure
After a short introduction to the test, participants watch the 12 videos in random order. After each scenario, participants receive a question (or two) and have 1 minute to provide an answer (original AToM).
or get four multiple choice questions (ATOM-Q). The order of the response options is randomized.
After participants select their response option, they are asked to rate their confidence on a scale from 0% to 100%.
What it Measures
The Adult Theory of Mind Test (AToM) is a measure of ToM abilities
Psychological domains
- Cognitive ToM: The ability to infer the beliefs and intentions of others
- Affective ToM: The ability to infer the emotional state of others
- Social Perception: Recognizing "rules" of social etiquette
- Working Memory: Participants must hold the details of the story in their head while simultaneously reasoning about the characters' internal states.
- Inhibitory Control: The ability to inhibit one's own knowledge to focus on a character's "false belief"
- Cognitive Flexibility: The ability to shift between different perspectives
- Language Comprehension: Ability to understand the literal meaning of the story before making social inferences
Main Performance Metrics
The original ATOM script does not provide main accuracy performance metrics. Collected responses need to be scored manually by test administrators. The script provides some latency measures as a measure of potential processing deficits.
• ATOM-Q:
- Proportion Correct, separate for Social/Physical questions: measure of accuracy
- Mean Correct Response Times: measure of processing speed
- LISAS: error-corrected processing speed measures
- Confidence Ratings: measure of metacognitive processing
Psychiatric Conditions
The following patient groups show impaired performance on the AToM test
- Autism Spectrum Disorder (ASD)
Test Variations
A test to study interpretations of others' beliefs, emotions and intentions ('Theory of Mind') using video scenarios of (scripted) real-life interactions. The test was developed by Brewer et al (2017) and requires manual scoring of the open-ended responses.
A multiple choice version of the ATOM; published by Brewer et al (2022). This test automatically scores the responses.
References
Search Google Scholar for peer-reviewed, published research using the Inquisit Adult Theory of Mind Test (AToM).
Brewer, N., Young, R. L., & Barnett, E. (2017). Measuring Theory of Mind in Adults with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 47(7), 1927–1941. https://doi.org/10.1007/s10803-017-3080-x
Livingston, L. A., Carr, B., & Shah, P. (2019). Recent Advances and New Directions in Measuring Theory of Mind in Autistic Adults. Journal of Autism and Developmental Disorders, 49(4), 1738–1744. https://doi.org/10.1007/s10803-018-3823-3
Brewer N, Young RL, Norris JE, Maras K, Michael Z, Barnett E. (2022). A Quick Measure of Theory of Mind in Autistic Adults: Decision Accuracy, Latency and Self-Awareness. J Autism Dev Disord. 2022 Jun;52(6):2479-2496. doi: 10.1007/s10803-021-05166-7. Epub 2021 Jun 28. PMID: 34184140; PMCID: PMC9114060.
Yeung, E. K. L., Apperly, I. A., & Devine, R. T. (2024). Measures of individual differences in adult theory of mind: A systematic review. Neuroscience and Biobehavioral Reviews, 157, 105481–105481. https://doi.org/10.1016/j.neubiorev.2023.105481