Assessing theory of mind nonverbally in those with intellectual disability and ASD: the penny hiding game.
A quick coin-hiding game spots theory-of-mind deficits in non-speaking children with ASD and ID and predicts their daily social struggles.
01Research in Context
What this study did
The team gave the Penny Hiding Game to three groups: kids with autism plus intellectual disability, kids with ID only, and typically developing kids.
The game is simple. A coin is hidden under one of two cups while the child watches. Then the child must guess where an uninformed adult will look. No talking is needed.
The researchers also measured each child’s verbal mental age and daily social skills.
What they found
Children with both autism and ID made more wrong guesses and used fewer tricks than the ID-only group.
To reach the same success level, the ASD+ID group needed about two extra years of verbal mental age.
Poor game scores lined up with weaker everyday social skills, showing the task catches real-life problems.
How this fits with other research
Carr (1994) and Weiss et al. (2001) already showed that even able autistic people fail natural mind-reading tasks. The new study extends that warning downward to kids who barely speak.
Schuwerk et al. (2015) used eye-tracking to find implicit false-belief deficits in high-functioning adults. Antonia et al. match that pattern with a low-tech cup game for low-verbal children.
Zhou et al. (2019) saw preschoolers with ASD skip spontaneous mentalizing during video scenes. The Penny Hiding Game gives you a five-minute way to spot the same gap without cameras or computers.
Why it matters
You now have a fast, word-free test that flags theory-of-mind trouble in clients who can’t sit for stories or answer questions. Use the Penny Hiding Game during intake to decide who needs perspective-taking lessons and who needs simpler social goals first.
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Join Free →Hide a penny under a cup, let the client watch, then ask, "Where will I look?" Note right or wrong to gauge mind-reading skills in under two minutes.
02At a glance
03Original abstract
Individuals with autism spectrum disorder (ASD) and low intellectual/language abilities are often omitted from experimental studies because of the challenges of testing these individuals. It is vital to develop appropriate and accessible tasks so that this significant part of the spectrum is not neglected. The theory of mind (ToM) has been extensively assessed in ASD, predominantly in relatively high-functioning individuals with reasonable language skills. This study aims to assess the ToM abilities of a sample of 132 participants with intellectual disability (ID) with and without ASD, matched in verbal mental age (VMA) and chronological age, using a naturalistic and nonverbal deception task: the Penny Hiding Game (PHG). The relationship between performance on the PHG and everyday adaptation was also studied. The PHG proved accessible to most participants, suggesting its suitability for use with individuals with low cognitive skills, attentional problems, and limited language. The ASD + ID group showed significantly more PHG errors, and fewer tricks, than the ID group. PHG performance correlated with Vineland adaptation scores for both groups. VMA was a major predictor of passing the task in both groups, and participants with ASD + ID required, on average, 2 years higher VMA than those with ID only, to achieve the same level of PHG success. VMA moderated the association between PHG performance and real-life social skills for the ASD + ID more than the ID group, suggesting that severely impaired individuals with ASD may rely on verbal ability to overcome their social difficulties, whereas individuals with ID alone may use more intuitive social understanding both in the PHG and everyday situations.
Autism research : official journal of the International Society for Autism Research, 2014 · doi:10.1002/aur.1405