"Reading the Mind in the Eyes" in Autistic Adults is Modulated by Valence and Difficulty: An InFoR Study.
Lean on easy, positive Eyes-Test items and the easy-minus-hard gap to spot autism in high-functioning adults faster.
01Research in Context
What this study did
Baltazar et al. (2021) looked at how autistic adults do on the "Reading the Mind in the Eyes" test.
They gave easy and hard items that showed happy, sad, or neutral eye photos.
The team asked who could spot mental states best and what items split autistic from non-autistic adults.
What they found
Easy, positive-eye items did the best job of telling groups apart.
The gain score (easy minus hard) also flagged autistic adults.
Hard or negative items added little diagnostic value.
How this fits with other research
Begeer et al. (2012) saw a similar story in kids. Their continuous Sandbox false-belief task caught subtle mind-reading gaps that pass-fail tasks miss.
Lee et al. (2024) give us a next step. Their Rasch cut-offs let you pair explicit scores (like the Eyes Test) with real-life social use scores. You can now see who knows the rules but can’t apply them.
Mueller et al. (2000) once showed photos don’t help on false-belief tasks. Baltazar et al. (2021) now show item feel (valence, difficulty) does matter on the Eyes Test. Together they warn: task design beats pretty pictures.
Why it matters
Stop giving the whole Eyes Test and hoping for a big score gap. Use only the easy, positive items first. If the client stumbles, note the easy-minus-hard gap. This quick slice saves time, lowers fatigue, and sharpens your adult autism screener. If the gap is wide, move to applied tasks like those in Lee et al. (2024) to plan real-world social skills goals.
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02At a glance
03Original abstract
Autism spectrum disorders (ASD) are heterogeneous and complex neurodevelopmental conditions that urgently need reliable and sensitive measures to inform diagnosis properly. The Reading the Mind in the Eyes Task (or Eyes Test from now on) is widely used for this purpose. A recent study showed that subcategories of items of the children version of the Eyes Test could be especially discriminative to distinguish ASD and control children. Here, we analyzed the performance on the Eyes Test of 30 high functioning (IQ > 70) adults with ASD and 29 controls from the InFoR cohort multicentric study, using a Generalized Linear Mixed Model. We found that valence and difficulty modulate the performance on the Eyes Test, with easy and positive items being the most discriminative to distinguish ASD and controls. In particular, we suggest this result might be actionable to discriminate ASD patients from controls in subgroups where their overall scores show less difference with controls. We propose for future research the computation of two additional indexes when using the Eyes Test: the first focusing on the easy and positive items (applying a threshold of 70% of correct responses for these items, above which people are at very low risk of having ASD) and the second focusing on the performance gain from difficult to easy items (with a progression of less than 15% showing high risk of having ASD). Our findings open the possibility for a major change in how the Eyes Test is used to inform diagnosis in ASD. LAY SUMMARY: The Eyes Test is used worldwide to inform autism spectrum disorders (ASD) diagnosis. We show here that ASD and neurotypical adults show the most difference in performance on subgroups of items: ASD adults do not improve as expected when comparing easy and difficult items, and they do not show an improvement for items displaying a positive feeling. We advise clinicians to focus on these comparisons to increase the property of the test to distinguish people with ASD from neurotypical adults.
Autism research : official journal of the International Society for Autism Research, 2021 · doi:10.1016/j.psyneuen.2014.04.024