The Theory of Mind Atlas
Tiffany L. Hutchins & Patricia A. Prelock © 2017
All entries in the Theory of Mind Atlas (ToMA) were developed for use with the Theory of Mind Inventory-2
(ToMI-2) for the purposes of explaining theory of mind in the conduct of research and clinical practice. This
document may be downloaded, adapted, and shared for professional purposes provided that the names and
copyright appearing in this header are retained. Visit theoryofmindinventory.com for more information
about our theory of mind educational resources and assessment and treatment materials.
Item 8: If I put my keys on the table, left the room, and my
child moved the keys from the table to a drawer, my child
would understand that when I returned, I would first look for
my keys where I left them.
Subscale(s): Basic
Item 12: If I showed my child a cereal box filled with cookies
and asked “What would someone who has not looked inside
think is in the box?”, my child would say that another person
would think that there was cereal in the box.
Subscale(s): Basic
These two items are intended to tap the understanding of false belief with specific regard to
beliefs about an unexpected location (item 8) and unexpected contents (item 12). As the term implies,
false belief (FB) understanding refers to the understanding that a person can hold a belief that
contradicts reality. For example, in the case of an unexpected location, Patty believes that her keys are
on the table when they are really in a drawer. That is, Patty has a mistaken or false belief about the
location of an object. In the case of unexpected contents, Patty might be shown a cereal box and (quite
reasonably but falsely) believe that the cereal box contains cereal when in fact, the cereal has been
removed and replaced by cookies without her knowledge. Although there are myriad ways in which
people can hold a mistaken belief, FBs about object locations and the contents of deceptive containers
have dominated research on theory of mind.
The most well-known version of the FB task (alternately referred to as the ‘standard’ FB task,
the ‘classic’ FB task, the ‘change location’ task, and the ‘Sally-Anne’ FB task) is the one originally used by
Baron-Cohen, Leslie, and Frith (1985)1 in their influential article “Does the autistic child have a theory of
mind”? In this task, children were shown two doll protagonists and told a story in which an object is
moved from an old location to a new location without the knowledge of the main protagonist.
Specifically, Sally puts a marble in a basket and leaves the room. In her absence, Anne enters and moves
the marble from the basket to a box and then Anne leaves. Children are asked, “When Sally returns,
where will Sally look for her marble?”2 Children who answer with the new (incorrect) location fail the
question whereas children who answer with the old (correct) location pass the question by presumably
demonstrating their knowledge that Sally has a false belief. Credit for the correct response is only given
if children also pass two additional control questions. The first is “Where is the marble really?” (to
ensure that the child understands the current actual location of the marble). The second question is
1
Baron-Cohen et al.s’ task was adapted from Wimmer and Perner’s (1983) “Maxi task”.
The wording of this question in later studies is typically “Where will Sally look for her marble first?” to ensure that
the child does not misunderstand the pragmatic intent of the question and mistakenly interpret the question as
“Where will Sally have to look for her marble in order to be successful in finding it?”
2
1
“Where was the marble in the beginning?” (to ensure the child’s correct memory of the original
location).
Over the last three decades, performance on the FB task has become a general marker or ‘litmus
test’ for theory of mind (Carpendale & Lewis, 2006; Wellman, 1988). Yet, the importance of FB
understanding has long been debated (e.g., Bloom & German, 2000; Russell, 2005; Wellman, Cross, &
Watson, 2001) and “many questions still remain about what exactly children are doing when they pass
false belief tests” (Lohmannn, Carpenter, & Call, 2005, p. 451). Indeed “we still know relatively little
about which skills feed into false belief and which later skills it feeds into” (Carpendale & Lewis, 2006, p.
78; also see Perner, Leekam, Wimmer, 1987; Wellman et al., 2001). Consider the Sally-Anne task
described above. To pass this task, the child needs to understand more than the concept of FB. With
regard to theory of mind, the child also needs to appreciate the concept of ‘seeing-leads-to-knowing’
(item 9). That is, the child needs to understand that because Sally did not see Anne move the marble,
Sally will not know the marble’s new location. Another example involves agency or ‘intentionality’ (item
24): the child must understand that people act in accordance with their goals and that Sally wants her
marble. Still another example involves counterfactual reasoning (item 29). “In order to acknowledge
false belief, children must suppress or ignore what they know to be true of the world” (Riggs, Peterson,
Robinson, & Mitchell, 1998, p. 74). In light of these considerations, it seems fair to conclude that the FB
task is not ‘pure’ but rather confounded in that it typically taps multiple theory of mind domains.
With regard to the development of FB-understanding as measured by standard FB tasks, the
overwhelming consensus across hundreds of studies is that typically developing 3-year-olds fail the task
whereas 4-year-olds tend to pass the task (e.g., Perner et al., 1987; Wiessman, Friederici, Singer, &
Steinbein). So one important question is: Why do 3-year-olds fail? As Bloom and German (2000)
explained:
“Several investigators have modified the FB task to make it simpler – for instance, by making the
questions simpler, more specific, and more pragmatically natural, making the change of location less
salient, giving the children a memory aid for false belief content, and so on. Such modified FB tasks
are often passed by 3-year-olds, a finding that has been used to support the argument that younger
children have sophisticated conceptual competence when it comes to understanding that beliefs
can be false, but that this competence is filtered through inefficient processing capacities” (p. B27).
Hence, it could be that younger children understand FBs but that their knowledge is masked by
memory and language task demands. To further address this possibility, researchers have begun to
explore the performance of infants on ‘implicit’ or ‘spontaneous’ FB tasks (i.e., nonverbal tasks that do
not rely on eliciting any specific response such as pointing or answering questions3). Although spirited
debate on the matter continues (with some arguing that infants show early conceptual competence in
FB-understanding; e.g., Baillargeon, Scott, & He, 2010; Roth & Leslie, 1998; Scott, Richman, &
3
Implicit FB tasks usually examine infants’ anticipatory looking, preferential looking, or other looking-patterns
using eye tracking technology. For example, infants are seated in front of a scene where the Sally-Anne FB task is
carried out in front of them using dolls. During the test section of the procedure, Sally returns to the room and
investigators measure looking time to different areas of the scene. If infants look to where the marble really is
indicates a lack of FB understanding but if they look to where the marble was originally, this is interpreted as FBunderstanding because infants are presumably anticipating where Sally where look for her marble based on her
FB). Research using these procedures generally indicate that infants understand implicit FBs: a finding that has also
been observed for great apes (Krupenye, Kano, Hirata, Call, & Tomasello, 2016).
2
Baillargeon, 2015), the majority of researchers have concluded that implicit and explicit FBunderstanding are qualitatively distinct, independent, and under the control of different cognitive
mechanisms (e.g., Apperly & Butterfill, 2009; Low & Wang, 2011; Perner et al., 1987; Wellman et al.,
2001; Weissmann et al., 2016)4.
When it comes to FB-understanding as it has traditionally been assessed, recall that the consensus is
that typically developing children pass the task between 4- and 5-years of age which provides good
rationale for FB-understanding as a Basic theory of mind capacity. As alluded to above, FB performance
is affected by the processing demands of the task (e.g., Lohmann et al., 2005). It is also positively
correlated with level of executive functioning (e.g., Carlson, Claxton, & Moses), pragmatic language
comprehension (Frank, Baron-Cohen, & Ganzel, 2015), and language ability. Regarding language, some
researchers have proposed that the acquisition of specific linguistic elements is necessary for FBunderstanding. For example, Bartsch and Wellman (1995) argued that theory of mind relies on acquiring
a mental state vocabulary (e.g., words like ‘think’, ‘know’) which help children reflect on unobservable
mental processes. In another line of research, de Villiers and colleagues (e.g., de Villiers and Pyers, 2002)
have argued that the mastery of sentential complements is responsible for the acquisition of FBunderstanding because this kind of syntactic structure (e.g., “He said he went to the store but he went
to the beach”) provides a cognitive framework for thinking about conflicting mental representations.
Contrariwise, other researchers have argued that it is not any specific language skill, but rather general
language ability that is the primary driver of FB-understanding and the bulk of the evidence contrasting
specific vs. general language accounts tends to favor the general language hypothesis (e.g., Cheung et
al., 2004; Lohmann et al., 2005; Milligan, Astington, & Dack, 2007). Still other researchers take a
different view and conclude that it is not any specific language skill (or general language for that matter)
that is causally responsible for FB-understanding (and a theory of mind), but rather the simple fact that
language allows interaction to happen among people (essentially a Vygotskian view; e.g., Astington,
1996; Tomasello, 2009). In light of the evidence for the various ways that language may contribute to
FB-understanding, most researchers tend to take an ‘all of the above’ position and adopt the view that
multiple aspects of language are causally and bi-directionally implicated.
Given the links between language and FB-understanding (and in line with the Vygotskian view of
language socialization), it is not surprising that FB-understanding is also strongly associated with social
experience and believed to be reliant upon social experience for its full expression (as are most aspects
of theory of mind; for review, see Garfield, Peterson, & Perry, 2001). Indeed, FB-understanding is
predicted by a variety of social-environmental factors: the age at which children demonstrate FBunderstanding is negatively correlated with family income and parental education (Cole & Mitchell,
1998; Cutting & Dunn, 1999; Weimer & Guajardo, 2005) and positively correlated with secure
attachment in infancy (e.g., Symons & Clark, 2000), the child’s number of older siblings (Ruffman,
Perner, Naito, Parkin, & Clements, 1998), and the amount and quality of early conversations about the
mind (especially talk that is rich in mental state terms and focuses on the nature, causes, and
consequences of mental states; e.g., “Which one do you like?”, “She thought that chickens could fly but
4
The two distinct FB systems are usually described as an early implicit process (present in infancy: it is automatic,
subconscious, spontaneous, inflexible) and a later-developing explicit process (emerging in childhood: it is slow,
conscious, deliberate, flexible). If the notion of dual FB processes is correct, it helps explain why some aspects of
mentalizing that implicate false representations (e.g., pretense) are acquired early whereas others are acquired
later (e.g., standard FB tasks, the appearance-reality distinction, counterfactual reasoning).
3
now she knows they really can’t”, “How would you feel if someone said that to you?”; de Rosnay, Fink,
Begeer, Slaughter, & Peterson, 2014; Ruffman & Parkin, 2001; Ruffman, Slade, & Crowe, 2002). Finally,
FB-understanding is correlated with a range of child cognitive and academic outcomes. For instance, it is
associated with the frequency of children’s own mental state term productions (e.g., Hughes & Dunn,
1998), has been implicated as an important factor in children’s emerging math and literacy ability (Blair
& Razza, 2007; Mason & Just, 2009), and has been argued to be causally-related to children’s social
emotional maturity and social competence (de Rosnay et al., 2014; Lalonde & Chandler, 1995; Peterson,
Slaughter, Moore, & Wellman, 2016).
In typical development, a summary of FB-understanding vis-à-vis the development of other theory
of mind domains shows that:

The development of desire-understanding (item 59), pretense (item 26), the mental-physical
distinction (item 16), seeing-leads-to-knowing (and not seeing leads to not knowing; item 9),
and the understanding of true beliefs precede the understanding of FBs (e.g., Hogrefe, Wimmer,
& Perner, 1986; Perner et al., 1987; Peterson, O’Reilly, & Wellman, 2016; Peterson, Wellman, &
Slaughter, 2012).

FB-understanding emerges around the same time as a wide range of other basic level theory of
mind competencies including the understanding of the appearance-reality distinction (item 11),
level 2 visual-perspective-taking (item 21). and counter-factual thinking (item 29) (Gopnik &
Astington, 1988; German & Nichols, 2003). This has been interpreted as reflecting the
development of a more foundational understanding that the mind itself is representational (e.g.,
Gopnik & Astington, 1988; Perner, 1991).

Theory of mind competencies that emerge after the mastery of FBs include (but are not limited
to), the understanding of biased cognition (item 40), the mind as an active interpreter (item 41),
emotional display rules (item 17), mixed emotions (item 36), sarcasm (item 2), pragmatics and
the metalinguistic aspects of language (see pragmatics subscale), and second-order
understanding of beliefs (items 22 & 23) (e.g., Carpendale & Chandler, 1996; Carpenter & Lewis,
2006; Peterson et al., 2012, 2016). Indeed, there is much more to a mature theory of mind than
the mastery of FBs.
FB understanding in ASD
Since Baron-Cohen et al.’s (1985) seminal article, hundreds of studies have documented deficits
in FB-understanding in ASD. At the same time, the individual differences within studies are interesting
and not all individuals with ASD fail standard tests of FB. As in typical development and ADHD, the ability
of children with ASD to pass FB tasks is positively correlated with level of executive functioning (e.g.,
Pellicano, 2010; Pellicano, Mayberry, Durkin, & Maley, 2006), the production of cognitive mental state
terms (e.g., “think”, “know”, “remember”) in children’s spontaneous speech (Tager-Flusberg, 1992;
2003), and language ability. In fact, Happé (1995) found that children with ASD required a far higher
verbal mental age to pass FB tasks than did other participants. While typically developing children had a
50% probability of passing the tasks at the verbal mental age of 4 years, those with ASD took more than
twice as long to reach that probability of success (at the advanced verbal age of 9;2). This and other
similar findings have led several researchers to propose that children with ASD with high intellectual and
4
verbal skills may be using a compensatory (essentially logical and nonmentalistic) strategy to ‘hack out’
the correct solution to FB tasks (Bowler, 1992; Durrleman & Franck, 2015; Eisenmajer & Prior, 1991;
Happé, 1995; Senju, 2012). This argument has recently received additional support from a study
examining both standard FB task performance and implicit or ‘spontaneous’ FB-task performance. Senju,
Southgate, White, and Frith (2009) found that although individuals with Asperger syndrome can pass the
standard FB tasks, they nevertheless failed tasks designed to assess the spontaneous attribution of
mental states. This notion gains importance when we consider that being able to compute the logic of
mental states is no guarantee that one can or will apply the principles more broadly: that is, to realworld theory of mind dilemmas. As Senju (2012) argued:
“Unlike experiments, the real social world is fluid and rapidly changing. We have to process
socially relevant information rapidly, spontaneously, and online in order to achieve day-to-day
social interaction…[the notion of a compensatory process is] consistent with…the findings that
training on FB tests does not necessarily improve social adaptation in ASD: the capacity for FBattribution may not be sufficient to deal with its spontaneous use in a fluid and rapidly changing
‘real’ social world” (p. 111).
In fact, while research has demonstrated that children with ASD can be taught to pass tests of
FBs, generalization of skills to the real world has proven elusive (Hadwin, Baron-Cohen, Howlin, & Hill,
1996; Swettenham, 1996). One notable exception involves studies implementing the use of ‘thought
bubbles’ to train FB-understanding which have demonstrated that training can transfer reliably to a
variety of untrained contexts (e.g., Wellman et al., 2002). Thus, for many children with ASD, thought
bubbles are a useful prosthesis for teaching not only FBs but a variety of mental processes. As Wellman
et al. (2002) explained:
“Thought-bubbles arguably provide a particularly natural or effective way of depicting
thoughts pictorially, one that could come to aid autistic individuals’ reasoning about people,
behavior, and mental states. In particular, thoughts are representational mental states and
thought-bubbles depict a person’s thoughts in a straightforward representational
fashion…Teaching an explicit compensatory strategy could help children with autism bypass
their deficit in understanding mental states” (p. 346).
FB understanding in ADHD
Several studies have examined FB-understanding in individuals with ADHD. Most of these
studies compare children with (or at risk for) ADHD with typically developing controls and conclude that
there are no differences between groups when FB-understanding is assessed using the traditional
(laboratory-type) Sally-Anne task (Charman, Carroll, & Sturge, 2001; Happé & Frith, 1996; Hutchins,
Prelock, Morris, Benner, Lavigne, & Hoza, 2015; Perner, Kain, & Barchfeld, 2002; Sodia, Hulsken, &
Thoermer, 2003; Yang, Zhou, Yao, Su, & McWhinnie, 2009). By contrast, meta-analyses and studies using
applied measures of FB-understanding (as would be needed to solve FB problems in the real world)
report that children with ADHD are impaired relative to their typically developing counterparts in FBunderstanding and lie intermediate between ASD and typically developing samples (Bora & Pantelis,
2016; Hutchins et al., 2015). These patterns of performance, combined with the fact that executive
function deficits occur in both conditions, may be responsible for the high degree of clinical overlap that
is observed between ADHD and ASD (e.g., Gonzalez-Gadea et al., 2013); nevertheless, social
incompetence in ASD and ADHD likely results from very different processes. First, while children with
5
ADHD tend to pass standard FB-tasks but fail to apply this understanding in the world, children with ASD
tend to fail in both contexts (Hutchins et al., 2015). This suggests a core conceptual deficit in ASD but a
theory of mind performance-related deficit in ADHD. This is important in light of the robust finding that
FB-understanding significantly correlates with executive functioning (Mary et al., 2015; Perner et al.,
2002). What this means is that children with ADHD are likely to be unimpaired on tasks that do not place
great demands on working memory, attention shifting, or inhibitory control (i.e., the Sally-Anne task)
but significantly impaired in tasks/contexts that do require these cognitive resources (i.e., the real
world) (Caillies, Bertot, Motte, Raynaud, & Abely, 2014; Hutchins et al., 2015; Sodian & Hulsken, 2005)5
and this conclusion fits with the finding that social cognitive deficits in ADHD improve with age (Bora &
Pantelis, 2016). Although we are not aware of training studies involving FBs and children with ADHD,
much research indirectly suggests that social cognition and social competence can be improved through
training in theory of mind and executive function which has been documented as successful for other
populations and which, in turn, has implications for improving academic achievement (for a review see
Kloo & Perner, 2008).
FB understanding DoHH
Theory of mind “is one of the main research fields on cognitive development in deaf children
today” (Courtin & Melot, 2005, p. 16) and studies on the development of FB-understanding are quite
numerous. The first study on this topic was conducted by Peterson and Siegal (1995) who evaluated the
FB task performance of signing, prelingually-deaf children (ages 8 – 13 years) of hearing parents6.
Results indicated that 65% of the children failed the FB task which typically developing children routinely
pass at age 4 years and the performance of the DoHH children was no different from the performance of
children with autism who had been tested in previous research. This study was important not only for
demonstrating the potential for profound theory of mind deficits in oral and late-signing DoHH children
but it was also theoretically influential for our understanding of theory of mind development. Once
thought to be uniquely disrupted in autism, evidence of similar performance deficits in a sample of deaf
children underscored the importance of language, social experience, and early family conversations
about the mind for theory of mind development. Subsequent studies have largely confirmed and
extended the findings of Peterson and Siegal (1995) and have concluded:
1) For the handful of competencies that have been studied, the sequence of steps in DoHH
children’s theory of mind development is the same as it is for typically developing hearing
children. Specifically, the aspects of theory of mind (we will use the terms that have been used
in this body of literature) that have received the most attention and the order in which they
develop are as follows (Peterson et al., 2016; Peterson & Wellman, 2009; Peterson, Wellman, &
Lui, 2005; Peterson, Wellman, & Slaughter, 2012):
5
The degree to which inhibitory demands affect performance in other theory of mind domains (e.g.,
understanding faux pas, emotion recognition, vocal recognition) is not as well understood at this time although
evidence is emerging to suggest that these aspects are moderated by different cognitive factors.
6
The literature generally (meaning there are exceptions; see O’Reilly, Peterson, & Wellman, 2014) indicates that
deaf children of deaf parents are not impaired in their theory of mind development which has led to the
conclusion that the challenges observed in deaf children who are otherwise typically developing is a result a
‘conversation’ deficit.
6







pretense (item 26)
‘diverse desires’ (understanding that two persons can have different desires about the same
objects)
‘diverse beliefs’ (understanding that two people can have different beliefs about the same
object)
‘knowledge access’ (what we call ‘seeing-leads-to-knowing’ [item 9]; the understanding that
seeing-leads-to knowing and not seeing leads to ignorance)
FB-understanding
‘hidden emotions’ (what we call ‘display rules ’ [item17]; the understanding that a person can
feel one emotion but display a different emotion)
sarcasm (item 2)
2) Although DoHH children show the typical developmental sequence, many (but not all) will also
evidence a significant developmental lag in these steps (a lag anywhere between 4 and 8 years
for FB-understanding is not uncommon in the literature; e.g., Courtin & Melot, 2005; Peterson &
Wellman, 2009; Russell et al., 1998). Moreover, the degree of impairment (the length of the lag)
is highly variable and linked in complex ways to aspects of the child’s social and hearing history.
Indeed, most DoHH children grow up in families where there are no other deaf members and no
member has proficient sign language. As a result, these children have fewer opportunities for
learning about mental states through play, conversation, and other types of social interaction
especially in their infancy and preschool years which are known to be a crucial period of
development.
“One question that arises from this concerns the extent to which these difficulties are confined
to the early years. It seems reasonable to assume that restricted early social experience arising
from deafness will delay theory of mind development. This implies the possibility of later
experience-related and age-related improvements in theory of mind performance...The extent
of this development, and the speed with which it may be expected to occur, however, are open
to question” (Russell et al. , 1998, p. 905).
As noted above, social experience, advances in language, and FB-understanding are tightly
intertwined in hearing children but perhaps even more so for DoHH children. Yet, the studies in search
of the most robust predictors of FB-understanding are mixed which is likely a result of noisy data. In fact,
several variables have been implicated as likely contributors to DoHH children’s theory of mind
challenges and any of these might be primary drivers of theory of mind challenges for any given
individual. These factors include the age of hearing loss onset, the nature of the hearing impairment
(e.g., sensorineural, conductive, auditory neuropathy spectrum disorder), the degree of hearing loss, the
length of time between first hearing loss and hearing aids or cochlear implantation, the degree of
hearing loss when hearing is aided or amplified, the amount of time during the day that hearing aids are
worn, and – of course – the nature of the home environment (e.g., the number of siblings, the primary
caregiver’s or other family member’s fluency in sign, primary caregiver’s tendency to talk about the
concrete/observable world as opposed to inner mental states as well as any formal supports to aid
familial communication). Unlike the case with ASD and ADHD, executive function factors appear to be of
minor importance for FB-understanding in DoHH children (Meristo & Hjelmquist, 2009; Pyers & de
Villiers, 2013).
7
Despite the complexity of the problem, some general findings have emerged that can provide
guidance for service-providers. Hearing parents who are not fluent in sign and choose the spoken
channel to communicate with their DoHH children should be aware of the following:
1). Age of cochlear implantation is negatively correlated with theory of mind outcomes
(Hutchins, Allen, & Schefer, 2017) such that children with very early cochlear implantation do not differ
significantly from hearing children on FB tasks or receptive and expressive language (Remmell & Peters,
2009).
2).FB-understanding is correlated with social competence and peer acceptance in middle and
late childhood even after the effects of age and language ability are removed (Peterson et al., 2016).
3). DoHH children often show a delay, but not a permanent deficit in FB-understanding and
theory of mind (Remmell, Bettger, & Weinberg, 2001). In fact, studies using thought-bubble training7
have shown that DoHH children are perfectly capable of developing FB-understanding and that the
effects of training generalize to other theory of mind domains (Wellman & Peterson, 2013; Tucci,
Easterbrooks, & Lederberg, 2016). In a related vein, rich interpersonal experience (e.g., secure
relationships where there is much discourse about the mind) is believed to facilitate DoHH children’s
(and adult’s) theories of mind (Hao, Su, & Chan, 2010).
4). FB-understanding does not guarantee that DoHH children have a fully mature theory of
mind. Several studies indicate that DoHH children can pass FB tasks and still evidence significant
problems with other aspects of theory of mind. Generally speaking, DoHH children are ultimately most
at risk for poor development of all advanced theory of mind skills (Hao et al., 2010; Hutchins et al., 2017)
with more specific research documenting particular difficulty in the areas of sarcasm (item 2), display
rules (item 17), empathy (item 34), complex emotion recognition (items 52, 55), second-order beliefs
(items 22 & 23), pragmatics (see the pragmatics subscale), and the understanding of mixed emotions
(item 46) (Dyck, Farrugia, Shochet, & Holmes-Brown, 2004; Netten et al., 2015; O’Reilly et al., 2014;
Peterson et al., 2016; Rieffe, 2012)
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