Diagnosis and evaluation.
I don’t, because I read it in a print article when I worked in the field, which was 20 years age, and I can’t even remember where I read it. It would have been in a professional journal, though, not a popular magazine, and I’m pretty sure it was a US publication.
I found an account of another experiment, where Sally takes a photograph of the marble in the basket before leaving the room. After Ann has moved the marble to the box, the autistic kids correctly answered that the photograph would show the marble in the basket, but incorrectly said Sally would look for the marble in the box. This seems to deal with the objection that they simply haven’t understood the question.
Hmm. In Googling “schizophrenia taste” and other similar things, I’m finding a lot of references to folks with schizophrenia tasting things in a distorted fashion (e.g., sensing a metallic aftertaste), but not having everything taste the same. Are you certain it’s schizophrenia that has this trait?
OK. The point is not that to someone with schizophrenia, everything tastes the same. The point is that everyone with schizophrenia answered this question on this diagnostic test this way, and virtually no non-schizophrenic did.
It’s possible that something about the test situation, or the wording of the question triggered schizophrenics to be untruthful.
It does not matter what the reason is. This question was highly reliable for distinguishing schizophrenics from non-schizophrenics, and since people who were trying to fake mental illness were unaware of how a schizophrenic responded to this question, it helped to ferret out malingerers.
Other questions regarding well-known genuine symptoms of schizophrenia were answered by malingerers positively, while real schizophrenics tended to lie on those questions, so questions like “Do you hear things other people don’t hear” were not very useful for discovering true schizophrenics.
If the study I read made it clear that this phenomenon was unique to a particular test, or particular facility, I don’t recall. To the best of my recollection, the article suggested that schizophrenics would answer this way under any sort of testing situation at any location. But I could be wrong.
My reason for mentioning this was to point out that it may be that autistic children may give a wrong answer that they know is a wrong answer, because something about the testing protocols provoke them to do so. If they think the wrong answer is what is expected of them, they may decide to cooperate.
This would explain why they perform differently when offered a reward.
If you want to discuss schizophrenia further, please PM me, so as not to derail this thread.
Not trying to challenge you or derail the thread; I just wanted to learn more about a strange phenomenon I’d never heard of before. I’ll drop it.
I don’t know if the test is used in diagnosing children. But in the original paper it is indeed presented as evidence that autistic kids lack a theory of mind. Maybe it wouldn’t be nowadays; there’s been a lot more research since 1985.
Forgive me for quoting myself, but the “different behavior for a reward” intrigues me. Is there any way to blind this test? To have people administer it without knowing what the anticipated results are, or which children have been diagnosed with what?
I can’t help wondering if there isn’t a “Clever Hans” thing going on. If the experimenters even mildly showed that they expected a particular response from the autistic children-- or, and this would not shock me, made no attempt to hide their expectations on the assumption that autistic children would not be sensitive enough to tone and body language to pick up on expectations-- well, they may have gotten exactly what they expected.
This neatly explains why the autistic kids “improved” for a reward.
I personally watched a four-yr-old autistic kid with very little language lock the front door after his father went to the car to get something, and then start giggling to himself, and when his father came back and found the door locked, started laughing hysterically.
Then, he let his father in, still laughing.
So obviously, he was able to think from his father’s perspective of not being able to get into the house, and found it funny that he’d stopped his father coming in without his knowledge.
OK, not the most sophisticated practical joke, but it was still pretty good for a 4-yr-old, even a non-autistic one.
I wonder if it’s the reward, or something about the different way the test is presented? Compare this test, which most people fail when presented with the abstract version, but can easily solve if the context is changed to social rules:
We should interview that dad and find out if the dad learned anything. Like, take the door key with you when you go out the door or change the lock set so a child can’t reach the bolt to lock you out and then stand on the inside and giggle.
When the context is changed they understand the question being asked. They already know that you have to be over 18 to drink beer and at the same time you don’t have to drink beer if you are over 18. They don’t know how to interpret the language in the original context which would they would rarely encounter or need to understand in real life. I don’t think the context of a social rule in particular matters.
That’s very interesting.
Actually, what I was getting at, was that what was operating for the kids was that trying to curry favor with the adult in the situation overrode other concerns, such as being factually correct.
In other words, non-autistic children processed very quickly that what was expected of them was to understand that the person who left the room did not know the marbles had been moved, so they did that.
Autistic children had a harder job, and were also less well-equipped for it. Autistic people tend to be a little slower at knowing what another person expects of them (on average-- you will find outliers), then, on top of that, the experimenters may have been sending mixed signals to the autistic kids, while being much clearer with the non-autistic kids.
Once a tangible reward was involved, the autistic children may have thought “This means he must want the factually correct answer, and I can ignore lower key signals otherwise”; in other words the expectation was finally clear, as far as the children were concerned.
I agree. People bring their own information to the test. The fact that in the real world, the information has social implications is probably not relevant.
That specific test is useful for discovering schizophrenics, but perhaps not as useful for discovering people who have decided not to take their drugs. I guess it depends on the context: my acquaintance used to routinely ask that question to people presenting or being presented for residential care. And I’ve known several schizophrenics.
It is a characteristic of florid psychosis that you don’t know which are “voices” and what are just voices, but people who are not entirely psychotic do know, and will tell you about it if you ask.
Well, no single question was the basis for a diagnosis. It was the answers to a couple of hundred questions, and then, that just screened for people who needed further examination-- and even then, the test was just given to people who had received a referral in the first place.
The point wasn’t so much that the one question about hearing voices was the be-all and end-all, as much as it is the one that malingerers are most often mendacious about, because it is so well-known. No matter how you phrase it, non-schizophrenics trying to get a false diagnosis will answer in the affirmative, while actual schizophrenics are much less likely to say “Yes.” Maybe that is for a variety of reasons-- maybe because some of them don’t relate to the term “hearing voices”; maybe because some of them are trying to avoid the diagnosis; maybe because some of them are trying to please the tester by giving what they think is the “right” answer.
The point the author of the article was making was that the question was not especially useful in screening for genuine schizophrenia, but very useful in screening for people pretending to have psychoses. When coupled with the question about food tasting the same, it was even more useful.
I can understand the question being used in detecting malingerers. But usefulness in detecting malingerers is not the same as uselessness in screening for schizophrenia.
I still take issue with the idea that it not useful in screening for genuine schizophrenia: in the experience of the psychiatrist I talked with, it is useful for that purpose, and he used it for that purpose.
And I can attest that for a non-psychiatrist, it is useful for screening for genuine schizophrenia: all of the people I know who reported hearing voices are schizophrenic: none of the people I know who are not schizophrenic have reported hearing voices (apart from the odd hypnagogic hallucination)
I still regret not knowing this / thinking this through with the first guy I knew. He was slightly worried, and later became distressed, and knowing what I know now, I would have been in contact with his parents and doctor to arrange urgent care.
But at the time, I was just “Hearing voices?” that’s interesting, but not very interesting.
Yes, diagnostic tools are useful, but developing an accurate theory of mind as it applies to both neurotypical and autistic patients is also useful, as that could potentially lead to more effective treatment or coping strategies.
Sample size of one, I just asked one that I know the Sally-Anne test. He is high functioning, but I have noticed he has trouble seeing things from other’s perspectives unless called to his attention. He said Sally should look for the ball where Anne put it, instead of where Sally last left it. I suspected he would answer it the other way, but nope evidently Sally can somehow read Anne’s mind and knew where the ball was.