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'Mind blindness' affects moral reasoning in autism

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Deborah Rudacille
17 February 2011

Bad judgment: Highly intelligent people with autism tend to evaluate behavior based upon outcomes, not intentions.

Two friends take a coffee break at a chemical plant. Mary asks Grace to pass the sugar, and Grace hands her a dispenser clearly labeled 'Sugar.' Unbeknownst to either woman, however, the dispenser contains not sugar, but a poisonous chemical that looks like it. Mary drinks her toxin-sweetened coffee and dies a few hours later.

Is Grace to blame?

Most people would say, "No," because Grace didn't know that the dispenser contained poison. But after reading 20 similar vignettes in which the actions of protagonists led to either a negative or neutral outcome, a group of 24 highly intelligent adults with autism consistently assigned a higher degree of moral blame to individuals with innocent intentions, compared with controls.

The results, which appeared online 31 January in the Proceedings of the National Academy of Sciences, show that unlike typical adults who judge accidental harms as less morally wrong than intentional ones, high-functioning people with autism tend not to weigh intention and outcome when engaged in moral reasoning1.

"Most people will tend to forgive accidental harm; these individuals were far less inclined to do so," says lead investigator John D. Gabrieli, professor of brain and cognitive sciences at the Massachusetts Institute of Technology.

The finding illuminates a core aspect of 'mind blindness' — a theory that holds that people with autism are unable to form an awareness of others' thoughts2. Also known as theory of mind, this concept has been somewhat controversial because it is so difficult to test in the laboratory.

Though even highly intelligent people with autism or Asperger syndrome are clearly challenged in their ability to understand other people's beliefs, desires and intentions, they often use their well-developed powers of logic to figure out the correct answer in laboratory tests.

In the new strategy, there are no right or wrong answers. The scenarios instead require individuals to weigh beliefs and intentions in a complex task of moral reasoning.

"We think of it as a stress test for intention versus outcome," says Gabrieli. "We asked ourselves what kind of experiment might reveal the kinds of everyday difficulties people with autism have reading the feelings and intentions of other people."

Mind games:

Healthy children develop a working theory of mind — the ability to infer another person's thoughts, beliefs and intentions — between 3 and 5 years of age. In 1985, U.K. researchers first showed that children with autism are impaired in this area using the false belief test3.

In the classic version of the test, a little girl named Sally puts a ball into a basket and goes out for a walk. While she is away, another little girl named Anne takes the ball out of the basket and puts it into a box. When Sally comes back, she wants to play with the ball. Where, the children are asked, will Sally look for the ball? "In the box," children with autism answer, unable to imagine that Sally might be operating under a false belief.

The false belief test has also been used to test theory of mind in adults with autism, but high-functioning individuals like those in the current study — who all have intelligence quotients of 120 or above — tend to pass the test easily.

"It's been very difficult to demonstrate [mind blindness] on behavioral tests, especially with adults who are very clever," says Uta Frith, emeritus professor of cognitive development at University College London and one of the architects of the theory of mind. Highly intelligent people with autism learn to use logic to help them correctly answer questions, she says. "This is part of their wonderful ability to adapt, to get around things."

In the new study, the 24 adults with autism passed a false belief test with ease, correctly answering questions such as: "Jenny put her chocolate away in the cupboard. Then she went outside. Alan moved the chocolate from the cupboard into the fridge. Half an hour later, Jenny came back inside. Does Jenny expect to find her chocolate in the cupboard or the fridge?"

Like the typical adults in the study, and in roughly the same amount of time, the participants with autism delivered the correct answers.

But the moral conundrums in the second set of experiments flummoxed them. The man traveling in Africa who encourages a friend to swim in a pond after seeing other tourists frolicking there is to blame for that friend being bitten by a mosquito and contracting malaria, they say, just as the girl who builds an igloo out of snowballs is to blame when icy snowballs crash on her friend's head. In case after case, they assign blame to individuals who intended no harm, failing to distinguish between intent and outcome.

By presenting people with autism with the kind of emotionally messy complications they encounter in social interactions, the researchers were able to tap the core of their impairment. "The test is maybe more like real life," Gabrieli says. "Much of our social life is a gray zone."

Teasing apart the various layers of theory of mind and showing precisely where high-functioning adults with autism falter is a crucial advance in understanding their deficits in social cognition, says Raphael Bernier, assistant professor of psychiatry at the University of Washington in Seattle.

The study doesn't explain whether high-functioning adults with autism truly understand false beliefs over time, or whether they merely learn to solve the tasks, Bernier notes. But it does suggest that in the case of the moral scenarios, their ability to reason is not just delayed, but absent entirely. "If these are delays, they are persistent delays that last well into adulthood for people with typical cognitive ability," he says.

Frith says she is delighted that these researchers have come up with a strategy that validates the theory she helped develop 25 years ago. "It does make sense of the social behavior," she says, "and it can be linked up to certain abnormal activations in the brain."

Impaired moral judgment is associated with distinct neural systems, including the right temporal parietal junction4. Gabrieli says his group is working on an imaging study focusing on which brain regions are active in these individuals while they are engaged in moral reasoning.

They'd better work quickly: Frith predicts that the utility of the new test may be limited. "I have no doubt that the Asperger's community will get hold of the test, study it, and learn the scenarios," she says.

References:

  1. Moran J.M. et al. Proc. Natl. Acad. Sci. U.S.A. Epub ahead of print (2011) PubMed

  2. Senju A. et al. Science 325, 883-885 (2009) PubMed

  3. Baron-Cohen S. Cognition 21, 37-46 (1985) PubMed

  4. Kana R.K. et. al. Soc. Neurosci. 4, 135-152 (2009) PubMed

Comments

Name: Mark Carew
23 February 2011 - 12:46PM

Re: 'Morality' judgement based on 'outcomes', It seems to me this is an example of strictly higher level of 'moral behavior' as compared with 'Normal'. It deals with absolute fact. Like a High Court Judge dealing with the letter of the Law.
I believe our 'normal' judgement is generally tempered by our 'shared consciousness' of common beliefs, so for example if something seems too good to be true, we generally might not believe it, like lottery win! once we understand the shared concept 'nobody would believe it'. Like a Jury sharing their judgement.
This 'arena' of the 'normal' shared consciousness may be as a foreign land to some.
Mark

Name: Shree Vaidya
23 February 2011 - 4:22PM

Thanks.Cause and effects are very intricate.Appreciate your great work.

Name: J.H
7 August 2011 - 1:57AM

"But after reading 20 similar vignettes in which the actions of protagonists led to either a negative or neutral outcome, a group of 24 highly intelligent adults with autism consistently assigned a higher degree of moral blame to individuals with innocent intentions, compared with controls."
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*Test for positive outcomes.....

(C) restricted repetitive and stereotyped patterns of behavior, interests and activities, as manifested by at least two of the following:

1. encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
2. apparently inflexible adherence to specific, nonfunctional routines or rituals
3. stereotyped and repetitive motor mannerisms (e.g hand or finger flapping or twisting, or complex whole-body movements)
4. persistent preoccupation with parts of objects
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The above section (C) is part of the DSM IV diagnostic criteria for Autistic disorder (299.00). Number 2 states: Apparently, inflexible adherence to specific non-functional routines and rituals BUT we know this definition isn't quite complete. People with Autism have inflexible ADHERENCE to specific FUNCTIONAL routines and rituals such as IEP's, transportation methods, etc, to name a few. Having sugar put in my coffee, could be look upon as simply an inflexible specific functional routine and when the routine is broken(poison is accidentally substituted for sugar) blame is assigned regardless of intent. The neurotypically mind believes blame is assigned based upon moral reasoning(intent vs. outcome), the autistic mind assigns blame based on the breaking of an inflexible specific functional routine where intent may or may not be consider as justification. All Theory.......

Name: J.H
7 August 2011 - 2:29AM

In addition, Typically developing individuals are probably more likely to embellish based upon appropriate societal norms than those on the autism spectrum. In a given social situation, neurotypicals are vastly more knowledgeable and experienced in given a socially political correct answer than those on the Autism spectrum. In other words, so-called moral reasoning(intent of the situation vs outcome of the situation) is just one of many factors involved in the decision making process of both groups and may not be the determining factor in the answers given.

Name: N. Cornell
31 August 2011 - 5:04PM

The researchers' interpretations of "the moral conundrums in the second set of experiments" flummoxed me. If a man travelling in Africa encourages his friend to swim where others are seen "frolicking", then the friend is bitten by a mosquito and gets malaria, is the man's action, then, albeit innocently, not the reason that his friend got malaria? If a girl builds an igloo out of snowballs, then the snowballs crash on her friend's head, did the girl's actions (and poorly-chosen building materials) not cause the accident? That is, although her intent may have been innocent, what does that have to do with the result? If she hadn't built the igloo the way she did, then gotten her friend in to test the structural integrity, the accident would not have occurred. In any situation, there can be good intent/good result, good intent/bad result, bad intent/good result, or bad intent/bad result. In all of these cases, what has "intent" to do with the fact that the action itself is the cause of the result, and therefore the initiator of the action is "to blame" for it, since it wouldn't have happened otherwise? And if this girl is just going to sit around complaining that she "didn't mean it," and it was, "just an accident," then her lack of feeling of responsibility("blame") for it may mean that she is one of those people who, through not acknowledging responsibility (blame,) never learn from their mistakes. In fact, isn't it thinking similar that of these adults with Asperger's, based on experience, which leads to wisdom and, hopefully, modifications in behavior? If the girl in the vignette does NOT feel herself to blame for her friend's condition after having snowballs crash on her head, why doesn't she? Doesn't she comprehend the connection between her shoddy igloo-building and her friend's burial in snowballs? People around her may console her that "You didn't mean to; it was just an accident," but why are they consoling her unless they know that she is probably aware of her responsibility in the disaster? (as is the adult with Asperger's who hears this scenario.) Of course it was an "accident," but when a school or apartment house collapses due to the builder's use of the masonry-equivalent of "snowballs" rather than the the proper packed bricks of ice, few people have trouble assigning the "blame" (responsible party.) It seems so clear to me--and the fundamental design of that part of the research study so muddy--that I'm wondering if perhaps it may be just an issue of semantics. Are the researchers using the term "blame" in a far more charged sense than the study's subjects habitually use it? Are the subjects simply viewing it as a mere logical (and seemingly irrefutable) correlation while the researchers are fixed on their context of the moral response? Cause and effect, and the recognition thereof, are as fundamental in the development of the healthy human being as sympathy or empathy may be. Or, as the old saying pithily puts it, "The road to Hell is paved with good intentions."

Name: ediself
12 January 2012 - 1:04PM

"If the girl in the vignette does NOT feel herself to blame for her friend's condition after having snowballs crash on her head, why doesn't she? Doesn't she comprehend the connection between her shoddy igloo-building and her friend's burial in snowballs? People around her may console her that "You didn't mean to; it was just an accident," but why are they consoling her unless they know that she is probably aware of her responsibility in the disaster?"
N Cornell: this is true! Even SHE is going to feel responsible, and "to blame", the reason neurotypicals don't assign "blame" for this is not based on any form of reasonning, it's based on the social contract that states "someone feels bad, she feels bad enough as it is, I'm going to make her feel better by lying to her and ignore facts".
The moral thing to do when you build an igloo and want to test its solidity is to test it yourself, not endangering others. This is moral. Being a bit dizzy and unable to imagine possible bad outcomes is not a real excuse for killing someone.....Now with the poisonned coffee, the only person who is to blame is the one who poisonned the sugar in the first place, duh, stop trying to make us autistics look like a hybrid of a monster and a robot, we're not stupid!

Name: mrvzz
5 July 2013 - 3:56PM

Exactly like cases of careless driving lead to death of pedestrian or cyclists.
Who is going to console the driver telling him "you did not intended to do any harm!"

You're driving a ton of steel, you are responsible for it.

Name: fraac
12 January 2012 - 3:46PM

Did any autistic people really blame the unaware sugar poisoner or is that sensationalist writing, Deborah?

As ediself notes, examples like a girl building a shonky igloo, when submitted to deeper (one might say autistic) analysis, aren't nearly such clearcut examples of unintentional harm.

Given the choice between a jury composed entirely of autistics or entirely of nonautistics, which would you pick? (The answer, of course, depends on how pretty you are.)

Name: ediself
13 January 2012 - 10:28AM

"They'd better work quickly: Frith predicts that the utility of the new test may be limited. "I have no doubt that the Asperger's community will get hold of the test, study it, and learn the scenarios," she says."
Quoting your last sentence here.
This is NOT what we do, dammit. We ANALYZE the scenarios given, to understand how YOUR mind works. Then we try to determine exactly what your beliefs about us are, based on the type of questions you design for us. Because believe it or not, you guys have preconcieved ideas and apparently don't deem it necessary to ASK US what we think. We are not going to learn the scenarios by heart to try and appear NT in one of your tests. I'm sure I'm speaking for most autistics here when I say that a diagnosis of autism is a relief and a validation of who we are, an explanation for our messy childhoods, and a lot of abuse endured because of our lower rank in your social games. No autistic person is going to try and cheat on a diagnosis for autism. If we seek diagnosis, it's to obtain diagnosis, and it's often a long battle. I for one am apalled by how shallow and hurtful this article is, try showing a bit of what you're so happy to say you have and we lack: compassion, understanding and empathy. Thanks.

Name: qwerty
7 February 2013 - 3:56AM

i agree with statements in other comments. sugar poisoner is innocent. no reason to expect poison in sugar. snow igloo builder is responsible. should've tested the thing...just like any other manufacturer. malaria is not guilty. friend had a choice whether to swim unless was physically forced to do so. this does explain some of the punishments i received as a child in the 1970 s from my ( now diagnosed ... but at the time just considered unsociable) father. punished when i injured myself when my home made hammock collapsed (obviously my fault for building the flimsy thing) punished when startled cat broke a clock (obviously should have considered the possible actions of the cat before sneaking up on it....) the list goes on....

Name: Ellie Kesselman
5 July 2013 - 1:39PM

I agree with majority of prior comments. Autistic individuals are supposedly fact driven, but lack comprehension of subtle interpersonal interaction. Fine.

Dissect sugar and poison story given facts provided. Note that it states clearly that neither woman is aware of the contents of the sugar container. Somehow, someone OTHER than either woman substituted poison for sugar in container marked sugar. That is the guilty party. If first woman's only information was that it was a container labelled "sugar", then she acted rationally, as did recipient who died. Autistic individual would have a deficiency to think otherwise, but it wouldn't be deficiency of moral reasoning! Again, I don't understand what this scenario proves.

Regarding collapsing igloos, there are societal norms and Rule of Law which dictate when one is culpable or not for one's actions. Autistic person could use that as basis for determining acceptable, socially "just' outcome.

Name: marvzz
5 July 2013 - 4:05PM

In my opinion the sugar scenario is fundamentally wrong, in the sense that they are at a chemical plant and someone willingly substitutes sugar with poison. But this person is not mentioned in the test. If we include our "terrorist" in the test, i think everyone, autistic and not, will blame him.

Name: Rivka
8 July 2013 - 6:39PM

Was there a control group (consisting of non-autistic adults)? None is mentioned.

Name: Jessica Wright
8 July 2013 - 7:35PM

Hi Rivka,
Thanks for your comment.
Yes, adults with autism were compared with typical adults who were matched by gender, age and IQ. In one experiment there were 13 typical participants and 13 with autism, the second included 15 controls and 13 adults with autism.

Name: Michelle
1 November 2013 - 10:18AM

Is there anywhere to access the exact methodology used, and the vignettes used?
Thanks

Name: Niall
15 February 2014 - 6:17PM

I'm trying to work out exactly which group is actually impaired here. I read these vignettes and, in some cases, I see a degree of culpable negligence. If someone builds a structure, and someone else is hurt when it collapses, then there is fault in the builder for failing to ensure structural integrity. If someone is in an environment when something that looks like sugar might not in fact be sugar, then negligence is involved, if to a lesser degree. If the sugar bowl had been in a coffee shop, then one could have safely assumed it was sugar. If it was in a chemical factory, it might have been any number of other things.

This impairment in allistic moral reasoning is reflected in law in many countries. For example, if a cyclist is killed by a motorist, I see a case, in many instances, for culpable negligence, suggesting the killer is as responsible as anyone else who kills as a result of negligence. Such a killer often escapes with no more than a rap on the wrist, which is deeply problematic in terms of public safety on the roads, because it sends a message to motorists that they can be negligent with no likelihood of consequences if that negligence results in loss of life.

To me, it presents another problem. I am aware that my variant prosody, differences in eye contact and poor understanding of the expectations of others in terms of social distance and these "hints" allistics persist in making and then insist they were "clear" signals present a problem for interlocutors in social situations, resulting in discomfort for those interlocutors. It them becomes irresponsible of me to attempt to socialise when I am aware of such issues. This is, however, poorly understood by many allistics, who seem to think it's "just a case of practice".

Name: Hilary
6 March 2014 - 10:39AM

Yes, my thought was the same: 'Shouldn't she at least have considered her igloo might collapse?'

Another thought: an autistic adult has spent their formative years being blamed for causing harm unintentionally. If your behaviour hurt your friend's feelings, this is your fault. It doesn't matter that you didn't mean to and had no idea this would happen; you should have been able to anticipate the result. So if the test subjects apply the same standards to the scenarios as they have learned in life...

...well, I suspect the researchers are not testing what they think they are testing. Alas, they seem to be suffering from a degree of 'mind blindness' that makes this possibility invisible to them...

Name: Marie
13 March 2014 - 6:24PM

I concur with much of what has been said above about the flawed reasoning that is inevitable when trying to "test" individuals according to a discrete moral code, which comes accompanied with outcomes based on specific social conventions.

By definition, autists have a different view of social norms, including moral norms, as "outside" factors that need to be adhered to in order to thrive, and not "innate", or given. It also implies that the test setting, being theoretical, and absolutely not "more like real life", means that an autist takes this factor into consideration as a variable. There is no correlation between a "theoretical" answer and a "real life" answer for autists, because that is where the real divide is. Failure to see these factors, to me, shows a lack of theory of mind on the part of the author.

There is no moral divide between having difficulty understanding where fault lies and where others think it should lie. The divide that this test shows is based in logic, as the author so cunningly - and condescendingly - put it in his conclusion, and not in subjective moral, which is as random as the sum total of any individual's life experiences.

And indeed, because autists have not only to trust their own judgment and experience, but also actively think of their adherence to social norms and wheigh them against convention, most autists I know are highly moral, not the opposite. In this view, using the phrase "impaired moral judgment", and indeed suggesting it as equating with the real issue, which is difficulty in seeing a normative view of the world, is highly offensive. When did autists become psychopaths, exactly?

I strongly encourage the author to use his theory of mind to try to map the psychology of morals in autists before making such damaging implications as equating parallel and contextual thinking with moral impairment.

Name: Marie
13 March 2014 - 6:32PM

My apologies to the author for not seeing the she was female, and using the masculine in the above comment.

Now, shall we debate on the implications of this error for the evaluation of my moral compass? Food for thought.

Name: Evelyn
16 March 2014 - 8:30PM

Hi I am doing my postgraduate research project and hoping to use some of this study in my research. Does anyone know where to access the complete stories and photographs used? Thanks

Name: Jane
16 April 2014 - 5:00PM

I don't have autism but my response to this would be that actually there is no right or wrong answer here and logically speaking some demand different answers. If it was me that got bitten by the mosquito I'd certainly be thinking 'if you hadn't encouraged me to go in that pool I wouldn't have been bitten, therefore it is your fault that happened,' that is inherently rational and logical. Outwardly I'd be obliged to say 'yes well, you didn't MAKE the mosquito bite me did you? I can see you just wanted me to have fun in the water.' Obviously they couldn't forsee that happening (but they are still guilty of being the instigator of the event leading to it) so we socially pardon them of wrongdoing, it's just a social expectation we do so based on the social logic that they will be so kind to us next time we are to blame.

On the other hand, with the sugar scenario the woman asked to be passed the sugar, she wasn't encouraged to have sugar in her tea by her friend, so there is no way to apportion blame and guilt to her.

Name: Jane
16 April 2014 - 5:03PM

In a test scenario we don't have to be 'socially appropriate' so I could give what I consider to be a fair answer without causing any offence to anyone.

There may be a difference in whether people are answering rationally or instinctively.

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