Social cognition in adults with autism spectrum disorders: Validation of the Edinburgh Social Cognition Test (ESCoT)

Asaad Baksh, Sharon Abrahams, Maya Bertlich, Rebecca Cameron, Sharon Jany, Terin Dorrian, Simon Baron-Cohen, Carrie Allison, Paula Smith, Sarah E MacPherson, Bonnie Auyeung

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Objective: Many existing tests of social cognition are not appropriate for clinical use, due to their length, complexity or uncertainty in what they are assessing. The Edinburgh Social Cognition Test (ESCoT) is a new test of social cognition that assesses affective and cognitive Theory of Mind as well as inter- and intrapersonal understanding of social norms using animated interactions. Method: To support the development of the ESCoT as a clinical tool, we derived cut-off scores from a neurotypical population (n=236) and sought to validate the ESCoT in a sample of Autism Spectrum Disorder (ASD; n=19) adults and neurotypical controls (NC; n=38) matched on age and education. The ESCoT was administered alongside established tests and questionnaire measures of ASD, empathy, systemizing traits and intelligence. Results: Performance on the subtests of the ESCoT and ESCoT total scores correlated with performance on traditional tests, demonstrating convergent validity. ASD adults performed poorer on all measures of social cognition. Unlike the ESCoT, performance on the established tests was predicted by verbal comprehension abilities. Using a ROC curve analysis, we showed that the ESCoT was more effective than existing tests at differentiating ASD adults from NC. Furthermore, a total of 42.11% of ASD adults were impaired on the ESCoT compared to 0% of NC adults. Conclusions: Overall these results demonstrate that the ESCoT is a useful test for clinical assessment and aid in the detection of potential difficulties in ToM and social norm understanding.
Original languageEnglish
JournalThe Clinical Neuropsychologist
Early online date18 Mar 2020
Publication statusE-pub ahead of print - 18 Mar 2020

Keywords / Materials (for Non-textual outputs)

  • Autism Spectrum Disorder
  • Edinburgh Social Cognition Test
  • social cognition
  • theory of mind
  • understanding social norms


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