Visual perspective taking impairment in children with autistic spectrum disorder

Evidence from typical development and neuroimaging studies suggests that level 2 visual perspective taking – the knowledge that different people may see the same thing differently at the same time – is a mentalising task. Thus, we would expect children with autism, who fail typical mentalising tasks like false belief, to perform poorly on level 2 visual perspective taking as well. However, prior data on this issue are inconclusive. We re-examined this question, testing a group of 23 young autistic children, aged around 8 years with a verbal mental age of around 4 years and three groups of typical children (n = 60) ranging in age from 4 to 8 years on a level 2 visual perspective task and a closely matched mental rotation task. The results demonstrate that autistic children have difficulty with visual perspective taking compared to a task requiring mental rotation, relative to typical children. Furthermore, performance on the level 2 visual perspective taking task correlated with theory of mind performance. These findings resolve discrepancies in previous studies of visual perspective taking in autism, and demonstrate that level 2 visual perspective taking is a mentalising task.