Looking for the lighthouse: A systematic review of advanced theory-of-mind tests beyond preschool

Advanced Theory of Mind (AToM) refers to the age-related progressions in mindreading that occur in the development of theory of mind after the age of 5 years. Despite the growth in studies, AToM remains a conceptually slippery skill to test in youth and adults. To address this conundrum, this paper reports a systematic review of the literature on AToM during the past ten years. We explored which measures are the most frequently used (a) across age groups, and (b) to study antecedents and consequences of AToM. Our study also reports on meta-analytic findings regarding the relation between AToM, language and executive control (antecedents), as well as between AToM and empathy (consequence). Results show a large variation for definitional operationalizations of AToM, ranging from understanding higher-order false belief and nonliteral speech, to the decoding of facial expressions and the recognition of social blunders also known as faux pas. In contrast, results showed relatively little variation in test use. Specifically, for each main operationalization, a single most frequently-used test was found (second-order false belief understanding; strange stories; reading the mind in the eyes test; faux pas recognition test; and Frith-Happé triangles test). Together, these five tasks accounted for more than 60% of measures used. The results of three meta-analyses revealed that individual differences in AToM were significantly related to language skills and inhibition, but not empathy. Our review extends past studies to show systematic differences in AToM task use, and will help researchers make informed decisions about task choice across the lifespan.