Working memory predicts changes in children’s theory of mind during middle childhood: A training study

Longitudinal relations between theory of mind and academic achievement among deaf and hard-of-hearing school-aged children

This 2-year longitudinal study investigated the bidirectional relations between the development of theory of mind (ToM) and academic competences in a sample of 270 deaf and hard-of-hearing (DHH) children (Mage at Wave 1 = 7.52 years, SD = 0.99; 58.5% boys and 41.5% girls). Across three waves (10 months apart), children were assessed for their ToM abilities, using the ToM scale and a second-order false belief task, as well as for their language and mathematics skills. Cross-lagged correlational analysis revealed significant bidirectional associations between ToM and academic achievement (language and mathematics). That is, ToM predicted academic achievement with similar strength as ToM development itself was predicted by academic achievement. Our results highlight the bidirectional nature of the association between ToM and academic achievement, and they show that ToM development plays a crucial role in DHH children's school functioning.

Social cognition and behavioral outcomes in congenital heart disease: profiles and neuropsychiatric comorbidities

Autism spectrum disorders are more prevalent in children with congenital heart disease (CHD) than in the general population. Children with CHD without diagnosed autism are also at increased risk for neurodevelopmental and psychiatric impairments. We characterized social and behavioral outcomes in children with CHD and examined neurodevelopmental and psychiatric comorbidities. Children without diagnosed autism who underwent infant open-heart surgery were eligible. Parent-reports assessed social communication, unusual behaviors, self-regulation, anxiety, and executive function (EF). Neuropsychological tests assessing theory of mind (ToM), working memory, and verbal comprehension were administered. Outcomes were compared to normative data. Linear regressions were estimated with parent-reported scores and ToM abilities as outcomes. Predictors were anxiety symptoms, parent-reported EF, and working memory scores. Covariates were age, parental education, ADHD diagnosis, and verbal comprehension. Clinically relevant comorbidities were identified (N children scoring ≥1SD below the norm). Fifty-six children (10.8 ± 1.8 years) participated virtually. Compared to norms, children with CHD had impaired ToM, more unusual behaviors (p = .002), and less self-regulation (p = .018), but better social communication (p = .014). "Autism-like" traits were positively associated with anxiety symptoms (ß(95% CI) = 0.28(0.08-0.49), p = .008) and worse working memory (ß(95% CI) = -0.36(-0.59-0.13), p = .003). Twenty-one out of 22 children who displayed clinically relevant social and behavioral scores also showed anxiety symptoms (n = 4), impaired EF (n = 7), or both (n = 10). Children with CHD without diagnosed autism have elevated unusual behaviors, lower self-regulation, and impaired ToM. There is a high risk of co-existing anxiety and impaired EF which may increase disease burden. Targeted therapeutic interventions are needed to reduce long-term psychosocial risks in these children.AbbreviationAttention deficit/hyperactivity disorder (ADHD), Autism Spectrum Rating Scale (ASRS), Behavior Rating Inventory of Executive Functions for school-aged children, 2nd Edition (BRIEF-2), cardiopulmonary bypass (CPB), congenital heart disease (CHD), Empathy/Systematizing Quotient Child Version (ESQ-C), Multidimensional Anxiety Scale for Children, 2nd Edition (MASC-2), Social Responsiveness Scale (School-age form), 2nd Edition (SRS-2), theory of mind (ToM), Theory of Mind Task Battery (ToM-TB), Wechsler Intelligence Scale for Children, 5th edition (WISC-V).

Executive function as a generalized determinant of psychopathology and functional outcome in school-aged autism spectrum disorder: a case-control study

BACKGROUND

Individuals with autism spectrum disorder (ASD) are challenged not only by the defining features of social-communication deficits and restricted repetitive behaviors, but also by a myriad of psychopathology varying in severity. Different cognitive deficits underpin these psychopathologies, which could be subjected to intervention to alter the course of the disorder. Understanding domain-specific mediating effects of cognition is essential for developing targeted intervention strategies. However, the high degree of inter-correlation among different cognitive functions hinders elucidation of individual effects.

METHODS

In the Philadelphia Neurodevelopmental Cohort, 218 individuals with ASD were matched with 872 non-ASD controls on sex, age, race, and socioeconomic status. Participants of this cohort were deeply and broadly phenotyped on neurocognitive abilities and dimensional psychopathology. Using structural equation modeling, inter-correlation among cognitive domains were adjusted before mediation analysis on outcomes of multi-domain psychopathology and functional level.

RESULTS

While social cognition, complex cognition, and memory each had a unique pattern of mediating effect on psychopathology domains in ASD, none had significant effects on the functional level. In contrast, executive function was the only cognitive domain that exerted a generalized negative impact on every psychopathology domain (p factor, anxious-misery, psychosis, fear, and externalizing), as well as functional level.

CONCLUSIONS

Executive function has a unique association with the severity of comorbid psychopathology in ASD, and could be a target of interventions. As executive dysfunction occurs variably in ASD, our result also supports the clinical utility of assessing executive function for prognostic purposes.

The mediating effect of language on the development of cognitive and affective theory of mind

Theory of mind (ToM) development is critical to effective social functioning and appears to depend on complementary language abilities. The current study explored the mediating influence of language on the development of both cognitive and affective ToM. A total of 151 children aged 5-12 years completed ToM (cognitive and affective) and language assessments, and parents provided ratings of their children's empathic ability. Results showed that language mediated the relationship between age and both cognitive and affective ToM but not parent-reported cognitive empathy. Examination of younger and older subgroups revealed that language mediated cognitive and affective ToM differently across developmental periods. Findings highlight the dynamic role that language plays in the development of both cognitive and affective ToM throughout early and middle childhood.

Theory of Mind in ADHD. A Proposal to Improve Working Memory through the Stimulation of the Theory of Mind

The aim of this study was to investigate the relationships between Theory of Mind (ToM), Working Memory (WM), and Verbal Comprehension (VC). Performance of these variables was evaluated in 44 elementary students (6-12 years) diagnosed with ADHD. Their performance in all variables was collected through the Neuropsychological Battery (NEPSY-II) and the Wechsler Intelligence Scale for Children IV. The results showed that fifty percent of the participants were below the 25th percentile in ToM and that this low performance was not related to age. In addition, analyses showed statistically significant relationships between WM, VC, and ToM. Analysis of the effect of WM and VC on ToM showed that only WM explained the variance in participant performance in ToM. These results led us to raise the need to include ToM among the skills to be stimulated in programs for the treatment of ADHD, accompanying other skills related to social adaptation that are usually included in such programs. Likewise, considering that ToM implies putting into practice skills such as considering different points of view, attending to relevant aspects of the context, making decisions, inferring mental states, and predicting behaviors, we believe that through the stimulation of ToM, WM would also be stimulated.

Children's Individual Differences in Executive Function and Theory of Mind in Relation to Prejudice Toward Social Minorities

Executive function (EF) and theory of mind (ToM) are key cognitive skills for socio-emotional adjustment. Executive function develops considerably between 3 and 7 years of age, and fosters the development of social cognition skills such as ToM. Studies with adults have shown a link between EF and prejudice, as well as between empathy and prejudice. Moreover, the relationship between EF, cognitive and affective ToM and prejudice has barely been studied in children. In this study, we aimed at examining the relationship between individual differences in EF, cognitive and affective ToM and prejudice toward the Romany ethnic minority. We expected a positive association between EF and ToM skills, and a negative association between EF and prejudice. We also predicted a negative association between ToM and prejudice. A total of 86 preschool (5-6 years old, N = 43) and third-grade (8-9 years old, N = 43) children participated in the study. Results showed a negative relationship between EF and prejudice, as well as between affective ToM and prejudice, after controlling for intelligence. Moreover, we found that EF significantly predicted prejudice. Exploratory correlational analyses suggested age-related differences in the EF skills underlying prejudice regulation. These findings suggest a distinctive contribution of cognitive and affective components of ToM to prejudice, and highlight the central role of EF in social behavior regulation.