Which are the best predictors of theory of mind delay in children with specific language impairment?

The link between the factuality of verb and the theory of mind ability of Mandarin-speaking children with high-functioning autism

BACKGROUND

Weak theory of mind (ToM) ability is a core deficit in children with autism. A growing body of work has found that there is a close relation between complement syntax and ToM in autistic children. However, researchers have not yet investigated whether other linguistic components may explain the difficulties in ToM reasoning in autistic children.

AIMS

To determine whether verb factuality (i.e., mental and action verbs) is related to ToM ability, as measured by a false belief understanding (FBU) task after controlling the effect of complement syntax for Mandarin-speaking autistic children.

METHODS & PROCEDURES

Participants were verbal autistic children, aged 4-7 years. Their IQ performance (verbal, performance and total IQ) and the comprehension of complement syntax were evaluated. A total of 38 children scoring over 9 points in complement syntax test and 90 points in the verbal IQ test were selected to complete verb factuality and FBU task. The χ2 tests and correlation analyses were carried out on two relations: (1) ToM ability and understanding of verb factuality; and (2) ToM ability and comprehension of complement syntax.

OUTCOMES & RESULTS

A total of 11 autistic children completed the action verb factuality task, while 14 completed the mental verb factuality task and 13 completed both tasks. Participants performed well on the verb factuality task, and their ToM performance appeared to be related to their linguistic ability, regardless of the type of verb (i.e., action or mental verb). However, complement syntax scores did not significantly predict the success of the FBU task for the autistic children.

CONCLUSIONS & IMPLICATIONS

The results of this study link weaker ToM ability with the understanding of verb factuality among autistic children aged 4-7 and provide new evidence for the view that the development of language facilitates improvement of ToM skills. The findings shed new light on how language affects or determines social interactions.

WHAT THIS PAPER ADDS

What is already known on the subject ToM ability is crucial for social interaction. It has been claimed that mental verb factuality (e.g., think, had thought) may play a role in the development of ToM reasoning in typically developing children, but whether there is a link between the mastery of verb factuality and ToM skills in autistic children is still unclear. What this study adds to existing knowledge Correlational analysis revealed links between verbal ToM measured by unexpected location task and factuality test of mental verbs as well as action verbs. More importantly, this study confirmed the extra role of verb factuality in explaining ToM ability after excluding the influence of the complement syntax. What are the potential or actual clinical implications of this work? This study suggests that the factuality of verbs could serve as a tool for autistic children to infer the mental states of others. Thus, training on this linguistic structure could be taken into consideration when improving the social skills of autistic children.

Specific learning disorders in young adults: Investigating pragmatic abilities and their relationship with theory of mind, executive functions and quality of life

BACKGROUND

Specific Learning Disorders (SLD) are lifelong conditions often associated with language difficulties, executive dysfunctions, and psychological problems. Previous research has shown that communicative-pragmatic ability may be impaired in SLD. However, the role of other cognitive abilities in explaining pragmatic difficulties has still not been fully investigated. The relationship between pragmatics and quality of life is not yet clear, as well.

AIMS

Firstly, the study assessed pragmatic comprehension abilities in adults with SLD. Secondly, we examined the relationship between pragmatics, theory of mind, executive functions and quality of life.

METHOD AND PROCEDURES

We enrolled 26 adults with SLD and 30 adults without SLD. Standardized tests assessing pragmatic comprehension, theory of mind and executive functions were used. The quality of life was investigated with a self-reported questionnaire.

OUTCOMES AND RESULTS

Pragmatic comprehension abilities were compromised in young adults with SLD. In this clinical population we also found a link between pragmatic comprehension and visual theory of mind. Finally, independently from the presence of SLD, pragmatics abilities were in relationship with quality of life.

CONCLUSIONS AND IMPLICATIONS

Overall, these data highlight the importance of including pragmatic abilities both in the clinical evaluation, as well as in psychological intervention for adults with SLD.

Theory of Mind Development in Italian Children with Specific Language Impairment and Autism Spectrum Disorder: Delay, Deficit, or Neither?

Some studies report delayed theory of mind (ToM) development in children with specific language impairment (SLI), while others do not. A ToM delay is acknowledged in children with autism spectrum disorder (ASD), while whether these children also display a deficit is still under debate. In the current study, we drew on a developmental trajectory approach to assess whether children with SLI or ASD displayed delays or deficits in their ToM performance. Forty-three children with SLI (age 4-10 years), 44 children with ASD (age 5-12 years), and 227 typically developing children (age 3-11 years) completed the ToM Storybooks. Children with SLI were not found to display either a delay or a deficit in ToM, while children with ASD were found to display a deficit.

Improving social emotional functioning in adolescents with Developmental Language Disorders: A mini review and recommendations

Adolescents with Developmental Language Disorders (DLD) have more difficulties in social emotional functioning than their typically developing peers (TD), such as shyness and anxiety in social situations, fewer peer relations, greater risk of victimization, social isolation and depression. In addition, they are more likely to report higher levels of hyperactivity and conduct problems. These problems derive from a complex interplay between difficulties in language, social communication, underlying cognitive deficits in Theory of Mind (ToM), Executive Functioning (EF) and self-directed speech (SDS). The aim of this mini review is to provide an overview of studies examining the effectiveness of interventions targeting the factors underlying social emotional functioning of school-aged children and adolescents with DLD. We found that studies dedicated to social emotional functioning in school-aged children and adolescents with DLD were relatively scarce. Based on this overview, we give suggestions to improve social emotional functioning in adolescents with DLD. We propose that intervention programs should target the social, linguistic and cognitive functions underlying social emotional functioning and create opportunities to practice these skills in daily, real-life situations with peers.

Theory of Mind in children and adolescents with Down syndrome

INTRODUCTION

To date, the evidence regarding False Belief (FB) abilities in individuals with Down syndrome (DS) has been both sparse and contradictory. Our study is the first systematic investigation targeting the relation between FB, mental age (MA), syntactic abilities (SA) and verbal short-term memory (VSTM) in individuals with DS so far.

METHOD

27 German-speaking children/adolescents with DS (aged 10;0-20;1 years) completed a location-change FB-task and four standardized measures assessing nonverbal intelligence & MA, VSTM, receptive and productive SA.

RESULTS

37.5 % (n = 9) of our participants passed the FB-task, whereas 62.5 % (n = 15) did not answer the target question correctly. While no significant differences emerged for MA and language abilities in individuals who passed and those who failed FB-testing, VSTM came out as a significantly associated factor for FB-performance in a median split analysis of raw-scores.

DISCUSSION

The results suggest that a substantial proportion of individuals with DS is impaired in FB-understanding. In contrast to previous findings on children with developmental disorders such as autism, developmental language deficit or hearing impairment, general and specific SA related to sentence complementation turned out to be of limited relevance for FB-understanding in individuals with DS.

Training Complements for Belief Reasoning in Developmental Language Disorder

Purpose Children with developmental language disorder (DLD) experience difficulties with an important Theory of Mind milestone, namely, false belief (FB) reasoning. Their FB success relates to mastery of a linguistic structure that is also challenging for them, namely, sentential complements (e.g., Claire says/thinks [that Santa Claus exists]). Training typically developing (TD) children on complements has been shown to boost complements and, in turn, enhance FB, but such training has never been explored with children with DLD, which is the aim of the current study. Method Fifty French-speaking children followed a novel training program: 30 with DLD (M _age = 7;3) and 20 TD (M _age = 4;3). They engaged in iPad applications targeting complementation with verbs of communication (e.g., say, shout, answer) during eight to 12 sessions lasting 30 min. Training commenced within 1-2 weeks of pretests and ceased 1-2 weeks before immediate posttests. After immediate posttests, the majority of children were available to be tested with follow-up tests after 4-6 weeks of no training. Results Findings revealed that both TD and DLD groups benefited from the training to significantly improve their complementation and FB scores. The gains achieved during immediate posttests were moreover maintained 6-8 weeks after training ceased, as revealed by preserved levels of performance during follow-up posttests. Conclusion This research thus suggests new avenues for therapeutic interventions for children with DLD, namely, the incorporation of a program directly training complements, which holds the promise of a double benefit, both for these structures and for Theory of Mind.

The Impact of Grammar on Mentalizing: A Training Study Including Children With Autism Spectrum Disorder and Developmental Language Disorder

Training on complements in English, German, and Mandarin has been reported to trigger improvements on both complements and Theory of Mind (ToM), with typically developing (TD) pre-schoolers on the verge of developing these skills (Hale and Tager-Flusberg, 2003; Lohmann and Tomasello, 2003; Shuliang et al., 2014). In the current study, we build on the idea that increasing mastery of complementation holds the promise of enhancing ToM, and seek (i) to replicate the positive effects observed in previous work for this effect in French-speaking TD children, and (ii) to pilot extending this to clinical children, more specifically those with Autism Spectrum Disorder (ASD) and Developmental Language Disorder (DLD), through exploring whether improvement in the latter, clinical groups follows that of the TD group. Sixty children with ToM difficulties, 16 with ASD (aged 5;6–11;8), 20 with DLD (aged 4;8–9;0) and 24 typically developing children aged (2;9–5;3 years), participated in a 4-week training program. Half received training targeting sentential complements and half received a control training targeting lexical skills. Complementation training, but not lexical training, led to a significant direct increase in complements, and also had the indirect effect of significantly boosting belief reasoning. TD and clinical groups followed the same patterns of performance. These results confirm previous findings in other languages for TD, and further suggest promising new directions for therapeutic programs addressing ToM delays in populations of different aetiologies, namely the incorporation of a motivating training on complementation.

The Interplay Between Theory of Mind and Social Emotional Functioning in Adolescents With Communication and Language Problems

Adolescents with developmental language disorders (DLDs) and adolescents who are deaf or hard of hearing (D/HH) are at greater risk of social emotional problems. These problems may not only be attributed to communication and language problems but, at least in part, to Theory of Mind (ToM) deficits as well. In this mini review, an overview is provided of studies on social emotional functioning and ToM performance in adolescents with DLD and D/HH adolescents. A possible interplay between social emotional functioning and Theory of Mind is discussed. There is empirical evidence for social emotional problems and ToM problems in both adolescents with DLD and D/HH. We hypothesized that language deficits as seen in adolescents with DLD and impoverished exposure to language and communication, as seen in adolescents who are D/HH can explain differences in social emotional functioning and ToM performance. The present mini review provides a possible framework for the relation between ToM and social emotional functioning in adolescents with communication and language problems, which is mediated by their limited linguistic ability or restricted language exposure and gives suggestions for future research.

Why parametric measures are critical for understanding typical and atypical cognitive development

Children's cognitive abilities improve significantly over childhood and adolescence. We know from behavioral research that core cognitive processes such as working memory and mental attention improve significantly across development. Functional magnetic resonance imaging (fMRI) allows for investigating the typically developing, living brain in action. In the last twenty years we have learned a great deal about brain correlates associated with how adults hold and manipulate information in mind, however, neurocognitive correlates across development remain inconsistent. We present developmental fMRI findings on cognitive processes such as working memory and mental attention and discuss methodological and theoretical issues in the assessment of cognitive limitations in the visual spatial and verbal domains. We also review data from typical and atypical development and emphasize the unique contribution parametric measures can make in understanding neurocognitive correlates of typical and atypical development.

A role for epistemic trust in speech-language pathology: A tutorial paper

This paper provides an introduction to epistemic trust for speech-language pathologists (SLPs). 'Epistemic trust' describes a specific form of trust that an individual places in others when learning about the world, particularly the social world. To date, the relevance of epistemic trust to SLP clinical practice has received little theoretical or empirical attention. The aim of this paper is to define epistemic trust and explain its relationship with parent-child attachment and mentalization which have, in turn, been linked with language development and use. Suggestions are made for ways in which SLPs may encourage epistemic trust in clients, emphasizing the need to establish strong therapeutic alliances. The authors conclude that epistemic trust is an important consideration for SLPs and that further research exploring the relationship between epistemic trust and language skills is needed to better understand the interplay of these variables and inform clinical practice.

Theory of mind in SLI revisited: links with syntax, comparisons with ASD

BACKGROUND

According to the linguistic determinism approach, knowledge of sentential complements such as: John says that the earth is flat plays a crucial role in theory of mind (ToM) development by providing a means to represent explicitly people's mental attitudes and beliefs. This approach predicts that mastery of complements determines successful belief reasoning across explicit ToM tasks, even low-verbal ones, and across populations.

AIMS

(1) To investigate the link between a low-verbal ToM-task and complements in Specific Language Impairment (SLI), (2) To determine whether this population shows similar ToM performance to that of children with Autism Spectrum Disorder (ASD) or those with Typical Development (TD) once these groups are matched on competency for complements, (3) To explore whether complements conveying a falsehood without jeopardizing the veracity of the entire sentence, such as complements of verbs of communication, are more crucial for belief attribution than complements which do not have this property, namely complements of verbs of perception, (?John sees that the earth is flat).

METHODS & PROCEDURES

Children with SLI (n = 20), with ASD (n = 34) and TD (n = 30) completed sentence-picture-matching tasks assessing complementation with communication and perception verbs, as well as a picture-sequencing task assessing ToM. Children were furthermore evaluated for general grammatical and lexical abilities and non-verbal IQ.

OUTCOMES & RESULTS

Results reveal that competency on complements relates to ToM performance with a low-verbal task in SLI, and that SLI, ASD and TD groups of equivalent performance on complements also perform similarly for ToM. Results further suggest that complements with an independent truth-value are the only ones to show a significant relation to ToM performance after teasing out the impact of non-verbal reasoning.

CONCLUSIONS & IMPLICATIONS

This study suggests that clinical groups of different aetiologies as well as TD children perform comparably for ToM once they have similar complementation skills. Findings further highlight that specific types of complements, namely those with an independent truth value, relate in a special way to mentalizing. Future work should determine whether these specific structures could be effective in ToM remediation programmes.

Theory of Mind Deficits and Social Emotional Functioning in Preschoolers with Specific Language Impairment

Children with Specific Language Impairment (SLI) often experience emotional and social difficulties. In general, problems in social emotional functioning can be cognitively explained in terms of Theory of Mind (ToM). In this mini-review, an overview is provided of studies on social-emotional functioning and ToM in preschoolers (average age from 2.3 to 6.2 years) with SLI. It is concluded that, similar to school-aged children with SLI, preschoolers with SLI have several social-emotional problems and that both cognitive and affective aspects of ToM are impaired in those children. Based hereon, three possible causal models for the interrelation between language, ToM and social emotional functioning are put forward. It is proposed that future research on the construct and measurement of early ToM, social emotional functioning and language development in preschoolers with SLI is needed to achieve early detection, tailored treatment, and ultimately insight into the pathogenesis of SLI.

Supporting the home language of bilingual children with developmental disabilities: From knowing to doing

There is a growing awareness of bilingualism and the needs of children with developmental disabilities who are exposed to more than one language. This growing awareness is paralleled by a growing research base in the area of bilingualism and emerging research in bilingual children with developmental disabilities. In this set of articles we see that there is general agreement that bilingualism does not increase risk for language impairment nor does intervention in the home language interfere with second language learning. Yet there continues to be challenges in putting this knowledge into practice. By better understanding the challenges to implementation in context we can better address the needs of children, families, and practitioners.

Theory of mind and specific language impairment in school-age children

Research on the relationship between aspects of language development and Theory of Mind (ToM) in children with language impairments suggests that children with language impairment show a delay in ToM development. This study aimed to examine the relationships of the syntactic, semantic, and pragmatic skills with ToM in school-age children. Twenty children with Specific Language Impairment (SLI) aged 9-12 years and two control groups, one matched for chronological age (CA) and one for language ability (LA) (aged 8-10 years) were compared on a set of language tasks tapping syntactic, semantic, and pragmatic skills and on an advanced test of ToM. Results showed that children with SLI performed poorly on the ToM task compared to the CA matches. Also, analysis showed that language skills and ToM are related and that syntactic and pragmatic abilities contributed significantly to the prediction of ToM performance in the SLI group. It is concluded that the syntax/pragmatic aspects of the language impact on ToM understanding in children with SLI.

Social cognition makes an independent contribution to peer relations in children with Specific Language Impairment

BACKGROUND

Language is important for developing and maintaining social relationships, and also for understanding others minds. Separate studies have shown that children with Specific Language Impairment (SLI) present difficulties in both abilities, although the role of social cognition (SC) on peers' perception remains unexplored.

AIMS

The present study aims to assess specific sociometric features of children with SLI through peer nominations of liking and disliking, and also to explore their relationship to the children's SC.

METHODS AND PROCEDURES

Thirty-five children with SLI attending ordinary schools (3;10 to 8;00 years old) and thirty-five age-matched children (AM) were assessed with language, SC and sociometric measures.

RESULTS

SLI group received more disliked nominations and had lower scores on SC tasks compared to the AM group. After controlling for age and language, SC made an independent contribution to disliked nominations within the SLI group.

CONCLUSIONS

Difficulties with peers of children with SLI are related to their language level but also with their SC abilities. Consequently, only resolving language impairments will not necessarily improve early peer acceptance in children with SLI.

IMPLICATION

This finding stresses the importance of early intervention programmes aimed at reducing deleterious effects in later development and socialization with peers.

Emotion Understanding in Clinically Anxious Children: A Preliminary Investigation

Children’s understanding of the nature, origins and consequences of emotions has been intensively investigated over the last 30–40 years. However, few empirical studies have looked at the relation between emotion understanding and anxiety in children and their results are mixed. The aim of the present study was to perform a preliminary investigation of the relationships between emotion understanding, anxiety, emotion dysregulation, and attachment security in clinically anxious children. A sample of 16 clinically anxious children (age 8–12, eight girls/boys) was assessed for emotion understanding (Test of Emotion Comprehension), anxiety (Screening for Child Anxiety Related Emotional Disorders-Revised and Anxiety Disorder Interview Schedule), emotion dysregulation (Difficulties in Emotion Regulation Scale) and attachment security (Security Scale). Children who reported more overall anxiety also reported greater difficulties in regulating their emotions, and were less securely attached to their parents. The results also showed that more specific symptoms of anxiety (i.e., OCD and PTSD) correlated not only with emotion dysregulation and attachment insecurity but also with emotion understanding. Finally, there were interrelations among emotion understanding, attachment security, and emotion dysregulation. The present results provide the first comprehensive evidence for a socio-emotional framework and its relevance to childhood anxiety.

Theory of Mind in Children With Specific Language Impairment: A Systematic Review and Meta-Analysis

The relation between language and theory of mind (ToM) has been debated for more than two decades. In a similar vein, ToM has been examined in children with specific language impairment (SLI), albeit with inconsistent results. This meta-analysis of 17 studies with 745 children between the ages of 4 and 12 found that children with SLI had substantially lower ToM performance compared to age-matched typically developing children (d = .98). This effect size was not moderated by age and gender. By revealing that children with SLI have ToM impairments, this finding emphasizes the need for further investigation into the developmental interface between language and ToM as well as the extended consequences of atypical language development.