Longitudinal Theory of Mind (ToM) Development From Preschool to Adolescence With and Without ToM Delay

Revisiting adolescence as a sensitive period for sociocultural processing

Waves of research and public discourse have characterized adolescence as periods of developmental risk and opportunity. Underlying this discussion is the recognition that adolescence is a period of major biological and social transition when experience may have an outsized effect on development. This article updates and expands upon prior work suggesting that adolescence may be a sensitive period for sociocultural processing specifically. By integrating evidence from developmental psychology and neuroscience, we identify how trajectories of social and neurobiological development may relate to adolescents' ability to adapt to and learn from their social environments. However, we also highlight gaps in the literature, including challenges in attributing developmental change to adolescent experiences. We discuss the importance of better understanding variability in biology (e.g., pubertal development) and cultural environments, as well as distinguishing between sensitive periods and periods of heightened sensitivity. Finally, we look toward future directions and translational implications of this research.

Brain activation and aberrant effective connectivity in the mentalizing network of preadolescent children at familial high-risk of schizophrenia or bipolar disorder

INTRODUCTION

Schizophrenia and bipolar disorder are characterized by social cognitive impairments and recent research has identified alterations of the social brain. However, it is unknown whether familial high-risk of these disorders is associated with neurobiological alterations already present in childhood.

METHODS

As part of The Danish High Risk and Resilience Study - VIA 11, we examined children at familial high-risk of schizophrenia (FHR-SZ, n = 121, 50% females) or bipolar disorder (FHR-BP, n = 75, 47% females) and population-based controls (PBC, n = 128, 48% females). Using functional magnetic resonance imaging and dynamic causal modeling, we investigated brain activation and effective connectivity during the social cognition paradigm from the Human Connectome Project.

RESULTS

We found similar activation of the mentalizing network across groups, including visual area V5, dorsomedial prefrontal cortex (dmPFC), and posterior superior temporal sulcus (pSTS). Nonetheless, both familial high-risk groups showed aberrant brain connectivity in the form of increased feedforward connectivity from left V5 to pSTS compared with PBC. Children at FHR-SZ had reduced intrinsic connectivity in bilateral V5 relative to PBC, whereas children at FHR-BP showed increased reciprocal connectivity between left dmPFC and pSTS, increased intrinsic connectivity in right pSTS, and reduced feedforward connectivity from right pSTS to dmPFC compared with PBC.

CONCLUSIONS

Our results provide first-time evidence of aberrant brain connectivity in the mentalizing network of children at FHR-SZ or FHR-BP. Longitudinal research is warranted to clarify whether aberrant brain connectivity during mentalizing constitutes an endophenotype associated with the development of a mental disorder later in life.

Bilingualism and second-order theory of mind development in autistic children over time: Longitudinal relations with language, executive functions, and intelligence

Theory of Mind has long been studied as a core weakness in autism spectrum disorder due to its relationship with social reciprocity, while bilingualism has been shown to compensate for autistic individuals' mentalizing weaknesses. However, our knowledge of the Theory of Mind developmental trajectories of bilingual and monolingual autistic children, as well as of the factors related to Theory of Mind development in autism spectrum disorder is still limited. The current study has examined first- and second-order Theory of Mind skills in 21 monolingual and 21 bilingual autistic children longitudinally across three time points, specifically at ages 6, 9, and 12, and also investigated associations between Theory of Mind trajectories and trajectories of the children's language, intelligence and executive function skills. The results reveal that bilingual autistic children outperformed their monolingual peers in second-order Theory of Mind at ages 9 and 12, and that intelligence and, especially, expressive vocabulary skills played a pivotal role in advancing bilingual autistic children's second-order Theory of Mind development. On the other hand, monolingual autistic children only managed to capitalize on their language and intelligence resources at age 12. The findings highlight the importance of investigating bilingualism effects on autistic children's advanced cognitive abilities longitudinally.

Assessing metarepresentational abilities in adolescence: an exploratory study on relationships between definitional competence and theory of mind

Introduction

Several developmental changes occur in adolescence, particularly in the metarepresentational domain, which allows and promotes adaptive sociality. We explored the possible relationships between theory of mind (ToM) and definitional competence, both metarepresentational, beyond age and gender effects.

Methods

To reach our goals, we involved 75 adolescents (age range 14-19 years, M = 15.7, and SD = 1.36). ToM was measured through "The Reading the Mind in the Eyes Test" (RMET), and definitional competence was assessed through a new instrument, namely, the "Co.De. Scale". Attention was paid to check whether results were different when considering mental states vs. non-mental states of the scale and emotional words vs. non-emotional words.

Results

T-tests showed that older adolescents (third grade of high school) performed better than younger ones (first grade of high school) in both tasks. Only in the male group, there were no school grade differences in the ToM task. Regression analyses showed that RMET performance predicted the score of non-emotional mental states definitions and, even if marginally, of ToM word definitions. However, RMET was not a predictor of the general performance of the definitional task or emotion definitions.

Discussion

Connections with global adolescents' development and possible educational implications are discussed.

Development and Psychometric Examination of a New Social Competence Outcome Measure for Children with Autism Spectrum Disorder: The Observational Social Competence Assessment

Current assessments of social competence for children with autism spectrum disorder (ASD) are mostly designed for screening or diagnosis, not for measuring outcomes. This study aimed to develop a professional-administrated outcome measure, the Observational Social Competence Assessment (OSCA), and examine its psychometric properties. The OSCA was constructed based on a multidimensional view of social competence (i.e., social skill elements, social reciprocity, and social adjustment). For psychometric evaluation, 89 children with ASD between 3 and 12 years (mean = 70.69 months, SD = 15.31) were assessed with the OSCA and with assessments of ASD symptoms, verbal comprehension ability, and adaptive function. The results show that the OSCA has good internal consistency (Cronbach's α = 0.820-0.954), test-retest reliability (intraclass correlation coefficients [ICC] = 0.917-0.960), and inter-rater reliability (ICC = 0.905-0.974). The OSCA also has good convergent (r = 0.508-0.703, p < 0.01) and divergent validity (r = 0.105, p = 0.496), as well as good responsiveness to changes in the social adjustment dimension (Cohen's d = 1.26 and standardized response mean [SRM] = 1.92). Conclusively, these results show that the OSCA is sufficiently reliable, valid and responsive to be applied as an outcome measure of social competence in children with ASD.

Enhancing social-emotional functioning in adolescents with developmental language disorder or deaf or hard of hearing through a Theory of Mind intervention

BACKGROUND

This study examines the effect of a Theory of Mind (ToM) intervention on ToM abilities and social-emotional functioning in adolescents with developmental language disorder (DLD) or who are deaf/hard of hearing (D/HH). It emphasizes the importance of self-reflection and measurement for personal growth. The research design incorporates both subjective and objective measures to evaluate the intervention's efficacy.

AIMS

To investigate the impact of the ToM intervention on ToM abilities and social-emotional functioning in adolescents with DLD or who are D/HH. It hypothesizes that participants in the intervention groups will show improved ToM and social-emotional functioning compared with those in the control groups.

METHODS & PROCEDURES

Adolescents with DLD or who are D/HH were recruited through collaboration with educational institutions. The study utilized a pre-/post-test design, assigning participants to either the intervention or the control group. The ToM intervention involved targeted activities to enhance ToM abilities. ToM abilities and social-emotional functioning were assessed using standardized tests and self-report questionnaires. Statistical analyses compared outcomes between the intervention and no intervention groups.

OUTCOMES & RESULTS

The findings reveal subjective improvements in social-emotional functioning among the D/HH intervention group. However, no significant effects on objective ToM measures were observed. These results highlight the need for further investigation and refinement of interventions in these areas. Future research should focus on improving intervention strategies and exploring additional objective measures to gain a comprehensive understanding of the intervention's impact on ToM and social-emotional functioning in this population.

CONCLUSIONS & IMPLICATIONS

The ToM intervention shows subjective benefits in improving social-emotional functioning among D/HH adolescents. However, it does not yield significant effects on objective ToM measures. These findings emphasize the ongoing need to refine interventions targeting ToM abilities and social-emotional functioning in this population. Future studies should explore alternative strategies and incorporate additional objective measures to enhance understanding and outcomes.

WHAT THIS PAPER ADDS

What is already known on this subject Before this study, it was known that ToM interventions have the potential to enhance ToM abilities. However, the specific effects of such interventions on subjective and objective measures for ToM and social-emotional functioning in adolescents with DLD or who are D/HH remained unclear, necessitating further research. What this paper adds to the existing knowledge This study adds to the existing knowledge by demonstrating subjective improvements in social-emotional functioning among adolescents who are D/HH and underwent a ToM intervention. However, no significant effects on objective ToM measures were observed. These findings highlight the need for refining interventions and exploring additional measures to better understand the intervention's impact. What are the potential or actual clinical implications of this work? The subjective improvements in social-emotional functioning observed in this study have important clinical implications. They suggest that ToM interventions can positively impact the social well-being of adolescents who are D/HH. However, the lack of significant effects on objective ToM measures emphasizes the need for further research and intervention refinement to address specific areas of improvement in this population.

The longitudinal relations between mental state talk and theory of mind

BACKGROUND

Previous investigations of associations between children's Theory of Mind (ToM) and parents' use of words relating to mental states (or mental state talk; MST) have predominantly been performed using cross-sectional designs and false belief tasks as indicators of ToM.

METHODS

We here report a longitudinal study of 3-5 year-olds (n = 80) investigating ToM development using the ToM scale and three different parental MST types: the absolute frequency of words, the proportions of words, and the vocabulary size.

RESULTS

Our results revealed significant relations between all parental MST types and later child ToM. Proportions of parental MST were most often related to the children's ToM at 4 years of age. However, the rate at which the children developed ToM from 3 to 5 years of age was associated with the other two parental MST type measures, namely, absolute frequency and vocabulary size. Additionally, our analyses revealed that parents' use of cognitive MST words (e.g., think, or know) were most frequently associated with children's ToM at 4 years of age compared to emotion and desire-related MST words.

CONCLUSIONS

We conclude that the parental ability to capture the thoughts, beliefs, and knowledge present in different scenarios is associated with children's ability to understand other minds. Moreover, parents' way of talking about the mental states of others is associated with their children's ability to understand and further develop ToM.

Emotion recognition and false belief in deaf or hard-of-hearing preschool children

This study aims to examine emotion recognition and false belief performances of 4-5-year-old (48-71 months) deaf or hard-of-hearing (DHH) children. The performances have been assessed using the Turkish Version of the Theory of Mind Task Battery for Children. The DHH children have been continuing schooling in inclusive settings with an auditory-oral approach. The emotion recognition performances of hearing children (n = 100) and DHH (n = 100) children have appeared to be similar. The ANOVA analysis has revealed that the groups do not differ concerning false belief performances between the ages of 4 and 5.5. However, from the age of 5.5, hearing children have performed better than DHH children. According to correlation analysis, parental education has been determined as a remarkable factor in DHH children's false belief development. The findings point to the need for research across a wide range of ages to better understand the developmental course of false belief in DHH children.

Relationship between social cognition and premorbid adjustment in psychosis: a systematic review

This systematic review provides a comprehensive overview of the association between premorbid adjustment and social cognition in people with psychotic spectrum disorder. Obtaining evidence of this association will facilitate early detection and intervention before the onset of psychosis. Literature searches were conducted in Scopus, PubMed and PsycINFO. Studies were eligible if they included patients with a psychotic disorder or at a high-risk state; social cognition and premorbid adjustment were measured; and the relationship between premorbid adjustment and social cognition was analysed. The authors independently extracted data from all included articles, and discrepancies were resolved through discussion. Literature searches were conducted in Scopus, PubMed and PsycINFO. Studies were eligible if they included patients with a psychotic disorder or at a high-risk state; social cognition and premorbid adjustment were measured; and the relationship between premorbid adjustment and social cognition was analysed. The authors independently extracted data from all included articles, and discrepancies were resolved through discussion. Of 229 studies identified, 23 met the inclusion criteria. Different methods of assessment were used to measure premorbid adjustment, such as the Premorbid Adjustment Scale or premorbid IQ, among others. Social cognition was assessed as a global measure or by domains using different instruments. A total of 16 articles found a relationship between social cognition (or its domains) and premorbid adjustment: general social cognition (n = 3); Theory of Mind (n  = 12); Emotional Recognition and Social Knowledge (n  = 1). This review shows evidence of a significant relationship between social cognition and premorbid adjustment, specifically between Theory of Mind and premorbid adjustment. Social cognition deficits may already appear in phases prior to the onset of psychosis, so an early individualized intervention with stimulating experiences in people with poor premorbid adjustment can be relevant for prevention. We recommend some future directions, such as carrying out longitudinal studies with people at high-risk of psychosis, a meta-analysis study, broadening the concept of premorbid adjustment, and a consensual assessment of social cognition and premorbid adjustment variables. PROSPERO registration number: CRD42022333886.

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.

Classroom Discourse: What Is Conveyed Through Educational Interpretation

When a deaf or hard-of-hearing child enters a classroom with an interpreter, the goal, and sometimes the assumption, is that they will be granted full access to the classroom experience. This study focuses on the clarity and completeness with which critical elements of classroom discourse are conveyed through the interpretations of 40 educational interpreters. Elements studied include conveyance of main ideas, directions for assignments, relevance strategies, orienting commentary, participation solicitation, mental state reference, and semantic organization. The interpretations clearly and completely conveyed approximately one-third to two-thirds of the information (M = 48.6%) related to these elements of classroom discourse. Frequent omissions and alterations rendered large parts of the message markedly different. Results suggest a need to improve training of educational interpreters, increase communication between teachers and interpreters, provide students supplementary services, and heighten awareness that the interpretation process is fallible in ways that can impact access to classroom discourse.

Prospective associations between maternal mind-mindedness, child theory of mind, and brain morphology in school-aged children

Mentalizing is defined as the ability to attribute mental states to oneself and others. In the context of parental behavior, parents' tendency to comment on their child's mental activities refers to the concept of mind-mindedness (MM). MM has been positively associated with various developmental outcomes in children, notably their own ability to mentalize, known as theory of mind (ToM). Although parental (MM) and child (ToM) mentalizing have important implications during childhood, their associations with children's neural structures are largely unknown. Among 62 mother-child dyads, maternal MM was rated from free-play sequences when children were aged 1 year, child ToM was assessed using a first-order false-belief task at 4 years of age, and structural MRI images were acquired at 10 years of age. Maternal MM was positively associated with gray matter volumes (GMV) in the dorsal prefrontal cortex and the superior temporal pole. Child ToM abilities were positively associated with GMV in the ventromedial prefrontal cortex. Though cortical regions associated with MM and ToM showed no anatomical overlap, many are functionally connected through a neural network highly involved in self-referential strategies for mentalizing. These findings suggest that MM and ToM may contribute to distinct sub-processes that collectively support social cognition development.

Psychopathic Traits and Theory of Mind Task Performance: A Systematic Review and Meta-analysis

This meta-analysis aims to examine the relationship between psychopathic traits and theory of mind (ToM), which is classically and broadly defined as competency in representing and attributing mental states such as emotions, intentions, and beliefs to others. Our search strategy gathered 142 effect sizes, from 42 studies, with a total sample size of 7463 participants. Random effects models were used to analyze the data. Our findings suggested that psychopathic traits are associated with impaired ToM task performance. This relationship was not moderated by age, population, psychopathy measurement (self-report versus clinical checklist) or conceptualization, or ToM task type (cognitive versus affective). The effect also remained significant after excluding tasks that did not require the participant to 1) mentalize or 2) differentiate self and other perspectives. However, interpersonal/affective traits were associated with a more pronounced impairment in ToM task performance compared to lifestyle/antisocial traits. Future research should investigate the effects of distinct psychopathy facets that will allow for a more precise understanding of the social-cognitive bases of relevant clinical presentations in psychopathy.

The moderating role of spirituality and gender in Canadian and Iranian emerging adolescents’ theory of mind and prosocial behavior

Introduction

While research has found a link between ToM and prosociality in terms of caring and helping others which may also vary across cultures, the moderating role of spirituality and culture of this association in emerging adolescence has received little attention.

Methods

The current study empirically “examined” the role of spirituality and gender in relation to ToM and prosocial behavior in Canadian and Iranian emerging adolescents. A total of 300 (153 girls) emerging adolescents (M = 11.502, SD = 2.228) were recruited from Montreal, Canada and Karaj, Iran. A series of double moderation analysis and ANOVA was conducted.

Results and discussion

Results indicated the difference between direct and indirect influences of ToM and its interactions with culture, gender, and spirituality on prosocial behavior. This implies an emerging complex framework which suggests the dynamic nonlinear interactions between these factors. Implications for youth’s social-emotional understanding will be discussed.

Theory of Mind and Parental Mental-State Talk in Children with CIs

Previous studies have suggested that parents may support the development of theory of mind (ToM) in their child by talking about mental states (mental state talk; MST). However, MST has not been sufficiently explored in deaf children with cochlear implants (CIs). This study investigated ToM and availability of parental MST in deaf children with CIs (n = 39, Mage = 62.92, SD = 15.23) in comparison with their peers with typical hearing (TH; n = 52, Mage = 52.48, SD = 1.07). MST was measured during shared storybook reading. Parents' narratives were coded for cognitive, emotional, literal, and non-mental references. ToM was measured with a parental questionnaire. Children with CIs had lower ToM scores than their peers with TH, and their parents used more literal references during shared storybook reading. There were no significant differences in the frequencies of cognitive and emotional references between groups. Parental emotional references contributed positively to children's ToM scores when controlling for the child's age and receptive grammar only in the CI group. These results indicated some distinctive features in parents of deaf children with CIs' MST and highlighted the role of MST in the development of ToM abilities in this group.

Factorial Validity of the Theory of Mind Inventory-2 in Typically Developing Children

The Theory of Mind Inventory-2 (ToMI-2) is a promising measure for assessing theory of mind (ToM) and social-related functions. However, limited evidence on its factorial validity hampers score interpretation. To examine the factorial validity, confirmatory factor analysis for two currently-available structures was performed in 420 typically developing children aged three to seven years. One, the development-based structure, contains three stages of ToM development: the early, basic, and advanced ToM stages. The other, the social-related structure, comprises three social-related ToM functions: emotion recognition, mental state term comprehension, and pragmatics. The results showed that these structures and the unidimensionality of each domain were not supported even after modifications. Thus, further revisions and examinations of the underlying structures of the ToMI-2 are needed.

When did you stop speaking to yourself? Age-related differences in adolescents' world knowledge-based audience design

The ability to adapt utterances to the world knowledge of one's addressee is undeniably ubiquitous in human social cognition, but its development and association with other cognitive mechanisms during adolescence have not been studied. In an online production task, we measured the ability of children entering adolescence (ages 11-12, M = 11.8, N = 29 ,   17   girls ) and adolescents (ages 15-16, M = 15.9, N = 29 ,   17   girls ) to tailor referential expressions in accordance with the inferred world knowledge of their addressee-an ability we refer to as world knowledge-based audience design (AD). A post-test survey showed that both age groups held similar assumptions about the addressees' knowledge of referents, but the younger age group did not consistently adapt their utterances in accordance with these assumptions during online production, resulting in a significantly improved AD behaviour across age groups. We also investigated the reliance of AD on executive functions (EF). Executive functioning (as reflected by performance on the Wisconsin card sorting task) increased significantly with age, but did not explain the age-related increase in AD performance. We thus provide evidence in support of an adolescent development of world knowledge-based AD over and above development of EF.

"Where's Wally?" Identifying theory of mind in school-based social skills interventions

This mini configurative review links theory of mind (ToM) research with school-based social skills interventions to reframe theoretical understanding of ToM ability based on a conceptual mapping exercise. The review's aim was to bridge areas of psychology and education concerned with social cognition. Research questions included: how do dependent variables (DVs) in interventions designed to enhance child social-cognitive skills map onto ToM constructs empirically validated within psychology? In which ways do these mappings reframe conceptualization of ToM ability? Thirty-one studies (conducted from 2012 to 2019) on social-cognitive skill with typically-developing children ages 3-11 were included as opposed to explicit ToM trainings in light of an identified performance plateau on ToM tasks in children. Intervention DVs mapped onto the following ToM constructs in at least 87% of studies: "Representation of Others and/or Self," "Knowledge/Awareness of Mental States," "Attributions/Explanations of Mental States," "Social Competence," "Predicting Behavior," and "Understanding Complex Social Situations." The absence of false-belief understanding as an intervention DV indicated a lack of direct training in ToM ability. A hierarchy to further organize the review's ToM framework constructs as either skills or competences within the construct of 'Representation of Others and/or Self' is proposed. Implications for the conceptualization of ToM and social-cognitive research as well as educational practice are discussed, namely how school social skill interventions conceptualize skill along a continuum in contrast to the common artificial dichotomous assessment of ToM skill (i.e., presence or lack), yet the development of ToM can nevertheless be supported by the school environment.

Just listen to your mind: Consequences of theory of mind development for deaf or hard-of-hearing children

BACKGROUND

Previous research reveals relations between theory of mind (ToM) and cognitive outcomes, but mostly among typically developing children.

AIM

To study these relations in children with developmental difficulties, this longitudinal study investigated the cognitive consequences of ToM in deaf or hard-of-hearing (DHH) children.

METHODS AND PROCEDURES

One hundred and thirty-four (X = 9.2 years) participants were assessed in three waves, i.e., one wave every ten months. The participants completed the ToM scale, language and literacy skills (LLS) tests, the academic self-concept in language (ASC-L) questionnaire, and the sensitivity to criticism measure.

OUTCOMES AND RESULTS

The results revealed that high levels of children's ToM ability predicted higher levels of LLS 20 months later. Mediators of this association were sensitivity to criticism and ASC-L. Controlling for LLS at T1, ASC-L at T2 mediated the relations between ToM and LLS at T3. Moreover, sensitivity to criticism predicted ASC-L, and sensitivity to criticism and ASC-L mediated the relation between ToM and LLS at T3. That is, children who were sensitive to criticism and held positive views of their academic self were also better skilled in ToM and in LLS.

CONCLUSIONS AND IMPLICATIONS

Our results can help improve the education of DHH students.

Immersive Media Presentation and Preschoolers’ Prosocial Behaviors: The Mediating Role of Theory of Mind

Although scholars have asserted that it is necessary to explore the effect of immersive media presentation on preschoolers’ prosocial behaviors, the empirical research, as well as the moderating roles of this link, remained limited. One hundred and twenty preschoolers (mean age = 5.4 years) were involved in three experiments of four waves. This study empirically examined the effect of media presentation, including immersive media presentation and traditional media presentation, on preschoolers’ prosocial behaviors and the moderating effect of theory of mind (ToM) on such links. After the experimental intervention, we find that the extent to which traditional media presentation and immersive media presentation impact preschoolers’ prosocial behaviors is different. First, the results show that preschoolers, who have been involved in traditional media presentation, do not notably reveal the development of their prosocial behaviors. However, in the group of high ToM, we find that traditional media presentation positively and significantly relates to preschoolers’ prosocial behaviors. That is to say, the positive influence of traditional media presentation depends on ToM. Second, the results also show that immersive media presentation positively and significantly relates to preschoolers’ prosocial behaviors whether ToM is high or not. Furthermore, ToM encourages the positive influence of immersive media presentation on preschoolers’ prosocial behaviors.

Development of social responsiveness and theory of mind in children of parents with schizophrenia or bipolar disorder

Social impairments are suggested as vulnerability markers for schizophrenia and bipolar disorder. Therefore, we investigated the development of social responsiveness and theory of mind (ToM) in children at familial high-risk of schizophrenia (FHR-SZ) or bipolar disorder (FHR-BP).

This study is part of The Danish High Risk and Resilience Study, a longitudinal cohort study of children at FHR-SZ or FHR-BP and population-based controls (PBC). Social responsiveness was measured with the Social Responsiveness Scale (SRS-2), completed by teachers and primary caregivers. ToM was measured using The Animated Triangles Task (ATT). Both SRS-2 and ATT were applied at age 7 and 11. A total of 520 children participated (FHR-SZ, n = 201; FHR-BP, n = 119; PBC, n = 200).

Results showed no significant time by group interactions. At follow-up, children at FHR-SZ exhibited impaired social responsiveness compared with PBC regardless of the informant. At both timepoints, a higher proportion of children at FHR-SZ were rated at a clinically significant level, implying inference in everyday social interactions. Compared with PBC, primary caregivers reported impairments in social responsiveness in children at FHR-BP at follow-up. The three groups did not differ in ToM at follow-up.

Social responsiveness and ToM do not develop differently in children at FHR-SZ, FHR-BP and PBC from age 7 to 11, but impairments in social responsiveness remain stable and may constitute a vulnerability marker particularly in children at FHR-SZ, but also FHR-BP. ToM abilities seem to improve and remain intact, but ToM development and ToM task properties should be taken into consideration.

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No developmental differences in social abilities in children at familial high-risk

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Children at familial high-risk exhibit impaired social responsiveness.

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Social responsiveness impairments are detectable already at an early age.

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Impairments in social responsiveness may constitute a vulnerability marker.

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11-Year-olds at familial high-risk have intact theory of mind.

Measuring Theory of Mind in Adolescents With Language and Communication Problems: An Ecological Perspective

We tested if the newly designed ToMotion task reflects a single construct and if the atypical groups differ in their performance compared to typically developing peers. Furthermore, we were interested if ToMotion maps a developmental sequence in a Theory of Mind (ToM) performance as exemplified by increasing difficulty of the questions asked in every item. The sample consisted of 13 adolescents that have been diagnosed with a developmental language disorder (DLD) and 14 adolescents that are deaf or hard of hearing (DHH). All of these adolescents were in special schools for secondary vocational education. The control group existed of 34 typical developing adolescents (TD) who were in regular intermediate vocational education, ranging from level 2 to 4. The ToMotion, available in a spoken Dutch version and in a version in Sign Language of the Netherlands (SLN), was used to map ToM abilities. An attempt has been made to fill the gap of missing studies of ToM in adolescents by developing a new measuring instrument. In conclusion, assessing ToM with the ToMotion results in a picture that DHH adolescents score lower than TD peers. However, their scores are as consistent as those of the TD peers. The picture of DLD adolescents is the reverse. They show no differences in ToM scores, but seem to be somewhat more inconsistent compared to TD peers. We provide a discussion on those results and its implications for future research. What this paper adds? The current study introduces a new visual Theory of Mind (ToM) task, ToMotion, designed specifically to assess ToM in adolescents in an ecologically valid way and adapted to the needs of adolescents with language and communication difficulties.

Theory of Mind as a Correlate of Bystanders' Reasoning About Intergroup Bullying of Syrian Refugee Youth

The current study examined how ingroup and outgroup Theory of Mind (ToM) predicts children’s and adolescents’ reasoning for their acceptability judgments of intergroup bullying of Syrian refugee peers and group support of intergroup bullying. Participants included 587 Turkish middle (n = 372, M_age = 12.19, SD = 1.01; 208 girls) and high school (n = 215, M_age = 14.81, SD = 0.97; 142 girls) students. Participants read a bias-based bullying story with a Syrian refugee peer targeted by an ingroup Turkish peer. Then, participants rated the acceptability of bullying and group support of bullying and were presented with a reasoning question (Why?) after each acceptability question (bullying and group support of bullying). Reasoning codes included Fairness, Refugee Status/War, Prejudice and Discrimination, Harm, Prescriptive Norms, Group Functioning, and Relationship with the Bully. Participants’ ingroup and outgroup ToM abilities (measured using the Strange Stories) were evaluated as predictors of reasoning. Results documented that middle school students were more likely to attribute mental states to their ingroup members compared to outgroup members while high school students’ ToM performance did not differ across contexts. Further, the more unacceptable participants judged bullying to be, the more they reasoned about the bullying by referencing fairness, refugee status, discrimination, and harm. Results also documented that ingroup and outgroup ToM were positively related to attribution to fairness and participants’ usage of multiple reasoning judgments while only outgroup ToM was a significant predictor of reasoning around refugee status/war, discrimination, and prejudice. The findings provide implications for intervention programs that tackle intergroup bullying by examining bystanders’ social cognitive skills in a specific context.

Prosocial Behavior in Preschoolers: Effects of Early Socialization Experiences With Peers

Over the last decades, many studies had focused on the psychological outcomes of children who have received early socialization outside of the family context, highlighting that the daycare experience can both positively and negatively influence the child’s social-emotional development. Despite the number of studies conducted, there is a lack of observational research on this topic. The purpose of this study is to investigate whether the early daycare experience can influence the prosocial behaviors that children exhibit during free-play social interactions with peers, focusing on their quantity and quality. In addition, the associations between the enactment of prosocial behaviors and social-emotional and behavioral competence were investigated. 160 preschoolers, 77 of whom had previously attended daycare, participated in the study and were focally observed during two free play sessions with peers. Each prosocial behavior was identified and subsequently classified using a coding scheme designed to consider the self-initiated or required origin of prosocial actions and their underlying motive. Emotion comprehension was measured using a standardized test, while social-emotional and behavioral competence was assessed using a questionnaire filled out by teachers. The main findings showed that children who had attended daycare had higher anger and aggression scores than those who had not, who, in turn, were rated by their teachers as having more internalizing behaviors. These characteristics seemed to account for the differences found in the tendency to act prosocial acts in response to a peer’s request, which was lower in children who had a previous daycare experience. Moreover, early socialization outside of the family context appeared to foster the comprehension of others’ intent to achieve emotional or instrumental personal goals and, at the same time, to reduce conventional/affiliative prosocial acts. Overall, this study suggested that the incidental effects of daycare on prosocial behavior might be canceled due to the peculiar social-emotional and behavioral characteristics of the two groups of children.

Advanced scaling and modeling of children’s theory of mind competencies: Longitudinal findings in 4- to 6-year-olds

First-order theory of mind (ToM) development has shown to conform to a Guttman scale, with desire reasoning developing before belief reasoning. There have been attempts to test for internal consistency and scalability in advanced ToM, but not over a broad age range and only with a limited set of tasks. This 2-year longitudinal study ( N = 155; Mage = 4.2; SD = 0.85 months; 68 girls, 87 boys) tests for the scalability of a broader range of ToM tasks, and we model the developmental transition from first-order to advanced ToM in 4- to 6-year-olds. Rasch analyses showed that psychometrically sound and developmentally sequenced scales emerge when measures of morally relevant and second-order false belief, as well as mental verb understanding, metacognition, and recognition of nonliteral speech are included. Individual differences were moderately stable over time, and there were systematic transitions from failure to success in children’s performance, suggesting that conceptual continuity exists between first-order and advanced ToM.

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.

Beliefs for human-unique social learning

Phillips et al. argue that understanding what others know is central to social cognition across species and that this understanding underlies human-unique accumulation and transmission of cultural knowledge. Knowledge representations can't be both what we have in common with our evolutionary ancestors and what sets us apart from them. Belief representations are necessary for human-unique social learning.

Willing and able? Theory of mind, social motivation, and social competence in middle childhood and early adolescence

This study investigated the links between theory of mind, social motivation, and children's social competence in middle childhood and early adolescence. Two hundred and sixty four children (136 girls, 128 boys) aged between 8 and 13 years (M Age = 10.88 years, SD = 1.45) completed theory-of-mind tests and self-report questionnaires measuring social motivation. Teachers rated children's social competence at school. Teacher-rated social competence was associated with individual differences in both theory of mind and children's motivation to develop and maintain social relationships. Results suggest that while individual differences in social motivation and theory of mind are partially overlapping, both theory of mind ability and social motivation contribute to successful social interaction at school.

The Development of Advanced Theory of Mind in Middle Childhood: A Longitudinal Study From Age 5 to 10 Years

This 5-year longitudinal study investigated advanced theory-of-mind (AToM) development in 161 German 5- to 10-year-olds (89 females, 72 males). Core aspects of AToM developed nonlinearly, with children reaching a milestone at the age of 7 years, around when they attained the conceptual insight that mental states can be recursive. In late elementary school, a multicomponent battery was used. Performance on many aspects of AToM was predicted by information-processing skills (intelligence and language at 6 years), but not by the age when children acquired the basic conceptual insight; only some naturalistic, social-interpretative tasks were correlated with children's age at acquisition. This study documents significant developmental progressions in middle-childhood AToM and suggests that different mechanisms may underlie diverse aspects of social cognition.

The impact of visual-spatial abilities on theory of mind in children and adolescents with autism spectrum disorder

BACKGROUND

Children and adolescents with autism spectrum disorder (ASD) often experience impaired social cognition.

AIMS

In the present study, we aimed to investigate the relation between visual-spatial abilities and theory of mind in children and adolescents with and without ASD.

METHODS

Forty-five boys from the age of 7 to 17 years with ASD and thirty-one aged matched boys without ASD participated and completed the test of intrinsic stable visual-spatial ability (test of visual perceptual skill-revised), intrinsic dynamic visual-spatial ability (animal mental rotation test), and theory of mind test (TOMT).

RESULTS

Results showed that relative to boys without ASD, boys with ASD had a lower performance in theory of mind and intrinsic visual-spatial abilities. Secondly, theory of mind correlated with visual-spatial abilities in boys with ASD. Theory of mind for first and second order beliefs was predicted by the intrinsic dynamic visual abilities, whereas the theory of mind ability of emotion recognition was predicted by visual-spatial static abilities. In children without ASD, theory of mind for emotion recognition was predicted by intrinsic visual-spatial ability and the theory of mind for first order beliefs.

DISCUSSION

Theory of mind can be predicted by visual-spatial abilities in children and adolescents with ASD. Future studies should investigate the role of different types of intrinsic dynamic visual-spatial abilities (e.g., egocentric vs. object-based mental rotation tasks) in relation to different aspects of theory of mind in children and adolescents with autism.

Advanced theory of mind in children with mild intellectual disability and deaf or hard of hearing children: A two-year longitudinal study in middle childhood

The present study investigates the development of advanced theory of mind (AToM) among typically developing (TD) children, children with mild intellectual disability (MID), and deaf or hard of hearing (DHH) children. The 2-year longitudinal study comprised three waves and included a large sample of children from Poland in middle childhood aged around 7.5-9.5 years (N = 779; M = 7.7, SD = 0.92 at wave 1). The analysis of children's understanding of second-order false belief and the Faux-Pas Recognition Test showed that TD children outperformed children with MID and DHH children on both measures. At 7.5 years, almost 60% of the TD children correctly solved the second-order false belief task; correct performance at 7.5 years in children with MID and DHH children was 27 and 38% respectively. Two years later, correct performance rose to 80% (TD children), 45% (children with MID), and 63% (DHH children). Despite these differences, the speed of AToM development did not differ across the groups. The development of faux-pas recognition followed a non-linear pattern, with TD children showing no further significant development after mid-elementary school. Our findings show differences in AToM development between TD children, children with MID, and DHH children, and they suggest that children's development of AToM may follow different developmental pathways, depending on the aspect of AToM under study.

Children's Developing Ability to Resolve Disagreements by Integrating Perspectives

Children live in a world where disagreement is commonplace. Although disagreement can sometimes be explained by differences in people's reliability, disagreement may also indicate that the referent elicits multiple perspectives. The present studies (total N = 129, 5- to 12-year-old ethnically diverse U.S. children, 42% girls) examined children's ability to resolve disagreement among two individuals by identifying referents that integrated the perspectives, and considered the extent to which any age-related change could be explained by epistemological understanding (i.e., acknowledging that two perspectives can be right). Children's age was positively correlated with their ability to integrate perspectives, and children performed at above-chance levels by approximately 10 years of age. Age differences in integrating perspectives were partially accounted for by epistemological understanding.

Mutual (Mis)understanding: Reframing Autistic Pragmatic "Impairments" Using Relevance Theory

A central diagnostic and anecdotal feature of autism is difficulty with social communication. We take the position that communication is a two-way, intersubjective phenomenon-as described by the double empathy problem-and offer up relevance theory (a cognitive account of utterance interpretation) as a means of explaining such communication difficulties. Based on a set of proposed heuristics for successful and rapid interpretation of intended meaning, relevance theory positions communication as contingent on shared-and, importantly, mutually recognized-"relevance." Given that autistic and non-autistic people may have sometimes markedly different embodied experiences of the world, we argue that what is most salient to each interlocutor may be mismatched. Relevance theory would predict that where this salient information is not (mutually) recognized or adjusted for, mutual understanding may be more effortful to achieve. This paper presents the findings from a small-scale, linguistic ethnographic study of autistic communication featuring eight core autistic participants. Each core autistic participant engaged in three naturalistic conversations around the topic of loneliness with: (1) a familiar, chosen conversation partner; (2) a non-autistic stranger and (3) an autistic stranger. Relevance theory is utilized as a frame for the linguistic analysis of the interactions. Mutual understanding was unexpectedly high across all types of conversation pairings. In conversations involving two autistic participants, flow, rapport and intersubjective attunement were significantly increased and in three instances, autistic interlocutors appeared to experience improvements in their individual communicative competence contrasted with their other conversations. The findings have the potential to guide future thinking about how, in practical terms, communication between autistic and non-autistic people in both personal and public settings might be improved.

Theory of Mind after Pediatric Traumatic Brain Injury: A Scoping Review

This scoping review aims to synthesize existing literature regarding theory of mind (ToM) outcomes, the neuropathology associated with ToM outcomes, and the relationship between ToM outcomes and social functioning in children and adolescents with traumatic brain injury (TBI). We searched MEDLINE^® and PsycINFO databases to identify all literature that examined ToM following pediatric TBI until July 2019. A total of 29 articles met inclusion and exclusion criteria and were included in the results. These articles examined a variety of aspects of ToM, which could be broadly grouped into those focused on cognitive, cognitive-affective, and pragmatic factors. The existing literature suggests that children and adolescents with TBI, compared with their typically developing peers and peers with orthopedic injuries, are more likely to have deficits in ToM. The evidence further shows that the age at which brain injury occurs contributes to ToM disruption. Neuroimaging techniques have offered crucial insights into how TBI may impact ToM performance in children and adolescents. Finally, this review provides evidence that disruption in ToM plays a role in the difficulties in social functioning demonstrated by children and adolescents with TBI. Limitations and gaps in the existing literature warrant future research in this field.

Spatial Ability and Theory of Mind: A Mediating Role of Visual Perspective Taking

This research tests the role of visual perspective taking (VPT) in mediating the relation between spatial ability and theory of mind (ToM). Study 1 demonstrated such mediation correlationally in seventy 3.5- to 4-year olds. In Study 2, twenty-three 3.5- to 4-year-olds were trained on using play blocks to copy preassembled models as a way to promote spatial ability. Resultant increases in VPT and ToM were compared to those from a control group learning to draw instead (n = 23). Both studies showed that the effect of spatial ability on ToM depended on VPT, suggesting a role of embodiment in ToM development in early childhood. These findings provide an alternative way to think about ToM development and the psychological mechanism that may be involved.

Theory-of-Mind Development in Young Deaf Children With Early Hearing Provisions

Deaf and hard-of-hearing (DHH) children born to hearing parents have profound theory-of-mind (ToM) delays, yet little is known about how providing hearing assistance early in life, through cochlear implants and hearing aids, influences their ToM development. We thus addressed (a) whether young DHH children with early hearing provision developed ToM differently than older children did in previous research and (b) what ToM understandings characterize this understudied population. Findings from 84 three- to six-year-old DHH children primarily acquiring spoken language demonstrated that accumulated hearing experience influenced their ToM, as measured by a five-step ToM scale. Moreover, language abilities mediated this developmental relationship: Children with more advanced language abilities, because of more time using cochlear implants and hearing aids, had better ToM growth. These findings demonstrate the crucial relationships among hearing, language, and ToM for DHH children acquiring spoken language, thereby addressing theoretical and practical questions about ToM development.

A Reciprocal and Dynamic Development Model for the Effects of Siblings on Children's Theory of Mind

In the field of social influences on Theory of Mind (ToM), more research has focused on the role of parents, but less research has examined the impact of siblings on children’s social understanding. We review existing research related to what factors might affect sibling–ToM association and how these potential factors affect ToM. Based on the literature review, we propose an integrative model that unites three categories of factors (i.e., sibling structural variables, sibling individual variables, parental intervening variables) that might have effects on the sibling–ToM association and highlights mental-state talks during sibling interactions at the intersection of sibling-related variables and ToM. Furthermore, we propose some issues arising from this review that need to be clarified in future studies. Specifically, we hope to clarify the specific effects of older and younger siblings on children’s understanding of human minds, the similarities and differences of sibling–ToM association under different cultural backgrounds, and the impact of family social disadvantage (e.g., lower SES) on the sibling–ToM association. All these works would benefit from the verification, revision, and expansion of our reciprocal influence model for the sibling–ToM association.

Theory of mind goes to school: Does educational environment influence the development of theory of mind in middle childhood?

Previous research has shown that the development of theory of mind (ToM) depends on various individual and social factors, but very little research has examined the role of the natural educational environment in the development of ToM in middle childhood. In accordance with the importance of social factors in development, in this longitudinal study of 156 typically developing children, we investigated whether educational setting-classes containing children with disabilities (inclusive) or without such children (general education)-is associated with enhanced ToM development. ToM was measured with the ToM Scale, the Chocolate task and the Faux Pas Recognition Test. Analysis showed that ToM development was better among children educated in inclusive classes than among those educated in traditional classes. The results have implications for ToM development among children with and without disabilities as well as for educational practice.

Interpretive theory of mind and empathic prosocial moral reasoning

Theory of mind (ToM) is seen as fundamental in development of social understanding. The study proposes that interpretive theory of mind (iToM), which follows ToM attainment, underlies important shifts towards mature social understanding. With ToM found to predict the needs orientation in prosocial moral reasoning (PMR), we hypothesized that iToM, unlike ToM, would account for PMR orientations requiring empathic reasoning. Those with iToM recognize the role of subjective processes, such as interpretation, in knowing. They can invoke others' subjective processes, not just their physical perspectives, in explaining others' decisions. A study with 225 7- to 11-year-old children (M_age  = 9.04, SD = 0.91) found that iToM, but not ToM, predicted empathic and internalized values PMR orientations when controlling for age, emotion understanding and inhibitory control. These findings show that iToM attainment plays a unique role in developing social understanding such as reflected in empathic reasoning-based PMR orientations.

Experts, peers, or celebrities? The role of different social endorsers on children's fruit choice

This study investigates whether the source providing nutritional information matters for children's choice of fruit over candy. We conducted a between-subject experimental study with children (6-11 years; M_age = 8.20; N = 340). Children watched an audiovisual cartoon with nutritional messages provided by experts (expert condition), by celebrities (celebrity condition), or by typical consumers (peer condition). Additionally, we included a control group in which children were not exposed to any cartoon. As the dependent variable, we measured children's fruit choice over candy. As a mediator, measuring message processing we included children's argument awareness. Children's age was included as a moderator. The results indicate that the experimental conditions were equally effective in creating argument awareness for healthy eating compared to the control group. Children's argument awareness was generally rather low, and it did not influence children's fruit choice over candy. Nevertheless, there was a direct effect of the expert condition on children's fruit choice, pointing to an internalized "expert heuristic". No moderating effects of children's age were present. Our study indicates that using experts to present nutritional information within narrative media content is a potentially successful strategy to create argument awareness for healthy food and to impact children's selection of healthy food whereas peer and celebrity social endorsers are not.

Cognitive and Affective Aspects of Theory of Mind in Greek-Speaking Children with Autism Spectrum Disorders

Substantial research indicates that individuals with Autism Spectrum Disorder (ASD) have difficulties with Theory of Mind (ToM) abilities, but rarely have studies used a comprehensive battery to measure both the cognitive and affective aspects of ToM. The present study tested this ability in 24 Greek-speaking children with ASD (ages 7-14), and their performance was compared to 24 age-, gender- and language-matched typically developing controls. Results showed that ASD children's performance was selectively impaired in both ToM aspects, supporting the distinction between ToM components. This is the first study of ToM abilities among Greek-speaking children with ASD, and the findings confirm that children with ASD are experiencing difficulties with socio-emotional understanding across languages and cultures.

Reduced neural selectivity for mental states in deaf children with delayed exposure to sign language

Language provides a rich source of information about other people's thoughts and feelings. Consequently, delayed access to language may influence conceptual development in Theory of Mind (ToM). We use functional magnetic resonance imaging and behavioral tasks to study ToM development in child (n = 33, 4-12 years old) and adult (n = 36) fluent signers of American Sign Language (ASL), and characterize neural ToM responses during ASL and movie-viewing tasks. Participants include deaf children whose first exposure to ASL was delayed up to 7 years (n = 12). Neural responses to ToM stories (specifically, selectivity of the right temporo-parietal junction) in these children resembles responses previously observed in young children, who have similar linguistic experience, rather than those in age-matched native-signing children, who have similar biological maturation. Early linguistic experience may facilitate ToM development, via the development of a selective brain region for ToM.

Theory of mind development from adolescence to adulthood: Testing the two-component model

The ability to infer mental and affective states of others is crucial for social functioning. This ability, denoted as Theory of Mind (ToM), develops rapidly during childhood, yet results on its development across adolescence and into young adulthood are rare. In the present study, we tested the two-component model, measuring age-related changes in social-perceptual and social-cognitive ToM in a sample of 267 participants between 11 and 25 years of age. Additionally, we measured language, reasoning, and inhibitory control as major covariates. Participants inferred mental states from non-verbal cues in a social-perceptual task (Eye Test) and from stories with faux pas in a social-cognitive task (Faux Pas Test). Results showed substantial improvement across adolescence in both ToM measures and in the covariates. Analysis with linear mixed models (LMM) revealed specific age-related growth for the social-perceptual component, while the age-related increase of the social-cognitive component fully aligned with the increase of the covariates. These results support the distinction between ToM components and indicate that adolescence is a crucial period for developing social-perceptual ToM abilities. Statement of contribution What is already known on this subject? To date, much research has been dedicated to Theory of Mind (ToM) development in early and middle childhood. However, only a few studies have examined development of ToM in adolescence. Studies so far suggest age-related differences in ToM between adolescents and young adults. What this study adds The study offers several methodological advantages including a large sample size with a continuous distribution of age (age 11-25) and the use of a comprehensive test battery to assess ToM and covariates (language, executive functions, reasoning). The results provide evidence for asymmetries in the development of two ToM components (social-perceptual and social-cognitive; the two-component account) across the studied age range: the social perceptual component showed specific development, while the age-related increase of the social-cognitive component fully aligned with increase of the covariates. Adolescence is a crucial period for developing social-perceptual ToM abilities.

Theory of mind, language, and reading: Developmental relations from early childhood to early adolescence

This study longitudinally investigated the relation between theory of mind (ToM) and verbal language skills in 231 children from preschool to early adolescence. Further, links to reading comprehension of texts at age 13;7 (years;months) were examined. To assess ToM, children completed false belief tasks at 5;6 and the Strange Stories at 12;8. To assess language, children completed a receptive grammar/sentence comprehension test at 3;6 and 5;6, a receptive vocabulary test at 3;6, 5;6 and 12;8, as well as a test of listening comprehension of texts at 13;7. A bidirectional relation between early and advanced measures of children's language skills and ToM was found: Changes in ToM were predicted by language skills, especially by receptive grammar/sentence comprehension; changes in children's receptive vocabulary were predicted by early ToM. However, early ToM had no direct or indirect effect on later listening comprehension or reading comprehension after controlling for early language skills. Only children's advanced ToM had a small indirect effect on reading comprehension, via listening comprehension. The results are discussed in light of ToM stability over time, and theories on how language and ToM development are intertwined.

Theory of Mind Development in Children with Visual Impairment: The Contribution of the Adapted Comprehensive Test ToM Storybooks

Research that focused on Theory of Mind (ToM) development in blind children showed that they were delayed, but not permanently deficient, in various types of false belief tasks. More recent studies reported first evidence of typical ToM development in blind children and suggested that more comprehensive tools to evaluate ToM had to be used. The current paper analyzed ToM development in blind children, using the adapted version of the ToM Storybooks; this is a standardized comprehensive test developed to provide a reliable and stable measurement, in comparison with the false belief tasks. Results showed that blind children's ToM performances were very similar to the ones of matched typically developing children, matched on chronological age and gender. The current finding supported the importance of the use of a more comprehensive tool to assess ToM in atypical population.