The mind behind the message: advancing theory-of-mind scales for typically developing children, and those with deafness, autism, or Asperger syndrome

The role of speech-language pathologists in supporting theory of mind through literacy-based activities

PURPOSE

This tutorial discusses the importance of speech-language pathologists (SLPs) supporting individuals with language disorders in their understanding of others' cognitive and affective states (theory of mind, ToM), with a special consideration given to applying these suggestions with individuals who are neurodivergent.

METHOD

I motivate this tutorial by first reviewing the literature related to ToM and language abilities for various populations of individuals with language difficulties, highlighting the need for explicitly targeting the language-related skills that are thought to underlie ToM for individuals with language disorders. I next present concrete examples of how to support ToM through literacy-based activities. I follow this discussion with a short description of how these activities may be applied with individuals who are neurodivergent through concrete examples, such as how inclusion of neurodivergent characters in storybooks can aid in educating children about understanding others' perspectives. It further emphasizes the importance of discussing various types of mental and emotional states for individuals who share as well as differ in their neurotypes.

CONCLUSIONS

Language skills are an integral part of ToM abilities. SLPs play an important role in supporting clients' academic, literacy, and social outcomes and can support important perspective-taking skills through associated language/communication skills. The various skills that fall under the umbrella term 'theory of mind' can be appropriately incorporated into intervention and literacy-based tasks in a way that respects differences in neurotype while still building important language and communication skills for clients.

The Association between Emotional Intelligence and Prosocial Behaviors in Children and Adolescents: A Systematic Review and Meta-Analysis

Emotional intelligence and prosocial behavior both play an important role in the development of children and adolescents. However, the strength of the association between emotional intelligence and prosocial behavior in children and adolescents is controversial. Hence, this study aimed to conduct a meta-analysis to evaluate the exact association between emotional intelligence and prosocial behavior in children and adolescents. Through a literature search, a total of 40 studies and 40 effect sizes were included in this meta-analysis (n = 20621). In this study, the main effect test shows that there is a significant positive correlation between emotional intelligence and prosocial behavior in children and adolescents (r = 0.43). Moreover, the present study found a significant moderating effect of age. More specifically, the association between early childhood (0-6 years) emotional intelligence and prosocial behavior is stronger than in middle childhood (7-12 years) and adolescence (13-18 years), and the correlation between emotional intelligence and prosocial behavior is stronger in boys than in girls. The culture was also found to be an important moderator, the association was found to be weaker for Western culture than for Eastern culture. Finally, a stronger correlation between the two variables was found when the emotional intelligence measurement tool was LZ (Emotional intelligence questionnaire compiled by Liu Yan and Zou Hong). These results indicated that improving children's and adolescents' emotional intelligence could be an important strategy to enhance children's prosocial behavior.

Evaluation of a New Adolescent Social Communication Assessment: The Transition Pragmatics Interview

PURPOSE

This study evaluated the psychometric functioning of a new criterion-referenced assessment of adolescent social communication, the Transition Pragmatics Interview (TPI), based on the synthesis model of pragmatics. Two ways of interpreting item difficulty were explored: (a) as a function of the synthesis model elements of social communication ability that items were designed to assess, and (b) as a function of the developmental level required for a successful response based on an adapted situational-discourse-semantics (SDS) model (Norris & Hoffman, 1993).

METHOD

Thirty-seven participants aged 14-22 years completed the TPI. Responses were analyzed using Rasch analysis to evaluate the functioning of the scale and to determine item difficulty. Items were coded for the SDS developmental level required for an adequate response. The mean Rasch item difficulty for items at each SDS developmental level was analyzed for the five adapted SDS domains.

RESULTS

Consistent with the first approach for interpreting item difficulty, TPI items varied in difficulty as a function of the element of social communication they were designed to assess (p < .001). Interpreting item difficulty based on the adapted SDS model was not supported: Items requiring higher SDS developmental levels were not more difficult than those requiring less (p = .55).

CONCLUSIONS

The TPI responses fit the Rasch model, supporting the TPI as a unidimensional measure and supporting the use of all items together to compute a single number that summarizes the level of social communication for each examinee. The item ordering from least to most difficult was consistent with prior findings on adolescent social communication development.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.26018545.

Development and validation of the newly developed Preschool Theory of Mind Assessment (ToMA-P)

Introduction

Theory of mind (ToM) refers to the ability to understand and attribute mental states to oneself and others. A ToM measure is warranted for preschool children to assess their ToM development from a multidimensional perspective (i.e., cognitive and affective dimensions). This study aimed to develop the Preschool Theory of Mind Assessment (ToMA-P) and to evaluate its construct validity and applicability.

Methods

The ToMA-P was developed based on comprehensive literature review and revised with expert panel feedback. Its psychometric properties were evaluated in 205 typically developing preschoolers with Rasch analysis for its dimensionality, item difficulties, and convergent validity.

Results

The results indicated that all ToMA-P items, except for one, fit the hypothesized two-dimensional construct. The item difficulties in the cognitive and affective dimensions followed developmental sequences. The ToMA-P scores exhibited good convergent validity, as evidenced by its significant correlations with age, verbal comprehension, adaptive functions, and daily ToM performance (p < 0.05). Children's responses and behaviors also showed that the ToMA-P has good applicability.

Discussion

This study provides empirical evidence that the ToMA-P measures cognitive and affective ToM following developmental sequences, and that it has potential as a clinical tool for assessing ToM in preschool children.

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.

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.

TANGO: A reliable, open-source, browser-based task to assess individual differences in gaze understanding in 3 to 5-year-old children and adults

Traditional measures of social cognition used in developmental research often lack satisfactory psychometric properties and are not designed to capture variation between individuals. Here, we present the TANGO (Task for Assessing iNdividual differences in Gaze understanding-Open); a brief (approx. 5-10min), reliable, open-source task to quantify individual differences in the understanding of gaze cues. Localizing the attentional focus of an agent is crucial in inferring their mental states, building common ground, and thus, supporting cooperation. Our interactive browser-based task works across devices and enables in-person and remote testing. The implemented spatial layout allows for discrete and continuous measures of participants' click imprecision and is easily adaptable to different study requirements. Our task measures inter-individual differences in a child (N = 387) and an adult (N = 236) sample. Our two study versions and data collection modes yield comparable results that show substantial developmental gains: the older children are, the more accurately they locate the target. High internal consistency and test-retest reliability estimates underline that the captured variation is systematic. Associations with social-environmental factors and language skills speak to the validity of the task. This work shows a promising way forward in studying individual differences in social cognition and will help us explore the structure and development of our core social-cognitive processes in greater detail.

Measures of individual differences in adult theory of mind: A systematic review

Theory of mind (ToM), the ability to understand and reason about mental states, has been extensively studied in young children and clinical populations. A growing interest in examining ToM in adults has emerged over the past two decades, but the extent to which existing measures are suitable for studying adults, especially in detecting individual differences, remains understudied. In this systematic review of 273 studies, 75 measures used to investigate individual differences in adults' ToM were identified. Their sensitivity to individual differences, reliability, and validity were examined. Results suggest that ceiling effects were prevalent, and there was limited evidence to establish the reliability or validity of these measures due to the lack of reports of psychometric properties. Interrelations among measures were inconsistent. These findings highlight the need for future empirical and theoretical work to broaden the evidence base regarding psychometric properties of measures, to develop new measures, and to lay out more specific hypotheses about the relevance of ToM for different social outcomes.

Open dataset of theory of mind reasoning in early to middle childhood

Theory of mind (ToM) reasoning refers to the process by which we reason about the mental states (beliefs, desires, emotions) of others. Here, we describe an open dataset of responses from children who completed a story booklet task for assessing ToM reasoning (n = 321 3-12-year-old children, including 64 (neurotypical) children assessed longitudinally and 68 autistic children). Children completed one of two versions of the story booklet task (Booklet 1 or 2). Both versions include two-alternative forced choice and free response questions that tap ToM concepts ranging in difficulty from reasoning about desires and beliefs to reasoning about moral blameworthiness and mistaken referents. Booklet 2 additionally includes items that assess understanding of sarcasm, lies, and second-order belief-desire reasoning. Compared to other ToM tasks, the booklet task provides relatively dense sampling of ToM reasoning within each child (Booklet 1: 41 items; Booklet 2: 65 items). Experimental sessions were video recorded and data were coded offline; the open dataset consists of children's accuracy (binary) on each item and, for many children (n = 171), transcriptions of free responses. The dataset also includes children's scores on standardized tests of receptive language and non-verbal IQ, as well as other demographic information. As such, this dataset is a valuable resource for investigating the development of ToM reasoning in early and middle childhood.

The three-factor structure of the Autism-Spectrum Quotient Japanese version in pregnant women

Background

There is a rising interest in perinatal mental health studies, and proper psychometric tools to assess autistic traits among this population in Japan are vital.

Objective

This study aimed to clarify the optimal factor structure of the AQ as part of a perinatal mental health research project.

Methods

We used the Japanese version of the AQ (AQ-J) to measure autistic-like traits in pregnant women. Participants were 4,287 Japanese women who were pregnant or who had given birth within the last month. We performed exploratory factor analysis (EFA) using the first sample group (n = 2,154) to obtain factor structures for the final item selections. We performed confirmatory factor analysis (CFA) using the second sample group (n = 2,133) to obtain a model with good fit, then compared the model to all previously proposed models to determine the best-fitting model.

Results

The EFA analysis identified a model consisting of 25 items distributed across three factors. Cronbach's alpha for the total 25-item AQ-J, 9-item "Social interaction" factor, 11-item "Non-verbal communication" factor, and 5-item "Restricted interest" factor was 0.829, 0.829, 0.755, and 0.576, respectively. McDonald's omega and its 95% confidence interval were 0.826 (0.821-0.836), 0.835 (0.821-0.837), 0.755 (0.744-0.766), and 0.603 (0.556-0.596), respectively. CFA confirmed that the three-factor structure had an acceptable fit (goodness of fit index: 0.900, comparative fit index: 0.860, root mean square error of approximation: 0.066). These findings indicated that the three-factor model was better than the 13 existing models.

Conclusion

The findings are discussed in relation to the adequacy of the AQ-J for assessing autistic traits in perinatal women. We recommend the use of this 25-item, three-factor AQ-J model for this population owing to its superiority to all previous models.

Neural correlates of theory of mind reasoning in congenitally blind children

Vision is an important source of information about other minds for sighted children, especially prior to the onset of language. Visually observed actions, eye gaze, and facial expressions of others provide information about mental states, such as beliefs, desires, and emotions. Does such experience contribute causally to the development of cortical networks supporting social cognition? To address this question we compared functional development of brain regions supporting theory of mind (ToM), as well as behavioral ToM reasoning, across congenitally blind (n=17) and sighted (n=114) children and adolescents (4-17 years old). We find that blind children in this age range show slightly lower ToM behavioral performance relative to sighted children. Likewise, the functional profile of ToM brain regions is qualitatively similar, but quantitatively weaker in blind relative to sighted children. Alongside prior research, these data suggest that vision facilitates, but is not necessary for, ToM development.

Comprehensive Assessments of Theory of Mind Abilities for School-Age Children: A Systematic Review

PURPOSE

Theory of mind involves perceiving both the thoughts and emotions of others. Theory of mind skills continue to develop in school-age individuals. For children at risk for social communication difficulties, evaluating theory of mind is warranted to determine whether theory of mind should be a target of intervention. There are hundreds of tasks designed to evaluate theory of mind, but many evaluate a single facet of the construct and have uneven psychometric properties. Comprehensive assessments evaluate both cognitive and affective aspects of theory of mind. The purpose of this systematic review was to identify comprehensive theory of mind assessments for school-age individuals and to critically appraise their measurement properties.

METHOD

Four databases were searched to identify 27 included records describing the measurement properties of comprehensive theory of mind assessments for 5- to 21-year-olds. Assessments appearing in at least three records were included. The methodological quality of the studies and the sufficiency of assessments' measurement properties were evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN).

RESULTS

Nine assessments were evaluated, and four met COSMIN standards for sufficient content validity and internal consistency to be recommended for clinical use.

CONCLUSIONS

Comprehensive assessments enable examiners to develop a profile of children's theory of mind strengths and needs. Strengths of the identified assessments include sufficient convergent validity and internal consistency. Further research is required to develop higher quality evidence for the content validity, structural validity, and reliability of the included assessments.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.23817495.

Children's processing of written irony: An eye-tracking study

Ironic language is challenging for many people to understand, and particularly for children. Comprehending irony is considered a major milestone in children's development, as it requires inferring the intentions of the person who is being ironic. However, the theories of irony comprehension generally do not address developmental changes, and there are limited data on children's processing of verbal irony. In the present pre-registered study, we examined, for the first time, how children process and comprehend written irony in comparison to adults. Seventy participants took part in the study (35 10-year-old children and 35 adults). In the experiment, participants read ironic and literal sentences embedded in story contexts while their eye movements were recorded. They also responded to a text memory question and an inference question after each story, and children's levels of reading skills were measured. Results showed that for both children and adults comprehending written irony was more difficult than for literal texts (the "irony effect") and was more challenging for children than for adults. Moreover, although children showed longer overall reading times than adults, processing of ironic stories was largely similar between children and adults. One group difference was that for children, more accurate irony comprehension was qualified by faster reading times whereas for adults more accurate irony comprehension involved slower reading times. Interestingly, both age groups were able to adapt to task context and improve their irony processing across trials. These results provide new insights about the costs of irony and development of the ability to overcome them.

Affect Recognition, Theory of Mind, and Empathy in Preschool Children with Externalizing Behavior Problems-A Group Comparison and Developmental Psychological Consideration

Preschool mental disorders are often associated with significant interpersonal problems, related to impaired affect recognition, theory of mind (ToM), and empathy. To date, these skills have not been studied together in preschoolers with externalizing behavior problems (EBPs). The aim of the present study was to investigate whether and to what extent preschool children with EBPs show impairments in affect recognition, ToM, and empathy. Preschoolers with EBPs, defined by current psychiatric treatment and T-scores ≥ 60 on the externalizing problem scale of the Child Behavior Checklist (CBCL/1½-5 or 6-18R) were compared to non-clinical controls (HCs), defined by no past and no current psychiatric treatment and T-scores < 60 on all CBCL broad-band scales. Groups were compared on affect recognition (NEuroPSYchological Assessment-II), affective ToM (Test of Emotion Comprehension), cognitive ToM (Extended Theory-of-Mind Scale), parent-reported emotional contagion, attention to others' feelings, and prosocial action (Empathy Questionnaire), IQ and language (Wechsler Preschool and Primary Scale of Intelligence-III Matrices, Active and Passive Vocabulary test), controlling for age, sex, and language abilities. Compared to 28 HCs, 22 preschoolers with EBPs (total sample meanage = 5.5 years +/- 0.8 years, range= 4.2-6.9 years, males 66%) had significantly greater impairments in cognitive ToM (p = 0.0012, η2 = 0.266), attention to others' feelings (p = 0.0049, η2 = 0.222), and prosocial action (p = 0.0070, η2 = 0.210), each representing strong effect sizes. EBPs were significantly related to cognitive domains, like prosocial action (r = -0.501), cognitive ToM (r = -0.425), and attention to others' feelings (r = -0.332), but not to affective domains of social cognition. Social cognitive development may be impaired as early as preschool age and should be promoted before the child starts school.

The relation between aggression and theory of mind in children: A meta-analysis

Previous findings on the association between theory of mind (ToM) and aggression in children are mixed. The social skills deficit view regarded ToM as a single-edged sword and proposed that a lack of ToM can lead to aggression, while the double-edged sword view proposed that children with advanced ToM can still show much aggression because children can also leverage ToM to harm others. To resolve the dispute between the two views, we conducted a meta-analysis combining cross-sectional and longitudinal findings from 53 studies including a total of 11,579 children aged between 2 and 15 years. The overall negative correlation between ToM and aggression was small but significant (r = -0.08). The negative correlation was robust, with the magnitude of the correlation being similar across physical versus relational aggression, proactive versus reactive aggression, cognitive versus affective ToM, preschoolers versus school-aged children, different aggression measurements, and different levels of societal individualism. Moreover, the negative correlation was found regardless of whether ToM and aggression were measured concurrently or at different time points, but the correlation was the largest when ToM was measured before aggression. Whether the aggression was bullying or not also moderated the association, with ToM only being negatively related to non-bullying aggression but not bullying. Together, these findings suggest that ToM is a single-edged sword to decrease general aggression and that aggression might also give rise to lower ToM capacity during development. RESEARCH HIGHLIGHTS: This study systemically reviewed the existing mixed findings on the association between aggression and ToM during childhood using a meta-analysis. There was a negative correlation between ToM and aggression in children aged between 2 and 15 years. The negative correlation between aggression and ToM was stronger when ToM was measured first, followed by aggression, than vice versa. There was a negative correlation between non-bullying aggression and ToM, whereas there was no correlation between bullying and ToM.

Language in autism: domains, profiles and co-occurring conditions

This article reviews the current knowledge state on pragmatic and structural language abilities in autism and their potential relation to extralinguistic abilities and autistic traits. The focus is on questions regarding autism language profiles with varying degrees of (selective) impairment and with respect to potential comorbidity of autism and language impairment: Is language impairment in autism the co-occurrence of two distinct conditions (comorbidity), a consequence of autism itself (no comorbidity), or one possible combination from a series of neurodevelopmental properties (dimensional approach)? As for language profiles in autism, three main groups are identified, namely, (i) verbal autistic individuals without structural language impairment, (ii) verbal autistic individuals with structural language impairment, and (iii) minimally verbal autistic individuals. However, this tripartite distinction hides enormous linguistic heterogeneity. Regarding the nature of language impairment in autism, there is currently no model of how language difficulties may interact with autism characteristics and with various extralinguistic cognitive abilities. Building such a model requires carefully designed explorations that address specific aspects of language and extralinguistic cognition. This should lead to a fundamental increase in our understanding of language impairment in autism, thereby paving the way for a substantial contribution to the question of how to best characterize neurodevelopmental disorders.

Asperger Syndrome (AS): A Review Article

A variant of autism spectrum disorder (ASD) known as Asperger syndrome (AS) is characterized by severe issues with interpersonal, verbal, and nonverbal communication as well as restricted and repetitive patterns of behavior and activities. Although there is no known cause for ASD, various genetic as well as non-genetic risk factors that may act either alone or in combination to induce ASD have been identified. The occurrence of ASD has been increasing worldwide. Co-occurring neuropsychological diseases are frequently present as well. The premise for diagnosis is the observation of abnormal conduct, with diagnostic criteria emphasizing limitations in social interaction and communication as well as constrained, repetitive behavioral patterns, activities, or hobbies. The degree of the illness and the presence of intellectual impairment have a significant impact on the prognosis. Like autism, Asperger's can neither be prevented nor treated. There is no specific medical therapy that can effectively cure all of the symptoms of autism. However, medications may be used as adjuvant therapy for maladaptive behaviors and co-occurring mental problems. The treatment aims to reduce core impairments, increase functional ability, and reduce harmful behaviors that could limit functional skills. It is crucial to provide proper care, establish supportive networks for individuals who are affected and their families, and use effective therapies to enhance functioning and results.

"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.

Theory of mind in patients with mild cognitive impairment: A systematic review

The focus of this systematic review was to collect and align studies which analyze the functionality of theory of mind (TOM) in patients with mild cognitive impairments (MCI). Specifically, we identified 20 papers published between 2012 and 2022 which met inclusion criteria. Papers search, selection, and extraction followed the PRISMA guidelines. In order to summarize data from the papers, we used a narrative synthesis approach. Results in 18 of these 20 papers show that theory of mind (TOM) is impaired in all types of MCI patients—regardless of different etiology and diagnostic criteria. Only 2 out of 20 reported no significant differences in TOM performance between MCI patients and healthy control subjects. The review additionally aimed to bundle the variety of the type of tasks used by the author to assess multiple domains of TOM. This heterogeneity does not allow us to make a comprehensive comparison between the results, so we suggest the need to align the results using the same type of tests and TOM assessment. In the end, our work highlights the 2 neuropsychological studies which confirm more of our results; due to the objective approach adopted to investigate this topic, we suggest exploring this point of view more in future research.

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.

The influence of group membership on false-belief attribution in preschool children

The ability to infer beliefs and thoughts in interaction partners is essential in social life. However, reasoning about other people's beliefs might depend on their characteristics or our relationship with them. Recent studies indicated that children's false-belief attribution was influenced by a protagonist's age and competence. In the current experiments, we investigated whether group membership influences the way children reason about another person's beliefs. We hypothesized that 4-year-olds would be less likely to attribute false beliefs to an ingroup member than to an outgroup member. Group membership was manipulated by accent (Experiments 1-3) and gender (Experiment 4). The results indicated that group membership did not consistently influence children's false-belief attribution. Future research should clarify whether the influence of group membership on false-belief attribution either is absent or depends on other cues that we did not systematically manipulate in our study.

Identification and Comprehension of Narrow Focus by Arabic-Speaking Adolescents With Moderate-to-Profound Hearing Loss

PURPOSE

Processing narrow focus (NF), the stressed word in the sentence, includes both the perceptual ability to identify the stressed word in the sentence and the pragmatic-semantic ability to comprehend the nonexplicit linguistic message. NF and its underlying meaning can be conveyed only via the auditory modality. Therefore, NF can be considered as a measure for assessing the efficacy of the hearing aid (HA) and cochlear implants (CIs) for acquiring nonexplicit language skills. The purpose of this study was to assess identification and comprehension of NF by HA and CI users who are native speakers of Arabic and to associate NF outcomes with speech perception and cognitive and linguistic abilities.

METHOD

A total of 46 adolescents (age range: 11;2-18;8) participated: 18 with moderate-to-severe hearing loss who used HAs, 10 with severe-to-profound hearing loss who used CIs, and 18 with typical hearing (TH). Test materials included the Arabic Narrow Focus Test (ANFT), which includes three subtests assessing identification (ANFT1), comprehension of NF in simple four-word sentences (ANFT2), and longer sentences with a construction list at the clause or noun phrase level (ANFT3). In addition, speech perception, vocabulary, and working memory were assessed.

RESULTS

All the participants successfully identified the word carrying NF, with no significant difference between the groups. Comprehension of NF in ANFT2 and ANFT3 was reduced for HA and CI users compared with TH peers, and speech perception, hearing status, and memory for digits predicted the variability in the overall results of ANFT1, ANFT2, and ANFT3, respectively.

CONCLUSIONS

Arabic speakers who used HAs or CIs were able to identify NF successfully, suggesting that the acoustic cues were perceptually available to them. However, HA and CI users had considerable difficulty in understanding NF. Different factors may contribute to this difficulty, including the memory load during the task as well as pragmatic-linguistic knowledge on the possible meanings of NF.

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.

Inhibitory Control of Emotional Interference in Deaf Children: Evidence From Event-Related Potentials and Event-Related Spectral Perturbation Analysis

BACKGROUND

Impairment of interference control ability may reflect a more general deficit in executive functioning, and lead to an increase in internal-externalized problems such as impulsivity, which has been reported in deaf children. However, few researches have examined the neural mechanism of this impairment.

METHODS

This study applied the electroencephalogram (EEG) technique to investigate the interference control ability in 31 deaf children and 28 hearing controls with emotional face-word stroop task.

RESULTS

Results from behavioral task showed that deaf children exhibited lower accuracy compared to hearing controls. As for EEG analysis, reduced activation of ERP components in N1 and enhanced activation of ERP components in N450 have been found in deaf children. Besides, incongruent condition elicited larger N450 than congruent condition. Furthermore, for brain oscillation, alpha band (600-800 ms) revealed a reduced desynchronization in deaf children, while theta band (200-400 ms) revealed an enhanced synchronization in deaf children and incongruent condition, which were in line with ERP components.

CONCLUSION

The present findings seem to indicate that the deficit during emotional interference control ability among deaf children might be due to the impaired attention allocation ability and emotional cognitive monitoring function during emotional conflict detection process. Consequently, reduced N1 and enhanced N450 might be due to early attention impairment causing more effort of deaf children later in emotional cognitive monitoring.

The development of early social cognitive skills in neurogenetic syndromes associated with autism: Cornelia de Lange, fragile X and Rubinstein-Taybi syndromes

BACKGROUND

Cornelia de Lange (CdLS), Fragile X (FXS) and Rubinstein-Taybi syndromes (RTS) evidence unique profiles of autistic characteristics. To delineate these profiles further, the development of early social cognitive abilities in children with CdLS, FXS and RTS was compared to that observed in typically developing (TD) and autistic (AUT) children.

METHODS

Children with CdLS (N = 22), FXS (N = 19) and RTS (N = 18), completed the Early Social Cognition Scale (ESCogS). Extant data from AUT (N = 19) and TD (N = 86) children were used for comparison.

RESULTS

Similar to AUT children, children with CdLS, FXS and RTS showed an overall delay in passing ESCogS tasks. Children with CdLS showed a similar degree of delay to AUT children and greater delay than children with FXS and RTS. The CdLS, FXS and RTS groups did not pass tasks in the same sequence observed in TD and AUT children. Children with CdLS (p = 0.04), FXS (p = 0.02) and RTS (p = 0.04) performed better on tasks requiring understanding simple intentions in others significantly more than tasks requiring joint attention skills.

CONCLUSIONS

An underlying mechanism other than general cognitive delay may be disrupting early social cognitive development in children with CdLS, FXS and RTS. Factors that may disrupt early social cognitive development within these syndromes are discussed.

Does Advanced Theory of Mind Protect Primary-School Children from Loneliness? Longitudinal Relations from 9-10 Years

Advanced theory of mind (AToM) has been associated with several socioemotional consequences, including loneliness. However, the empirical evidence for this relation is mixed, with some studies finding no significant associations. The present study aimed to replicate and extend previous cross-sectional work. Specifically, we investigated the longitudinal associations between AToM and loneliness in late primary school [from grade 3 (G3) to grade 4 (G4)] by assessing 122 children for AToM (social reasoning) skills, loneliness and self-esteem (aged 9.06 ± .33 years, mean ± SD; 68 girls, 54 boys). Regression analyses showed that G4 loneliness was predicted by G3 self-esteem (β = .231, p <.05). However, in contrast with earlier findings, neither concurrent nor longitudinal associations emerged between AToM (social reasoning) and loneliness, suggesting that AToM alone affects children's real-world social functioning less than currently assumed.

Understanding and breaking the intergenerational cycle of abuse in families enrolled in routine mental health services: study protocol for a randomized controlled trial and two non-interventional trials investigating mechanisms of change within the UBICA II consortium

Background

Parents’ mental illness (MI) and parental history of early life maltreatment (ELM) are known to be significant risk factors for poor parenting while poor parenting is a crucial mediator of the intergenerational continuity of child maltreatment. Hence, maltreatment prevention programs for families with an MI parent, which pay particular attention to experiences of ELM in the parent, are urgently needed. Parental mentalizing was previously found to mediate successful parenting. Interventions aimed at improving the parental mentalizing capacity reduced maltreatment risk in parents. The aim of the present study is to investigate the effectiveness of a mentalization-based parenting-counseling in acutely mentally ill parents currently treated at a psychiatric hospital.

Methods

Mentalization-based parenting-counseling (MB-PC) vs. enhanced standard clinical care (SCC+) will be administered in a cluster-randomized-controlled trial (RCT). Patients treated at psychiatric hospitals with children between 1.5 and 15 years will be included in the trial. MB-PC will be administered as a 12-h combined individual and group program enriched by social counseling (over a course of 5 weeks) as add-on to standard clinical care, while the control condition will be standard clinical care plus a 90-min psychoeducation workshop on positive parenting. Primary efficacy endpoint is self-reported parenting practices at follow-up. Embedded within the RCT will be two sub-studies investigating social cognition and dyadic synchrony as biobehavioral mechanisms of change.

Discussion

The main goal of the present study is to investigate ways to break the intergenerational continuity of maltreatment by assessing the benefits of a prevention program which aims at improving parenting in vulnerable mothers and fathers. MB-PC is a short, low-cost intervention which can be delivered by nurses and social workers and is applicable to MI patients with children with a broad range of diagnoses. If it is shown to be effective, it can be directly implemented into standard psychiatric hospital care thereby providing help to prevent child maltreatment.

Trial registration

German Clinical Trials Register DRKS00017398. Registered on 5 July 2019

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.

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.

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.

Theory of Mind (ToM) Development in Thai Deaf Children

This study explored theory of mind (ToM) development in school-aged deaf children. To address new questions, we gave a standard, well-controlled false-belief test to a large (n = 200) sample of severely-to-profoundly deaf children aged 8-15 years in a non-Western culture (Thailand). There were 190 deaf children of hearing parents and 10 deaf native signers with signing deaf parents, consistent with overall population ratios. Comparing our Thai sample's ToM performance on standard tests of false-belief understanding with that reported in past studies, our results showed a 67% ToM success rate for Thai severely-to-profoundly deaf children of hearing parents similar to collective findings from past research on smaller samples in Australia, Estonia, France, Great Britain, Sweden, and the United States. Our Thai deaf native signers likewise performed equivalently to native signers of similar age studied in past research in Australia and the United States. Collectively, the detailed findings of our study suggest promising new directions for future studies to pursue in order to build upon this novel and theoretically provocative evidence about how ToM development and ToM delay unfold for school-aged deaf children growing up in varied cultures, school settings, and family circumstances.

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.

Measurement of Cognition for the National Children's Study

The National Children's Study Cognitive Health Domain Team developed detailed plans for assessing cognition longitudinally from infancy to early adulthood. These plans identify high-priority aspects of cognition that can be measured efficiently and effectively, and we believe they can serve as a model for future large-scale longitudinal research. For infancy and toddlerhood, we proposed several paradigms that collectively allowed us to assess six broad cognitive constructs: (1) executive function skills, (2) episodic memory, (3) language, (4) processing speed, (5) spatial and numerical processing, and (6) social cognition. In some cases, different trial sequences within a paradigm allow for the simultaneous assessment of multiple cognitive skills (e.g., executive function skills and processing speed). We define each construct, summarize its significance for understanding developmental outcomes, discuss the feasibility of its assessment throughout development, and present our plan for measuring specific skills at different ages. Given the need for well-validated, direct behavioral measures of cognition that can be used in large-scale longitudinal studies, especially from birth to age 3 years, we also initiated three projects focused on the development of new measures.

Analogical Comparison Promotes Theory-of-Mind Development

Theory-of-mind (ToM) is an integral part of social cognition, but how it develops remains a critical question. There is evidence that children can gain insight into ToM through experience, including language training and explanatory interactions. But this still leaves open the question of how children gain these insights-what processes drive this learning? We propose that analogical comparison is a key mechanism in the development of ToM. In Experiment 1, children were shown true- and false-belief scenarios and prompted to engage in multiple comparisons (e.g., belief vs. world). In Experiments 2a, 2b, and 3, children saw a series of true- and false-belief events, varying in order and in their alignability. Across these experiments, we found that providing support for comparing true- and false-belief scenarios led to increased performance on false-belief tests. These findings show that analogical comparison can support ToM learning.

Lies and Irony Understanding in Deaf and Hearing Adolescents

Lies and irony are paradigmatic examples of nonliteral communication; many deaf children and even adults have difficulty in understanding them. The present study assessed the understanding of lies and irony in 96 adolescents living in Spain in urban settings (58 deaf participants, 38 hearing participants; 10-19 years old). We investigated whether deaf and hearing participants differ in their performance, and the effects of age, theory of mind (ToM), and language on the understanding of these nonliteral meanings in deaf participants. The results show that deaf participants do not find it difficult to detect nonliteral statements, but they experience difficulty in attributing the real motivation to the speaker. ToM and language explained performance in the understanding of nonliteral communication in the deaf group. The results suggest the need to focus on promoting the ability to attribute real motivations to speakers. We propose an assessment sequence that differs from those used in other studies. In the proposed sequence, ToM skills would be combined with other skills that influence the understanding of lies and irony and would be sequenced according to the observed performance in deaf adolescents.

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.

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.