Dynamics of the Theory of Mind construct: A developmental perspective

Background/Objectives: Executive functions (EFs) and Theory of Mind (ToM) are often compromised in children with Specific Learning Disorders (SLD). Although evidence highlights the malleability of EF, studies have yet to investigate whether school-based interventions can enhance both cool and hot EF domains and support ToM development in this population. This study evaluated the effectiveness of a structured, classroom-based EF training program in improving cool EF, hot EF, and ToM in children with SLD. Methods: Forty students with SLD (aged 8-10 years) were allocated to an intervention group (n = 24) or a passive control group (n = 16). The program was delivered in small groups during regular school hours over 6-9 weeks (18 sessions). Pre- and post-intervention assessments measured cool EFs (working memory, planning, cognitive flexibility, inhibition), hot EFs (affective decision-making, delay of gratification), and ToM (false belief understanding, mental state/emotion recognition). Results: The intervention group showed significant within-group improvements in working memory, planning, and cognitive flexibility, whereas the control group showed no significant changes. Between-group comparisons revealed significant effects for working memory, planning, and ToM mental state/emotion recognition, with medium-to-large effect sizes. No significant group differences were found for hot EFs or ToM false belief understanding. Conclusions: These findings suggest that participation in a structured, school-based EF program is associated with selective improvements in specific cool EF components and one aspect of ToM in children with SLD, supporting the potential value of classroom-based interventions for cognitive and socio-cognitive development.

Weak theory of mind (ToM) ability is a core deficit in children with autism. A growing body of work has found that there is a close relation between complement syntax and ToM in autistic children. However, researchers have not yet investigated whether other linguistic components may explain the difficulties in ToM reasoning in autistic children. To determine whether verb factuality (i.e., mental and action verbs) is related to ToM ability, as measured by a false belief understanding (FBU) task after controlling the effect of complement syntax for Mandarin-speaking autistic children. Participants were verbal autistic children, aged 4-7 years. Their IQ performance (verbal, performance and total IQ) and the comprehension of complement syntax were evaluated. A total of 38 children scoring over 9 points in complement syntax test and 90 points in the verbal IQ test were selected to complete verb factuality and FBU task. The χ2 tests and correlation analyses were carried out on two relations: (1) ToM ability and understanding of verb factuality; and (2) ToM ability and comprehension of complement syntax. A total of 11 autistic children completed the action verb factuality task, while 14 completed the mental verb factuality task and 13 completed both tasks. Participants performed well on the verb factuality task, and their ToM performance appeared to be related to their linguistic ability, regardless of the type of verb (i.e., action or mental verb). However, complement syntax scores did not significantly predict the success of the FBU task for the autistic children. The results of this study link weaker ToM ability with the understanding of verb factuality among autistic children aged 4-7 and provide new evidence for the view that the development of language facilitates improvement of ToM skills. The findings shed new light on how language affects or determines social interactions. What is already known on the subject ToM ability is crucial for social interaction. It has been claimed that mental verb factuality (e.g., think, had thought) may play a role in the development of ToM reasoning in typically developing children, but whether there is a link between the mastery of verb factuality and ToM skills in autistic children is still unclear. What this study adds to existing knowledge Correlational analysis revealed links between verbal ToM measured by unexpected location task and factuality test of mental verbs as well as action verbs. More importantly, this study confirmed the extra role of verb factuality in explaining ToM ability after excluding the influence of the complement syntax. What are the potential or actual clinical implications of this work? This study suggests that the factuality of verbs could serve as a tool for autistic children to infer the mental states of others. Thus, training on this linguistic structure could be taken into consideration when improving the social skills of autistic children.

Theory of Mind (ToM) is the ability to infer other people’s mental states likeintentions or desires. ToM can be differentiated into affective (i.e.,recognizing the feelings of another person) and cognitive (i.e., inferring themental state of the counterpart) subcomponents. Recently, subcortical structuressuch as the basal ganglia (BG) have also been ascribed to the multifacetedconcept ToM and most BG disorders have been reported to elicit ToM deficits. Inorder to assess both the correlates of affective and cognitive ToM as well asinvolvement of the basal ganglia, 30 healthy participants underwentevent-related fMRI scanning, neuropsychological testing, and filled inquestionnaires concerning different aspects of ToM and empathy. Directlycontrasting affective (aff) as well as cognitive (cog) ToM to the control (phy)condition, activation was found in classical ToM regions, namely parts of thetemporal lobe including the superior temporal sulcus, the supplementary motorarea, and parietal structures in the right hemisphere. The contrast aff > phyyielded additional activation in the orbitofrontal cortex on the right and thecingulate cortex, the precentral and inferior frontal gyrus and the cerebellumon the left. The right BG were recruited in this contrast as well. The directcontrast aff > cog showed activation in the temporoparietal junction and thecingulate cortex on the right as well as in the left supplementary motor area.The reverse contrast cog > aff however did not yield any significant clusters.In summary, affective and cognitive ToM partly share neural correlates but canalso be differentiated anatomically. Furthermore, the BG are involved inaffective ToM and thus their contribution is discussed as possibly providing amotor component of simulation processes, particularly in affective ToM.

This study investigated Theory of Mind (ToM) development in children with hearing loss, comparing children with mild-to-moderate hearing loss (MHL, n = 26), severe-to-profound hearing loss (SHL, n = 31), and typical hearing (TH, n = 53), aiming to explore the differences between the three groups and potential factor related to the ToM development in children with hearing loss. Participants completed the ToM scale and language assessments. One-way ANOVA and Bonferroni post-hoc tests were used to analyze group differences, while Pearson's correlation examined relationships between ToM, language, and background variables. Results revealed that both MHL and SHL groups showed delays in overall ToM skills compared to TH peers, with the SHL group exhibiting more substantial delays. The MHL group demonstrated delays only in hidden emotion understanding, while the SHL group showed delays from knowledge access through false belief and hidden emotion tasks. Language comprehension was significantly correlated with ToM skills in both hearing loss groups. Aided audibility was associated with false belief understanding in the MHL group. The study highlights the impact of hearing loss severity on ToM development and emphasizes the crucial role of language comprehension in ToM skills. Findings suggest the need for tailored interventions addressing language and communication challenges to support ToM development in children with hearing loss.

Theory of Mind (ToM) is a foundational skill related to understanding the thoughts, beliefs, and desires of oneself and others. There are child factors that play an important role in the development of ToM (e.g., language and vocabulary) as well as environmental factors (e.g., conversations among family members and socioeconomic status). In this review, we discuss the role of language in ToM and include the nature of social interactions that scaffold ToM development. We review research on deaf and hard-of-hearing children and children with specific language impairment; 2 groups who experience difficulties with language for different reasons, but both encounter deficits in ToM development. Finally, we conclude with examples of how clinicians can easily assess a child's ToM abilities and offer empirical evidence that aspects of ToM can be scaffolded with explicit instruction.

This study examined the concurrent and longitudinal relationships between children's theory of mind (ToM) and their beliefs about learning. A sample of 63 children was tested for theory of mind and verbal ability at four time points: 5, 6, 7 and 8 years of age. In addition, at Time 4, children were administered a questionnaire investigating their beliefs about learning. Results showed longitudinal and concurrent relationships between ToM and constructivist, but not reproductive, beliefs about learning. Crucially, false-belief understanding at age 5 predicted unique variance in constructivist beliefs about learning at age 8, when controlling for subsequent levels of ToM. This relationship was not due to verbal ability. The authors discuss theoretical and practical implications of the longitudinal effect of theory of mind ability on constructivist beliefs about learning.

Meta-analysis of social cognition in amyotrophic lateral sclerosis

Some evidence suggests that patients with bipolar disorder (BD) have better Theory of Mind (ToM) skills than patients with schizophrenia/schizoaffective disorder (SCH). However, this difference is not consistently reported across studies, so rather than being global, it may be restricted to specific aspects of ToM. Our primary objective was to compare higher order ToM performance between BD and SCH patients using the Hinting Task (HT). Ninety-four remitted patients were recruited (BD = 47, SCH = 47). Intelligence quotient (IQ), attention, memory, executive functions, and processing speed were also assessed. Patients with BD performed better on the HT than patients with SCH, even when the analysis was adjusted for IQ and neurocognition (p < 0.001, [Formula: see text] = 0.144). Regression analysis in the total sample showed that a diagnosis of SCH and lower IQ were associated with lower HT scores (R2 = 0.316, p < 0.001). In the BD group, verbal memory and processing speed were the main predictors of HT performance (R2 = 0.344, p < 0.001). In the SCH group, no variable was significant in explaining HT performance. In the context of previous studies that found no significant differences in the most basic aspects of ToM (e.g., understand other people's thoughts/beliefs), our results suggest that differences between the two disorders might be limited to the more challenging aspects (e.g., understand the intended meaning of indirect requests). No causal inferences can be made in this cross-sectional study. However, regression analyses show that whereas in BD patients, ToM functioning would be partially modulated by neurocognitive performance, in SCH patients, it could be largely independent of the well-known neurocognitive impairment.

Research Findings: Emotion knowledge (EK) enables children to identify emotions in themselves and others, and its development facilitates emotion recognition in complex social situations. Sociocognitive processes, such as theory of mind (ToM), may contribute to developing EK by helping children realize the inherent variability associated with emotion expression across individuals and situations. The present study explored how ToM, particularly false belief understanding, in preschool predicts children's developing EK in kindergarten. Participants were 60 Head Start children ages 3 to 5 years. ToM and EK measures were obtained from standardized child tasks. ToM scores were positively related to performance on an EK task in kindergarten after we controlled for preschool levels of EK and verbal ability. Exploratory analyses provided preliminary evidence that ToM serves as an indirect effect between verbal ability and EK. Practice or Policy: Early intervention programs may benefit from including lessons on ToM to help promote socioemotional learning, specifically EK. This consideration may be most fruitful when the targeted population is at risk.

The rationalistic theories of morality emphasize that reasoning plays an important role in moral judgments and prosocial behavior. Theory of mind as a reasoning ability in the mental domain has been considered a facilitator of moral development. The present study examined whether theory of mind was consistently positively associated with morality from middle childhood to late adulthood. Two hundred and four participants, including 48 elementary school children, 45 adolescents, 62 younger adults, and 49 older adults, completed theory of mind, moral judgment and prosocial behavior tasks. Theory of mind was measured with strange stories that tapped into an understanding of lies, white lies, double bluffs, irony, and persuasion. Moral judgments were measured with variants of the trolley dilemma. Prosocial behavior was measured through participants' performance in an interactive situation in which a helping request was made. The results indicated specific rather than similar developmental trajectories of theory of mind, moral judgments, and prosocial behavior. There was a quadratic trend in theory of mind, a combination of quadratic and cubic trends in deontological moral judgments and a linear decline in helping behavior. It is thus suggested that theory of mind may not be associated with morality in an unchanging way during development. Further results indicated that theory of mind and deontological moral judgments were negatively correlated for children, adolescents, and older adults but positively correlated for younger adults. Theory of mind and helping behavior were positively correlated for children but negatively correlated for adolescents. However, the relationships disappeared in adulthood. In sum, the present study reveals that theory of mind may be a nice tool for its facilitation of deontological moral judgments and prosocial behavior, but it may also be a nasty tool for its blocking of deontological moral judgments and prosocial behavior. Moreover, theory of mind may be a permanent tool for moral judgment development but a temporary tool for prosocial behavior development. Thus, the present study enriches the rationalistic theories of morality from a developmental perspective. Different relationships between theory of mind and morality from middle childhood to late adulthood are discussed.

Traditionally, it had been assumed that meta-representational Theory of Mind (ToM) emerges around the age of 4 when children come to master standard false belief (FB) tasks. More recent research with various implicit measures, though, has documented much earlier competence and thus challenged the traditional picture. In interactive FB tasks, for instance, infants have been shown to track an interlocutor's false or true belief when interpreting her ambiguous communicative acts (Southgate et al. 2010 Dev. Sci. 13, 907–912. (doi:10.1111/j.1467-7687.2009.00946.x)). However, several replication attempts so far have produced mixed findings (e.g. Dörrenberg et al. 2018 Cogn. Dev. 46, 12–30. (doi:10.1016/j.cogdev.2018.01.001); Grosse Wiesmann et al. 2017 Dev. Sci. 20, e12445. (doi:10.1111/desc.12445); Király et al. 2018 Proc. Natl Acad. Sci. USA 115, 11 477–11 482. (doi:10.1073/pnas.1803505115)). Therefore, we conducted a systematic replication study, across two laboratories, of an influential interactive FB task (the so-called ‘Sefo’ tasks by Southgate et al. 2010 Dev. Sci. 13, 907–912. (doi:10.1111/j.1467-7687.2009.00946.x)). First, we implemented close direct replications with the original age group (17-month-olds) and compared their performance to those of 3-year-olds. Second, we designed conceptual replications with modifications and improvements regarding pragmatic ambiguities for 2-year-olds. Third, we validated the task with explicit verbal test versions in older children and adults. Results revealed the following: the original results could not be replicated, and there was no evidence for FB understanding measured by the Sefo task in any age group except for adults. Comparisons to explicit FB tasks suggest that the Sefo task may not be a sensitive measure of FB understanding in children and even underestimate their ToM abilities. The findings add to the growing replication crisis in implicit ToM research and highlight the challenge of developing sensitive, reliable and valid measures of early implicit social cognition.

This study examines the link between language abilities and Theory of Mind (ToM) development in individuals with Williams Syndrome (WS) and Down Syndrome (DS). We compared the results of 16 participants with WS, aged 6.3 to 27.2 years (Mean = 15.9 years, SD = 6.8 years), to those of 16 participants with DS, aged 10.7 to 23.9 years (Mean = 16.8 years, SD = 3.6 years). Using the French version of the ToM test-Revised (ToM test-R), we assessed three levels of ToM development: prerequisites, first-order beliefs, and second-order beliefs. Language abilities were evaluated using the Isadyle French language assessment battery, focusing on word comprehension, word production, syntax comprehension and production, and emotional lexicon. The results showed that the WS group performed significantly better in overall ToM skills in the ToM test-R compared to the DS group. Moreover, language skills were significantly associated with ToM development in the WS group, but not in the DS group. These findings underscore the importance of language development, particularly syntax and emotional understanding, in ToM acquisition. Through the application of a cross-syndrome approach, this study provides insights into how each syndrome impacts ToM development and the role of language in this process.

The present study investigated school readiness in Brazilian (Portuguese-Japanese dual language learner or DLL) 5-year-olds in Japan (1) by examining their language skills, executive function (EF), and theory of mind (ToM) in comparison to their monolingual peers and (2) by investigating the developmental relations between these three skills. DLLs scored lower than monolinguals in Japanese language skills, specifically in receptive vocabulary and the understanding of complement clauses in Japanese. DLLs and monolinguals performed similarly in EF, particularly in inhibitory control tasks measuring interference suppression and response inhibition. However, monolinguals outperformed DLLs in ToM tasks assessing false belief understanding. Finally, DLLs’ interference suppression and understanding of complement clauses were both positively related to their false belief understanding. In conclusion, DLLs had school readiness difficulties in Japanese language skills and ToM, but not in EF, compared to their Japanese monolingual peers. Furthermore, the positive relationship of language and EF skills with ToM development, which is commonly reported in monolingual children, extended to an understudied population of DLLs in this study.

Introduction: Mentalizing ability is the issue in the social cognition of patients with brain injury that has received the most attention. The present study investigated mentalization ability in patients with prefrontal cortex damage. The aims of this study were to investigate: (a) whether patients with prefrontal cortex damage are impaired in mentalizing ability, including theory of mind (ToM) and empathy; (b) whether patients with ventromedial prefrontal cortex damage are impaired in different aspects of ToM; (c) whether patients with ventromedial prefrontal cortex damage are impaired in different aspects of empathy; and (d) whether impairment of mentalizing ability in patients with prefrontal cortex damage can be explained by executive dysfunction. Method: Mini-Mental State Examination (MMSE), Matrix Reasoning subtest, working memory, executive function, theory of mind, and empathy assessments were conducted on eight patients with ventromedial prefrontal cortex damage, 15 patients with dorsolateral prefrontal cortex damage, and 19 normal comparisons matched for level of education and intelligence. Results: The results showed that performance on affective and nonverbal theory of mind was significantly lower in patients with dorsolateral prefrontal cortex damage than in the comparison group. Performance on personal distress items of empathy was significantly lower in the ventromedial prefrontal cortex damage group than in the dorsolateral prefrontal cortex damage group. In addition, further multiple regression analysis showed that affective theory of mind could be explained by the Wisconsin Card Sorting Test–Modified (WCST–M), with an explained variance of up to 44%. Conclusion: The present study suggests that the impairment of mentalizing ability in patients with prefrontal cortex damage is partially the result of executive dysfunction.

The association between executive function (EF) and theory of mind (ToM) has been hotly debated for 20 years. Competing accounts focus on: task demands, conceptual overlap, or functional ties. Findings from this meta-analytic review of 102 studies (representing 9,994 participants aged 3-6 years) indicate that the moderate association between EF and one key aspect of ToM, false belief understanding (FBU) is: (a) similar for children from different cultures, (b) largely consistent across distinct EF tasks, but varies across different types of false belief task, and (c) is asymmetric in that early individual differences in EF predict later variation in FBU but not vice versa. These findings support a hybrid emergence-expression account and highlight new directions for research.