Language predictors of theory of mind in cochlear implant children compared to normal-hearing peers
Abstract
Background and Aim: Theory of mind (ToM) is very necessary to have successful social interaction. Hearing impairment disrupts the ToM development and language acquisition. This study aimed to compare ToM abilities of children with cochlear implant (CI) and normal hearing (NH) to clarify the role of language skills in ToM development.
Methods: Participants were CI and NH children in two age ranges of 5−6 and 8−9 years. Main measures were basic and advanced tasks of ToM test (Abbreviated as B. ToM and A. ToM), and comprehension of mental–state verbs and relative clauses. Regression analysis was used to assess how language skills predict ToM.
Results: CI children obtained significantly lower scores in all subscales of ToM test (p ≤ 0.001). Regression models for CI group aged 5−6-year showed that their comprehension of mental-state verbs predicted 53% of B. ToM. In CI children aged 8−9 years, comprehension of relative clauses and mental-state verbs together predicted 61% of B. ToM and 73% of A. ToM variances. Furthermore, comprehension of relative clauses predicted 43% of B. ToM and 31% of A. ToM in younger NH children.
Conclusion: Comprehension of mental-state verbs can predict only B. ToM in CI children aged 5−6 years and both B. ToM and A. ToM in CI children aged 8−9 years. Therefore, it is the main factor to predict ToM ability of preschool and school-age children with CI. The role of language should be considered by people who are helping these children for their cognitive problems.
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10. Astington JW, Baird JA. Why language matters for theory of mind. Oxford University Press; 2005.
11. Lohmann H, Tomasello M. The role of language in the development of false belief understanding: A training study. Child Dev. 2003;74(4):1130-44. doi: 10.1111/1467-8624.00597
12. de Villiers JG, de Villiers PA. The role of language in theory of mind development. Top Lang Disord. 2014;34(4):313-28. doi: 10.1097/TLD.0000000000000037
13. Woolfe T, Want SC, Siegal M. Signposts to development: Theory of mind in deaf children. Child Dev. 2002;73(3):768-78. doi: 10.1111/1467-8624.00437
14. Peterson CC, Siegal M. Representing inner worlds: Theory of mind in autistic, deaf, and normal hearing children. Psychological Science. 1999;10(2):126-9. doi: 10.1111/1467-9280.00119
15. Remmel E, Peters K. Theory of mind and language in children with cochlear implants. J Deaf Stud Deaf Educ. 2009;14(2):218-36. doi: 10.1093/deafed/enn036
16. Sundqvist A, Lyxell B, Jönsson R, Heimann M. Understanding minds: Early cochlear implantation and the development of theory of mind in children with profo¬und hearing impairment. Int J Pediatr Otorhinolaryngol. 2014;78(3):537-43. doi: 10.1016/j.ijporl.2013.12.039
17. Ketelaar L, Rieffe C, Wiefferink CH, Frijns JHM. Does hearing lead to understanding? Theory of mind in toddlers and preschoolers with cochlear implants. J Pediatr Psychol. 2012;37(9):1041-50. doi: 10.1093/jpepsy/jss086
18. de Villiers J. The interface of language and theory of mind. Lingua. 2007;117(11):1858-78. doi: 10.1016/j.lingua.2006.11.006
19. Cheung H, Chen H-C, Yeung W. Relations between mental verb and false belief understanding in Cantonese-speaking children. J Exp Child Psychol. 2009;104(2):141-55. doi: 10.1016/j.jecp.2009.05.004
20. Delkhah Z, Soleymani Z, Dadgar H, Mousavi N. [Comparison of basic theory of mind in 5-6 years Farsi speaking children with cochlear implant and normal peers]. Journal of Modern Rehabilitation. 2016;9(7):72-8. Persian.
21. Delkhah Z, Soleymani Z, Dadgar H. Basic and advanced theory of mind in school-aged children with cochlear implants. Aud Vestib Res. 2018;27(3):137-42. doi: 10.18502/avr.v27i3.55
22. Ghamarani A, Alborzi S, Khayer M. [Validity and reliability of the theory of mind test (TOM test) for use in Iran]. Journal of Psychology. 2006;10(2):181-99. Persian.
23. Muris P, Steerneman P, Meesters C, Merckelbach H, Horselenberg R, van den Hogen T, et al. The TOM test: A new instrument for assessing theory of mind in normal children and children with pervasive developmental disorders. J Autism Dev Disord. 1999;29(1):67-80. doi: 10.1023/a:1025922717020
24. Hajgholam Rezayi Z. Comparison of the effect of theory oh mind and storytelling on understanding of mental verbs in 5-6 years old children with hearing impairment in Kerman. [Master Thesis]. Tehran: University of Social Welfare and Rehabilitation Sciences; 2012. Persian. [unpublished]
25. Rahmany R, Marefat H, Kidd E. Persian speaking chil¬dren's acquisition of relative clauses. European Journal of Developmental Psychology. 2011;8(3):367-88. doi: 10.1080/17405629.2010.509056
26. Williams MN, Grajales CAG, Kurkiewicz D. Assumptions of multiple regression: Correcting two misconceptions. Practical Assessment, Research, and Evaluation. 2013;18:11. doi: 10.7275/55hn-wk47
27. Guo L-Y, Spencer LJ. Development of grammatical accuracy in English-speaking children with cochlear implants: A longitudinal study. J Speech Lang Hear Res. 2017;60(4):1062-75. doi: 10.1044/2016_JSLHR-H-16-0182
28. Peterson CC. Theory‐of‐mind development in oral deaf children with cochlear implants or conventional hearing aids. J Child Psychol Psychiatry. 2004;45(6):1096-106. doi: 10.1111/j.1469-7610.2004.t01-1-00302.x
29. Longobardi E, Spataro P, Rossi-Arnaud C. Relations between theory of mind, mental state language and social adjustment in primary school children. European journal of developmental psychology. 2016;13(4):424-38. doi: 10.1080/17405629.2015.1093930
30. Charman T, Shmueli-Goetz Y. The relationship between theory of mind, language, and narrative discourse: An experimental study. Curr Psychol Cogn. 1998;17(2):245-71.
31. Brooks R, Meltzoff AN. Connecting the dots from infancy to childhood: A longitudinal study connecting gaze following, language, and explicit theory of mind. J Exp Child Psychol. 2015;130:67-78. doi: 10.1016/j.jecp.2014.09.010
32. Hale CM, Tager‐Flusberg H. The influence of language on theory of mind: Dev Sci. 2003;6(3):346-59. doi: 10.1111/1467-7687.00289
33. Smith M, Apperly I, White V. False belief reasoning and the acquisition of relative clause sentences. Child Dev. 2003;74(6):1709-19. doi: 10.1046/j.1467-8624.2003.00633.x
34. Longobardi E, Spataro P, Renna M, Rossi-Arnaud C. Comparing fictional, personal, and hypothetical narratives in primary school: story grammar and mental state language. Eur J Psychol Educ. 2014;29(2):257-75. doi: 10.1007/s10212-013-0197-y
35. de Mulder HNM, Wijnen F, Coopmans PHA. Interrelationships between Theory of Mind and language development: A longitudinal study of Dutch-speaking kindergartners. Cognitive Development. 2019;51:67-82. doi: 10.1016/j.cogdev.2019.03.006
36. Fontana E, Adenzato M, Penso JS, Enrici I, Ardito RB. On the relationship between Theory of Mind and syntax in clinical and non-clinical populations: State of the art and implications for research. The Open Psychology Journal. 2018;11(1):95-104. doi: 10.2174/1874350101811010095
37. Peters K, Remmel E, Richards D. Language, mental state vocabulary, and false belief understanding in children with cochlear implants. Lang Speech Hear Serv Sch. 2009;40(3):245-55. doi: 10.1044/0161-1461(2009/07-0079)
38. Liu M, Wu L, Wu W, Li G, Cai T, Liu J. The relationships among verbal ability, executive function, and theory of mind in young children with cochlear implants. Int J Audiol. 2018;57(12):875-882. doi: 10.1080/14992027.2018.1498982
39. Schick B, de Villiers P, de Villiers J, Hoffmeister R. Language and theory of mind: A study of deaf children. Child Dev. 2007;78(2):376-96. doi: 10.1111/j.1467-8624.2007.01004.x
40. Vissers C, Koolen S. Theory of mind deficits and social emotional functioning in preschoolers with specific language impairment. Front Psychol. 2016;7:1734. doi: 10.3389/fpsyg.2016.01734
41. Smit L, Knoors H, Hermans D, Verhoeven L, Vissers C. The interplay between theory of mind and social emotional functioning in adolescents with communication and language problems. Front Psychol. 2019;10:1488. doi: 10.3389/fpsyg.2019.01488
42. Brock LL, Kim H, Gutshall CC, Grissmer DW. The development of theory of mind: predictors and moderators of improvement in kindergarten. Early Child Development and Care. 2018;189(12):1914-24. doi: 10.1080/03004430.2017.1423481
2. Wimmer H, Perner J. Beliefs about beliefs: Representation and constraining function of wrong beliefs in young children's understanding of deception. Cognition. 1983;13(1):103-28. doi: 10.1016/0010-0277(83)90004-5
3. Gopnik A, Astington JW. Children's understanding of representational change and its relation to the understanding of false belief and the appearance-reality distinction. Child Dev. 1988;59(1):26-37. doi: 10.1111/j.1467-8624.1988.tb03192.x
4. Perner J, Wimmer H. “John thinks that Mary thinks that…” attribution of second-order beliefs by 5-to 10-year-old children. Journal of experimental child psychology. 1985;39(3):437-71. doi: 10.1016/0022-0965(85)90051-7
5. Baron-Cohen S, O'riordan M, Stone V, Jones R, Plaisted K. Recognition of faux pas by normally developing children and children with Asperger syndrome or high-functioning autism. J Autism Dev Disord. 1999;29(5):407-18. doi: 10.1023/a:1023035012436
6. Happé FG. An advanced test of theory of mind: Understanding of story characters' thoughts and feelings by able autistic, mentally handicapped, and normal children and adults. J Autism Dev Disord. 1994;24(2):129-54. doi: 10.1007/BF02172093
7. Flavell JH. Theory-of-mind development: Retrospect and prospect. Merrill-Palmer Quarterly. 2004:274-90. Retrieved March 17, 2021, from http://www.jstor.org/stable/23096166
8. Milligan K, Astington JW, Dack LA. Language and theory of mind: Meta‐analysis of the relation between language ability and false‐belief understanding. Child Dev. 2007;78(2):622-46. doi: 10.1111/j.1467-8624.2007.01018.x
9. Miller CA. Developmental relationships between language and theory of mind. Am J Speech Lang Pathol. 2006;15(2):142-54. doi: 10.1044/1058-0360(2006/014)
10. Astington JW, Baird JA. Why language matters for theory of mind. Oxford University Press; 2005.
11. Lohmann H, Tomasello M. The role of language in the development of false belief understanding: A training study. Child Dev. 2003;74(4):1130-44. doi: 10.1111/1467-8624.00597
12. de Villiers JG, de Villiers PA. The role of language in theory of mind development. Top Lang Disord. 2014;34(4):313-28. doi: 10.1097/TLD.0000000000000037
13. Woolfe T, Want SC, Siegal M. Signposts to development: Theory of mind in deaf children. Child Dev. 2002;73(3):768-78. doi: 10.1111/1467-8624.00437
14. Peterson CC, Siegal M. Representing inner worlds: Theory of mind in autistic, deaf, and normal hearing children. Psychological Science. 1999;10(2):126-9. doi: 10.1111/1467-9280.00119
15. Remmel E, Peters K. Theory of mind and language in children with cochlear implants. J Deaf Stud Deaf Educ. 2009;14(2):218-36. doi: 10.1093/deafed/enn036
16. Sundqvist A, Lyxell B, Jönsson R, Heimann M. Understanding minds: Early cochlear implantation and the development of theory of mind in children with profo¬und hearing impairment. Int J Pediatr Otorhinolaryngol. 2014;78(3):537-43. doi: 10.1016/j.ijporl.2013.12.039
17. Ketelaar L, Rieffe C, Wiefferink CH, Frijns JHM. Does hearing lead to understanding? Theory of mind in toddlers and preschoolers with cochlear implants. J Pediatr Psychol. 2012;37(9):1041-50. doi: 10.1093/jpepsy/jss086
18. de Villiers J. The interface of language and theory of mind. Lingua. 2007;117(11):1858-78. doi: 10.1016/j.lingua.2006.11.006
19. Cheung H, Chen H-C, Yeung W. Relations between mental verb and false belief understanding in Cantonese-speaking children. J Exp Child Psychol. 2009;104(2):141-55. doi: 10.1016/j.jecp.2009.05.004
20. Delkhah Z, Soleymani Z, Dadgar H, Mousavi N. [Comparison of basic theory of mind in 5-6 years Farsi speaking children with cochlear implant and normal peers]. Journal of Modern Rehabilitation. 2016;9(7):72-8. Persian.
21. Delkhah Z, Soleymani Z, Dadgar H. Basic and advanced theory of mind in school-aged children with cochlear implants. Aud Vestib Res. 2018;27(3):137-42. doi: 10.18502/avr.v27i3.55
22. Ghamarani A, Alborzi S, Khayer M. [Validity and reliability of the theory of mind test (TOM test) for use in Iran]. Journal of Psychology. 2006;10(2):181-99. Persian.
23. Muris P, Steerneman P, Meesters C, Merckelbach H, Horselenberg R, van den Hogen T, et al. The TOM test: A new instrument for assessing theory of mind in normal children and children with pervasive developmental disorders. J Autism Dev Disord. 1999;29(1):67-80. doi: 10.1023/a:1025922717020
24. Hajgholam Rezayi Z. Comparison of the effect of theory oh mind and storytelling on understanding of mental verbs in 5-6 years old children with hearing impairment in Kerman. [Master Thesis]. Tehran: University of Social Welfare and Rehabilitation Sciences; 2012. Persian. [unpublished]
25. Rahmany R, Marefat H, Kidd E. Persian speaking chil¬dren's acquisition of relative clauses. European Journal of Developmental Psychology. 2011;8(3):367-88. doi: 10.1080/17405629.2010.509056
26. Williams MN, Grajales CAG, Kurkiewicz D. Assumptions of multiple regression: Correcting two misconceptions. Practical Assessment, Research, and Evaluation. 2013;18:11. doi: 10.7275/55hn-wk47
27. Guo L-Y, Spencer LJ. Development of grammatical accuracy in English-speaking children with cochlear implants: A longitudinal study. J Speech Lang Hear Res. 2017;60(4):1062-75. doi: 10.1044/2016_JSLHR-H-16-0182
28. Peterson CC. Theory‐of‐mind development in oral deaf children with cochlear implants or conventional hearing aids. J Child Psychol Psychiatry. 2004;45(6):1096-106. doi: 10.1111/j.1469-7610.2004.t01-1-00302.x
29. Longobardi E, Spataro P, Rossi-Arnaud C. Relations between theory of mind, mental state language and social adjustment in primary school children. European journal of developmental psychology. 2016;13(4):424-38. doi: 10.1080/17405629.2015.1093930
30. Charman T, Shmueli-Goetz Y. The relationship between theory of mind, language, and narrative discourse: An experimental study. Curr Psychol Cogn. 1998;17(2):245-71.
31. Brooks R, Meltzoff AN. Connecting the dots from infancy to childhood: A longitudinal study connecting gaze following, language, and explicit theory of mind. J Exp Child Psychol. 2015;130:67-78. doi: 10.1016/j.jecp.2014.09.010
32. Hale CM, Tager‐Flusberg H. The influence of language on theory of mind: Dev Sci. 2003;6(3):346-59. doi: 10.1111/1467-7687.00289
33. Smith M, Apperly I, White V. False belief reasoning and the acquisition of relative clause sentences. Child Dev. 2003;74(6):1709-19. doi: 10.1046/j.1467-8624.2003.00633.x
34. Longobardi E, Spataro P, Renna M, Rossi-Arnaud C. Comparing fictional, personal, and hypothetical narratives in primary school: story grammar and mental state language. Eur J Psychol Educ. 2014;29(2):257-75. doi: 10.1007/s10212-013-0197-y
35. de Mulder HNM, Wijnen F, Coopmans PHA. Interrelationships between Theory of Mind and language development: A longitudinal study of Dutch-speaking kindergartners. Cognitive Development. 2019;51:67-82. doi: 10.1016/j.cogdev.2019.03.006
36. Fontana E, Adenzato M, Penso JS, Enrici I, Ardito RB. On the relationship between Theory of Mind and syntax in clinical and non-clinical populations: State of the art and implications for research. The Open Psychology Journal. 2018;11(1):95-104. doi: 10.2174/1874350101811010095
37. Peters K, Remmel E, Richards D. Language, mental state vocabulary, and false belief understanding in children with cochlear implants. Lang Speech Hear Serv Sch. 2009;40(3):245-55. doi: 10.1044/0161-1461(2009/07-0079)
38. Liu M, Wu L, Wu W, Li G, Cai T, Liu J. The relationships among verbal ability, executive function, and theory of mind in young children with cochlear implants. Int J Audiol. 2018;57(12):875-882. doi: 10.1080/14992027.2018.1498982
39. Schick B, de Villiers P, de Villiers J, Hoffmeister R. Language and theory of mind: A study of deaf children. Child Dev. 2007;78(2):376-96. doi: 10.1111/j.1467-8624.2007.01004.x
40. Vissers C, Koolen S. Theory of mind deficits and social emotional functioning in preschoolers with specific language impairment. Front Psychol. 2016;7:1734. doi: 10.3389/fpsyg.2016.01734
41. Smit L, Knoors H, Hermans D, Verhoeven L, Vissers C. The interplay between theory of mind and social emotional functioning in adolescents with communication and language problems. Front Psychol. 2019;10:1488. doi: 10.3389/fpsyg.2019.01488
42. Brock LL, Kim H, Gutshall CC, Grissmer DW. The development of theory of mind: predictors and moderators of improvement in kindergarten. Early Child Development and Care. 2018;189(12):1914-24. doi: 10.1080/03004430.2017.1423481
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| Issue | Vol 30 No 3 (2021) | |
| Section | Research Article(s) | |
| DOI | https://doi.org/10.18502/avr.v30i3.6534 | |
| Keywords | ||
| Theory of mind mental verb relative clause cochlear implant | ||
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How to Cite
1.
Delkhah Z, Farmani HR, Soleymani Z. Language predictors of theory of mind in cochlear implant children compared to normal-hearing peers. Aud Vestib Res. 2021;30(3):200-208.
