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COGNITIVE AND AFFECTIVE THEORY OF MIND IN CHILDREN AND YOUNG
ADOLESCENTS
A Thesis Submitted to the Committee on Graduate Studies in Partial Fulfillment of the
Requirements for the Degree of Master of Science in the Faculty of Arts and Science
TRENT UNIVERSITY
Peterborough, Ontario, Canada
(c) Copyright by Ashley Toohey 2015
Psychology M. Sc. Graduate Program
September 2015
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Abstract
Cognitive and Affective Theory of Mind in Children and Young Adolescents
Ashley Toohey
Recently, a distinction has been made between cognitive theory of mind, the ability to
make inferences about other's beliefs and thoughts, and affective theory of mind, the ability to
make inferences about other's emotional states. The purpose of this study is to determine if the
distinction between cognitive and affective theory of mind is developmentally appropriate and
whether the relation between language and theory of mind is maintained when cognitive and
affective theory of mind are examined separately. The sample consisted of 20 children aged 6 to
9 years, and 27 children aged 11 to 15 years. Results showed that the older group outperformed
the younger group on both cognitive and affective theory of mind, and that different aspects of
language were related to each type of theory of mind. This suggests the distinction between
cognitive and affective theory of mind may in fact be valid in this age range.
Keywords: Cognitive Theory of Mind, Affective Theory of Mind, Development, Language
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Acknowledgements
I would like to sincerely thank Dr. Nancie Im-Bolter for supervising and mentoring me
for the past four years. Her passion for the research she does sparked my initial interest in this
field and without her unwavering patience, guidance, and faith in me as an academic, I am
certain I would not have accomplished this piece of work. Dr. Im-Bolter’s commitment to the
highest standards and unwavering work ethic are inspiring. I feel very fortunate to have had the
opportunity to work with someone for whom I have a great deal of respect and admiration.
I would also like to thank Dr. Brenda Smith-Chant and Dr. Hugo Lehmann for taking
time out of their busy schedules to serve as my committee members. Their invaluable feedback
has helped elevate the quality of this transcript. I would like to thank Keely Owens-Jaffray for
her help and support throughout this process, for answering my endless questions, and
encouraging me to stay on task.
I would also like to thank the children and parents who were involved in this study.
Without their participation, this thesis would not have been possible. To Trent University, as
well as the Social Sciences and Humanities Research Council of Canada, thank you for funding
this research project.
Finally, I would like to thank my friends and family. In particular, I would like to thank
my parents for providing me with constant support and encouragement, and for letting me use
them as sounding boards when I needed to think out loud.
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Contents
Abstract ii
Acknowledgements iii
List of Figures v
List of Tables vi
Overview 1
Theory of Mind 2
Theory of Mind and Language 8
Cognitive Versus Affective Theory of Mind 14
Present Study 21
Hypotheses 21
Methods 22
Participants 22
Procedure 22
Measures 22
Socioeconomic Status 22
Nonverbal Intelligence 23
Language Skills 23
Cognitive Theory of Mind 23
Affective Theory of Mind 23
Results 26
Data Screening 26
Sample Characteristics 27
Group Differences in Type of Theory of Mind 28
Relations Between Higher Order Theory of Mind and Language 29
Predicting Performance on Theory of Mind 30
Higher Order Cognitive Theory of Mind 30
First Order Affective Theory of Mind 31
Higher Order Affective Theory of Mind 31
Discussion 31
Cognitive and Affective Theory of Mind in Children and Young Adolescents 32
Cognitive and Affective Theory of Mind and Language 35
References 38
Appendix A- Parent Questionnaire 51
Appendix B- Happe Strange Stories Vignettes and Questions 52
Appendix C- Real and Deceptive Emotion Vignettes and Questions 54
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List of Figures
Figure 1-Facial Array for Real and Deceptive Emotion Task 25
Figure 2-Performance on Theory of Mind Type by Age Group Controlling For Task
Comprehension 29
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List of Tables
Table 1-Group Differences in Background Characteristics, IQ, and Language 27
Table 2-Adjusted Means and Standard Deviations of Group Performance on Theory of Mind
Tasks 28
Table 3-Correlations for Age, Language, and Theory of Mind 30
Table 4-Hierarchical Multiple Regression Analyses Predicting Theory of Mind from Age,
Semantic Language Competence, and Syntactic Language Competence 31
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Cognitive and affective theory of mind in children and young adolescents
Overview
Theory of mind refers to children’s developing concepts of the mental activity of others
such as beliefs and thoughts (Bjorklund, 2005) and implies the possession of a causal-
explanatory framework to account for the actions of others (Miller, 2006). Theory of mind is
typically first seen in children at 3 or 4 years of age (Astington & Jenkins, 1999; Bosacki, 2000;
Miller, 2006; Miller, 2009) and continues to develop and increase in complexity throughout later
childhood and adolescence (Bosacki, 2000; Miller, 2006). Studies indicate a significant
relationship between language and theory of mind such that lower performance on one is linked
with lower performance on the other (Astington & Jenkins, 1999; Milligan, Astington & Dack,
2007). This suggests that lower language competence could negatively impact the development
of theory of mind and research with children with autism, specific language impairment, and
hearing impairment supports this idea (e.g., Gillot, Furniss & Walter, 2004; Happé, 1995;
Jackson, 2001; Schick, de Villiers, de Villiers & Hoffmeister, 2007).
Recently, a distinction has been made between cognitive theory of mind, the ability to
make inferences about other's beliefs and thoughts, and affective theory of mind, the ability to
make inferences about other's emotional states (e.g., Kalbe et al., 2010). The majority of
research to date however, has focused on adult samples. As such, it is not known whether this
distinction applies to children nor whether the well-established relation between theory of mind
and language holds when examining cognitive and affective theory of mind separately. The
purpose of the current study is to determine if cognitive and affective theory of mind are distinct
in children and young adolescents and whether the relation between language and theory of mind
is maintained when cognitive and affective theory of mind are examined separately.
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Theory of Mind
Theory of mind refers to our ability to explain and predict what people do based on what
we think about their wants, desires, hopes, goals, ideas, knowledge, and opinions as well as how
we believe these mental processes are related (Bjorklund, 2005). Theory of mind is often
referred to as “mentalizing” or “mind reading” as it involves using mental state understanding of
another individual in order to predict and explain their behaviour. For example, you see
someone slip on a wet floor and fall. You may think that this person is physically hurt and would
therefore be upset or sad. You might also think that person’s pride might be wounded and that
they might look around to see if anyone saw them fall. You may hypothesize that the person
would get up and brush themselves off and/or check to see if they or their wardrobe sustained
any injuries or damage. The ideas we generate about another person’s beliefs, emotions, and
behaviours are a result of our ability to develop a theory of that person’s mental state.
Research demonstrates that at around 4 years of age, children understand that people’s
actions are based on their thoughts, ideas, and beliefs of the world (Bosacki, 2000). At this point
in their development, children begin to understand that different people will have different
interpretations of the same situation depending on their perspective and that not everyone likes
and wants the same things (Miller, 2006). In this case, children show an ability to understand
that others have thoughts, ideas, and beliefs that are different from theirs. This understanding of
others’ thoughts and beliefs is referred to as first-order theory of mind (e.g., “John thinks that the
chocolate is in the cupboard”).
There are three classic tasks used to tap first-order theory of mind: unexpected location,
deceptive contents, and appearance-reality. These tasks are also referred to as false belief tasks
as they involve the child’s ability to understand that people will act in accordance with their
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beliefs about reality even if those beliefs are false (Miller, 2004). A typical unexpected location
task involves presenting a child with a scenario in which a character (Maxi) puts chocolate (or
some other object) in a particular location (e.g., a green cupboard in the kitchen) (Wimmer &
Perner, 1983). After Maxi leaves the room, another character (Maxi’s mother in this case)
transfers the chocolate to a different, unexpected, location (a blue cupboard). The child is then
asked where Maxi will look for his chocolate when he comes back to the kitchen. A child who
has first-order theory of mind will answer “the green cupboard” because this is where Maxi last
saw the chocolate. A child without first-order theory of mind would reply “the blue cupboard”
because they fail to understand that Maxi’s knowledge is not only different from reality (i.e.,
where the chocolate actually is), but also different from the child’s. Maxi did not see his mother
move the chocolate even though the child did. As a result, Maxi has a false belief regarding the
location of the chocolate. A child who successfully completes this false belief task and who has
first-order theory of mind would recognize that Maxi has a false belief, which affects Maxi’s
behaviour (i.e., where Maxi would look for the chocolate).
A typical deceptive contents task involves showing a child a box that clearly indicates the
contents (e.g., Smarties box) (Perner, Leekman & Wimmer, 1987). Without being shown the
contents of the box, the child is asked what they think is in the box. The child answers
"Smarties". The child is then shown that the box actually contains pencil crayons and is asked
what another child would think was in the box. A child who has first-order theory of mind will
answer "Smarties" because this is what the box appears to contain. A child without first-order
theory of mind would reply "pencil crayons" because they fail to understand that the other child's
knowledge is different from reality (i.e., what the box really contains). The other child was not
shown the contents of the Smarties box, and as a result, has a false belief regarding its contents.
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A typical appearance-reality task involves showing a child an object that appears to be
something it is not (Flavell, Flavell & Green, 1983). For example, a child would be shown an
object that looks like a rock, but is really a sponge, and asked what the object looks like. The
child would answer "a rock". The child would then be given the object to manipulate and asked
whether the object is really a rock or a sponge. A child is said to understand the appearance-
reality distinction if they respond “a sponge” when asked what the object really is, and “a rock”
when asked what the object looks like. The child who lacks theory of mind does not understand
that what the object appears to be and what the object is in reality are two different things.
Theory of mind continues to develop beyond early childhood (Bosacki, 2000; Miller,
2006) although research in this development period is sparse. Research has demonstrated that
children are able to start representing what is referred to as “second-” or “higher” order theory of
mind (i.e., “John thinks that Jane thinks that the man is in the park”) between the ages of 5 and 9
(Astington, Pelletier & Homer, 2002; Filippova & Astington, 2008; Perner & Wimmer, 1985;
Sullivan, Zaitchik & Tager-Flusberg, 1994). Whereas first-order theory of mind refers to beliefs
one has of another person’s mental state (i.e., “John thinks that the sky is green”), second-order
theory of mind refers to beliefs one has about what another thinks of yet another’s mental state.
Mastery of second-order theory of mind tasks requires realizations regarding mental states
beyond those necessary for success on tasks that measure first-order theory of mind (Miller,
2009). As such, second-order theory of mind is acquired only after mastery of first-order theory
of mind, which acts as a building block upon which second-order theory of mind is built.
A classic second-order theory of mind task is the Second Order Location Change Task,
also referred to as the Ice Cream Van Task (Perner & Wimmer, 1985). This task involves the
following scenario, which is either acted out with figures and objects or illustrated with pictures.
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In the scenario three main characters, John, Mary, and the ice cream man, are at a park. John
wants to buy an ice cream but he does not have enough money. The ice cream man tells John he
will be in the park all day so John goes home to get some money. The ice cream man then
changes his mind and tells Mary he is going to go to the church. Mary decides to go to John’s
house to tell John that the ice cream man has gone to the church. Unknown to Mary, John sees
the ice cream man and the ice cream man tells John he is going to the church to sell ice cream.
When Mary arrives at John’s house she is told that John has gone out to buy an ice cream.
Children are then asked a question that taps second order theory of mind, “Where does Mary
think that John has gone to buy an ice cream?”. The correct answer is, “the park’’ because Mary
does not know that John has seen the ice cream man. Using this task, Perner and Wimmer
(1985) demonstrated that by roughly 7 years of age, children are able to represent second-order
beliefs. As such, they can determine that Mary thinks John went to the park.
Subsequent studies of second-order theory of mind have adapted Perner and Wimmer's
(1985) Ice Cream Van task due to the memory demands and artificial nature of the story. In an
effort to ensure that children’s performance on second-order false-belief tasks was not due to the
information processing and linguistic demands of these tasks, researchers have made
modifications to the methodology such as adding probe questions (to ensure comprehension of
the story), feedback, and memory aids (e.g., “Remember, Mary does not know that the ice-cream
man told John where he was going”) to the story or using fewer characters and settings. These
studies showed that children as young as 5 years of age were able to correctly attribute second
order false beliefs (e.g. Banerjee, 2002; Bennett & Matthew, 2000; Lockl & Schneider, 2007;
Naito & Seki, 2009; Silliman, Diehl, Hnath-Chisolm, Zenko, & Friedman , 2003; Sullivan et al.,
1994); however, these studies are not without their drawbacks. Although one of the main
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reasons for the modifications was to ensure that younger children did not fail second-order
theory of mind tasks due to memory or linguistic demands, there is little investigation focusing
on the actual association between language competence and second-order theory of mind. This
is curious when we consider that Lockl and Schneider (2007) found that language competence at
three years of age predicted performance on second-order theory of mind tasks two years later.
Another problem with much of the research investigating second-order of theory of mind is the
reliance on artificial scenarios that depend on second order change of location (e.g., ice cream
moving from one location to another “unexpected” one).
To remedy this problem, other studies examining second-order or higher order theory of
mind have used tasks such as the Happé Strange Stories (Happé, 1994), Real and Deceptive
Emotion Task (Dennis, Barnes, Wilkinson & Humphreys, 1998), Social Faux Pas (Baron-Cohen,
O'Riordan, Stone, Jones & Plaisted, 1999) and Awkward Moments (Heavey, Phillips, Baron-
Cohen & Rutter, 2000), which utilize more natural scenarios and contexts. The Happé Strange
Stories consist of short stories with situations that are more likely to be encountered by children
in their everyday lives. In this task, children are presented with a series of vignettes in which a
character says something that is not literally true for a variety of different reasons including that
it is a joke, a sarcastic remark, or a white lie. For example, two characters see a lady come out of
the hairdresser's with a funny haircut. One of them says to the other "It looks like she got in a
fight with a lawnmower." The child is asked if what the character said is true and then why the
character said this. Children’s responses are scored on their ability to explain the character’s true
intentions. Answers that reflect higher order theory of mind would refer to the character’s
thoughts, beliefs, and intentions in order to explain the reasoning behind the character’s
behaviour. Studies investigating higher order theory of mind using the Happé Strange Stories
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have demonstrated that this task is sensitive to the developmental nature of higher order theory
of mind with older children outperforming younger children (e.g. Adrian, Clemente &
Villanueva, 2007; Brent, Rios, Happé & Charman, 2004; O'Hare, Bremner, Nash, Happé &
Pettigrew, 2009). In addition, research using the Happé Strange Stories task with adults between
the ages of 50 and 90 have not shown ceiling effects (Charlton, Barrick, Markus & Morris,
2009), thereby highlighting that this task is appropriate to use with a wide age range of
participants, including older children and adolescents.
A task similar to the Happé Strange Stories is the Real and Deceptive Emotion Task
(Dennis et al., 1998). This task was adapted from Harris, Donnelly, Guz, and Pitt-Watson
(1986), which was designed to examine the appearance-reality distinction with respect to
emotions. In the Real and Deceptive Emotion Test, the child is presented with a series of
vignettes in which the main character (Terry) feels a certain emotion but outwardly displays a
different emotion due to the situation Terry is in. For example, the child (a girl) is told that Terry
sees someone wearing funny clothes, but that the person would be angry if Terry laughed at
them. So in this situation Terry hides how she feels. The child is asked to indicate the emotion
Terry feels inside and why Terry feels that way. The child is then asked to indicate the emotion
Terry would show on her face and why Terry would do that. In this example, Terry would be
happy inside because she found the clothing quite funny but Terry would show a neutral
expression on her face because she thinks the person wearing the funny clothes would get angry
if Terry laughed. Dennis et al. (1998) used this task to examine theory of mind in children with
and without brain injury who were between the ages of 6 and 15 years. Regardless of brain
injury status, there was a significant effect of age for questions that asked Terry's reason for
concealing her emotions. Further, children in both groups who were older than 10 years had less
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difficulty identifying deceptive emotions (i.e., the emotion shown on the face) (Dennis et al.,
1998). These findings highlight that younger children have more difficulty understanding that
the way someone else feels inside may not be the same as how they choose to show on the
outside.
More recently, Dennis, Lockyer, and Lazenby (2000) found that children with autism had
difficulty identifying the emotion felt, the emotion displayed, and the reason for the use of
deceptive emotional expression compared to the children without autism. It has been established
in the literature that children with autism show poor theory of mind skills (e.g., Baron-Cohen,
Leslie & Frith, 1985; Happé, 1994; Leslie & Frith, 1988; Perner, Frith, Leslie & Leekam, 1989;
Yirmiya, Solominica-Levi & Shulman, 1996). Given this well-established finding, we would
expect that children with autism would have more difficulty with the Real and Deceptive
Emotion task, which proposes to tap theory of mind, than their typically developing peers. It has
been well established in the literature that children with autism have language deficits (e.g.,
Baltaxe, 1977; Frith, 1989; Lord, 1985; Paul, 1985; Tager-Flusberg, 1989). These difficulties in
communicative language have been proposed to explain the poor performance children with
autism tend to exhibit on theory of mind tasks (e.g.; Capps, Kehres & Sigman, 1998; Hale &
Tager-Flusberg, 2005; Paul, 1987). This relation between language and theory of mind has been
an area of intense focus in theory of mind literature.
Theory of Mind and Language
There is now a well established relation between theory of mind and language (e.g.
Astington & Jenkins, 1999; Bosacki, 2000; Hughes & Dunn, 1998; Miller, 2004; Milligan et al.,
2007). In addition, longitudinal research has shown that earlier performance on measures of
language predicts later performance on false-belief tasks in 3 and 4 years olds (Astington &
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Jenkins, 1999; Slade & Ruffman, 2005) and that earlier false belief task performance in 3 and 4
year olds predicts later performance on language measures (Slade & Ruffman, 2005). Although
Astington and Jenkins (1999) found that early theory of mind performance was not predictive of
later language skills, Slade and Ruffman (2005) found that in addition to early language skills
predicting later performance on theory of mind, early theory of mind performance did in fact
predict later language skills once the wide range of possible scores on the language measures and
the narrow range of possible scores on the theory of mind tasks was taken into account. These
results point to the relation between theory of mind and language being positive and reciprocal in
nature, at least in preschool children.
The relation between theory of mind and language makes sense intuitively when we
consider that throughout the first few years, the development of theory of mind and language are
interwoven in complex ways (Miller, 2006). Infants demonstrate an appreciation of others’
intentions within the context of communicative interactions or during interactions where there is
shared attention on an object or an act. For example, when someone reaches out to pick up an
infant, that infant will in turn reach out to that person (Miller, 2006). This joint attention, the
coordination of attention between another, the self, and an external object or event, is seen as a
precursor to language skills (Tomasello, 1995). In a longitudinal study, Charman et al. (2001)
measured what is referred to as joint attention at 20 months and found that it significantly
predicted theory of mind at 44 months. Further, in a more recent study, Kristen, Sodian,
Theormer and Perst (2011) found that comprehension of referential pointing, or pointing that has
the specific intent of referring to something, at 9 months was predictive of mental state language
use at 24 and 36 months. These findings highlight that communicative acts in infancy, which
reflect early language competence, may predict theory of mind. Taken together, these findings
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highlight the complex interplay between language and mental state understanding early on in
theory of mind development.
In preschool children, two components of language have been found to correlate with
theory of mind -- semantics and syntax. Semantics refers to our knowledge of word meaning
and word properties (Hughes & Dunn, 1998). This knowledge of word meaning includes our
understanding of associations between the words themselves and what they represent (e.g.,
things, concepts, actions, etc.). As a result, semantic language can be used to make unobservable
beliefs and intentions, as well as their relationship to behaviour, explicit by providing verbal
labels to represent mental states (Zadeh, Im-Bolter & Cohen, 2007). These verbal labels serve to
make unobservable beliefs, motives, and intentions observable or visible. Theory of mind is
dependent on the semantic understanding of mental state language, such as think, know, and
believe, in order to consider why a person behaves in a particular way (i.e., developing a theory
of another’s mental intentions). Young children hear and begin to take part in conversations in
which people explain and make predictions about the behaviours of others using mental state
language involving desires and beliefs (Miller, 2006). Ruffman, Slade and Crowe (2002) found
that mental state utterances of children between the ages of 2 and 5 years involving desires and
beliefs predicted later performance on theory of mind tasks. Toddlers begin to use mental state
terms such as think and know, as well as emotion words such as happy and sad as they are
exposed to them and begin to associate meaning with them through their semantic understanding
of these and other such terms (Miller, 2006). Moore, Pure and Furrow (1990) found that, in 4 to
6 year olds, understanding mental state language such as think and know was related to false-
belief understanding. In a longitudinal study, Ruffman, Slade, Rowlandson, Rumsey and
Garnham (2003) found that, starting at 3 years of age, semantic language performance uniquely
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predicted variance in later false belief understanding over a 2.5 year period. Given the
inseparable relationship between understanding mental states and mental state language, it is not
surprising that research shows a significant relation between semantic language ability and
children’s performance on tasks that tap false belief understanding (Doherty, 2001; Garnham,
Brooks, Garnham, & Ostenfeld, 2000; Moore et al., 1990; Ruffman et al., 2003). Without words
and the meanings assigned to them, mental states would remain unobservable.
Syntactic ability, which is the understanding of the rules that dictate how sentences are
formed, has also been found to correlate with theory of mind (Astington & Jenkins, 1999;
Rakhlin et al., 2011; Ruffman et al., 2003). Astington and Jenkins (1999) point out that mental
state awareness requires mental representations of complex language constructions consisting of
a sentence with a subordinate clause embedded in it. For example, in the sentence, “Mary thinks
the earth is flat.”, the subordinate clause, “the earth is flat,” acts as the grammatical object of the
verb thinks in the sentence. Such a clause is referred to as an object complement. Object
complements play a key role in mental state understanding because they allow the reporting of
false beliefs, that is, the whole sentence may be true even though the subordinate clause is false
(Astington & Jenkins, 1999). Therefore, one could honestly say, “Mary thinks the earth is flat”
even though in reality, the earth is not flat. Object complements allow us to express our
understanding of other’s beliefs, desires, thoughts, and feelings (i.e., theory of mind).
The importance of object complements for theory of mind has been demonstrated in a
number of different studies with children with typical and atypical development. In a one year
longitudinal study with 3 to 5 year olds, de Villiers and Pyers (2002) found that mastery of object
complements was predictive of successful false belief performance. Schick et al. (2007) found
that understanding object complements was a significant and independent predictor of success on
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theory of mind tasks in a group of deaf and hearing children aged 3 to 8 years. Miller (2004)
found that children with specific language impairment had difficulty with object complements
compared to their typically developing peers. Further, for both groups, performance on object
complement tasks was highly and positively correlated with performance on false belief tasks
(Miller, 2004). Given the central role that both semantic knowledge and object complements
play in our understanding of others’ mental states or intentions it is not surprising that
researchers have become interested in whether semantic or syntactic language plays a more
important role in theory of mind.
Work by Astington and Jenkins (1999) suggests that syntactic language may be more
critical for theory of mind than semantics, at least in preschoolers. Astington and Jenkins (1999)
used scores on semantic and syntactic language tests taken at time 1 in their longitudinal study to
predict theory of mind at time 2. Results of their hierarchical analyses revealed that, after
controlling for age and semantic language competence, syntactic language significantly predicted
later performance on measures of theory of mind (Astington & Jenkins, 1999). However,
semantic language did not significantly predict theory of mind after age and syntactic language
were accounted for suggesting syntactic language played a unique role in theory of mind. More
recently, Ruffman, et al. (2003) have argued that Astington and Jenkins's (1999) findings are
misleading because a number of the items used to assess syntax relied on background semantic
knowledge. In an effort to determine the extent to which semantic and syntactic language
uniquely accounted for higher order false belief understanding, Ruffman et al. (2003) conducted
a longitudinal study over 2.5 years. Results from their two studies were mixed. In their first
study, Ruffman et al. (2003) found that semantics and structural language (a composite of syntax
and semantics scores) predicted false belief at later times, but syntax alone did not. However, as
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a result of their second study Ruffman et al. (2003) found that object complements (syntactic
language) predicted unique variance in all the theory of mind tasks even after accounting for age
and other language variables whereas semantic language was a unique predictor in one of the
theory of mind tasks only. Taken together, the literature highlights that some aspects of syntactic
language may be a better predictor of theory of mind than semantic language; however, more
research is required in order to determine whether syntactic or semantic language plays a more
critical role in theory of mind.
Much less is known about the relation between higher order theory of mind and language.
The few studies that have been conducted suggest that language continues to play an important
role in theory of mind as children move into middle childhood (e.g., Andres-Roqueta, Adrian,
Clemente & Katsos, 2013; Bosacki, 2000; Gillot et al., 2004; Grazzani & Ornaghi, 2012; Miller,
2001; Rakhlin, et al., 2011). However, findings are mixed as to whether semantic, syntactic, or
general language ability plays a more important role in theory of mind during this developmental
period. Bosacki (2000) found that in a group of children ages 10 to 13 years, general language
was positively correlated with theory of mind. If language is important for theory of mind then
children with deficits in language should demonstrate deficits in their performance on theory of
mind tasks. Gillot et al. (2004) compared theory of mind in children with specific language
impairment, with autism, and with typical development between 8 and 12 years of age. Using
the Happe Strange Stories task, Gillot et al. (2004) found that typically developing children
provided more correct mental state answers than the children with specific language impairment
and with autism. A more recent study by Andres-Roqueta et al. (2013) investigated the role of
language on performance on two false belief tasks in a group of 3 to 7 year olds. They found
that children with specific language impairment performed similarly to the language matched
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controls but more poorly than age matched control group on both false belief tasks. Further,
grammar (syntactic language) was found to be the best predictor of theory of mind performance
(Andres-Roqueta et al., 2013).
Given the importance of understanding object complements for first order theory of
mind, it stands to reason that a firm grasp of complex syntax would be especially important for
higher-order theory of mind. In order for a child to explain what they think another person thinks
of another person’s thoughts, the child needs to be able to understand and construct syntactically
complex sentences containing multiple embedded object complements. Results from Rakhlin et
al. (2012) support the continued importance of syntax for theory of mind performance.
Researchers found that in a group of 6 to 12 year olds, scores on language measures were
positively related to scores on a false belief task after controlling for IQ and short-term memory.
Specifically, children who failed the false belief task had significantly lower scores for syntactic
complexity on narratives they created than children who passed the false belief task. Further, use
of mental state language (semantic language) was not related to performance on the false belief
task. Although these findings highlight that language and theory of mind continue to be
associated in middle childhood, they do not provide clear insight into the relative importance of
semantic versus syntactic language.
Cognitive versus Affective Theory of Mind
Although theory of mind has been an intense focus of research for several decades now, the vast
majority of studies have concentrated on what are referred to as cognitive mental states (i.e.,
thoughts, beliefs, and intentions). Recent research with adults suggests that mental state
understanding can be differentiated into cognitive and affective components (e.g., Duval et al.,
2011; Duval et al., 2012; Genizi et al., 2012; Gupta, Tranel & Duff, 2012; Kalbe et al., 2010;
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Shamay-Tsoory et al., 2007; Shamay-Tsoory, Hagai, Aharon-Peretz & Levkovitz, 2010). It
should be noted that research has found support for there being two distinct types of empathy,
cognitive and emotional. Further, findings highlight that the terms affective theory of mind and
cognitive empathy, may essentially be used interchangeably. As the focus of this paper is on
theory of mind, we will be using the terms cognitive and affective theory of mind. Investigations
of affective mental states (i.e., emotional) in children are limited. In fact, much of the research to
date on this cognitive/affective distinction has focused on adult samples and individuals with
neurologically-based difficulties.
Studies with adults have used brain imaging techniques in order to determine the specific
neural substrates involved in these two aspects of mental state understanding and to show that
the brain areas associated with them are distinct (e.g., Gupta et al., 2012; Kalbe, et al., 2010;
Sebastian et al., 2012; Shamay-Tsoory et al., 2010). Generally, these studies show differences in
brain area activation while participants completed cognitive versus affective theory of mind tasks
(e.g., Gupta et al., 2012; Kalbe, et al., 2010; Sebastian et al., 2012; Shamay-Tsoory et al., 2010).
A recent meta-analysis found that brain regions linked with the main substructure related to
cognitive theory of mind have little or no direct connections with areas of the brain involved in
emotion processing, whereas those linked to the main substructure related to affective theory of
mind are responsible for the representation and regulation of emotion information (Abu-Akel &
Shamay-Tsoory, 2011). Further, research with individuals who have damage to the substructure
related to affective theory of mind, but not to the substructure related to cognitive theory of
mind, show impairments in affective, but not cognitive theory of mind (e.g., Gupta et al., 2012;
Shamay-Tsoory et al., 2007).
Evidence from these neural imaging studies has been used to form the basis for the
16
distinction between cognitive and affective theory of mind. In these studies the Yoni task
(Shamay-Tsoory et al., 2007), or the very similar Tom's Taste task (Duval et al., 2011), is often
used to assess cognitive and affective theory of mind (e.g., Duval et al., 2011; Duval et al., 2012;
Genizi et al., 2012; Kalbe et al., 2010; Shamay-Tsoory et al., 2007; Shamay-Tsoory et al., 2010).
In the Yoni task, participants are presented with a cartoon outline drawing of a face, Yoni, in the
center of the computer screen and four coloured thought bubbles surrounding him. Participants
examine Yoni’s facial expression and/or eye gaze direction to answer a question regarding
Yoni’s thoughts or emotions, which are posed near the top of the screen. There are three
conditions in this task; cognitive, affective, and physical. The cognitive and affective conditions
contain first-order and higher order theory of mind questions. A first-order question asks what
Yoni is thinking (cognitive) or feeling (affective). In each case the direction of Yoni’s eye gaze
to one of the four thought bubbles indicates what he thinks or feels. An example of a first-order
cognitive item would be an image of Yoni, with a neutral facial expression, and his eyes looking
at one of the four thought bubbles around his head. The question on the screen would be, “Yoni
is thinking of apples”. The correct answer would be to select the image (apples) that Yoni’s eye
gaze is directed to. An example of a first-order affective item would be an image of Yoni, with a
smile on his face, and his eyes looking at one of the four thought bubbles around his head. The
question would be, “Yoni loves dogs” and the correct answer would be to select the image (dogs)
that Yoni’s eye gaze is directed to.
Higher order cognitive items incorporate questions that ask what Yoni is thinking about
what another individual thinks (e.g., “Yoni is thinking of the fruit that John wants”), but similar
to the first-order cognitive the correct answer is indicated by the direction of Yoni’s eye gaze.
Higher order affective items depict Yoni looking forward but with different emotional
17
expressions on his face. In each item, Yoni is surrounded by four thought bubbles, one of which
contain a facial expression that matches the expression on his face and the participant is asked to
match the facial expressions (e.g., "Yoni identifies with John”). Using this task, researchers have
found differences in brain activation during the cognitive and affective subtests, which has been
taken as confirmation that theory of mind is made up of both cognitive and affective components
that are functionally different from one another. Once differences in neural activation were
found in healthy adults, researchers started investigating differences in performance on cognitive
and affective theory of mind in atypical samples. This was done not only to determine which
groups of individuals outperformed others on cognitive and/or affective tasks, but also in an
effort to more precisely isolate the parts of the brain involved in each domain.
One of the major limitations of the Yoni, and also Tom's Taste, task is that it may not be
measuring theory of mind. In three of the four tasks, there is a clear visual cue as to which
answer is correct because of Yoni's changing eye direction. This means that participants can get
the question correct by simply selecting the image that matches the direction of Yoni’s eye gaze.
It is questionable that correctly identifying gaze direction taps cognitive or affective theory of
mind. Instead, the questions may be measuring the participants’ inferential thinking and problem
solving skills as opposed to their ability to understand and predict another’s mental activity.
Further, the higher order affective component of this task does not really seem to get at
understanding another’s affective mental state but rather, one’s ability to recognize and match
emotional expressions. Moreover, despite the well established relation between theory of mind
and language, none of the studies using the Yoni or Tom’s Taste task have examined whether
cognitive and affective theory of mind are related to language skill.
Although the Yoni task is commonly used to examine cognitive and affective theory of
18
mind in adults, there are a number of other tasks that have also been used. Affective theory of
mind is often assessed in older adolescent and adult samples using the Reading the Mind in the
Eyes test (e.g., Baron-Cohen et al., 1999; Baron-Cohen, Wheelwright, Hill, Raste & Plumb,
2001; De Ferrari et al., 2015), which features facial expressions of complex emotions (e.g.,
scheming, guilty, threatening, etc.). In the Reading the Mind in the Eyes test, participants are
shown a series of photographs of facial expressions that depict various emotions but are of the
eye region only. Participants are then asked to select one of the four emotion words they think
the person in the photograph is thinking or feeling. Although this task is often used to assess
affective theory of mind, Baron-Cohen et al. (2001) concede that it does not, in fact, fully tap
affective theory of mind. That is, the task measures attribution or identification of emotional
mental states (e.g., compassion), but it does not require the individual to infer the reason for or
intention behind the emotional mental state (e.g., compassion for another's loss of a loved one).
In order to remedy this problem, others have used story based tasks to tap affective theory of
mind. These tasks require participants to correctly identify the emotion an individual is feeling
based on a short story they heard or read (e.g., Altmann, Bohm, Lubrich, Menninghaus & Jacobs,
2012; Lecce, Demicheli, Zocchi & Palladino, 2015; Lecce, Zocchi, Pagnin, Palladino &
Taumoepeau, 2010; Santangelo et al., 2012). However, these tasks fail to explore the intention
behind the emotional mental state. As such, they fail to fully tap into affective theory of mind.
Recently, an expanded version of the Real and Deceptive Emotion Test has been used to
assess affective theory of mind in children with traumatic brain injury (Dennis et al., 2013).
Dennis et al. (2013) point out that affective theory of mind involves communicating and
understanding the affective states of others based on what we believe they feel and think. As
such, they argue that selecting an emotional expression that we believe matches the inner (or
19
real) emotions of others is a form of affective theory of mind. The focus of Dennis et al.’s study
was to examine group differences on affective theory of mind in children who had suffered
traumatic brain injury and those who had orthopedic injuries. Though they did find group
differences, Dennis et al. also found that regardless of injury type, all children performed better
on the ‘Feel Inside’ questions than they did on the ‘Look on Face’ questions. Although the Real
and Deceptive Emotion Test is not considered to be a typical higher-order affective theory of
mind task, it does tap higher-order mental state understanding because it requires the child
consider how they think someone else would act based on what that individual thinks about yet
another individual’s motives, emotions, or beliefs. In the Real and Deceptive Emotion Test, the
child must understand that an individual might display emotions that are not always congruous to
how she actually feels because she is considering another person’s feelings. This understanding
requires a complex level of mental state understanding. This idea is supported by Harwood and
Farrar (2006), who found that the ability to understand false beliefs is related to the ability to
understand conflicting emotions. Unlike the Reading the Mind in the Eyes task, the Real and
Deceptive Emotion Test requires the inference of emotional states in addition to identification of
internal emotions and display of external emotions. Further, identification of emotions is based
on a vignette rather than matching direction of eye gaze, and as a result, there is no possibility of
physically cuing the participant to the correct response like in the Yoni task. For these reasons,
the Real and Deceptive Emotion Test addresses the main limitations of the two tasks most
commonly used to assess affective theory of mind.
Although studies examining cognitive and affective theory of mind focus on adult
samples, research with adolescents can provide clues regarding the potential distinction between,
and development of, these two aspects of theory of mind. Sebastian et al. (2012) investigated the
20
neural correlates of cognitive and affective theory of mind in adolescents and adults. No group
differences were found for the cognitive theory of mind measure. However, results indicated
that adolescents made significantly more errors on items measuring affective theory of mind than
the adult sample. In addition, Sebastian et al. observed more activation in the brain area
associated with affective theory of mind in their adolescent sample than in their adult sample
when responding to affective theory of mind items. Sebastian et al. suggested that these findings
suggest that there may be developmental changes that occur in affective theory of mind
throughout adolescence. This idea is further supported by results of Vetter, Altgassen, Phillips,
Mahy, and Kliehel (2013) in a study of 12 to 22 year olds that found 35% of variance in their
affective theory of mind task was explained by age. These findings suggest that affective theory
of mind may continue to develop into late adolescence or early adulthood.
There appear to be only two studies that have included measures of cognitive and
affective theory of mind in children with typical development. However, the focus of these
studies was not on the distinction between, or development of, cognitive and affective theory of
mind, but rather their association with reading metaknowledge (e.g., Lecce, et al., 2010) or
declarative metamemory (e.g., Lecce et al., 2015). Lecce et al. (2010) found that, after
controlling for verbal ability, there was a significant correlation between early cognitive, but not
affective, theory of mind and later reading metaknowledge (strategies and purpose). Lecce et al.
(2015) found that, after controlling for verbal and nonverbal ability and working memory,
cognitive rather than affective theory of mind was related to declarative metamemory, or
people’s knowledge about the functioning of their own memory. These results suggest that
cognitive and affective theory of mind may be distinct in children but do not add to our
understanding of the developmental nature of cognitive and affective theory of mind. In
21
addition, little is known about the relations between language and cognitive and affective theory
of mind since Lecce et al. (2010) and Lecce et al. (2015) used language as a control variable only
rather than in relation to type of theory of mind.
Present Study
The purpose of the current study was twofold. The first was to address a gap in the
literature with respect to whether the distinction between cognitive and affective theory of mind
holds in children and young adolescents ages 6 to 15. The second was to address a gap in the
literature with respect to the relation between language and both cognitive and affective theory of
mind.
Hypotheses
1) Given the developmental nature of theory of mind in general, it was predicted that the older
group would outperform the younger group on both cognitive and affective theory of mind.
2) Based on findings that indicate affective theory of mind continues to develop in late
adolescence and early adulthood, it was expected that older children would perform similarly on
tasks measuring cognitive and affective theory of mind whereas younger children would score
higher on a task measuring cognitive theory of mind compared to affective theory of mind.
3) Given the established relation between language and theory of mind, it was predicted that
language would be significantly associated to both cognitive and affective theory of mind.
Further, based on findings that syntactic language plays a more important role for theory of mind
than semantic language, it was predicted that syntactic language would be a better predictor of
both cognitive and affective theory of mind than semantic language.
22
Method
Participants
Participants included two groups of children representing a younger group (middle
childhood) and an older group (early to mid adolescence). The younger group of children were
aged 6 to 9 years (n = 20; mAge = 7.73; SD = 1.44) and included 9 males and 11 females. The age
range for this group was based on research suggesting children aged 5 years are able to pass
second order theory of mind tasks (Astington et al., 2002; Fillipova & Astington, 2008; Perner &
Wimmer, 1985; Sullivan et al., 1994). The older sample of children was aged 11 to 15 years (n =
27; mAge = 12.88; SD = .96) and included 7 males and 20 females. Children were recruited via the
use of advertisement and flyers in community centers, libraries, day care centers and other child-
oriented organizations, as well as online through social media. The first language for all
participants was English; six of the participants were bilingual, three in the younger sample and
three in the older sample.
Procedure
All children were seen for one session of roughly 90 to 120 minutes, with breaks
provided as necessary. Parent consent and child assent was given prior to beginning the session.
Parents were asked to complete a brief background questionnaire that included questions
regarding general medical history (e.g., hearing and vision problems), general school
performance (e.g., repeated any grades, learning difficulties), and parent occupation.
Measures
Socioeconomic Status (SES). Mother’s and father’s occupation were coded using the
Blishen scale (Blishen, Carroll & Moore, 1987), which provides a score for socioeconomic status
that takes into account both occupation and education. Scores on the Blishen scale range from
23
17.81 (newspaper carriers and vendors) to 101.74 (dentists, physicians, surgeons).
Nonverbal Intelligence. The Matrix Analogies subtest from the Wechsler Abbreviated
Scale of Intelligence (WASI, Wechsler, 1999) was used to estimate nonverbal IQ.
Language Skills. The receptive and expressive aspects of semantic language were
measured using the Peabody Picture Vocabulary Test-Fourth Edition (PPVT-4: Dunn & Dunn,
2007) and the Expressive Vocabulary Test-Second Edition (EVT-2: Williams, 2007),
respectively. The Test for Reception of Grammar-Second Edition (TROG-2: Bishop, 2003) and
the Formulated Sentences subscale of the Clinical Evaluation of Language Fundamentals-Fourth
Edition (CELF-4: Semel, Wiig & Secord, 2003) were used to assess the receptive and expressive
aspects of syntactic language, respectively.
Cognitive Theory of Mind. Higher order cognitive theory of mind was assessed using
the Happé Strange Stories task (Happé, 1994). In this task, children are read eight short stories
about hypothetical characters, which were also provided in written form in order to reduce
memory demand. All stories depicted situations in which one character says something that is
not literally true. For example:
Daniel and Ian see Mrs Thompson coming out of the hairdresser’s one day. She looks a
bit funny because the hairdresser cut her hair much too short. Daniel says to Ian, “She
must have been in a fight with a lawnmower!”
For each story children were asked if what the character said was true ("Is it true what Daniel
says?") as a comprehension check and why the character said what they did ("Why does he say
this?") to assess higher order cognitive theory of mind.
For all comprehension questions children’s responses received a score of ‘0’ for incorrect
responses and ‘1’ for correct responses. For the explanation questions (“Why did he/she say
24
that?”), children’s responses received a score of ‘0’ for incorrect response (e.g., “Maybe she used
a lawn mower to cut her hair”), ‘1’ for correct responses that were based on physical actions (i.e.,
contained no mental state terms, e.g., “It looks like short grass cut by a lawnmower”), ‘2’ for
correct responses that reflected an understanding of protagonist’s mental state (i.e., contained
mental state terms, e.g., “He wanted to be funny”), or ‘2.5’ for correct responses that reflected an
understanding of the protagonist’s mental state and alluded to consideration of the other
character’s mental state (e.g., “Because he found it funny and thought that his friend would find
it funny as well”). Proportion scores for comprehension questions were calculated out of a total
possible 8 points. A total proportion score for responses to higher order cognitive theory of mind
questions was also calculated for each participant out of a total possible 20.
Inter-rater reliability of at least 0.74 was achieved on a sample not included in the current
study before scoring of the current study data was completed. Kappa coefficients (all p < .005 or
less) were calculated for all stories and ranged from κ = .74 to κ = 1.00.
Affective Theory of Mind. Higher order affective theory of mind was assessed using
the Real and Deceptive Emotion task (Dennis et al., 1998). In this task, children were read 10
short vignettes about a hypothetical character, Terry, which were also provided in written form to
reduce memory demands. All vignettes depicted situations that involve a mismatch between
Terry’s feelings and facial expressions and instructions stress that Terry is trying to hide the way
he/she feels. Items were balanced so half the vignettes have a positive valence (i.e., Terry is
trying to hide positive feelings) and half have a negative valence (i.e., Terry is trying to hide
negative feelings). For example:
A big boy runs past Terry. Suddenly the boy slips and falls over. The boy would be angry
with Terry if he knew that Terry thought this was funny. Terry tries to hide how (s)he
25
feels.
Prior to asking children the critical questions that tap higher order theory of mind, two questions
were asked that assessed the child’s comprehension of the story. The first asked about the
situation that provoked the felt emotion (“What happened to the big boy?”) and the second asked
about the reason why the real emotion should be hidden (“What will he do if Terry shows how
he/she feels?”). Children were then presented with a gender neutral face array showing five
facial expressions (from left to right depicting very happy, a bit happy, not happy/not sad/just
OK, a bit sad, and very sad; see Figure 1) and asked to point to the facial expression that
matched how Terry would look or feel (“How did Terry really feel when the boy fell over?”;
“How did Terry try to look on his/her face when the boy fell over?”). After each facial
expression question, children were asked why Terry would look or feel that way (“Why did
Terry feel like that?”; “Why did Terry look like that?”).
Figure 1. Facial Array for Real and Deceptive Emotion Task
For all comprehension and facial array questions, children’s responses received a score of
‘0’ for incorrect responses and ‘1’ for correct responses. The ‘why’ feel inside questions (“Why
did Terry feel like that?”) were scored on a 2-point scale: ‘0’ for an incorrect response, ‘1’ for
correct responses that were based on physical actions (i.e., contained no mental state terms, e.g.,
“Because the boy fell”), or ‘2’ for correct responses that reflected an understanding of Terry’s
mental state (i.e., contained mental state terms, e.g., “Because he thought it was funny that the
26
boy fell”). The ‘why’ look on face questions (“Why did Terry look like that?”) were scored on a
3-point scaled: ‘0’ for incorrect response, ‘1’ for correct responses that were based on physical
actions (i.e., contained no mental state terms, e.g., “So he wouldn’t get beat up”), ‘2’ for correct
responses that contained mental state terms, which referred to Terry (i.e., protagonist’s
perspective, e.g., “To pretend it’s not funny”), or ‘3’ for correct responses that contained mental
state terms, which referred to Terry and to the other individual(s) in the story (i.e., both the
protagonist’s and antagonist’s perspectives, e.g., “Because he didn’t want the boy to know he
thought it was funny”). Proportion scores were created for the comprehension questions out of a
total possible 20 points, the ‘why’ feel inside questions, which represent first order affective
theory of mind, out of a possible 20, as well as for the ‘why’ look on face questions out of a
possible 30, which represent higher order affective theory of mind.
Inter-rater reliability of at least .89 was achieved on a sample not included in the current
study before scoring of the current study data was completed. Kappa coefficients (all p < .005 or
less) were calculated for all question types of all ten stories. The range of kappa coefficients for
the ‘why’ feel inside questions was κ = .76 to κ = 1.00 and the ‘why’ look on face questions was
κ = .91 to κ = 1.00.
Results
Data Screening
Prior to conducting data analysis data distributions were examined to ensure normality,
multivariate normality, homogeneity of variance, sphericity, and homogeneity of regression
slopes. As would be expected, comprehension scores on the cognitive and affective theory of
mind tasks were skewed since most children passed the comprehension questions on these tasks.
When homogeneity of variance was found to be violated, t and significance values were obtained
27
from the data for ‘equal variances not assumed’.
For the multiple regression analyses, bivariate and residual plots were assessed for
linearity, bivariate normality, multicollinearity, and homoscedasticity between the independent
and dependant variables. Linearity was confirmed and there were no multivariate outliers.
Sample Characteristics
T-tests were used to assess group differences between the younger and older groups for
socioeconomic status (SES), nonverbal IQ, and language. Means and standard deviations can be
found in Table 1. No significant differences were found with respect to SES, nonverbal IQ, or
language competence. Chi square analysis showed no significance differences with respect to
gender (see Table 1).
Table 1
Group Differences in Background Characteristics, IQ, and Language
Younger
(n = 20)
Older
(n = 27)
t/2
(df = 1, 45)
p
d
M S.D. M S.D.
N N
Boys (%) 9 (45) 7 (26) 1.86 .220
SES 62.85 9.81 58.61 10.64 1.40 .169 .41
PIQ 105.80 11.41 102.70 10.24 .98 .334 .29
Language
Competence
Semantic Language .63 .74 .76 .58 -.68 .503 -.20
Syntactic Language .24 .66 .32 .51 -.49 .629 -.14
Note: SES = Socioeconomic Status; PIQ = Performance IQ; Semantic and Syntactic language
scores represent z-scores
28
Group Differences in Type of Theory of Mind
Results from t tests on comprehension questions revealed that the older group
significantly outperformed the younger group on the cognitive task, t (45) = -2.22, p = .031, d = -
.71, as well as the affective task, t (45) = -3.42, p = .003, d = -1.03. Due to group differences on
the comprehension questions, a 2 (age group) x 3 (theory of mind type) ANCOVA, with
performance on the comprehension questions from the theory of mind tasks used as covariates,
was conducted to determine group differences in type of theory of mind. Means and standard
deviations can be found in Table 2. Analyses showed a main effect for age group, F (1, 43) =
4.41, p = .042, η2
p = .09, no main effect for theory of mind type, F (1, 43) = .07, p = .934, η2
p =
.00, and no significant interaction, F (1, 43) = 1.20, p = .306, η2
p = .03. However, it should be
noted that the interaction showed a small effect (Cohen, 1988). Examination of this interaction
reveals a trend of the older group showing better performance than the younger group on higher
order cognitive theory of mind and first order affective theory of mind but no difference between
the two groups on higher order affective theory of mind (see Figure 2). Within the younger
group and older group, a trend indicated no difference between higher order cognitive theory of
mind and higher order affective theory of mind, with both being lower than first order affective
theory of mind.
Table 2
Adjusted Means and Standard Deviations of Group Performance on Theory of Mind Tasks
Younger
(n = 20)
Older
(n = 27)
M S.D. M S.D.
Higher Order Cognitive .56 .14 .70 .09
First Order Affective .66 .15 .81 .09
Higher Order Affective .57 .22 .63 .16
29
Figure 2. Performance on Theory of Mind Type by Age Group Controlling for Task
Comprehension.
Relations Between Theory of Mind and Language
Pearson Product Moment Correlations were calculated to examine the relations between
age in years, semantic and syntactic language, higher order cognitive theory of mind, first order
affective theory of mind, and higher order affective theory of mind in the entire sample
combined (see Table 3). Significant positive relationships were found between age and first
order affective theory of mind and higher order cognitive theory of mind but not between age
and higher order affective theory of mind. This supports the results found with the ANCOVA
discussed above. Semantic language was only significantly related to higher order cognitive
theory of mind; however, syntactic language was related to higher order cognitive theory of mind
and higher order affective theory of mind. All three types of theory of mind were related to each
other.
30
Table 3
Correlations for Age, Language, and Theory of Mind
1 2 3 4 5 6
1. Age --
2. Semantic Language .07 --
3. Syntactic Language .10 .66** --
4. Higher Order Cognitive .55** .29* .42** --
5. First Order Affective .57** .12 .23 .51** --
6. Higher Order Affective .23 -.01 .30* .55** .36* --
M 10.69 .71 .29 .64 .74 .60
SD 2.83 .65 .57 .13 .14 .19
*p < .05. **p < .01
Predicting Performance on Theory of Mind
Parallel hierarchical multiple regressions were performed to determine the relative
contribution of age, and semantic and syntactic language to each type of theory of mind. Age in
years was entered at step one, followed by semantic language at step two, and finally syntactic
language at step three. Syntactic language was entered last because previous literature has
indicated that it is a more important predictor of theory of mind performance than semantic
language. The findings are summarized in Table 4.
Higher Order Cognitive Theory of Mind. Age, semantic language, and syntactic language
were all significant predictors of higher order cognitive theory of mind (see Table 4). This
indicates that language competence is important for higher order cognitive theory of mind
beyond the effects of development (i.e., age), with syntactic language playing a prominent role.
31
Table 4
Hierarchical Multiple Regression Analyses Predicting Theory of Mind From Age, Semantic
Language Competence, and Syntactic Language Competence
Higher Order
Cognitive
First Order
Affective
Higher Order
Affective
Predictor ΔR2 β ΔR
2 β ΔR
2 β
Step1
Age
.30**
.55
.32**
.57
.05
.23
Step 2
Semantic Language
.07*
.26
.07
.08
.00
-.03
Step 3
Syntactic Language
.07*
.34
.03
.22
.16**
.53
Total R2 .44 .35 .21
n 47 47 47
*p < .05. **p < .01
First Order Affective Theory of Mind. Age was the only significant predictor of first
order affective theory of mind, suggesting development rather than language is important for first
order affective theory of mind. This is different than what has been found in the theory of mind
literature using false belief or first order cognitive theory of mind tasks.
Higher Order Affective Theory of Mind. Syntactic language competence was the only
significant predictor of higher order theory of mind accounting for 16% of the variance (p =
.005).
Discussion
The current study investigates cognitive and affective theory of mind in children and
young adolescents as well as the relation between these types of theory of mind and language.
As expected, young adolescents outperform children on measures of cognitive and affective
32
theory of mind. This is not surprising given existing research that has established the
developmental nature of theory of mind in general. Consistent with our hypothesis young
adolescents perform similarly on tasks of cognitive and affective theory of mind; however,
contrary to expectations, so did children. Finally, as predicted, language is related to both
cognitive and affective theory of mind.
Cognitive and Affective Theory of Mind in Children and Young Adolescents
Results from the current study highlight that both cognitive and affective theory of mind
develop into young adolescence. Previous research has established that cognitive theory of mind
continues to develop and increase in complexity beyond early childhood (e.g., Astington et al.,
2002) although the vast majority of research has focused on the preschool period. Findings from
the current study also support research that suggests affective theory of mind may develop into
late adolescence (Sebastian et al., 2012; Vetter et al., 2013). As previously discussed, the
literature has demonstrated that children first become proficient at first order cognitive mental
state understanding before they are able to develop higher order theories of others’ cognitive
mental states. Research with adults has demonstrated that depending on the task used, they do
not ceiling (Charlton, Barrick, Markus, & Morris, 2009). This indicates that mental state
awareness may continue to develop into adulthood. Children in the current study did not show
performance at ceiling levels on either theory of mind task, suggesting further improvements are
still likely.
Further underlining the continued development of theory of mind is our finding that both
groups perform better on first order affective theory of mind than either type of higher order
theory of mind. Given research demonstrating that first order cognitive tasks are mastered by the
age of 4 (e.g., Astington & Jenkins, 1999), it is not surprising that children in our study had little
33
difficulty with the first order affective theory of mind task. This finding suggests that affective
theory of mind may in fact develop in a first and higher order manner, similar to cognitive theory
of mind. Supporting this idea is research on emotion understanding, which shows a positive
relation between age and general emotion understanding (Pons & Harris, 2000). By preschool,
children can recognize and name facial expressions of basic emotions when they are presented as
pictures (Cutting & Dunn, 1999) and from around 9 to 11 years, children understand that there
can be a discrepancy between the emotion an individual outwardly expresses and the emotion
they actually feel (Arsenio & Lover, 1999; Cutting & Dunn, 1999). Further supporting the idea
that the development of affective theory of mind may follow a similar pattern as cognitive theory
of mind is research that shows that correct belief-based emotion attributions do not occur until 5
to 7 years of age (e.g., de Rosnay, Pons, Harris & Morell, 2004; Pons, Harris & de Rosnay,
2004). Taken together, our findings suggest that both affective and cognitive theory of mind
develop from early childhood to adolescence and perhaps beyond. This highlights the
importance of examining theory of mind beyond early childhood in order to gain a better insight
of how our understanding of others’ mental states develops.
Contrary to what we expected, within group differences on the higher order theory of
mind tasks did not decrease with age; both groups performed similarly on tasks of cognitive and
affective theory of mind. However, with regards to differences in performance between the two
groups, a small interaction effect reveals a trend of the older group outperforming the younger
group on both first order affective and higher order cognitive theory of mind. We would expect
that the older group would outperform the younger group on first order affective theory of mind
because we would anticipate that their understanding of first order mental states would be more
advanced than that of children in our younger group. As mentioned, the interaction effect
34
indicates a trend of both groups performing similarly on higher order affective theory of mind
but the older group outperforming the younger group on higher order cognitive theory of mind.
These findings suggest that there may be different developmental trajectories for understanding
others’ emotions versus understanding their thoughts. Supporting this possibility are results
from research on emotion understanding and theory of mind which have found that early
emotion understanding in preschool years predicts later first order cognitive theory of mind
performance (O’Brien et al., 2006). Further, authors have found that understanding of belief-
based emotions lags in comparison to false-belief understanding in a group of 5 to 7 year olds
(Bender, Pons, Harris & de Rosnay, 2011). Together, these findings seem to suggest that
understanding others’ cognitive mental activity versus their affective mental activity may
increase in complexity at different times throughout development and that these two type of
theory of mind may in fact build upon one another. Our lack of significant findings to support
our second hypothesis while still finding a small effect seems to indicate that we may have had a
power issue. It would be important in future studies to have a larger sample, which would also
allow for more complicated analyses that examines the interplay between the two types of theory
of mind. This would help determine if they build off each other in a more complex manner than
simply first order affective into higher order affective theory of mind and first order cognitive
into higher order cognitive theory of mind. It is possible that first order affective theory of mind
is important for higher order cognitive theory of mind and similarly first order cognitive for
higher order affective theory of mind.
One of the main goals of the current study was to investigate whether the distinction
between cognitive and affective theory of mind is valid in children and young adolescents.
Results of our correlation analyses reveal different patterns of relations between age and
35
language with cognitive versus affective theory of mind. Further, cognitive and affective theory
of mind, though correlated, are not completely related, which suggests the two may be distinct.
Taken together, these findings indicate it is plausible to suggest that cognitive and affective
theory of mind, as studied here, have different developmental trajectories and can be considered
distinct aspects of theory of mind in this age range. The findings of the current study clearly
demonstrate that more research should focus on theory of mind in children beyond the preschool
years. Little is known about the processes involved in higher order theory of mind and the
individual differences contributing to higher order theory of mind in adolescents and adults.
Future studies should include younger and/or older participants to further investigate the
developmental nature of both cognitive and affective theory of mind.
Cognitive and Affective Theory of Mind and Language
As expected, both semantic and syntactic language are related to theory of mind in
children and young adolescents. Further, our findings support the idea that syntactic language is
of particular importance to higher order cognitive theory of mind being a significantly predictor
of performance after accounting for age and semantic language. Contrary to what was expected,
neither semantic nor syntactic language are related to first order theory of mind. Children
typically pass first order cognitive theory of mind tasks at 4 years of age, when their language
skills are still developing and therefore, are critical for theory of mind. Older children have well
developed semantic and syntactic language skills, and as such, are no longer critical for first
order affective theory of mind. That is, their semantic and syntactic language competence is at a
level where variation in skill is no longer is associated with variation in understanding others’
affective mental activity. Research investigating the role of language in theory of mind
development beyond preschool and early childhood is sparse. However, our findings support the
36
current findings that indicate the continued importance of language for developing theory of
mind. For example, better general vocabulary is associated with better theory of mind in
preadolescents (Bosacki et al., 2000) and research with adults shows that second order belief
attributions are related to non-literal language comprehension, a language skill that continues to
develop into adulthood (e.g., Brune & Bodenstein, 2005; Freedman & Struss, 2011; Gaudreau et
al., 2013). Together, these findings highlight that language continues to play an important role in
theory of mind development beyond development of first order mental state understanding.
Syntactic, but not semantic, language is a better predictor of higher order theory of mind
in the current study. This supports the importance of syntactic rather than semantic language for
theory of mind, which has been proposed by a number of investigators (e.g., Astington &
Jenkins, 1999). This makes sense when we consider that mental state awareness requires
understanding of complex syntactic elements such as object complements (Astington & Jenkins,
1999). When we represent higher order theory of mind, the complexity of the syntactic elements
involved increases compared to first order theory of mind, thereby making syntactic language
crucial for understanding higher order mental states. Representing first-order theory of mind
requires fewer embedded sentences (e.g., I think he knows) than higher order theory of mind
(e.g., I think she knows that he doesn’t like her), thereby causing higher order theory of mind to
rely more heavily on syntactic language competence. In order to determine how the relation
between language and theory of mind changes over time, it would be important to tap other
aspects of language, such as pragmatic and figurative language, which develop well into
adulthood. Similarly, further investigation of cognitive and affective theory of mind is required.
In addition, executive function, which has been shown to be important for theory of mind, has
not been investigated with respect to affective theory of mind in children. Research examining
37
multiple factors would allow us to gain a better understanding of the cognitive processes that aid
in theory of mind development and allow us to investigate possible differences in the factors that
promote cognitive versus affective theory of mind development. The findings of the current
study provide further support for this distinction between cognitive and affective theory of mind
and highlight the importance of examining both types within a developmental framework.
38
References
Abu-Akel, A., & Shamay-Tsoory, S. (2011). Neuroanatomical and neurochemical bases of
theory of mind. Neuropsychologia, 49(11), 2971-2984. doi:
10.1016/j.neuropsychologia.2011.07.012
Adrian, J. E., Clemente, R. A., & Villanueva, L. (2007). Mothers’ use of cognitive state verbs in
picture-book reading and the development of children’s understanding of mind: a
longitudinal study. Journal of Child Development, 78(4), 1052-1067. doi:
10.1111/j.1467-8624.2007.01052.x
Altmann, U., Bohm, I. C., Lubrich, O., Menninghaus, W., & Jacobs, A. M. (2012). The power of
emotional valence-from cognitive to affective processes in reading. Frontiers in
Human Neuroscience, 6,(Article 192?). Doi: 10.3389/fnhum.2012.00192
Andres-Roqueta, C., Adrian, J. E., Clemente, R. A., & Katsos, N. (2014). Which are the best
predictors of theory of mind delay in children with specific language impairment?
International Journal of Language & Communication Disorders, 48(6), 726-737. doi:
10.1111/1460-6984.12045.
Arsenio, W., & Lover, A. (1999). Children’s conceptions of socio-moral affect: Happy
victimizers, mixed emotions, and other expectancies. New York: Cambridge University
Press.
Astington, J. W., & Jenkins, J. (1999). A longitudinal study of the relation between language and
theory-of-mind development. Developmental Psychology, 35(5), 1311-1320.
doi:10.1037/0012-1649.35.5.1311
Astington, J. W., Pelletier, J., & Homer, B. (2002). Theory of mind and epistemological
development: The relation between children’s second-order false-belief understanding
39
and their ability to reason about evidence. New Ideas in Psychology, 20, 131-144. doi:
10.1016/S0732-118X(02)00005-3
Baltaxe, C. A. M. (1977) Pragmatic deficits in language of autistic adolescents. Journal of
Pediatric Psychology, 2(4), 176-180. doi: 10.1093/jpepsy/2.4.176
Banerjee, R. (2002). Children’s understanding of self-presentational behavior: Links with
mental-state reasoning and the attribution of embarrassment. Merrill-Palmer Quarterly,
48(4), 378-404. doi: 10.1353/mpq.2002.0015
Baron-Cohen, S., Leslie, A. M., & Frith, U. (1985). Does the autistic child have a “theory of
mind”? Cognition, 21(1), 37-46. doi: 10.1016/0010-0277(85)90022-8
Baron-Cohen, S., O’Riordan, M., Stone, V., Jones, R., & Plaisted, K. (1999). Recognition of
faux pas by normally developing children and children with Asperger syndrome or high-
functioning autism. Journal of Autism and Development Disorders, 29(5), 40-418. doi:
10.1023/A:1023035012436
Baron-Cohen, S., Wheelwright, S., Hill, J., Raste, Y., & Plumb, I. (2001). The “reading the mind
in the eyes” test revised version: A study with normal adults, and adults with asperger
syndrome or high-functioning autism. Journal of Child Psychiatry, 42(2), 241-251.
Bender, P. K., Pons, R., Harris, P. L., & de Rosnay, M. (2011). Do young children
misunderstand their own emotions? European Journal of Developmental Psychology,
8(3), 331-348. doi: 10.1080/17405629.2010.495615
Bennett, M., & Matthews, L. (2000). The role of second-order belief-understanding and social
context in children’s self-attribution of social emotions. Social Development, 9(1), 126-
130. doi: 10.1111/1467-9507.00115
40
Bishop, D. (2003). Test for Reception of Grammar, Version 2. Oxford, UK: Psychological
Corporation.
Bjorklund, D. F. (2005). Children’s thinking: Cognitive development and individual differences
(4th
ed.). Toronto, ON: Nelson.
Blishen, B. R., Carroll, W. K., & Moore, C. (1987), The 1981 socioeconomic index for
occupations in Canada. Canadian Review of Sociology, 24, 465–488. doi:10.1111/j.1755-
618X.1987.tb00639.x
Bosacki, S. L. (2000). Theory of mind and self-concept in preadolescents: Links with gender and
language. Journal of Educational Psychology, 92(4), 709-717. doi: 1O.1037//O022-
O663.92.4.7O9
Brent, E., Rios, P., Happé, F., & Charman, T. (2004). Performance of children with autism
spectrum disorder on advanced theory of mind tasks. Autism, 8(3), 283-299. doi:
10.1177/1362361304045217
Brune, M. & Bodenstein, L. (2005). Proverb comprehension reconsidered—“theory of mind”
and the pragmatic use of language in schizophrenia. Schizophrenia Research, 75, 233–
239. doi: 10.1016/j.schres.2004.11.006
Capps, L., Kehres, J., & Sigman, M. (1988). Conversational abilities among children with autism
and children with developmental delays. Autism, 2(4), 325–344. doi:
10.1177/1362361398024002.
Charlton, R. A., Barrick, T. R., Markus, H. S., & Morris, R. G. (2009). Theory of mind
associations with other cognitive functions and brain imaging in normal aging.
Psychology and Aging, 24(2), 338–348. doi: 10.1037/a0015225
Charman, T., Baron-Cohen, S., Swettenham, J., Baird, G., Cox, A., & Drew, A. (2000). Testing
41
joint attention, imitation, and play as infancy precursors to language and theory of mind.
Cognitive Development, 15(4), 481-498. doi: 10.1016/S0885-2014(01)00037-5.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences: Second edition. Hilside,
NJ: Lawrence Erlbaum Associates.
Cutting, A. L., & Dunn, J. (1999). Theory of mind, emotion understanding, and family
background: Individual differences and interrelations. Child Development, 70,853–865.
De Farrari, A. R., Lagravinese, G., Pelosin, E., Pardini, M., Serrati, C., Abbruzzese, G., &
Avanzino, L. (2015). Freezing of gait and affective theory of mind in Parkinson disease.
Parkinsonism and Related Disorders, 509-513. doi: 10.1016/j.parkreldis.2015.02.023
de Rosnay, M., Pons, F., Harris, P. L., & Morell, J. M. B. (2004). A lag between understanding
false belief and emotion attribution in young children: Relationships with linguistic
ability, and mother’s mental-state language. British Journal of Developmental
Psychology, 22, 197–218. doi: 10.1348/026151004323044573
de Villiers, J. G., & Pyers, J. E. (2002), Complements to cognition: A longitudinal study of the
relationship between complex syntax and false-belief-understanding. Cognitive
Development, 17(1), 1037-1060. doi: 10.1016/S0885-2014(02)00073-4.
Dennis, M., Agostino, A., Taylor, H. G., Bigler, E. D. Rubin, K., Vannatta, K., et al. (2013).
Emotional expression of socially modulated emotive communication in children with
traumatic brain injury. Journal of the International Neuropsychological Society, 18, 1-10.
doi: 10.1017/S1355617712000884
Dennis, M., Barnes, M. A., Wilkinson, M., & Humphreys, R. P. (1998). How children with head
injury represent real and deceptive emotion in short narratives. Brain and Language, 61,
450-483. doi: 10.1006/brln.1997.1886
42
Dennis, M., Lockyer, L., & Lazenby, A. L. (2000). How high-functioning children with autism
understand real and deceptive emotion. Autism, 4(4), 370-381. doi:
10.1177/1362361300004004003
Doherty, M. J. (2000). Children’s understanding of homonymy: Metalinguistic awareness and
false belief. Journal of Child Language, 27, 367-392.
Dunn, L. M., Dunn, D. M. (2007). Peabody Picture Vocabulary Test, Fourth Edition.
Bloomington, MN: Pearson Assessments.
Duval, C., Benjanin, A., Piolino, P., Laisney, M., de La Sayette, V., Belliard, S., et al. (2012).
Theory of mind impairments in patients with semantic dementia. Brain; A Journal of
Neurology, 135, 228-241. Doi: 10.1093/brain.awr309
Duval, C., Piolino, P., Bejanin, A., Eustache, F., & Desgranges, B. (2011). Age effects on
different components of theory of mind. Journal of Consciousness & Cognition, 20,
627-642. Doi: 10.1016/j.concog.2010.10.025
Filipova, E., & Astington, J. W. (2008). Further development in social reasoning revealed in
discourse irony understanding. Child Development, 79(1), 126-138.
Flavell, J., Flavell, E., & Green, F. (1983). Development of the appearance–reality distinction.
Cognitive Development, 15, 95–120. doi: 10.1016/0010-0285(83)90005-1
Freedman, M., & Stuss, D. T. (2011). Theory of mind in Parkinson’s disease. Journal of the
Neurological Sciences, 310, 225–227. doi: 10.1016/j.jns.2011.06.004
Frith, U. (1989). Autism: Explaining the enigma. Oxford: Blackwell.
Garnham, W. A., Brooks, J., Garnham, A., & Ostenfeld, A.-M. (2000), From synonyms to
homonyms: Exploring the role of metarepresentation in language understanding.
Developmental Science, 3(4), 248-441. doi: 10.1111/1467-7687.00137.
43
Gaudreau, G., Monetta, L., Macoir, J., Poulin, S., Laforce R. Jr., & Hudon, C. (2013). Verbal
irony comprehension in older adults with amnestic mild cognitive impairment.
Neuropsychology, 27(6), 702-712. doi: 10.1037/a0034655.
Genizi, J., Shamay-Tsoory, S. G., Shahar, E., Yaniv, S., & Aharon-Perez, J. (2012). Impaired
social behavior in children with benign childhood epilepsy with centrotemporal spikes.
Journal of Child Neurology, 27(2), 156-161. doi: 10.1177/0883073811414420
Gillott, A., Furniss, F., & Walter, A. (2004). Theory of mind ability in children with specific
language impairment. Child Language Teaching and Therapy, 20(1), 1-11.
doi:10.1191/0265659004ct260oa
Grazzani, I., & Ornaghi, V. (2012). How do use and comprehension of mental-state language
related to theory of mind in middle childhood? Cognitive Development, 27(2), 99-111.
doi: 10.1016/j.cogdev.2012.03.002.
Gupta, R., Tranel, D., & Duff, M. C. (2012). Ventromedial prefrontal cortex damage does not
impair the development and use of common ground in social interaction: Implications
for cognitive theory of mind. Neuropsychologia, 50, 145-152. doi:
10.1016/j.neuropsychologia.2011.11.012
Hale, C. M., & Tager-Flusberg, H. (2005). Brief report: The relationship between discourse
deficits and autism symptomatology. Journal of Autism and Developmental Disorders,
35(4), 519-242. doi: 10.1007/s10803-005-5065-4.
Happé, F. G. E. (1994). An advanced test of theory of mind: Understanding of story characters’
thoughts and feelings by able autistic, mentally handicapped and normal children and
adults. Journal of Autism and Developmental Disorders, 24, 129-154.
doi:1007/BF02172093
44
Happé, F. G. E. (1995). The role of age and verbal ability in the theory of mind task performance
of subjects with autism. Child Development, 66(3), 843-855. doi: 0009-3920/95/6603-
0005
Harris, P. L., Donnelly, K., Guz, G. R., & Pitt-Watson, R. (1986). Children’s understanding of
the distinction between real and apparent emotion. Journal of Child Development, 57(4),
895-909. doi: 10.1111/j.1467-8624.1986.tb00253.x
Harwood, M. D., & Farrar, M. J. (2010). Conflicting emotions: The connection between
affective perspective taking and theory of mind. British Journal of Developmental
Psychology, 24(2), 401-418. doi: 10.1348/02615100550302.
Heavy, L., Phillips, W., Baron-Cohen, S., & Rutter, M. (2000). The awkward moments test: A
naturalistic measure of social understanding in autism. Journal of Autism and
Development Disoder, 30(3), 225-236. doi: 10.1023/A:1005544518785
Hughes, C., & Dunn, J. (1998). Understanding mind and emotion understanding: Longitudinal
associations with mental state talk between young friends. Developmental Psychology,
34(5), 1026-1037. doi: http://dx.doi.org/10.1037/0012-1649.34.5.1026
Jackson, A. L. (2001). Language facility and theory of mind development in deaf children.
Journal of Deaf Studies and Deaf Education, 6(3), 161-176. doi: 10.1093/deafed/6.3.161
Kalbe, E., Schlegel, M., Sack, A., Nowak, D., Dafotakis, M., Bangard, C. et al. (2010).
Dissociating cognitive from affective theory of mind: A TMS study. Cortex, 46, 769-
780.
Kristen, S., Sodian, B., Thoerner, C., & Perst, H. (2011). Infants’ joint attention skills predict
toddlers’ emerging mental state language. Developmental Psychology, 47(5), 1207-1219.
doi: 10.1037/a0024808.
45
Lecce, S., Demicheli, P., Zocchi, S., & Palladino, P. (2015). The origins of children’s
metamemory: The role of theory of mind. Journal of Experimental Child Psychology,
131, 56-72. doi: 10.1016/j.jecp.2014.11.005
Lecce, S., Zocchi, S., Pagnin, A., Palladino, P., & Taumoepeau, M. (2010). Reading minds: The
relation between children’s mental state knowledge and their metaknowledge about
reading. Child Development, 81(6), 1876-7893. doi: 10.1111/j.1467-8624.2010.01516.x
Leslie, A. M., & Frith, U. (1988). Autistic children’s understanding of seeing, knowing and
believing. British Journal of Developmental Psychology, 6, 315-324. doi:
10.1111/j.2044-835X.1988.tb01104.x
Lockl, K., & Schneider, W. (2007). Knowledge about the mind: Links between theory of mind
and later metamemory. Child Development, 78(1), 148-167. doi: 10.1111/j.1467-
8624.2007.00990.x
Lord, C. (1985). Autism and the comprehension of language. In E. Schopler, & G. B. Mesibov
(Eds.), Communication problems in autism (pp. 275-281). US: Springer.
Milligan, K., Astington, J. W., & Dack, L. A. (2007). Language and theory of mind: Meta-
analysis of the relation between language ability and false-belief understanding. Child
Development, 78(2), 622-646. doi: 10.1111/j.1467-8624.2007.01018.x
Miller, C. A. (2001). False belief understanding in children with specific language impairment.
Journal of Communication Disorders, 34(1-2), 73-86. doi: 10.1016/S0021-
9924(00)00042-3.
Miller, C. A. (2004). False belief and sentence complement performance in children with
specific language impairment. International Journal of Language & Communication
Disorders, 39(2), 191-213. doi: 10.1080/13682820310001616994
46
Miller, C. A. (2006). Developmental relationships between language and theory of mind.
American Journal of Speech-Language Pathology, 15, 142-154. doi: 1058-0360/06/1502-
0142
Miller, S. A. (2009). Children’s understanding of second-order mental states. Psychological
Bulletin, 135(5), 749-773. doi:10.1037/a0016854
Moore, C., Pure, K., & Furrow, D. (1990). Children’s understanding of the modal expression of
speaker certainty and uncertainty and its relation to the development of a representational
theory of mind. Child Development, 61(3), 722-730, doi: 10.1111/j.1467-
8624.1990.tb02815.x.
Naito, M., & Seki, Y. (2009). The relationship between second-order false belief and display
rules reasoning: The integration of cognitive and affective social understanding.
Developmental Science, 12(1), 150-164. doi: 10.1111/j.1467-7687.2008.00748.x
O’Brien, M., Weaver, J. M., Nelson, J. A., Calkins, S. D., Leerkes, E. M., & Marcovitch, S.
(2011). Longitudinal associations between children’s understanding of emotions and
theory of mind. Cognition and Emotion, 25(6), 1074-1086. doi:
10.1080/02699931.2010.518417
O’Hare, A. E., Bremner, L., Nash M., Happé, F., Pettigrew, L. M. (2009). A clinical assessment
tool for advanced theory of mind performance in 5 to 12 year olds. Journal of Autism and
Developmental Disorders, 39, 916-928. doi: 10.1007/s10803-009-0699-2
Paul, L. (1985) Programming peer support for functional language. In S. Warren & A. Rogers-
Warren (Eds.), Teaching functional language: Generalization and maintenance of
language skills (pp. 298-307). Austin, TX: Pro-Ed.
47
Paul, R. (1987). Communication. In D. J. Cohen & A. M. Donnellan (eds.), Handbook of autism
and pervasive developmental disorders. New York: Wiley.
Perner, J., Frith, U., Leslie, A. M., & Leekam, S. R. (1989). Exploration of the autistic child’s
theory of mind: Knowledge, belief, and communication. Child Development, 60(3), 689-
700. doi: 10.1111/j.1467-8624.1989.tb02749.x
Perner, J., Leekam, S. R., & Wimmer, H. (1987). Three-year olds' difficulty with false belief:
The case for a conceptual deficit. British Journal of Developmental Psychology, 5, 125-
137. doi: 10.1111/j.2044-835X.1987.tb01048.x
Perner, J., & Wimmer, H. (1985). “John thinks that Mary thinks that...” attribution of second-
order beliefs by 5-to-10-year-old children. Journal of Experimental Psychology, 39(3),
437-471. doi: 10.1016/0022-0965(85)90051-7
Pons, F., & Harris, P. L. (2000). Test of Emotion Comprehension. Oxford, UK: Oxford
University Press.
Pons, F., Harris, P. L., & de Rosnay, M. (2004). Emotion comprehension between 3 and 11
years: Developmental periods and hierarchical organizations. European Journal of
Developmental Psychology, 1, 127–152. doi: 10.1080/17405620344000022
Rakhlin, N., Kornilov, S. A., Reich, J., Babyonyshev, M., Koposov, R. A., & Grigorenko, E. L.
(2011). The relationship between syntactic development and theory of mind: Evidence
from a small-population study of a developmental language disorder. Journal of
Neurolinguistics, 24, 476-496. doi:10.1016/j.jneuroling.2011.03.001
Ruffman, T., Slade, L., & Crowe, E. (2002). The relation between children’s and mothers’
mental state language and theory-of-mind understanding. Child Development, 73(3), 734-
751. doi: 10.1111/1467-8624.00435.
48
Ruffman, T., Slade, L., Rowlandson, K., Rumsey, C. & Garnham, A. (2003). How language
relates to belief, desire, and emotion understanding. Cognitive Development, 18, 139-158.
doi: 10.1016/S0885-2014(03)00002-9
Santangelo, G., Vitale, C., Trojano, L., Errico, D., Amboni, M., Barbarulo, A. M., et al., (2012).
Neuropsychological correlates of theory of mind in patients with early Parkinson’s
Disease. Movement Disorders, 27(1), 98-105. doi: 10.1002/mds.23949
Sebastian, C., Fontaine, N., Bird, G., Blakemor, S. J., Brito, S., McCory, E., & Viding, E. (2012).
Neural processing associated with cognitive and affective theory of mind in
adolescents and adults. Social Cognitive and Affective Neuroscience, 7(1), 53-63. doi:
10.1093/scan/nsr023
Semel, E., Wiig, E., & Secord, W. (2003). Clinical Evaluation of Language Fundamentals,
Fourth Edition. San Antonio, TX: The Psychological Corporation.
Schick, B., de Villiers, P., de Villiers, J. & Hoffmeister, R. (2007). Language and theory of
mind: A study of deaf children. Child Development, 78(2), 376-396. doi: 0009-
3920/2007/7802-0002
Shamay-Tsoory, S., Hagai, H., Aharon-Peretz, J., & Levkovitz, Y. (2010). The role of
orbitofrontal cortex in affective theory of mind deficits in criminal offenders with
psychopathic tendencies. Cortex, 46 (5), 668-677. doi: 10.1016/j.cortex.2009.04.008
Shamay-Tsoory, S. G., Shur, S., Barcai-Goodman, L., Medlovich, S., Harari, H., & Levkovitz,
Y. (2007). Dissociation of cognitive from affective components of theory of mind in
schizophrenia. Psychiatry Research, 149, 11-23. doi: 10.1016/j.psychres.2005.10.018
Silliman, E. R., Diehl, S. F., Hnath-Chisolm, R., Zenko, C. B., &Friedman, S. A. (2003). A new
look at performance on theory-of-mind tasks by adolescents with autism spectrum
49
disorder. Language, Speech & Hearing Services in Schools, 34(3), 236-252. doi:
10.1044/0161-1461(2003/020)
Slade, L., & Ruffman, T. (2005). How language does (and does not) relate to theory of mind: A
longitudinal study of syntax, semantics, working memory and false belief. The British
Journal of Developmental Psychology, 23, 117-141. doi: 10.1348/026151004X21332.
Sullivan, K., Zaitchik, D., & Tager-Flusberg, H., (1994). Preschoolers can attribute second-order
beliefs. Developmental Psychology, 30(3), 395-402. doi: 10.1037/0012-1649.30.3.395
Tager–Flusberg, H. (1989). A psycholinguistic perspective on language development in the
autistic child. In G. Dawson (Ed.), Autism: New directions in diagnosis, nature and
treatment (pp. 92–115). New York: Guilford Press.
Tomasello, M. (1995). Joint attention as social cognition. In C. Moore & P. J. Dunham (Eds.),
Joint Attention: Its Origin and Role in Development, pp. 103-130. Hillsdale, N. J.:
Lawrence Erlbaum.
Vetter, N. C., Altgassen, M., Phillips, L., Mahy, C. E. V., & Kliegel, M. (2013). Development of
affective theory of mind across adolescence: Disentangling the role of executive
functions. Developmental Neuropsychology, 38(2), 114-125. Doi:
10.1080/87565641.2012.733786
Wechsler, D. (1999). Wechsler Abbreviated Scale of Intelligence. San Antonia, TX: NCS
Pearson.
Williams, K.T. (2007). Expressive Vocabulary Test, Second Edition. Circle Pines, MN: AGS
Publishing.
Wimmer, H. & Perner, J. 1983. Beliefs about beliefs: Representation and constraining function
of wrong beliefs in young children’s understanding of concept. Cognition, 13, 103-128.
50
doi: 0010-0277/83/010103-26
Yirmiya, N., Solomonica-Levi, D., & Shulman, C. (1996). The ability to manipulate behavior
and to understand manipulation beliefs: A comparison of individuals with autism, mental
retardation, and normal development. Developmental Psychology, 32(1), 62-69. doi:
10.1037/0012-1649.32.1.62
Zadeh, Z. Y., Im-Bolter, N., & Cohen, N. J. (2007). Social cognition and externalizing
psychopathology: An investigation of the mediating role of language. Journal of
Abnormal Child Psychology, 35, 141-152. doi:10.1007/s10802-006-9052-9
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Appendix A: Parent Questionnaire
The questions below are to provide us with information to add to the knowledge we will gain from the tasks your child is completing. All information is kept strictly confidential and no identifying information will ever be used for research or publication purposes. Answering these questions is optional and you may decline to provide the information asked if you wish. Child's surname: ________________________ Child's given name: ________________________ Parent/Guardian's surname: ________________________ Given name: ________________________ Mother's Occupation: ____________________________________________________ Father's Occupation: ____________________________________________________ Note. If currently unemployed please indicate previous occupation
Primary language spoken at home: ________________________ Additional languages spoken at home: ________________________________________________ Medical History Please answer the following questions in regards to the child enrolled in the study. History of Vision Problems Yes____ No____ Wears Glasses Yes____ No____ History of Hearing Problems Yes____ No____ Ear Infections 1-5 Yes____ No____ 5-10 Yes____ No____ Organic/Chronic Yes____ No____ Ear Tubes Yes____ No____ When? _____________________ Hearing Test Yes____ No____ When? _____________________ If yes, results: ________________________________________________ Educational History Please answer the following questions in regards to the child enrolled in the study. Present Grade: ______ Has the child repeated a grade? Yes ____ No____ If so, why? ___________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Learning difficulties? Yes____ No____ If so, please list/describe. _______________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Identified as exceptional? Yes____ No____
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Appendix B: Happe Strange Stories Vignettes and Questions
Story 1: One day Aunt Jane came to visit Peter. Now Peter loves his Aunt very much, but today
she is wearing a new hat. A new hat, which Peter thinks is very ugly. Peter thinks his aunt looks
silly in it and much nicer in her old hat. But when Aunt Jane asks Peter, “How do you like my
new hat”, Peter says, “Oh, it’s very nice”.
Comprehension Question: Is it true what Peter said?
Mental State Understanding Question: Why did he say it?
Story 2: Daniel and Ian see Mrs. Thompson coming out of the hairdresser’s one day. She looks a
bit funny because the hairdresser cut her hair much too short. Daniel says to Ian, “She must have
been in a fight with a lawnmower!”
Comprehension Question: Is it true what Daniel said?
Mental State Understanding Question: Why did he say it?
Story 3: Late one night old Mrs. Peabody is walking home. She doesn’t like walking home alone
in the dark because she is always afraid that someone will attack her and rob her. She really is a
very nervous person! Suddenly, out of the shadows comes a man. He wants to ask Mrs.
Peabody what time it is, so he walks towards her. When Mrs. Peabody sees the man coming
towards her, she starts to tremble and says, “Take my purse, just don’t hurt me please!”
Comprehension Question: Was the man surprised at what Mrs. Peabody said?
Mental State Understanding Question: Why did she say that, when he only wanted to ask her the
time?
Story 4: It is Halloween and Chris is going to a fancy costume party. He is going as a ghost. He
wears a big white sheet with eyes cut out to see through. As he walks to the party in his ghost
costume, he bumps into Mr. Brown. It is dark, and Mr. Brown says, “Oh! Who is it?” Chris
answers, “I’m a ghost Mr. Brown!”
Comprehension Question: Is it true what Chris said?
Mental State Understanding Question: Why did Chris say this?
Story 5: Emma has a cough. All through lunch she coughs and coughs and coughs. Father says,
“Poor Emma, you must have a frog in your throat!”
Comprehension Question: Is it true what Father says to Emma?
Mental State Understanding Question: Why does he say this?
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Story 6: Jill wanted to buy a kitten, so she went to see Mrs. Smith, who had lots of kittens she
didn’t want. Now Mrs. Smith loved the kittens, and she wouldn’t do anything to harm them.
But she couldn’t keep them all herself. When Jill visited she wasn’t sure she wanted one of Mrs.
Smith’s kittens, since they were all males and she wanted a female. But Mrs. Smith said, “If no
one buys the kittens I’ll just have to drown them!”
Comprehension Question: Is it true what Mrs. Smith said?
Mental State Understanding Question: Why does she say this to Jill?
Story 7: Jane and Sarah are best friends. They both entered the same painting competition. Now
Jane wanted to win this competition very much, but when the results were announced it was her
best friend Sarah who won, not her. Jane was very sad she had not won, but she was happy for
her friend, who got the prize.
Jane said to Sarah, “Well done, I’m so happy you won!”
Jane said to her mother, “I am sad I didn’t win that competition!”
Comprehension Questions: Is it true what Jane said to Sarah?; Is it true what Jane said to her
mother?
Mental State Understanding Questions: Why does Jane say she is happy and sad at the same
time?
Story 8: One day, while she is playing in the house, Anna accidentally knocks over and breaks
her mother’s favorite crystal vase. Oh dear, when her mother finds out she will be very angry!
So when Anna’s mother comes home and sees the broken vase and asks Anna what happened,
Anna says, “The dog knocked it over, it wasn’t my fault!”
Comprehension Question: Is it true what Anna said?
Mental State Understanding Question: Why did she say that?
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Appendix C: Real and Deceptive Emotion Vignettes and Questions
Test Story 1: A big boy runs past Terry. Suddenly the boy slips and falls over. The boy would be
cross with Terry if he knew that Terry thought this was funny. Terry tries to hide how (s)he feels.
Concealment A: What happens to the big boy?
Concealment B: What will he do if Terry shows how (s)he feels?
Feel Inside A: How did Terry really feel when the boy fell over? [select from face array]
Feel Inside B: Why did Terry feel like that?
Look on Face A: How did Terry try to look on his/her face when the boy fell over? [select from
face array]
Look on Face B: Why did Terry look like that?
Test Story 2: Terry wants to go outside, but (s)he has a tummy ache. (S)he knows that if (s)he
tells his/her Mom that (s)he has a tummy ache, his/her Mom will say that (s)he can’t go out.
Terry tries to hide the way (s)he feels.
Concealment Information Questions
What was the matter with Terry?
What will Terry’s Mom say if she knows Terry has a tummy ache?
Feel Inside Questions
How did Terry really feel when (s)he had a tummy ache? [select from face array]
Why did Terry feel like that?
Look on Face Questions
How did Terry try to look on his/her face when (s)he had a tummy ache? [select from face array]
Why did Terry look like that?
Test Story 3: Terry is playing a game of cards. When (s)he gets his/her cards, (s)he sees that
they are good ones so (s)he might win. The other children might not want to play against him/her
if they know (s)he has good cards. Terry tries to hide the way (s)he feels.
Concealment Information Questions
What happened to Terry in the card game?
What will the other children do if they know Terry has good cards?
Feel Inside Questions
How did Terry really feel when (s)he saw his/her good cards? [select from face array]
Why did Terry feel like that?
Look on Face Questions
How did Terry try to look on his/her face when (s)he saw his/her cards?[select from face array]
Why did Terry look like that?
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Test Story 4: Terry has just had a haircut. The hairdresser/barber cut off too much hair and (s)he
looks really silly. At school Terry’s friends laugh at him/her and tell him/her that (s)he looks like
a porcupine. His/her friends will keep laughing at him/her if they know how (s)he feels. Terry
tries to hide the way (s)he feels.
Concealment Information Questions
What happened to Terry at the hairdresser/barber?
What will his/her friends do if Terry shows how (s)he feels?
Feel Inside Questions
How did Terry really feel about his/her haircut? [select from face array]
Why did Terry feel like that?
Look on Face Questions
How did Terry try to look on his/her face when his/her friends laughed at his/her haircut? [select
from face array]
Why did Terry look like that?
Test Story 5: Terry is playing a game with his/her friend. At the end of the game Terry wins and
his/her friend loses. If Terry looks pleased about winning his/her friend won’t play anymore.
Terry tries to hide how (s)he feels.
Concealment Information Questions
What happens at the end of the game?
What will Terry’s friend do if (s)he know how Terry feels?
Feel Inside Questions
How did Terry really feel when she won the game? [select from face array]
Why did Terry feel like that?
Look on Face Questions
How did Terry try to look on his/her face when (s)he won the game? [select from face array]
Why did Terry look like that?
Test Story 6: Terry is walking down the street when an old lady walks past him/her. The old lady
is wearing funny clothes. The old lady would get mad at Terry if she knew Terry thought she
looked funny. Terry tries to hide the way (s)he feels.
Concealment Information Questions
What is the old lady wearing?
What will the old lady do if she know how Terry feels?
Feel Inside Questions
How did Terry really feel when she saw the old lady wearing funny clothes? [select from face
array]
Why did Terry feel like that?
Look on Face Questions
How did Terry try to look on his/her face when (s)he saw the old lady wearing funny clothes?
[select from face array]
Why did Terry look like that?
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Test Story 7: Terry tries to sit in his/her chair but (s)he falls on the floor and hurts him/herself.
(S)he knows that the other children will laugh if (s)he shows how (s)he feels. So Terry tries to
hide how (s)he feels.
Concealment Information Questions
What happens to Terry?
What will the other children do if (s)he shows how (s)he feels?
Feel Inside Questions
How did Terry really feel when (s)he fell over? [select from face array]
Why did Terry feel like that?
Look on Face Questions
How did Terry try to look on his/her face when (s)he fell over? [select from face array]
Why did Terry look like that?
Test Story 8: Terry wants to play a trick on his/her sister, so (s)he takes his/her sister’s favorite
toy and hides it. His/her sister can’t find her toy anywhere and she would be cross if she knew
Terry hid it. Terry tries to hide how (s)he feels.
Concealment Information Questions
What happens to Terry’s sister when she comes home?
What will Terry’s sister do if she knows how Terry feels?
Feel Inside Questions
How did Terry really feel when his/her sister couldn’t find the toy? [select from face array]
Why did Terry feel like that?
Look on Face Questions
How did Terry try to look on his/her face when his/her sister couldn’t find the toy? [select from
face array]
Why did Terry look like that?
Test Story 9: Terry’s friends are playing together and telling jokes. All of the children laugh at a
joke but Terry doesn’t understand it. Terry doesn’t want the other children to know that (s)he
doesn’t understand it in case they think (s)he’s silly. Terry tries to hide the way (s)he feels.
Concealment Information Questions
What happens to Terry when (s)he listens to the joke?
What would the other children think if they knew that (s)he didn’t understand?
Feel Inside Questions
How did Terry really feel when (s)he heard the joke? [select from face array]
Why did Terry feel like that?
Look on Face Questions
How did Terry try to look on his/her face when (s)he heard the joke? [select from face array]
Why did Terry look like that?
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Test Story 10: Terry’s big brother is teasing him/her. Terry knows that his/ her brother will keep
on teasing him/her if he knows how (s)he feels. So Terry tries to hide how (s)he feels.
Concealment Information Questions
What is Terry’s brother doing?
What will he do if he knows how (s)he feels?
Feel Inside Questions
How did Terry really feel when his/her brother teased him/her? [select from face array]
Why did Terry feel like that?
Look on Face Questions
How did Terry try to look on his/her face when his/her brother teased him/her? [select from face
array]
Why did Terry look like that?