Theory-of-mind development in oral deaf children with cochlear implants or conventional hearing aids Peterson, CC Abstract: J Child Psychol Psychiatry. 2004 Sep;45(6):1096-106. Findings Autism is characterized in part by an abnormality in the development of theory-of-mind (TOM), the ability of people to perceive and understand other peoples’ thinking to predict their behavior. The TOM is typically measured by a standard test (the False Beliefs Test), requiring a child to predict what a protagonist will do, say, or think when they are presented with a mistaken belief. Children with autism generally perform less well on TOM tests. TOM development is also seriously delayed in late-signing deaf children and possibly in deaf individuals learning speech with conventional hearing aids. Cochlear implants can substantially boost auditory acuity and rates of language growth, but despite the implant, children with cochlear implants exhibit problems similar to autistic children when socializing with hearing peers. In this study Dr. Peterson explored whether deaf children with cochlear implants escape the TOM problems. The False Belief Test was given to 52 children (4-12 years old), divided into four groups: (1) 13 children with cochlear implants, (2) 13 severely deaf children without cochlear implants but with conventional hearing aids, (3) 9 children with autism who attended a special school for autism, and (4) 17 typically developing preschoolers with no significant developmental disabilities. Groups 1 and 2 were evenly divided between those attending oral-only versus sign-plus-oral schools. Dr. Peterson found no significant TOM differences between deaf children with implants and those with hearing aids, nor between those in oral-only versus sign-plus-oral schools. Also, the deaf children (Groups 1 and 2) did not perform any better on the TOM tests than the children with autism (Group 3). The typically developing preschoolers with normal hearing (Group 4) scored significantly higher than all other groups. For the deaf and the autistic children, as well as the preschoolers, the rate of language development and verbal maturity significantly predicted variability in TOM. Conclusions The authors conclude that deaf children with cochlear implants are as delayed in ToM development as children with autism and their deaf peers with hearing aids or late sign language. Thus, peer interaction and early fluent communication with other children and family is important for the growth of social cognition and language. The authors suggest that those children who acquire language swiftly will have more chances than their peers with delayed language to take a full part in a broad range of interactions with others. Previous research show that hearing parents of oral deaf children with cochlear implants complained that their children suffered problems with peer conversation and peer social relations. Such problems could limit social interactions that facilitate TOM development.
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