THE RELATION BETWEEN THEORY OF MIND AND EXECUTIVE FUNCTIONS IN CHILDREN WITH FETAL ALCOHOL SPECTRUM DISORDERS
Main Article Content
Keywords
Fetal Alcohol Spectrum Disorder (FASD), Theory of Mind (ToM), executive functioning
Abstract
Background
Children with Fetal Alcohol Spectrum Disorders (FASD) are faced with a range of physical, cognitive, behavioral, and/or learning deficits, as well as poor executive functioning and social skills. Theory of mind (ToM) is the ability to understand that one’s own perspective may differ from the perspective of another individual. ToM develops around age 4 and is correlated with performance on executive functioning tasks.
Objective
The goals of this study were to examine ToM performance in young children with FASD, how age was related to ToM performance, and whether ToM abilities were related to underlying executive function difficulties.
Method
Fifty-three children (aged 4 to 8 years) participated: 25 children with FASD and 28 control children. All children were tested on measures of ToM, executive functioning, and receptive vocabulary.
Results
More children in the FASD group (44%) failed one or both ToM measures than in the control group (25%). Older children with FASD performed worse on ToM than younger children, but this was not the case for the control group. For the FASD group, ToM performance was correlated with a measure of inhibition, but for the control group, ToM was correlated with visual-spatial working memory.
Conclusions
Children with FASD have difficulty on ToM tasks, and this difficulty may be related to underlying deficits in inhibition.
References
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6. Whaley S, O'Connor M, Gunderson B. Comparison of the adaptive functioning of children prenatally exposed to alcohol to a nonexposed clinical sample. Alcohol Clin Exp Res 2001;25:1018-24.
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12. Tager-Flusberg H, Sullivan K, Boshart J. Executive functions and performance on false belief tasks. Dev Neuropsychol 1997;13:487-93.
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18. Keenan T. Memory span as a predictor of false belief understanding. NZ J Psychol 1998;27:36- 43.
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21. Perner J, Stummer S, Lang B. Executive Functions and Theory of Mind: Cognitive Complexity or Functional Dependence? Mahwah, NJ: Lawrence Erlbaum Associates Publishers, 1999.
22. Carlson SM, Moses LJ. Individual differences in inhibitory control and children's theory of mind. Child Dev 2001;72:1032-53.
23. Hala S, Hug S, Henderson A. Executive function and false-belief understanding in preschool children: Two tasks are harder than one. J Cogn Dev 2003;4:275-98.
24. Baron-Cohen S. Is Asperger Syndrome/highfunctioning autism necessarily a disability? Dev Psychopathol 2000;12:489-500.
25. Ozonoff S, Pennington BF, Rogers SJ. Executive function deficits in high-functioning autistic individuals: Relationship to theory of mind. J Child Psychol Psychiatry 1991;32:1081- 105.
26. Buitelaar JK, Van der Wees M, SwabbBarneveld H, Van der Gaag RJ. Theory of mind and emotion-recognition functioning in autistic spectrum disorders and in psychiatric control and normal children. Dev Psychopathol 1999;11:39-58.
27. Fahie CM, Symons DK. Executive functioning and theory of mind in children clinically referred for attention and behavior problems. J Appl Dev Psychol 2003;24:51-73.
28. Hughes C, Dunn J, White A. Trick or treat? Uneven understanding of mind and emotion and executive dysfunction in "hard-to-manage" preschoolers. J Child Psychol Psychiatry 1998;39:981-94.
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30. Pears KC, Fisher PA. Emotion understanding and theory of mind among maltreated children in foster care: Evidence of deficits. Dev Psychopathol 2005;17:47-65.
31. Roebuck T, Mattson S, Riley E. Behavioral and psychosocial profiles of alcohol-exposed children. Alcohol Clin Exp Res 1999;23:1070-6.
32. Thomas S, Kelly S, Mattson SN, Riley EP. Comparison of social abilities of children with Fetal Alcohol Syndrome to those of children with similar IQ scores and normal controls. Alcohol Clin Exp Res 1998;22:528-33.
33. Coggins TE, Olswang LB, Olson HC, Timler GR. On Becoming Socially Competent Communicators: The Challenge for Children with Fetal Alcohol Exposure. San Diego, CA: Academic Press, 2003.
34. Timler GR, Olswang LB, Coggins TE. "Do I know what I need to do?" A social communication intervention for children with complex clinical profiles. Lang Speech Hear Serv Sch 2005;36:73-85.
35. Rasmussen C, Bisanz J. Executive functioning in children with Fetal Alcohol Spectrum Disorder: Profiles and age-related differences. Child Neuropsychol 2009;15: 201-15.
36. Schonfeld AM, Paley B, Frankel F, O'Connor MJ. Executive functioning predicts social skills following prenatal alcohol exposure. Child Neuropsychol 2006;12:439-52. 37. Astington JW, Jenkins JM. A longitudinal study of the relation between language and theory of mind development. Dev Psychol 1999;35:1311- 20.
38. Hughes C, Dunn J. Understanding mind and emotion: Longitudinal associations with mental state talk between young friends. Dev Psychol 1998;34:1026-37.
39. Ruffman T, Slade L, Rowlandson K, Rumsey C, Garnham A. How language relates to belief, desire, and emotion understanding. Cogn Dev 2003;18:139-58.
40. Happe F. The role of age and verbal-ability in the theory of mind task-performance of subjects with autism. Child Dev 1995;66:843-55.
41. Tager-Flusberg H, Joseph RM. How language facilitates the acquisition of false-belief understanding in children with autism. In: Astington JW, Baird JA, eds. Why Language Matters for Theory of Mind. New York: Oxford University Press, 2005:298-318.
42. Chandler MJ, Fritz AS, Hala SM. Small scale deceit: Deception as a marker of 2-, 3- and 4- year-olds' early theories of mind. Child Dev 1989;60:1263-77.
43. Milligan K, Astington JW, Dack LA. Language and theory of mind: Meta-analysis of the relation between language ability and falsebelief understanding. Child Dev 2007;77:622- 46.
44. Astley S, Clarren S. Diagnostic Guide for Fetal Alcohol Syndrome and Related Conditions: The 4-digit code (2nd ed.). University of Washington, Seattle: FAS Diagnostic and Prevention Network, 1999.
45. Astley S. Diagnostic Guide for Fetal Alcohol Syndrome and Related Conditions: The 4-digit code (3rd ed.). University of Washington, Seattle: FAS Diagnostic and Prevention Network, 2004.
46. Wimmer H, Perner J. Beliefs about beliefs: Representation and constraining function of wrong beliefs in young children's understanding of deception. Cognition 1983; 13:103-28.
47. Kochanska G, Murray K, Jacques TY, Koenig AL, Vandegeest KA. Inhibitory control in young children and its role in emerging internalization. Child Dev 1996;67: 490-507.
48. Pickering SJ, Gathercole SE. Working Memory Test Battery for Children. London: The Psychological Corporation, 2001.
49. Baron-Cohen S, Leslie AM, Frith U. Does the autistic child have a “theory of mind”? Cognition 1985;21:37-46.
50. Wellman HM, Cross D, Watson J. Meta-analysis of theory-of-mind development: The truth about false belief. Child Dev 2001;72:655-84.
51. Stigler JW, Miller KF. A good match is hard to find: Comment on Mayer, Tajika, and Stanley (1991). J Educ Psychol 1993;85:554-9.
52. Fisher N, Happe F. A training study of theory of mind and executive function in children with autistic spectrum disorders. J Autism Dev Disord 2005;35:757-71.
2. Carmichael Olson H, Feldman J, Streissguth AP, Sampson PD, Bookstein FL. Neuropsychological deficits in adolescents with Fetal Alcohol Syndrome: Clinical findings. Alcohol Clin Exp Res 1998;22:1998-2012.
3. Mattson SN, Riley EP. A review of the neurobehavioral deficits in children with Fetal Alcohol Syndrome or prenatal exposure to alcohol. Alcohol Clin Exp Res 1998;22: 279-94.
4. Streissguth AP, Barr HM, Sampson PD, Bookstein FL. Prenatal alcohol and offspring development: The first fourteen years. Drug Alcohol Depend 1994;36:89-99.
5. Rasmussen C. Executive functioning and working memory in Fetal Alcohol Spectrum Disorder. Alcohol Clin Exp Res 2005;29:1359- 67.
6. Whaley S, O'Connor M, Gunderson B. Comparison of the adaptive functioning of children prenatally exposed to alcohol to a nonexposed clinical sample. Alcohol Clin Exp Res 2001;25:1018-24.
7. Carlson SM, Moses LJ, Breton C. How specific is the relation between executive function and theory of mind? Contributions of inhibitory control and working memory. Infant Child Dev 2002;11:73-92.
8. Wellman H. The Child's Theory of Mind. Cambridge, MA: MIT Press/Bradford Books, 1990.
9. Perner J. Understanding the Representational Mind. Cambridge, MA: MIT Press, 1991.
10. Gopnik A. How we know our minds: The illusion of first-person knowledge of intentionality. Behav Brain Sci 1993;16:1-14.
11. Perner J, Lang B. Development of theory of mind and executive control. Trends Cogn Sci 1990;3:337-44.
12. Tager-Flusberg H, Sullivan K, Boshart J. Executive functions and performance on false belief tasks. Dev Neuropsychol 1997;13:487-93.
13. Hughes C. Executive function in preschoolers: Links with theory of mind and verbal ability. Brit J Dev Psychol 1998;16:233-53.
14. Oberauer K. Executive Functions, Working Memory, Verbal Ability, and Theory of Mind - Does it all Come Together? Mahwah, NJ: Lawrence Erlbaum Associates Publishers, 2005.
15. Carlson SM, Moses LJ, Claxton LJ. Individual differences in executive functioning and theory of mind: An investigation of inhibitory control and planning ability. J Exp Child Psychol 2004;87:299-319.
16. Moses LJ, Carlson SM, Sabbagh MA. On the Specificity of the Relation Between Executive Function and Children's Theories of Mind. Mahwah, NJ: Lawrence Erlbaum Associates Publishers, 2005.
17. Davis HL, Pratt C. The development of children's theory of mind: The working memory explanation. Aust J Psychol 1995;47:25-31.
18. Keenan T. Memory span as a predictor of false belief understanding. NZ J Psychol 1998;27:36- 43.
19. Gordon AC, Olson DR. The relation between acquisition of a theory of mind and the capacity to hold in mind. J Exp Child Psychol 1998;68:70-83.
20. Keenan T. Mind, Memory, and Metacognition: The Role of Memory Span in Children's Developing Understanding of the Mind. Malden, MA: Blackwell Publishing, 2000.
21. Perner J, Stummer S, Lang B. Executive Functions and Theory of Mind: Cognitive Complexity or Functional Dependence? Mahwah, NJ: Lawrence Erlbaum Associates Publishers, 1999.
22. Carlson SM, Moses LJ. Individual differences in inhibitory control and children's theory of mind. Child Dev 2001;72:1032-53.
23. Hala S, Hug S, Henderson A. Executive function and false-belief understanding in preschool children: Two tasks are harder than one. J Cogn Dev 2003;4:275-98.
24. Baron-Cohen S. Is Asperger Syndrome/highfunctioning autism necessarily a disability? Dev Psychopathol 2000;12:489-500.
25. Ozonoff S, Pennington BF, Rogers SJ. Executive function deficits in high-functioning autistic individuals: Relationship to theory of mind. J Child Psychol Psychiatry 1991;32:1081- 105.
26. Buitelaar JK, Van der Wees M, SwabbBarneveld H, Van der Gaag RJ. Theory of mind and emotion-recognition functioning in autistic spectrum disorders and in psychiatric control and normal children. Dev Psychopathol 1999;11:39-58.
27. Fahie CM, Symons DK. Executive functioning and theory of mind in children clinically referred for attention and behavior problems. J Appl Dev Psychol 2003;24:51-73.
28. Hughes C, Dunn J, White A. Trick or treat? Uneven understanding of mind and emotion and executive dysfunction in "hard-to-manage" preschoolers. J Child Psychol Psychiatry 1998;39:981-94.
29. Cicchetti D, Rogosch FA, Maughan A, Toth SL, Bruce J. False belief understanding in maltreated children. Dev Psychopathol 2003;15:1067-91.
30. Pears KC, Fisher PA. Emotion understanding and theory of mind among maltreated children in foster care: Evidence of deficits. Dev Psychopathol 2005;17:47-65.
31. Roebuck T, Mattson S, Riley E. Behavioral and psychosocial profiles of alcohol-exposed children. Alcohol Clin Exp Res 1999;23:1070-6.
32. Thomas S, Kelly S, Mattson SN, Riley EP. Comparison of social abilities of children with Fetal Alcohol Syndrome to those of children with similar IQ scores and normal controls. Alcohol Clin Exp Res 1998;22:528-33.
33. Coggins TE, Olswang LB, Olson HC, Timler GR. On Becoming Socially Competent Communicators: The Challenge for Children with Fetal Alcohol Exposure. San Diego, CA: Academic Press, 2003.
34. Timler GR, Olswang LB, Coggins TE. "Do I know what I need to do?" A social communication intervention for children with complex clinical profiles. Lang Speech Hear Serv Sch 2005;36:73-85.
35. Rasmussen C, Bisanz J. Executive functioning in children with Fetal Alcohol Spectrum Disorder: Profiles and age-related differences. Child Neuropsychol 2009;15: 201-15.
36. Schonfeld AM, Paley B, Frankel F, O'Connor MJ. Executive functioning predicts social skills following prenatal alcohol exposure. Child Neuropsychol 2006;12:439-52. 37. Astington JW, Jenkins JM. A longitudinal study of the relation between language and theory of mind development. Dev Psychol 1999;35:1311- 20.
38. Hughes C, Dunn J. Understanding mind and emotion: Longitudinal associations with mental state talk between young friends. Dev Psychol 1998;34:1026-37.
39. Ruffman T, Slade L, Rowlandson K, Rumsey C, Garnham A. How language relates to belief, desire, and emotion understanding. Cogn Dev 2003;18:139-58.
40. Happe F. The role of age and verbal-ability in the theory of mind task-performance of subjects with autism. Child Dev 1995;66:843-55.
41. Tager-Flusberg H, Joseph RM. How language facilitates the acquisition of false-belief understanding in children with autism. In: Astington JW, Baird JA, eds. Why Language Matters for Theory of Mind. New York: Oxford University Press, 2005:298-318.
42. Chandler MJ, Fritz AS, Hala SM. Small scale deceit: Deception as a marker of 2-, 3- and 4- year-olds' early theories of mind. Child Dev 1989;60:1263-77.
43. Milligan K, Astington JW, Dack LA. Language and theory of mind: Meta-analysis of the relation between language ability and falsebelief understanding. Child Dev 2007;77:622- 46.
44. Astley S, Clarren S. Diagnostic Guide for Fetal Alcohol Syndrome and Related Conditions: The 4-digit code (2nd ed.). University of Washington, Seattle: FAS Diagnostic and Prevention Network, 1999.
45. Astley S. Diagnostic Guide for Fetal Alcohol Syndrome and Related Conditions: The 4-digit code (3rd ed.). University of Washington, Seattle: FAS Diagnostic and Prevention Network, 2004.
46. Wimmer H, Perner J. Beliefs about beliefs: Representation and constraining function of wrong beliefs in young children's understanding of deception. Cognition 1983; 13:103-28.
47. Kochanska G, Murray K, Jacques TY, Koenig AL, Vandegeest KA. Inhibitory control in young children and its role in emerging internalization. Child Dev 1996;67: 490-507.
48. Pickering SJ, Gathercole SE. Working Memory Test Battery for Children. London: The Psychological Corporation, 2001.
49. Baron-Cohen S, Leslie AM, Frith U. Does the autistic child have a “theory of mind”? Cognition 1985;21:37-46.
50. Wellman HM, Cross D, Watson J. Meta-analysis of theory-of-mind development: The truth about false belief. Child Dev 2001;72:655-84.
51. Stigler JW, Miller KF. A good match is hard to find: Comment on Mayer, Tajika, and Stanley (1991). J Educ Psychol 1993;85:554-9.
52. Fisher N, Happe F. A training study of theory of mind and executive function in children with autistic spectrum disorders. J Autism Dev Disord 2005;35:757-71.