THEORY OF MIND: LANGUAGE AND AUTISM

By definition, Theory of Mind (ToM) is the ability to attribute mental states – beliefs, intents, desires, pretending, knowledge, etc. — to oneself and others and to understand that others have beliefs, desires, intentions, and perspectives that are different from one’s own. It enables one to understand that mental states can be the cause of—and thus be used to explain and predict—the behavior of others.

Simply put, Theory of Mind is the ability to understand the mental state of others i.e. it is the ability to put yourself in the mind of another person- to have a theory (here, referring to a person’s tacit belief rather than theory in the scientific sense) about their state of mind.

Theory of mind forms a basis for a child’s acquisition of language and the development of appropriate social behavior and skills. The earliest stages of communication depend on the infant’s interest in and engagement with other social individuals with minds, and it is through these interactions that children begin to learn words and meanings. The continuing interactions become enormously enriched by language, leading to greater understanding of the perspectives people bring to conversation. More conversation in rich social contexts allows for mental state words (think, pretend, forget) to emerge. Being able to talk about minds leads to a richer theory, one that continues to help make sense of social situations. It is through this greater comprehension, and the parallel development in metalinguistic skills, that children become capable of really understanding, and using, nonliteral language, such as jokes, metaphors, irony, sarcasm, and lies (de Villiers, de Villiers, ColesWhite, & Carpenter, 2009; Happe, 1995; ´ Tager-Flusberg, 2000). A mature ToM thus helps in the later pragmatic language developments.

Theory of mind is involved in all aspects of daily living and social interactions. It underlies learning and teaching and the ability to follow directions and understand socially based information. ToM skills are essential for working cooperatively. They also underlie the ability to manipulate and deceive others. A lack of ToM skills is considered by many to be a core deficit in autism.

Authors have coined the term ‘mindblindness’ to describe this inability to attribute mental states. They say that mindblindness is what leads to a profound lack of insight into the nature of normal social interactions and that this lack of insight would lead to limited social relationships (Rutter & bailey, 1994). Autistic children lack not only social insight, they also lack normal social communication skills, and have problems with playful imagination (Firth, 2000). Consistent with this finding, children with autism who pass the ToM tasks tend to have higher levels of verbal ability than those who fail such tasks (Eisenmajer & Prior, 1991, Happe, 1995). Thus, this goes to show a correlation between ToM and the different aspects of social, language, and cognitive skills.

Theory of mind development begins early in life, as does the shift from the typical course of development that is seen in children across the autism spectrum. At 5 months of age, typical children can recognize different facial expressions, but understanding the meaning occurs a few months later. Once young children are able to reliably interpret the facial expressions of others, they begin to use this nonverbal information to guide their behavior. For example, a toddler may look at his mother’s face for cues about whether it is safe to approach an unfamiliar person. Dawson and Osterling (1994) studied videotapes of first birthday parties of typical children and children who later received a diagnosis of Autistic Disorder and found that the best predictor of future diagnosis was lack of attention to the face of others.

Intention, or acting in a particular way either consciously or unconsciously to bring about a desired outcome, is also an early marker of ToM development. Within the first year of life infants come to understand that the behavior of others is goal-directed. Children with autism spectrum tend to use people as objects. For example, they may grab an adult’s hand and use it to reach a desired item. Intentional communication begins in infancy in the form of gestures and moves to simple language. Joint attention is a form of intentional communication and refers to behaviors such as pointing to or bringing an object of interest to another person to share enjoyment, or changing eye gaze to share attention with another. Children with autism are less likely to use joint attention, but may point to request an object. In addition, the use of gestures to communicate is often strikingly absent in people with autism spectrum disorders across ages.

Typically developing 2-year olds engage in pretend play and demonstrate some understanding of pretense. 2-year olds with autism usually do not engage in pretend or imaginative play; rather, their play tends to be limited to the exploration of the physical aspects of toys. Children with autism rarely imagine an object to be something that it is not (e.g., pretending a block is a car). At approximately 2 years of age, typical children can predict what other people may want, and that this may be different from their own wants. Children with autism have less difficulty understanding simple desires compared to other mental states such as beliefs, but they still lag behind their typical peers in this area of development (Baron-Cohen, 1993).

Around 3-4 years old, children start demonstrating pretend play in which they take on the roles of others (Nicolopoulou & Richer, 2007).
At 4-years old, typically developing children start to understand that others can hold beliefs that are different from reality (false-belief). Whereas various studies have shown that the majority (around 80%) of children with autism, even those with average intelligence, fail to understand this false-belief. (Baron-Cohen, 1993). 4 -year olds also start to talk about the mental states of characters in stories they tell (Nicolopoulou & Richner, 2007). They begin to use words that represent internal states, such as know, forget, think, and remember (Owens, 2012) which are not observed in children with autism.
By 5 years old, children can accurately identify many of the emotions people might have in specific situations (Michalson, L. & Lewis, M., 1985) whereas for individuals with autism, difficulties with emotional understanding persist throughout life.

Here are some simple things you can do at home with your child to promote his or her ToM:

• Follow your child’s lead – In order to tune-in, children need to be paying attention to other people. This can’t happen if you are talking about or playing with things that your child is not interested in or attending to. Observe your child’s interests and then get down to his or her physical level so that you are face-to-face. This will help your child pay attention to you and tune-in to your facial expression. Give up your ideas of what he should do or how he should play, and join in his play by copying his actions and adding to his or her play ideas. Once you are paying attention to the same thing, you will have an opportunity to use “tuning-in” language.
• Use “tuning-in language” – This means putting your own and your child’s perspective into words. Imagine what your child is wanting, thinking or feeling, and say something about it, like “oh, you want a cookie”, “Don’t worry. You thought I was gone, but I’m here!”, or “I’m upset because you threw your toy”. You can also explain why other people do the things they do – for example, “Sally looks happy. She must really like her present”.
• Role play with your child when you pretend together – Role play helps develop ToM because it encourages children to think about and act out other peoples’ perspectives. When children first learn to role play, they pretend to be individuals whom they have experienced in everyday life, like pretending to be Mommy, a doctor, bus driver or teacher. Stay in role when you role play together. For example, if you are pretending to be a doctor and your child is the patient, say and do things a doctor would do, and avoid being a real-life parent for the moment.

Every time you interact with and talk to your child, you have an opportunity to put into words what you are both thinking and feeling. These types of conversations will deepen his understanding of his own thoughts and feelings, how others may have different thoughts and feelings from his own, and how we all act based on what we are thinking and feeling.

• ntz, J. (2002). Theory of mind in autism: Development, implications, and interventions. The Reporter, 7(3), 18-25.
• Theory of mind, language, and conversation – www.talkingkids.org
• Resches & Perez Pereira (2007). Referential communication abilities and Theory of Mind development in preschool children. Journal of Child Language, 23, 291-239.
• Lauren Lowry. “Tuning In” to Others: How Young Children Develop Theory of Mind. The Hanen Centre.