Why is developing Theory of Mind important for speech therapy?

As adults we understand that others have emotions, we comment on this to show we understand and respond to their needs (most of the time!). Being able to do this is called having a theory of mind (ToM).

Theory of Mind skills are directly related to mental state, emotional vocabulary and grammar skills.

In light of recent research, the speech and language therapy profession has become increasingly interested in the development of these skills in very young children and the relationship these skills have to language impairments.

What group of children might struggle to develop Theory of Mind

Children with autism are known for having social communication difficulties and deficits in theory of mind, meaning that they find it challenging to see the world from another person’s perspective. However other groups of children can have challenges here too including children with language impairments, deafness and attention-deficit disorder.

Early development of Theory of Mind

Traditionally it was thought that ToM developed when a child was around 4 or 5 years of age, however recent research has highlighted that babies start to develop this from the moment they are born with the help of their caregivers. For example, babies will attempt to copy mouth and facial expressions of their caregivers, demonstrating that they are starting to understand a world outside of their own minds. These very early communication exchanges are thought to lay the foundations for theory of mind and mark the start of a child’s journey to becoming aware of others. (Gallagher & Hutto, 2008)

At this stage you will recognize the sort of games that parents play with children e.g. peek a boo or engaging with and playing with a toy together. It is here that we learn to pay attention to what someone else is looking at or ask for their shared attention when looking at something. If at this stage a child is struggling, over emphasizing your emotions can help with engagement Gutstein (2009) as children with ToM deficits may need more than just subtle clues.

It can sometimes be challenging to bring a child’s attention away from what they want to focus on, so starting from their point of interest will work better and if so, intruding on their play, holding desired items out of reach and supporting them in getting used to another presence might help.

Moving on from joint attention and engagement.

At around 18 months to four years of age children will start to develop a sense of self and pretend play. Having a sense of self is a building block for ToM as it is the point at which children will start to understand that others have different likes and desires and they are separate from those around them. We can support children at this stage by encouraging pretend play e.g. pretend to eat a plastic cookie or take on roles in play e.g. the mummy or the daddy. Reading the same story over and over again and using props and then guiding creativity and pretending within the story.

Understanding those around us

Between four and five years of age, it is thought that children will start to develop skills in reflecting on what someone else is thinking or feeling. The ability to understand emotions develops so that social emotions such as embarrassment, guilt, pride and shame start to be understood.  At around 2-3 years of age children will show emotions such as guilt or regret. Around 5 years they might be able to imagine situations where these emotions would be felt, but it is not until they are 7 years old that they can describe contexts where these emotions are experienced. (Harris, Olthof, Terwogt, & Hardman, 1987)

Children who are exposed to lots of reflective talk about emotions tend to have stronger skills in this area. For example, commenting on the emotions of people around you and explaining why they might feel the way they do, can help your child to tune in and develop stronger ToM skills.

Books can also support this, for example, The Doghouse (Thomas, 2008) asks children to think about what they think the animals might be feeling and thinking.

Ability to anticipate the thoughts and actions of others

In later development children will start to predict what one person is thinking or feeling about what another person is thinking of feeling! As adults this is not always something that we have mastered 100 percent! Just think about miscommunications between couples! However, this skill starts to develop after age 7. Here children start to become aware of lies, sarcasm and figurative language (where what is said is not what is meant) e.g. ‘watch your back!’

Having an idea of how theory of mind develops can help us to support children’s emotional development, can give them opportunities to learn how to engage, share attention and develop their emotional vocabulary.

As adults, we are constantly learning about other people’s mental states. The things that help us develop as adults will also support children. For example, increasing our exposure to situations and opportunities for learning about mental states, talking openly about these and reflecting on them, be that through real life experiences, movies or books.

ToM can be a fun area to work with your child whilst supporting their language skills along the way!

In the next blog you will be provided with even more ideas and practical tips how to develop ToM! 

Written by Carolyn Fox, Children's speech and language therapist.

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