Research Reports - Theory of mind in children with traumatic brain injury

J Int Neuropsychol Soc. 2012 Sep;18(5):908-16

Dennis M, Simic N, Gerry Taylor H, Bigler ED, Rubin K, Vannatta K, Gerhardt CA, Stancin T, Roncadin C, Yeates KO

Theory of mind (ToM) involves thinking about mental states and intentions to
understand what other people know and to predict how they will act. We studied
ToM in children with traumatic brain injury (TBI) and age- and gender-matched
children with orthopedic injuries (OI), using a new three-frame Jack and Jill
cartoon task that measures intentional thinking separate from contingent task
demands. In the key ToM trials, which required intentional thinking, Jack
switched a black ball from one hat to another of a different color, but Jill did
not witness the switch; in the otherwise identical non-ToM trials, the switch was
witnessed. Overall accuracy was higher in children with OI than in those with
TBI. Children with severe TBI showed a larger decline in accuracy on ToM trials,
suggesting a specific deficit in ToM among children with severe TBI. Accuracy was
significantly higher on trials following errors than on trials following correct
responses, suggesting that all groups monitored performance and responded to
errors with increased vigilance. TBI is associated with poorer intentional
processing in school-age children and adolescents relative to peers with OI;
furthermore, children with TBI are challenged specifically by intentional
demands, especially when their injury is severe.
 

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