Theory of mind acquisition in children who are deaf: The importance of early identification and communication access

Objectives: The aim of this study was to compare Theory of Mind (ToM) acquisition in typically-hearing preschool-age children (TH), and deaf children of hearing parents (DCHP) who received a cochlear implant by 18 months of age, to determine if early access to spoken language via a cochlear implant affected ToM acquisition. Methods: Participants included 25 children with cochlear implants ages 3.0 to 6.5 years and 25 age-matched children with TH all of whom were enrolled in preschools with typical peer models. The test battery included measures of expressive and receptive language and ToM. Results: There were no differences between DCHP and TH peers on language or ToM performance. Hearing age was significantly different; DCHP had been exposed to spoken language for less time than their hearing counterparts by approximately 12 months. Language skills were correlated with ToM after controlling for chronological age. Discussion: Early cochlear implantation may ameliorate some of the deleterious effects of congenital, profound deafness on oral language development; this could positively influence the development of social cognition. Conclusions: Children who are deaf who receive a cochlear implant early and who have good oral language skills are more likely to acquire ToM in a typical time frame. Key words: Cochlear implants, theory of mind, social cognition, languag