Understanding minds: early cochlear implantation and the development of theory of mind in children with profound hearing impairment.
OBJECTIVE
The present study investigates how auditory stimulation from cochlear implants (CI) is associated with the development of Theory of Mind (ToM) in severely and profoundly hearing impaired children with hearing parents. Previous research has shown that deaf children of hearing parents have a delayed ToM development. This is, however, not always the case with deaf children of deaf parents, who presumably are immersed in a more vivid signing environment.


METHODS
Sixteen children with CI (4.25 to 9.5 years of age) were tested on measures of cognitive and emotional ToM, language and cognition. Eight of the children received their first implant relatively early (before 27 months) and half of them late (after 27 months). The two groups did not differ in age, gender, language or cognition at entry of the study. ToM tests included the unexpected location task and a newly developed Swedish social-emotional ToM test. The tests aimed to test both cognitive and emotional ToM. A comparison group of typically developing hearing age matched children was also added (n=18).


RESULTS
Compared to the comparison group, the early CI-group did not differ in emotional ToM. The late CI-group differed significantly from the comparison group on both the cognitive and emotional ToM tests.


CONCLUSIONS
The results revealed that children with early cochlear implants solved ToM problems to a significantly higher degree than children with late implants, although the groups did not differ on language or cognitive measures at baseline. The outcome suggests that early cochlear implantation for deaf children in hearing families, in conjunction with early social and communicative stimulation in a language that is native to the parents, can provide a foundation for a more normalized ToM development.
Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden; The Swedish Institute for Disability Research, Linköping University, Linköping, Sweden. Electronic address: anett.sundqvist@liu.se.
Annette
A
Sundqvist
Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden; The Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
Björn
B
Lyxell
Sahlgrenska University Hospital, Department of Otolaryngology and The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Radoslava
R
Jönsson
Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden; The Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
Mikael
M
Heimann
D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000379:methods*; D003054:Cochlear Implants; D003071:Cognition / Q000502:physiology; D015331:Cohort Studies; D032882:Comprehension; D003638:Deafness / Q000523:psychology* / Q000601:surgery*; D005260:Female; D034381:Hearing Loss / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007805:Language Development Disorders / Q000175:diagnosis* / Q000523:psychology; D008297:Male; D009483:Neuropsychological Tests; D019986:Persons with Hearing Disabilities; D011788:Quality of Life; D018570:Risk Assessment; D013548:Sweden; D056345:Theory of Mind; D013997:Time Factors; D016896:Treatment Outcome; D014705:Verbal Behavior / Q000502:physiology
Cochlear implants; Theory of mind