2023 Early Hearing Detection & Intervention Conference

March 5-7, 2023 • Cincinnati, OH

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3/19/2018  |   2:15 PM - 3:15 PM   |  Theory of Mind Development in Children who are Hard of Hearing: Understanding False Belief   |  Capitol 3

Theory of Mind Development in Children who are Hard of Hearing: Understanding False Belief

In late preschool, children advance in their understanding that people have thoughts, beliefs, and feelings that guide how they respond to situations and to others. This ability to understand self and others is often referred to as a “theory of mind” (ToM); it provides children with powerful tools for navigating their social world. False belief understanding involves knowing that people act on what they believe, even if incorrect (e.g., dad trying to take a bite from a plastic apple because he thought it was real). This aspect of ToM emerges around 5 years of age. Previous studies show that deaf children from hearing families are often delayed in understanding false belief, while deaf children who have Deaf parents achieve false belief at expected ages. These findings suggest a key role for language access in the development of ToM concepts. The current study examined false belief development in children who are hard of hearing (CHH), to address a gap in the literature, and to further understand the role of language access in ToM development. False belief concepts were examined in CHH learning spoken language compared to hearing peers (HP) at 5 (n=142 CHH, 57 HP) and 6 years of age (n=50 CHH, 6 HP), and again at second grade (n=80 CHH, 43 HP). Results suggest that CHH are delayed in false belief understanding in preschool, but by second grade, they did not differ from hearing peers. Mechanisms that may explain these results will be explored. Strategies for promoting the development of theory of mind concepts in young children who are deaf or hard of hearing will be discussed. Strategies parents can use at home to encourage children’s social understanding of others will be emphasized.

  • Participants will list three major conclusions from studies of theory of mind development in children who are hard of hearing.
  • Participants will identify four early experiences that promote theory of mind development in young children who are deaf or hard of hearing.
  • Participants will identify three coaching strategies for supporting families in promoting theory of mind development in young children who are deaf or hard of hearing.

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Presenters/Authors

Mary Pat Moeller (), Director, Center for Childhood Deafness, Language & Learning at Boys Town National Research Hospital , marypat.moeller@boystown.org;
Mary Pat Moeller, Ph.D. is the former Director of the Center for Childhood Deafness, Language & Learning and the Language Development Laboratory at Boys Town National Research Hospital in Omaha, Nebraska. Her research explores factors influencing the outcomes of children who are deaf or hard of hearing. She was co-principal investigator with J. Bruce Tomblin of an NIH-funded, prospective, multi-site, longitudinal study of spoken language development in children who are hard of hearing. Dr. Moeller conducted NIH-funded health communication research related to Newborn Hearing Screening and early intervention. She and her colleagues at Boys Town National Research Hospital developed parallel websites (www.babyhearing.org and www.audiciondelbebe.org) as part of their efforts to disseminate information on early identification. Dr. Moeller has published and lectured internationally on topics related to developmental outcomes and early intervention practices for children who are deaf or hard of hearing.


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Sophie E. Ambrose (), Boys Town National Research Hospital Center for Childhood Deafness, Language & Learning, sophie.ambrose@boystown.org;
Sophie E. Ambrose, Ph.D, CCC-SLP, is Director of the Communication Development Laboratory at Boys Town National Research Hospital (BTNRH). Her recent research focuses on examining the relationships between the communication development of toddlers who are deaf or hard of hearing and the communicative behaviors of their caregivers (NIDCD R03 grant). She has been a co-investigator on another NIDCD-funded grant, the Outcomes of Children with Hearing loss study, and its second grant phase, Outcomes of School Age Children who are Hard of Hearing. Her current work is designed to test the effectiveness and assess the feasibility of implementing two innovative interventions that use coaching models to support families of children who are deaf or hard of hearing. Prior to her time at BTNRH, Dr. Ambrose completed her Ph.D. under the direction of Dr. Marc Fey at the University of Kansas, and then served as a research associate in Dr. Laurie Eisenberg’s laboratory at the House Ear Institute. She completed a postdoctoral fellowship in Dr. Mary Pat Moeller’s Language Development Laboratory.


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Elizabeth Walker (), University of Iowa, Elizabeth-walker@uiowa.edu;
Elizabeth Walker, PhD, CCC-A/SLP is an assistant professor in the Department of Communication Sciences and Disorders at the University of Iowa. Her research focuses on pediatric aural habilitation, specifically examining malleable factors that relate to individual differences in speech perception and language outcomes for children who are deaf or hard of hearing. For the past few years, she has been an investigator on several NIH-funded research grants, including the University of Iowa Cochlear Implant project, Outcomes of Children with Hearing Loss study, and Complex Listening in School Age Children who are Hard of Hearing.


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