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Theory of Mind in Children with Traumatic Brain Injury

  • Maureen Dennis (a1) (a2), Nevena Simic (a1) (a3), H. Gerry Taylor (a4), Erin D. Bigler (a5) (a6), Kenneth Rubin (a7), Kathryn Vannatta (a8) (a9), Cynthia A. Gerhardt (a8) (a9), Terry Stancin (a4) (a10), Caroline Roncadin (a11) and Keith Owen Yeates (a8) (a9)...

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. (JINS, 2012, 19, 1–9)

Corresponding author
Correspondence and reprint requests to: Maureen Dennis, Department of Psychology, The Hospital for Sick Children, 555 University Avenue, Toronto, ON. Canada, M5G 1X8. E-mail:
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