Social Inclusion /Theory of Mind: More than words and
sounds?
Anne FULCHER, Aleisha DAVIS, Katie NEAL, Tracy HOPKINS, Alyshia HANSEN,
Janna WELLER
AGBell LSLS Symposium
10th July , 2015
Baltimore, Maryland
• 45 years of service to >2000
children
• Focus on Listening and Spoken
Language
• Family-centred Transdisciplinary
• Integrated Implant and Early
Intervention Program
• Families from diverse cultural and
linguistic background
• Individual, Group and
Teleintervention Programs
• 5 Centres with services across ACT
NSW Tasmania
• Children with all range of needs,
all levels and types of hearing, all
devices options
• Currently 250 children 0-6yrs,
135 children 7yrs plus
• 45 years of service to >2000
children
• Focus on Listening and Spoken
Language
• Family-centred Transdisciplinary
• Integrated Implant and Early
Intervention Program
• Families from diverse cultural and
linguistic background
• Individual, Group and
Teleintervention Programs
• 5 Centres with services across ACT
NSW Tasmania
• Children with all range of needs,
all levels and types of hearing, all
devices options
• Currently 250 children 0-6yrs,
135 children 7yrs plus
Transdisciplinary approach to service
• Involves a team of professionals who
– work collaboratively,
– share the responsibilities of
• Evaluating, Planning, & Implementing services
– Families are valued members of the team, involved in all aspects.
– One professional is chosen as the primary service provider,
and acts as the conduit for the expertise of the team.
– The full team remains involved, and the primary provider reports back
to the team constantly.
What does this provide in context of
hearing loss ?
Pediatric Audiologists
ENT/
Medical
Specialists
Therapists/
Educators
Child and Family
Counsellors
Family Guidance in 2015?
Since 2010…
•
•
•
•
Age appropriate language AND speech
Possible by 3 years of age
Improvements by 4 and 5 years
If:
– UNHS
– 1-3-6 treatment
– CI <18m
– No other diagnosed additional needs
Fulcher, Purcell, Baker & Munro, 2012; May-Mederake, 2012; Sharma, 2009; Wie, 2010;
Keeping up with typical hearing peers
• Possible at all ages of Early Intervention,
• From birth if screening, diagnosis,
intervention happens appropriately and no
other impacting factors
• Not ‘dipping out’ of the average range
= no ‘catching up’ to do
NOT YET!
Are standardized scores enough?
• What are ‘outcomes’?
• What are our ultimate goals?
• What are the families’ ultimate goals?
What is the purpose of language?
• Definition of “successful communication”?
• IDEAs?
Well Spoken “Language”
But “COMMUNICATION”= how it is used
Social Success & Inclusion
Social Skills
What do we mean?
Social skills: ways of dealing with others to create positive
interactions; the route to creating and developing relationships
children learn social skills through experience with peers/parents;
FEATURES:
• clear communication
• consideration of feelings of others
• responsibility for actions
• able to control themselves
• able to assert themselves
(Mazarin, 2015)
“Pragmatics”
“Pragmatics”
An individual may say words clearly and use long, complex
sentences with correct grammar, but still have a
communication problem - if he or she has not mastered the
rules for social language
FEATURES:
• saying inappropriate or unrelated things during conversations
• telling stories in a disorganized way
• having little variety in language used
“Pragmatics” [HANDOUT]
3 Major Communication Skills
•
Using language for different purposes
–
–
–
–
–
•
greeting (e.g., hello, goodbye)
informing (e.g., I'm going to get a cookie)
demanding (e.g., Give me a cookie)
promising (e.g., I'm going to get you a cookie)
requesting (e.g., I would like a cookie, please)
Changing language according to the needs of a listener or situation, such as
– talking differently to a baby than to an adult
– giving background information to an unfamiliar listener
– speaking differently in a classroom than on a playground
•
Following rules for conversations and storytelling
–
–
–
–
–
–
–
taking turns in conversation
introducing topics of conversation
staying on topic
rephrasing when misunderstood
how to use verbal and nonverbal signals
how close to stand to someone when speaking
how to use facial expressions and eye contact
Theory of Mind
What is Theory of Mind?
• The ability to make inferences about the beliefs and desires of
other people
• Mentally put ourselves in another’s shoes and have a sense of
what they are thinking/feeling
Rachel knew her
mother would be
proud of her
The audiologist
wondered what her
colleagues would think of
her new haircolour??
How do they feel?
hmm
Iconic “False Belief” Task
VIDEO: Typical hearing child failing False
Belief
VIDEO: Typical hearing child passing False
Belief task
Social Skills, Inclusion & Outcomes
Research social outcomes
What can happen if our social skills; pragmatics
and ToM are compromised?
What we know…
HEARING LOSS AND MENTAL HEALTH
• poorer social relations
• varying degrees of psychological distress
• stress, anxiety, loss of security, depression,
loneliness, low self-confidence, shame, and
anger were commonly associated with living
with hearing loss
(Hogan et al.,2001).
More recently...
HEARING LOSS AND HRQoL
Over the past 10 years two population studies
have reported an association between hearingrelated social participation difficulties and
reduced HRQoL…and mental health.
Cummins’ (2010); Hogan et al. (2012)
Some encouraging news?
First Voice Social Inclusion Study
Benchmarking the social
inclusion (SI) of children
with hearing loss
educated using a
listening and spoken
language approach
Dr Gabriella Constantinescu,
A/Prof Dimity Dornan,
Dr Rebecca Phillips and
Aleisha Davis
First Voice: Who are we?
 Established in 2010 as the National Voice for member
centres whose primary focus is the provision of listening
and spoken language to children with hearing loss (HL)
 Have the largest cohort of children with HL in the world,
supporting more than 1,000 children with HL
 About 720 children in early intervention
 About 40% of children have a cochlear implant
Aims
Aim 1: To review the literature and develop a
model for defining and evaluating SI
Aim 2: To develop a purpose-designed
parent-report survey to measure SI
Aim 3: To compare the SI of young children
with HL educated using a listening and
spoken language approach with the SI of
their hearing peers
Model of SI
Overarching definition: SI refers to the connectedness of the
individual with their social setting rather than purely their
‘presence’
The 5 Faces of SI:
 Personal independence and selfdetermination
 Health and access to services
 Education
 Interacting with society and fulfilling social
roles
 Economic participation of the parent
 Education participation
 Education and skills
Model of SI
Overarching definition: SI refers to the connectedness of the
individual with their social setting rather than purely their
‘presence’
The 5 Faces of SI:
 Personal independence and selfdetermination
 Health and access to services
 Education
 Interacting with society and fulfilling social
roles
 Economic participation of the parent
 Social networks
 Social participation
 Acceptance
 Role functioning
 Behaviour
 Social resources
Online Survey
 The 5 Faces can guide the selection and development
of surveys to address the breadth of SI
 Developed an online parent-report survey about their
child’s SI related to the 2 faces of ‘Education’ and
‘Interacting with society and fulfilling social roles’
 Questions addressing the 2 Faces were selected from a national
survey – the Longitudinal Study of Australian Children (LSAC)
 This allowed benchmarking of the findings against this national
dataset
Comparing the SI
Inclusion criteria for children with HL:




Aged 4-5 years
Permanent bilateral HL
Optimally aided (hearing aids and/or cochlear implants)
Enrolled in a listening and spoken language early intervention
for a minimum of 6 months
 No physical or cognitive difficulties impacting on learning.
Inclusion criteria for typical hearing children:
 Aged 4-5 years
 No health conditions.
Demographics
Characteristics
Children with HL
(n = 78)
Typical hearing children
(n = 3,265)
Age
M = 4.93 years (SD = 0.54)
M = 4.74 years (SD = 0.22)
Gender
43 Males; 35 Females
1613 Males; 1652 Females
Amplification type
• 38 HA2 -Age at HA fitting M=1.04 years (SD=1.18)
• 14 HACI -Age at HA fitting M=1.32 years (SD=1.19)
-Age at implant M=2.50 years (SD=1.17)
• 26 CI2 -Age at 1st implant M=1.33 years (SD=1.02)
Age HL identified
M = 0.90 years (SD = 1.19)
Age enrolled in First Voice
M = 1.32 years (SD = 1.28)
Vocabulary
M = SS 95.24 (SD = 19.81)
Language
M = SS 93.07 (SD = 19.82)
Speech
M = SS 93.26 (SD = 16.42)
Assessed using
the PPVT-4
Assessed using
the PLS-4/
CELF-P/ CELF-4
Assessed using
GFTA-2
Study Findings
Overall Finding: children with HL usually demonstrated comparable
SI outcomes to typical hearing children.
Education face of SI
 Parents of children with HL were usually more likely than those of
typical hearing children to be ‘satisfied’ rather than ‘very satisfied’
with the education program (p=0.05)
 This may be due to the relationship and communication between the
parents and the teacher/school.
Implication for practice: To enhance satisfaction, clinicians may need to
guide parents in advocating for their child’s individual needs and level of
communication needed
Study Findings
Interacting with society & fulfilling social roles face of SI
 Children with HL usually had a similar level of participation in
activities as their typical hearing peers, if not better
 e.g. social activities such as sports or community events, reading a book
(p=0.004), or playing with toys or games (p=0.02).
 This may be due to parents being empowered to readily involve their child
in social activities.
 Children with HL usually had comparable behaviours, emotions and
relationships to children with typical hearing, and were usually more
likely to have appropriate conduct skills.
 This may be due to parents facilitating socially appropriate behaviours
through modelling the use of appropriate language in context.
Implication for practice: Clinicians may need to continue to empower
parents and support them in facilitating behaviours
Take home messages
Need to consider how connected a child is with their social setting rather than
their presence
The 5 Faces model can be used to guide the development of surveys to
benchmark SI
Children with HL educated using a listening and spoken language approach
usually demonstrate comparable SI outcome to typical hearing children
Findings from the First Voice Sound Connections study are currently under peerreview and implications for practice are being shared with member centres
Theory of Mind
Summary of general research in
Theory of Mind
ToM skills:
• predict several key childhood competences:
e.g., social interactional skills, and
consequently interactions and peer popularity
(Wellman & Liu, 2004)
• positively correlates with teacher ratings of
social competence (Liddle & Nettle,2006)
Theory of Mind Framework
Neuro
Linguistic
ToM
Linguistic/
Cognitive
Pragmatic
Theory of Mind Research:
1. Neuroscience:
Rebecca Saxe: How we read each other's minds | TED Talk ...
• group of brain regions in human cortex that selectively
and specifically underlie ToM skills
• more diffuse areas in children
• brain regions for Theory of Mind: how does the brain – an
electrical and biological machine – construct abstract
thoughts?
• adult moral judgements can be altered using magnetic
pulses
• little advice re optimizing these areas to date
RTPJ brain area for ToM
SAXE VIDEO snapshot
Aged 5-12 years
RTPJ brain area for ToM
“Diverse Beliefs” In ToM
Development
2. Linguistic/Cognitive View of ToM Development
• Propose interface between language/cognition development
and ToM
• From 2-4y, no research to support influence between
language/cognition and ToM
• After 4y, at false belief attainment stage, the role of the mastery
of syntactic structures indicates language development assists
ToM reasoning.
• For each ToM development, parallel language/cognition
developments can be described
Lingua. 2007 Nov; 117(11): 1858–1878. Jill de Villiers
The Interface of Language and Theory of Mind
Pragmatic Approach to ToM
3. Pragmatic Approach to Development of ToM
• propose children develop ToM through
interpersonal processes
• postulate the emergence and development of
ToM system driven by children's interactive
experiences
• examine communication between e.g., the
role/format of mother/father–child
communications
Jihyun Sung, Hui-Chin Hsub, 2014; Liszkowski (2013)
Where does it start?
VIDEO: Mother and Baby talking
Baron_Cohen,1995
Application of Theory of Mind to
Other Fields
Are humans the only ones with Theory of Mind?
Tomasello et al., 2003
M. Tomasello, J. Call, B. Hare Chimpanzees understand psychological states - the question is which ones
and to what extent Trends Cogn. Sci., 7 (2003), pp. 153–156
Application of Theory of Mind to
Other Fields
In related fields:
• Autism: Simon Baron-Cohen
• Down’s Syndrome
• Vision
• Mental Health: Schizophrenia/ Dementia
What happens if we don’t develop ToM
skills?
Video: Is it ok to lie? When?
“Imagination is more important than knowledge”
Albert Einstein
Seigal & Peterson,2003; Wellspring, 2010; Chandler, Fritz & Hala, 1989)Smallscale deceit: Deception as a marker of two- three- and four-year-olds’ early
theories of mind. Child Development.
TOM outcomes HL research
Staged Acquisition of ToM
(Wellman & Peterson, 2009)
• consistent five-step ToM stages confirmed in deaf children
• deaf children substantially delayed behind hearing children
– understanding pretending
– false belief
– other ToM concepts
• corresponded to delayed uptake of social pretend play in
the deaf children
TOM outcomes HL research
Staged Acquisition of ToM
(Wellman & Peterson, 2009)
• if social pretence understanding is included, both deaf and
hearing children’s ToM sequences shown to extend to six
sequential developmental steps.
• deaf children understood social pretending at an earlier
step in the ToM sequence than hearing children, but at later
chronological ages.
• placement of pretence relative to other ToM milestones
varied with hearing status.
TOM outcomes HL research
Systemic Acquisition of ToM Skills
• Prerequisite for passing false belief tasks is the understanding the
difference between what is said or thought may not be the truth
• Belief that language is modular and doesn’t overlap with other
cognitive processes
• Acquisition of syntactical structures impacting on way false belief
tasks are structured and results levels of syntax intimately related
to ToM development
Crain & Thornton (1998)
TOM outcomes HL research
De Rosnay
Combines 4 lines of research:
Language and conversation play a role in individual development:
1. children with advanced language skills are better at mental-state
2.
3.
4.
understanding than those without advanced language skills
deaf children born into non-signing families lag in mental-state
understanding
exposure to maternal conversation rich in references to mental
states promotes mental-state understanding
experimental language-based interventions need exploring
Harris, de Rosnay, Pons, 2005; De Rosnay & Fink, 2013;
TOM outcomes HL research
?? the mechanism by which language and conversation help
children's understanding of mental states.
3 competing interpretations:
1. lexical enrichment (the child gains from acquiring a rich
mental-state vocabulary),
2. syntactic enrichment (the child gains from acquiring syntactic
tools for embedding one thought in another), and
3. pragmatic enrichment (the child gains from conversations in
which varying perspectives on a given topic are articulated).
Pragmatic enrichment emerges as the most promising candidate.
Harris, de Rosnay, Pons, 2005; De Rosnay & Fink, 2013;
TOM outcomes HL research
• sequential progress up scale consistent across 3
disparate/contrasting cultural groups _ (e.g.,
United States vs. China vs. ‘deaf’)
• extensive delay: deaf children vs. U.S. and
Chinese preschoolers
• deaf children of DEAF parents do better?? Why?
• deaf children can continue to acquire ToM skills
up to 10 - 16 years (Wellman, Fang and Peterson, 2011)
Nicastri et al., 2014
• Unilateral CI’s vs typical hearing
• Matched for CA and language level (WNL)
• No sig. difference in ability to comprehend
inferences
• Sig. difference in ability to comprehend
figurative language/metaphors (“a stench of
failure”…)
Translational research: what were we
seeing in clinical practice?
• How do we really monitor and teach social
skills and development as part of a Listening
and Spoken Language program?
• Past parents and students qualitative
experiences and feedback and focus in area
Need for evidence
What did we do next?
ACTION!!!
Outcomes collection: Methodology
• Devised 6 step assessments
• What did it look like? _[See Ax Handout]
• Based on collaboration with Peterson/Crain
Method
• Assessment in two month window
• Graduates December 2012 (5/6yrs of age)
• 6 step Theory of Mind scale of tasks (Wellman et al., 2011)
– Each step taps into a different aspect of hierarchical
development
– No rigorous norms have been published
– Minor changes to match local experience e.g. Cheerios→
Weetbix
ToM Assessment Overview
• Description of stages
– What does each ToM stage mean?
– Can we link these ToM stages to language skills
– Video Ax examples (3)
Outcomes collection: Results
• Graduating outcomes 2012 – 2014
• Demographics
RESEARCH QUESTIONS:
• Typical vs atypical acquisition?
• Delayed vs non-delayed acquisition?
• Relationship to language skill?
• Contribution from other factors?
– SEIFA, siblings, engagement, device, language exposure, level of
hearing loss, service level, preschool/child care attendance, age of
fitting, age of entry to EI, age of diagnosis, level of listening,
Outcomes: Theory of Mind acquisition
• Initial results
consistent with
literature indicating
higher percentage of
children with atypical
acquisition.
• Significant difference
for children with
bilateral hearing loss
(p=<0.05).
Study demographics n=133
Number of Children
Grouping
Symmetry
Unilateral HL n=20 15%
Age of Children in years at assessment
Typical Hearing n=20 15%
Bilateral HL n=93 70%
Identification, Amplification,
Intervention
UHNS
referred
Bilateral
(median)
Unilateral
(median)
Bilateral
(range)
Unilateral
(range)
Identification
1mth
1mth
0-13mths
0-4mths
Amplification
4mths
31mths
0-61mths
3-74mths
Intervention
5mths
18mths
0-55mths
3-46mths
Typical or Atypical Acquisition
% Atypical acquisition
% Typical acquisition
% Typical/delayed acquisition
% Maintain typical acquisition
Atypical & Delayed
Atypical/delayed
acquisition
Typical acquisition
Does socio-economic status matter?
A changing landscape in service delivery?
What did we do about it?
• Trial program – “Thinkables”
– GOAL: Full roll out for TSC by 2015
– Normative data collection
TOM outcomes HL research
Research-Based Principles of Thinkables Program:
1. lexical enrichment (the child gains from acquiring a rich
2.
3.
mental-state vocabulary),
syntactic enrichment (the child gains from acquiring syntactic
tools for embedding one thought in another), and
pragmatic enrichment (the child gains from conversations in
which varying perspectives on a given topic are articulated).
Pragmatic enrichment emerges as the most promising candidate.
Harris, de Rosnay, Pons, 2005; De Rosnay & Fink, 2013;
PILOT: “Thinkables” Strategies
Make
Predictions
Enriched
conversations
Pretend Play
Make
Inferences
Sabotage to
stimulate
problem solving
Guessing
Narratives
Explanations
Descriptions
Persuasion
Developing
Theory of Mind
Role-playing
Humour &
Sarcasm
Give Hints
Jokes &
Riddles
Berndsen (2005). Theory of mind: implications for intervention.
Retrieved 8/03/06, from www.speechpathology.com
Discuss
emotions &
opinions
2 Pilot Studies:
“Thinkables/Listening to Learn”
PARTICIPANTS:
2 groups of 4 children aged 4 years
• 1 term/12 sessions 1/week during term
• 1 week/4 sessions in school holidays
QUANTITATIVE RESULTS:
At age 4 years: Pre – post ToM Ax indicated all children achieved 100% in ToM tasks
QUALITATIVE RESULTS:
• POST 1 term/12 sessions: “Huge difference in the areas of pragmatics; perspective
taking, tracking conversation ...” ; “Changes have been evident and significant”.
• POST 1 week/4 sessions: school holidays; my child was “over the moon to be
here”. Parents and kids all participated in activities. “It was pretty amazing to
observe changed behaviour at school”
Trial program
s
• Commitment to attend all sessions
• Should we commence at younger ages?
• Need for skilled LSLS practitioners confident
in ToM strategies
• Punctuality
• Ideal group numbers
• Capacity of TSC staff numbers
s
Roll out across 5 Centres
• Model of service delivery changed
• Processes to manage:
– Skilled staff
– Families expectations
– Preschool attendance conflicts
– Other professionals
– Teleintervention
Model of Service Delivery:
CONFIDENT KIDS INTERVENTION PROGRAM
• Available at 5 centres + teleintervention families
• 8 ToM modules
– Choice of 2 terms/different days
– 1-1 therapy not provided while attending CK sessions
• Staffing:
– CK Manager
– 2 LSLSs at each Centre
– Child and Family Counsellor at each centre
• all clinical staff received minimum monthly ongoing
training
• Information Shout Outs to families (see Handout)
Model of Service Delivery:
CONFIDENT KIDS INTERVENTION PROGRAM
• Family Handouts weekly; input from:
1. LSLSs
2. CFC
3. Audiologist
• Parents participate at the beginning and end
of each session
• 2 Guided observations via videolink for
parents to view entire session
CK Module Content
1. Key concepts addressing theory of mind being
explored in the Confident Kids program
2. Perspective Taking: We all have different likes and
dislike
3. Role Play: Pretending to be something else /Guided
Observation for families
4. Prediction and Inferring
5. Overhearing
6. Tracking Conversation
7. False Belief
8. Wrap Up Session!
Confident Kids Module 1 Videos
HANDOUT: Module 1
“A TASTE”
•
•
•
•
Greeting Song
What Could it Be _exploration+ imagination?
Story: “Not Box”
Activity: Make “Not a Box”
How can we do this in every day life?
CHIEF FOCUS of CK
• Everyday environment carryover
• ENRICHED Book reading
• Weekly Handouts_Parent Tips
[Sample of parent handout]
Confident Kids measurements
Pre and Post measures:
• ToM 6 stages of development
• Parent Questionnaires (see Handout)
(Wellman & Liu, 2009)
Confident Kids Outcomes
ALD/FM
use?
Distance
listening
Lack of
overhearing
Therapy
in noise?
Tonal
Detection
Tone of
Voice
Intonational
cues?
Use of
mental State
Language
Theory
of Mind
Parental
Input
1child/2
adults
Intervention
Concrete vs
Abstract
Opportunities
to ‘fail’
More CK
•
•
•
•
•
•
•
s
Families feeling they are missing out
Not as important as 1-1
Learning new skills for therapists and kids
Group management skills of therapists
Move away from traditional ‘therapy’
Effectively measuring outcomes
Do Ax measure what we are targeting?
What factors might impact ToM
Development?
INFLUENCING FACTORS
- additional needs
- late diagnosis
- device use
- family engagement
- presence chronic ME
- languages other than English
Next studies?
Impact of:
• Therapists trained not only in use of mental state
language/mechanisms
actively target ToM early
but in GROUP management strategies
• UNHS: 1-3-6 babies? Delayed acquisition skills may
not hamper ToM progress?
• Simultaneous bilateral CI under 12m?
• Families enabled to use ToM strategies in everyday
routines from early ages
Future Research
•
•
•
•
•
•
•
•
•
•
•
1 week intensive versus 1 term /1 per week?
ToM Strategies commenced at toddler times
Intervention study: ToM versus no treatment
Continue to look beyond traditional outcome measures – social
inclusion
Optimise access to sound – MAPping, FM use, CI with more residual
hearing/unilateral HL.. outside traditional candidacy
Change order of questions in Ax
Importance of Auditory Memory development
Facilitating parent skills/mind set
What are the pre-requisite skills in babies? Toddlers? Parents?
Other approaches to ToM development? More linguistically based?
Do children with HL focus on what they hear last for longer periods
than typically hearing peers?
Who are we here for?
Changes in intervention
• Review of services provided indicated:
– Less 1-1 intervention for older children
• Frequency reducing towards school age as skills developing
typically
– Increased focus on groups (peer and social education)
– Increased service through teleintervention
– Increased focus on ‘real life listening’ and intervention in
realistic environments (not only quiet therapy rooms)
Conclusions/Future Directions?
Keep track of our “CARBs”
• Challenge - innovations, new research and alternate ways
of delivering services, challenging their knowledge and
current clinical practice
• A-V – strictly speaking NO, but ethically correct response
to wider, whole person capabilities and parent feedback
• Revolutionise – integrate learning into clinical practice,
revolutionising how services are delivered and
revolutionising the profession as a whole.
• Broaden – ‘think outside’ the box. New evidence
and innovative and efficient ways of delivering services in
many contexts, aiming to ‘broaden’ knowledge and
optimize outcomes in broader areas
The Shepherd Centre team
Thank you to the children
and families that share their
journey with us.
We’d also like to acknowledge past
TSC staff members who have
contributed to the design and
implementation of our Theory of Mind
research
[email protected]
References
Astington JW, Jenkins JM. Theory of mind development and social understanding. Cognition and Emotion. 1995; 9:151-165.
Hughes C, Jaffe SR, Happe F, Taylor A, Caspi A, Moffitt TE. Origins of individual differences in Theory of Mind: From nature to
nurture? Child Development. 2005; 76:356-370.
Ching, T. Y. C., Crowe, K., Martin, V., Day, J., Mahler, N., Youn, S., . . . . Orsini, J. (2010). Language development and everyday
functioning of children with hearing loss assessed at 3 years of age. International Journal of Speech-Language Pathology, 12(2),
124-131.
Fitzpatrick, E. M., Crawford, L., Ni, A., & Durieux-Smith, A. (2011). A Descriptive Analysis of Language and Speech Skills in 4-to 5-YrOld Children With Hearing Loss. Ear and Hearing, 32(5), 605-616.
Fulcher, A., Purcell, A. A., Baker, E., & Munro, N. (2012). Listen up: Children with early identified hearing loss achieve ageappropriate speech/language outcomes by 3&#xa0;years-of-age. International Journal of Pediatric Otorhinolaryngology, 76(12),
1785-1794
Geers, A. E., & Sedey, A. L. (2011). Language and Verbal Reasoning Skills in Adolescents With 10 or More Years of Cochlear Implant
Experience. Ear & Hearing, 32(1) Supplement, Long-Term Outcomes of Cochlear Implantation in Early(Childhood), 39S-48S.
Olson S, Lopez-Duran N, Lunkenheimer E, Chang H, Sameroff A. Individual differences in the development of early peer
aggression: Integrating contributions of self-regulation, theory of mind, and parenting. Development and Psychopathology. 2011;
23:253-266.
Ruffman T, Slade L, Crowe E. The relation between children’s and mother’s mental state language and theory-of-mind
understanding. Child Development. 2002; 73:734-751.
Santiesteban I, Sarah White S, Cook, Gilbert S, Heyes C, Bird G. Training social cognition: From imitation to Theory of Mind.
Cognition. 2012; 122:228-235.
Schick B, de Villiers P, de Villiers J, Hoffmeister R. Language and theory of mind: A study of deaf children. Child Development.
2007; 78: 376-396.
Wellman H, Fuxi F, Peterson C. Sequential progressions in a theory of mind scale: Longitudinal perspectives. Child Development.
2011; 82(3):780-792.
Wellman H, Liu D. Scaling of theory of mind tasks. Child Development. 2004; 75:523-541.
Rebecca Saxe: How we read each other's minds | TED Talk ...
HANDOUTS
• Key references
• developmental timelines Tom acq
• developmental pragmatic scale – Yoshinago +
tsc adapted version
• module outline
• CK program questionnaire
• adapted ToM strategies
• CK parent handouts