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Theory of Mind in Children: Implications for Social Success and Hearing Loss
Theory of Mind in children is the ability to recognize that other people have their own thoughts, feelings, beliefs, and perspectives. These skills aid children to build friendships, understand feelings, overcome social challenges, and increase reading comprehension. Children with hearing loss generally have a different development of Theory of Mind, because they do not have the opportunity to overhear discussions in everyday situations.
Why do some kids understand how someone else feels so well while others have a hard time making friends, having conversations, or reading social situations? The answer often involves Theory of Mind in children. As children develop, they learn that other individuals think differently than they do. These perspective-taking skills help us with communication, relationships and achievement in the classroom. Adults can help children with hearing loss develop Theory of Mind through regular interactions, shared reading, and social experiences.
The building blocks of social skills for children with hearing loss illustrate the progression from foundational self-concept and theory of mind to successful relationship development. Credit: Supporting Success for Children with Hearing Loss
Ingredients for Social Communication
- Pragmatic Language
- Pragmatics Checklist: Ages 2.5 to 7 years
- Self-Concept
- Theory of Mind
What is Theory of Mind?
The ability to take someone else’s perspective. It includes the awareness that a situation may not look the same to another person AND the ability to view a scene from someone else’s viewpoint. It includes social cognition, or being able to ‘read’ what someone is thinking or feeling from their expressions and body language.
Theory of Mind includes:
(1) Recognizing others’ feelings
(2) Thinking about consequences of actions
(3) Recognizing that someone else may be thinking or feeling differently than you do
Why Theory of Mind in Children Matters
Theory of Mind affects much more than friendship. At school, children use these skills every day to follow discussions, to recognize feelings, to predict how others might react, to manage social difficulties, and to understand characters when they read. Theory of mind development in children helps them to be successful in school and to have healthy social relationships.
How Theory of Mind (TOM) Supports Learning and Social Success
• READING COMPREHENSION
• SOCIALIZATION
Why Theory of Mind in Children with Hearing Loss May Develop Differently
- Even when they have good language skills, many children with hearing loss lag 3.5 years behind children with typical hearing in their ability to identify and describe the feelings of others, which is foundational to TOM development.
- Research with 12-year-olds comparing children with typical hearing to those with hearing loss found that the TOM skills of a child with hearing loss were similar to those of a 6-year-old with typical hearing.
- There is a correlation between language level and understanding false beliefs that is due to diminished exposure to interactive conversations from a young age. Children who are ‘Deaf of Deaf’ do not appear to have TOM issues.
- For more in-depth information on TOM, go here and here.
Assessing Theory of Mind
- For ages 4-6, but can be administered to older children.
Summary of Pragmatic Development + Theory of Mind Hierarchy 6 months – 8 years
The Social Language Development Test – Elementary is designed to assess language-based skills of social interpretation and interaction with friends, skills found to be most predictive of social language development.
Theory of Mind Assessment Tools
The Social Language Development Scale includes items specific to Theory of Mind development and provides an overview of pragmatics, social cognition, and theory of mind use for children starting at age 6.
The Theory of Mind Inventory is a parent-completed assessment instrument for children ages 2-17.
Subscribe to the ToMI-2 Trial! ToMI-2: Nationally-normed and criterion-referenced Theory of Mind Assessment: easy-to-use broadband measure for research, diagnosis, screening, and treatment planning. Image Credit: theoryofmindinventory.com
The ToMI-2 consists of 60 items designed to tap a wide range of social cognitive understandings. The ToMI-2 is designed to tap a wide range of theory of mind competencies; thus, it may be particularly helpful for identifying areas of strength and weakness in an individual’s social-cognitive profile, and it can be used to identify developmentally appropriate targets for treatment.
This well-validated parent-informant measure is designed to assess a wide range of theory of mind competencies; it does not suffer from a ceiling effect when administered to individuals with autism spectrum disorder, and it is not vulnerable to test-practice effects and child linguistic, cognitive, and motivational factors. This assessment tool is also available in 12 languages. Subscribe to the ToMI – Free Trial (password is tomi-ft)
Theory of Mind Atlas. Sign up for a free account to get access to the Atlas. Image Credit: theoryofmindinventory.com
Example TOMI report. Free Theory of Mind Atlas!
Theory of Mind Inventory CEU courses are available.
ARTICLE: Using the Theory of Mind Inventory to Detect a Broad Range of Theory of Mind Challenges in Children with Hearing Loss: A Pilot Study. ToMI-2 results revealed a wide variation of ToM strengths and challenges both within and between individuals. ToMI-2 scores also positively correlated with scores for hearing vocabulary and a test of pragmatic language development and negatively correlated with the age of cochlear implantation. The results are encouraging for the use of the ToMI-2 to detect ToM challenges in children with hearing loss.
Look here for worksheets you can use to develop social cognition and recognize emotions.
How Theory of Mind Develops in Children
Early Development (Ages 2-5)
- By age 2, children can understand that people will feel happy if they get what they want and will feel sad if they do not. They may see that what they want is different from another’s wants.
- 2-year-olds talk about what they and others want and like and feel.
- 3-year-olds also talk about what people think and know.
- Precursors: Knowing that feelings can be associated with stimuli. (get a gift, feel happy) (typically by age 5-6)
Growing Perspective-Taking (Ages 6-8)
- First Manifestations: you can act differently than you feel (hurt person laughing) (typically age 7-8)
Advanced Social Thinking
- More Advanced: understanding humor (typically age 11-12)
These are the building blocks of Social Cognition, which is being able to ‘read’ what people are thinking or feeling by their facial expressions and body language.
Activities That Build Theory of Mind in Children
- Talking about misunderstandings
- Talking about why jokes are funny
- Engaging in rich pretend play
- Talking about people’s thoughts, wants, feelings, and WHY they act the way they do
- Reading stories with surprises, mistakes, secrets; invite children to see things from a different point of view
- Vocabulary: Emotions! Thinking words (suppose, think, imagine…)
How Parents and Teachers Can Support Theory of Mind in Children
At Home
- Read stories together.
- Talk about feelings.
- Ask perspective-taking questions.
- Encourage pretend play.
At School
- Discuss characters’ motivations.
- Teach emotion vocabulary.
- Use role-playing activities.
- Encourage cooperative learning.
Theory of Mind in Children: Key Takeaways
- Theory of Mind helps children understand other people’s thoughts and feelings.
- Perspective-taking supports friendships, reading comprehension, and communication.
- Children with hearing loss may need additional support developing these skills.
- Parents and educators can intentionally strengthen Theory of Mind through everyday conversations and play.
- Early support improves long-term social success.
Frequently Asked Questions About Theory of Mind in Children
What is Theory of Mind in children, and why is it crucial for development?
Theory of Mind in children is the cognitive ability to understand that other people have thoughts, feelings, beliefs, and motivations that differ from one’s own. It enables children to predict how someone else will act, understand non-verbal social cues, display empathy, and build healthy peer relationships.
Why do children with hearing loss often experience delays in Theory of Mind?
Theory of Mind relies heavily on incidental listening, spontaneously overhearing adult discussions, background chatter, and emotional updates in everyday conversations. DHH children frequently miss these subtle background dialogues. Without intentional access to social language, they have fewer opportunities to naturally observe how others think and feel.
How does Theory of Mind directly impact reading comprehension?
Reading comprehension requires more than just decoding words; it demands perspective-taking. Children rely on Theory of Mind in children to analyze storybook characters, infer unspoken motives, understand plot twists, and grasp why characters experience specific emotions. Strengthening ToM skills directly boosts a student’s literacy performance.
What are the key stages of Theory of Mind development by age?
Theory of Mind develops through a progressive series of developmental milestones:
| Developmental Stage | Typical Age Range | Key Social Cognition Ability |
| Early Awareness | Infant – Toddler | Recognizing basic emotions in others and understanding simple desires (e.g., “She wants that toy”). |
| Diverse Beliefs | Ages 3 – 4 | Understanding that two people can hold different beliefs about the same event or situation. |
| False-Belief Understanding | Ages 4 – 5 | Realizing that someone can hold a belief that is factually incorrect (the classic ToM benchmark). |
| Advanced Social Cognition | Ages 6+ | Decoding subtle social nuances, sarcasm, white lies, figure-of-speech metaphors, and complex empathy. |
How can parents and teachers actively build Theory of Mind skills at home and school?
To accelerate perspective-taking skills, especially for DHH students, educators and families should deploy this three-step support framework:
- Use Explicit Emotion Vocabulary & Visual Cues:
- Language & Cues.
- Do not assume a child understands an adult’s reaction. Explicitly name emotions and use visual signifiers, emotion charts, or clear facial expressions to make internal thoughts visible.
- Ask Perspective-Taking Questions During Storytime:
- Literacy Practice.
- Pause while reading or viewing media to ask open-ended reflection questions like: “Why do you think he did that?” or “How do you think she feels right now, and why?”
- Utilize Role-Playing and Cooperative Group Work:
- Play & Interaction.
- Encourage pretend play, drama activities, and structured small-group tasks that require children to negotiate, take turns, and consider their peers’ points of view.
What standardized assessments measure Theory of Mind in children?
When educators or speech-language pathologists suspect gaps in social cognition, they turn to validated assessment tools. Common evaluations include the Theory of Mind Inventory (ToMI-2), Wellman and Liu’s Theory of Mind Scale, and custom false-belief tasks. These tools pinpoint specific gaps in perspective-taking, allowing intervention teams to tailor targeted IEP goals.
Additional Resources:
- Understanding Theory of Mind in Deaf and Hard of Hearing Individuals: Insights from Dr. Carol Westby and Dr. Tiffany Hutchins
- Social Skills
- Key Factors in Language, Social, and Developmental Outcomes
- Self-Esteem and Fitting In: Supporting DHH Students
- Social Needs & “I hate my hearing aids.”
- Social Communication – Pragmatics
- Summer Camps for DHH Children
Continue Learning About Self-Confidence and Self-Concept
- How They See Themselves: Self-Concept in Children with Hearing Loss
- Self-Concept in Early Childhood
- Self-Concept in School-Age Children
- Self-Identity and Hearing Loss
- Building Self-Esteem and Addressing Issues of Fitting In
- Self-Advocacy Skills for Students with Hearing Loss
Posted by Karen L. Anderson, PhD, Supporting Success for Children with Hearing Loss, February 17, 2012.
Last Update: July 2026.
