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Nonverbal assessment of theory of mind in children with Down's syndrome: relationships between executive functioning abilities and theory of mind performance
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Nonverbal assessment of theory of mind in children with Down's syndrome: relationships between executive functioning abilities and theory of mind performance

Julia C. Snoza
Master of Science (M.S.), Drexel University
Mar 2023
DOI:
https://doi.org/10.17918/00001607
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Abstract

Cognitive flexibility Executive functions (Neuropsychology) Inhibition Philosophy of mind Down Syndrome
Children with Down syndrome (DS) show marked differences in their early development when compared to typically developing (TD) peers. Major domains of impairment include intellectual abilities, executive functioning, structural language, and Theory of Mind (ToM). ToM encompasses the ability to conceptualize and understand others' thoughts, emotions, perspectives, and intentions. In TD children, these abilities typically begin to mature around age 4-6, while in children with DS, we see delays in ToM development based on chronological age. Although these delays may be due to core social cognitive challenges, they may also be related to underlying delays in language and executive functioning skills, two domains of cognitive functioning that are heavily relied upon in traditional ToM tests. The present study sought to fill gaps in the literature by using a nonverbal assessment (The Penny Hiding Game (PHG)) to explore relationships between cognitive flexibility, response inhibition, and DS children's ToM performance. 63 participants (n=34 DS, n=29 TD) were included, and analyses were carried out to 1) compare group performance on the PHG, a largely nonverbal ToM assessment tool, and 2) explore the relationship between executive functioning skills (response inhibition and cognitive flexibility) and ToM skills. Results demonstrated a significant impairment on the PHG for the DS group when compared to the younger, developmentally similar TD group [F(1, 60)= 5.60, p= .021, [eta][p]²=.085]. In contrast, no statistically significant associations between the PHG and tasks of inhibition or cognitive flexibility emerged. However, an association of medium effect which approached statistical significance was observed between the PHG and the cognitive flexibility task ([beta]=.364, t=1.98, p=.058), such that stronger PHG performance was associated with stronger cognitive flexibility skills. These findings are discussed within the context of the larger research literature on ToM abilities in DS.

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