In both my private practice and school-based position, many of my students struggle with understanding the feelings and thoughts of others. Research indicates that these difficulties may stem from delays in developing theory of mind (TOM). The concept of TOM is defined as the “ability to impute mental states to oneself and others” (Premack & Woodruff, 1978). Deficits/delays in TOM are often associated with autism spectrum disorder (Baron-Cohen, 1995). However, TOM deficits may be an underpinning for social communication difficulties exhibited by children with language processing, behavioral disorders and attention deficits as well.
As noted in my previous post, TOM (or perspective taking) can be subcategorized into affective-cognitive (Dvash & Shamay-Tsoory, 2014): cognitive, which involves thinking about and responding to the thoughts, beliefs and intentions of others, and affective, which involves thinking about and responding to the emotions of others. TOM can be further differentiated into interpersonal (thinking of others) and intrapersonal (reflecting on your own thoughts and emotions). This has implications for therapy as our goal is to differentiate the TOM profile that defines our students and teach the underlying cognitive, lingusitic and emotional skills that will support communication. For example, research indicates that children with autism possess weaker interpersonal TOM skills and stronger intrapersonal TOM.
I love using picture books in therapy to develop perspective taking, both cognitive and affective. In this elementary level activity, I used The Doghouse, by Jan Thomas.
In the story, a group of animals are playing ball when Pig accidentally kicks it into the doghouse. One-by-one, the frightened animals enter the doghouse to find the ball, but do not return. The illustrations provide opportunities to discuss affective perspectives by analyzing facial expressions and body language.
To address cognitive TOM the children predicted what the animals are thinking that would cause them to be afraid. I used the Bubble app, which easily allows students to insert thinking bubbles and type thoughts onto images stored in your camera.
As the story continues, the animals become more frightened. This is a great opportunity to target a continuum of emotional vocabulary — worried, nervous, scared, frightened, terrified, petrified.
To facilitate intrapersonal TOM (as well as syntax, and episodic memory) I had the children reenact the book, which I videotaped. At our next session we plan to watch the video and talk about the experience.
How do you address TOM with your students? Do you think it is important to differentiate TOM subsets?