When we consider pragmatics competence, we are looking at how students deal with language and use it appropriately within context. Theory of Mind deals with the mental and emotional states that may help explain such use of language. Theory of mind is the ability to attribute mental states— beliefs, intents, desires, pretending, knowledge, etc. —to oneself and others and to understand that others have beliefs, desires, and intentions that are different from one’s own.

Cognitive Theory of Mind can be interpersonal or intrapersonal. Interpersonal cognitive theory of mind refers to the ability to understand that others can have thoughts, beliefs, desires different than my own. Additionally, the ability to infer mental states of others and infer behavior based on thoughts. Intrapersonal cognitive theory of mind refers to the ability to reflect on one’s own mental states, plan one’s behavior, and use metacognitive learning strategies.

Affective Theory of Mind is broken down into three areas. Interpersonal affective cognitive theory of mind refers to one’s ability to recognize emotions of others, infer emotions of others, and infer behavior based on emotions. Intrapersonal affective cognitive theory of mind refers to one’s ability to reflect on one’s own emotions, regulate one’s own emotions and motivation.

Affective empathy refers to one’s ability to empathize with others. Affective Cognitive Theory of Mind (Cognitive empathy) refers to both one’s awareness and reflection on one’s own emotions and the ability to recognize or infer what others are feeling (understanding the emotions of others cognitively). For example, when the development of most aspects of ToM appears affected, we might observe the student to use much fewer emotional words than typical children. We might also observe  significant difficulties with self-regulation of behavior and emotions and/or poor identification of emotions and recognizing causes of emotions. Another difficulty that we might observe is the difficulty in identifying emotion in tone of voice.

Development of Theory of Mind

Preschool foundations – symbolic skills (play & language)

1st order ToM – Predicting what someone is thinking/ feeling

2nd order ToM – Predicting/ knowing what one person thinks another person thinks/feels

Higher order ToM Lies, Figurative-language, Sarcasm

Here are some ideas to assess Theory of Mind

We can evaluate autobiographical memories, recall accuracy, recall detail, recall amount, perspective (first person or observer), elicitation (free or cued recall).

We can assess episodic memory (8 to 12 years). Start by conducting an autobiographical interview, generate details about a past or future event in response to a cue word. For example, have the student “describe a specific time a few months in the past that you think of when you hear…” or “imagine a time in the next few months the word … makes you think of.” Positive words may include: friend, easy. Negative words may include: naughty, tired. And neutral words may include bath or boo.

First Order Interpersonal ToM: 4-5 years – Predicting/knowing what another person thinks/feel; Thinking about what I know/don’t know; how I feel

First Order Cognitive Interpersonal ToM Predicting/knowing what someone else is thinking/feeling. For example, a False Belief Task can be completed where achild must infer that another person does not possess knowledge that they possess. For example, a child may be shown a candy box containing pennies rather than candy and are asked what someone else would expect to find in the box.

We can also use the Clinical Assessment of Pragmatics, to review pragmatic knowledge (awareness of social rules), affective expression, and interpretation of context cues.


This article is based on Dr. Carol Wesby’s presentation at the 2020 SLP Power Up Conference at the Lavi Institute. 

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