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Theory of Mind in Children with Fetal Alcohol Spectrum Disorders
Author(s) -
Lindinger Nadine M.,
MalcolmSmith Susan,
Dodge Neil C.,
Molteno Christopher D.,
Thomas Kevin G. F.,
Meintjes Ernesta M.,
Jacobson Joseph L.,
Jacobson Sandra W.
Publication year - 2016
Publication title -
alcoholism: clinical and experimental research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.267
H-Index - 153
eISSN - 1530-0277
pISSN - 0145-6008
DOI - 10.1111/acer.12961
Subject(s) - theory of mind , fetal alcohol , psychology , fetal alcohol syndrome , developmental psychology , prenatal alcohol exposure , feeling , cognition , clinical psychology , pregnancy , psychiatry , social psychology , biology , genetics
Background Theory of mind (ToM) refers to the ability to understand and make inferences about other people's intentions, feelings, and beliefs. Although children with fetal alcohol spectrum disorders ( FASD ) are known to have deficits in social‐cognitive function, little is known about ToM in FASD . Methods ToM ability was assessed using a developmentally sensitive ToM battery, including the reading the mind in the eyes ( RME ) test, a measure of mental inferential ability that has been found to be impaired in other clinical populations. IQ and executive function ( EF ) were assessed as potential mediating variables. The battery was administered to 63 children (aged 9 to 11 years) from Cape Town, South Africa, whose mothers had been prospectively recruited during pregnancy. Children with fetal alcohol syndrome ( FAS ; n = 8) and partial FAS ( PFAS ; n = 19), as well as nonsyndromal heavily exposed children ( n = 17), were compared to children born to abstaining or light drinkers ( n = 19 ) from the same community. Results No FASD group differences were found on the less challenging ToM tasks. By contrast, children with FAS and PFAS performed more poorly than controls on a more challenging ToM task, the RME test. A continuous measure of prenatal alcohol exposure (PAE) was more sensitive than FASD diagnosis in that it was related to 4 higher‐order ToM measures, particularly the ability to attribute mental states assessed on RME . IQ only partially mediated the effect of exposure on RME performance, and these effects were not mediated by EF . Hence, the data suggest that these ToM measures tap into a specific alcohol‐related social‐cognitive deficit that does not merely reflect poorer EF . FASD diagnosis and PAE were each also related to RME after control for attention deficit/hyperactivity disorder. Conclusions These findings suggest that deficits in higher‐order ToM function may play a significant role in the social‐cognitive behavioral impairment in FASD .