be2e2f158a8d35ae58a206d0966314c2 behavsci-15-01065.pdf 662e14798f409f9fba85efcaf9ab63840a5fee66 behavsci-15-01065.pdf e5b031a1b8afdaacec33c6033a09a8947a821afc22041899c9fbaae91ee02f70 behavsci-15-01065.pdf Title: Theory of Mind Development in Deaf and Hard-of-Hearing Individuals: A Systematic Review Subject: Theory of Mind (ToM) is a construct that includes a range of connected abilities linked to the understanding of others’ mental states. During the last three decades, ToM development has been studied extensively in deaf and hard of hearing (DHH) individuals and performances compared to the typically hearing (TH) population. Given the advances in the early diagnosis of deafness, interventions, and hearing devices over this period, variations in task performance among DHH participants might have been reduced. The current systematic review aims to synthesize all studies of ToM in DHH individuals and answer the following question: Do DHH individuals (Population), compared to a control sample of TH and/or among themselves (Comparator), in an assessment of ToM (Intervention), have differentiated results (Outcome)? After a search of the literature, 97 papers were included. We found that, in general, TH participants outperformed their DHH peers in ToM measures; however, there was a wide range of results. Explanations for this variability included the quality of early interactions and early exposure to both signed and spoken language. The review also indicates that the understanding of false belief was the most studied component within ToM, while other components, such as understanding intention and irony, require further research. Implications of these findings for clinical practice are discussed. Keywords: deaf; hard of hearing; Theory of Mind; false belief; signed language; cochlear implant; parent–child interactions Author: Leire Martín, Mario Figueroa, Beatriz de Diego-Lázaro, Raquel Balboa-Castells and Gary Morgan Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25; modified using OpenPDF 1.4.2 CreationDate: Wed Aug 6 07:53:24 2025 CEST ModDate: Wed Aug 6 07:57:20 2025 CEST Custom Metadata: yes Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 32 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1351396 bytes Optimized: no PDF version: 1.5 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- MLTPMG+VnURWPalladioL Type 1 Custom yes yes yes 173 0 JFHHAW+URWPalladioL-Roma Type 1 Custom yes yes yes 174 0 DOFZGJ+URWPalladioL-Ital Type 1 Custom yes yes yes 175 0 NLOZND+URWPalladioL-Bold Type 1 Custom yes yes yes 176 0 EGEOFJ+PalatinoLinotype TrueType WinAnsi yes yes no 474 0 EGEOFH+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 475 0 EGEOFJ+PalatinoLinotype TrueType WinAnsi yes yes no 521 0 EGEOFH+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 522 0 EGFCPC+Calibri TrueType WinAnsi yes yes no 523 0 EGEOFJ+PalatinoLinotype TrueType WinAnsi yes yes no 561 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-08-27 03:07:58 CEST RepresentationInformation: behavsci-15-01065.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-08-26 06:22:43 CEST Size: 1351396 Format: PDF Version: 1.5 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 1391 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: ViewerPreferences: HideToolbar: false HideMenubar: false HideWindowUI: false FitWindow: true CenterWindow: false DisplayDocTitle: false NonFullScreenPageMode: UseNone Direction: L2R ViewArea: CropBox ViewClip: CropBox PrintArea: CropBox PageClip: CropBox PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Children: Item: Title: Theory of Mind Item: Title: ToM Development in Typically Hearing Individuals Item: Title: Explanations of ToM Development Item: Title: ToM Development in DHH Individuals Item: Title: Research Questions of the Systematic Review Item: Title: Method Children: Item: Title: Eligibility Criteria Item: Title: Information Sources and Search Strategy Item: Title: Selection and Data Collection Process Item: Title: Results Children: Item: Title: Search Results Item: Title: Risk of Bias Assessment Item: Title: Discussion Children: Item: Title: ToM Task Performance of DHH Individuals Children: Item: Title: Quality of Early Interaction Item: Title: Early Access to Language Item: Title: Other Variables Item: Title: ToM Components Assessed in DHH Individuals Item: Title: Limitations of the Review Process Item: Title: Conclusions and Clinical Implications Item: Title: Appendix A Item: Title: Appendix B Item: Title: References Info: Title: Theory of Mind Development in Deaf and Hard-of-Hearing Individuals: A Systematic Review Author: Leire Martín, Mario Figueroa, Beatriz de Diego-Lázaro, Raquel Balboa-Castells and Gary Morgan Subject: Theory of Mind (ToM) is a construct that includes a range of connected abilities linked to the understanding of others’ mental states. During the last three decades, ToM development has been studied extensively in deaf and hard of hearing (DHH) individuals and performances compared to the typically hearing (TH) population. Given the advances in the early diagnosis of deafness, interventions, and hearing devices over this period, variations in task performance among DHH participants might have been reduced. The current systematic review aims to synthesize all studies of ToM in DHH individuals and answer the following question: Do DHH individuals (Population), compared to a control sample of TH and/or among themselves (Comparator), in an assessment of ToM (Intervention), have differentiated results (Outcome)? After a search of the literature, 97 papers were included. We found that, in general, TH participants outperformed their DHH peers in ToM measures; however, there was a wide range of results. Explanations for this variability included the quality of early interactions and early exposure to both signed and spoken language. The review also indicates that the understanding of false belief was the most studied component within ToM, while other components, such as understanding intention and irony, require further research. Implications of these findings for clinical practice are discussed. 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