Theory of mind and hearing loss: Teaching children for social and academic success

by Emily Humphrey, MSDE, CED

Five-year-old Sam is building a tower out of blocks when Jack walks by and knocks it over. Jack pauses, laughing, while Sam cries. Jack hands Sam some blocks to build, but becomes frustrated when Sam walks away. Ultimately, Jack ends up most upset in this scenario. Jack cannot understand that Sam did not think knocking his tower over was funny.  At this point, a teacher must intervene and understand that Jack is exhibiting difficulty understanding theory of mind. Theory of mind is the ability to understand that what you think and believe may be different from what another person thinks and believes. Behavior is motivated by our own and others’ knowledge and beliefs. By age 4, children can correctly predict that a person’s behavior is dependent on what he thinks and knows, even when the belief is false (Schick, Villiers, Villiers and Hoffmeister, 2007).

Research shows that children with hearing loss have delays in developing theory of mind. Researchers speculate that the lack of access to conversations in the environment causes children with hearing loss to miss important information about the world. Even with the best hearing technology, children with hearing loss often miss out on overhearing and incidental learning opportunities. Children with hearing loss often have varying levels of receptive and expressive language abilities. One study shows an ability to comprehend complex syntactic elements predicts theory of mind skills. For example, a child who understands and uses sentences like “He thought the cheese was in the refrigerator” perceives theory of mind (Schick et al. 2007).

An underdeveloped theory of mind affects reading comprehension, critical thinking, social relationships and collaboration. All of these are imperative to success in school. Children with hearing loss are often explicitly taught vocabulary, syntax and concepts. Why should teaching theory of mind be any different? Below is a list of ideas compiled to encourage theory of mind development in the classroom.

Language: Target language that includes metacognition; “thinking about thinking”. As educators, we can model how we think about thinking by using phrases such as “I think…” “I wonder…” “What would happen if…” “I remember…” “I would…” “I bet…” throughout the day. Make complex language structures such as because and but a priority. This syntax offers insight and practice explaining actions and behaviors.

Literacy: Fairy tales are generally rich in exposing characters’ perspectives. Use the above language to encourage inferences directly based on a character’s behavior. Act out the story. Your student can internalize a character’s perspective when he takes on that role.

Play: Offer ample opportunities for symbolic play and encourage role play. Create a play script and model how to play. Practice changing the ending or sequence of play to further flexibility in thinking. Board games can foster collaboration and perspective taking.

Math: Practice having students explain how they got an answer, even if that answer is wrong. Math errors are most commonly miscalculations but could be misinterpretation of the directions or task. A misinterpretation would give you and the other students insight into another way to think. A calendar routine provides ample mathematical concepts that can strike conversation. You can incorporate predictions about weather to practice mental state verbs.

Science: Take advantage of the scientific method! The scientific method is a structured and repetitive tool to practice making predictions. Encourage disagreements for students to hear views and rationale that differ from their own. Reflect on the outcomes and circle back to what you thought versus what happened.


Schick, B. (2014). Social Cognition and Theory of Mind. Communication Considerations A-Z,1-4. Retrieved October 13, 2017, from

Buijsen, M. V., Hendriks, A., Ketelaars, M., & Verhoeven, L. (2011). Assessment of theory of mind in children with communication disorders: Role of presentation mode. Research in Developmental Disabilities,32(3), 1038-1045. doi:10.1016/j.ridd.2011.01.036

Peterson, C. C. (2015). Empathy and Theory of Mind in Deaf and Hearing Children. Journal of Deaf Studies and Deaf Education,21(2), 141-147. doi:10.1093/deafed/env058

Schick, B., Villiers, P. D., Villiers, J. D., & Hoffmeister, R. (2007). Language and Theory of Mind: A Study of Deaf Children. Child Development,78(2), 376-396. doi:10.1111/j.1467-8624.2007.01004.x

Emily Humphrey served as a classroom teacher in the Anabeth and John Weil Early Childhood Center at CID – Central Institute for the Deaf. She currently works as a parent educator in the CID Joanne Parrish Knight Family Center (coaching caregivers of children ages birth to three with hearing loss). Emily organizes and contributes to CID’s blog for professionals.

4 replies
  1. Shannon
    Shannon says:

    Hi Ms. Humphrey,

    Thank you for sharing this insight. I am also a graduate student, studying speech-language pathology. Lia and I are currently talking a course on teaching language and literacy to D/HH children, and your article reminded me of something we have discussed in class: the importance of modeling. You wrote about how we can incorporate theory of mind into the language we use by modeling with phrases like “I wonder.” Sometimes, D/HH children have simply not had enough exposure to phrases or interactions like this, in which their communication partner thinks aloud. I think this practice of explaining your thoughts or behaviors is important not only in the classroom, but also at home. All of your suggestions would be beneficial practices for parents to adopt, but simply thinking aloud seems like a very easy and accessible option to teach parents, to help support their children’s development of theory of mind.

    Thank you!

    • Emily Humphrey
      Emily Humphrey says:

      Absolutely! Modeling thinking aloud is one seemingly simple modification a parent can make in everyday life to encourage theory of mind development. A great habit for professionals and parents alike. I appreciate your thoughtfulness and attention to detail–thank you for sharing!

  2. Lia
    Lia says:

    Hi Ms. Humphrey,
    I enjoyed reading your post regarding the promotion of theory of mind in students who are deaf or heard of hearing. I am currently a graduate student studying severe and multiple disabilities special education with a focus on autism and intellectual disability (ID). Many students with autism and intellectual disabilities do not successfully convey empathy or understand others’ perspectives. It was interesting to learn that students who are D/HH experience challenges with theory of mind due to their lower frequency of “overhearing and incidental learning opportunities.” I agree that, because these students have a deficit in this area, theory of mind must be explicitly taught, just as any academic skill. Your suggestions regarding the incorporation of theory of mind into various subject areas were very helpful. In addition to the methods you mentioned, there are also several formal curricula that foster theory of mind skills. Although these curricula are intended for children who have autism/ID, I think they could potentially be beneficial for students who are D/HH.

    Thank you so much for your insightful post.

    • Emily Humphrey
      Emily Humphrey says:

      Hi Lia! Your kind words are great to hear. It’s good to know that you’ve found the tips helpful. Exactly to your point, a delay or deficit in theory of mind affects a wide range of students. While the reason for the delay or deficit varies, the subject matter doesn’t vary necessarily. Formal curricula on the subject of theory of mind would be beneficial for students who are D/HH…thank you for bringing this up!


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