The first aim of this study was to investigate the links between literacy, working memory and theory of mind in children with intellectual disability. Earlier studies have demonstrated these relationships in typically developing children.
This was investigated in 48 children with intellectual disability (mental age = 6:7 years, chronological age = 12:4 years). Mental age was assessed with the block design test of the WISC-III, i.e. the Swedish version of the WISC-R. Working memory was tested with six tests (digit span forward and backward, listening span with and without dual task, clown span [visuospatial test where participants had to recall placement of dots put on a drawing of a clown. The test was an adaption of the “Mr Peanut”-test.] with and without dual task). Theory of mind was tested with 6 tests (Sally Anne test of 1st and 2nd order theory of mind, own developed tests to minimize working memory load on the theory of mind task for 1st and 2nd order theory of mind, irony, and social blunders). Literacy was tested with 3 tests (comprehension of written words, comprehension of written sentences, and comprehension of written stories).
Factor analyses was made for the three concepts (working memory, theory of mind, and literacy) and the following factors were found: visuospatial working memory (loading on clown span with and without dual task), phonological working memory (loading on digit span and listening span both with and without dual task), Sally Anne theory of mind (loading on Sally Anne tests of 1st and 2nd order theory of mind), working memory free theory of mind (loading on own developed for 1st and 2nd order theory of mind), Advanced theory of mind (loading on own developed tests of irony, and social blunders), Literacy (loading on comprehension of written words and comprehension of written sentences. Comprehension of written stories did not load on the factor). There are intercorrelations between working memory, theory of mind, and Literacy, but not for all factors of all variables. All intercorrelations between the factors are shown in Table 1.
Table 1. Intercorrelations between six variables of working memory (WM), theory of mind (ToM) and literacy: Visuospatial working memory, phonological working memory, Sally Anne theory of mind, working memory free theory of mind, advanced theory of mind and literacy. The six variables were created through factor analysis.
* Correlation significant at the 0.05 level (onetailed). ** Correlation significant at the 0.01 level (onetailed).
The second aim of this study was to examine if training of theory of mind also would improve literacy. A computerized theory of mind training program was developed. The program showed social situations (with pictures and speech) and the trainee had to chose from three given alternatives of what happened in the situation. Feedback (speech and instructions to choose another alternative) was given if the answer was wrong. The program adapted the level of difficulty according to performance.
One group (n = 21, mental age = 6:6 years, chronological age = 12:5 years) got computerized theory of mind training 15 minutes a day for 5 weeks at school. They improved their theory of mind ability compared to a group (n = 27, mental age = 6:8 years, chronological age = 12:3 years) that got similar computerized mathematical training (Interaction effect in an analysis of variance, F(1, 44) = 4.97, p < .05, partial η2 = .10). Literacy improved equally in both groups, which means that there was no transfer effect to literacy. The same was true for working memory. It was investigated if the training effect was dependent on any initial skills, but no significant correlations could be found between training gain and initial working memory, theory of mind and literacy abilities in the theory of mind training group.
The conclusion is that working memory, theory of mind and literacy correlates in children with intellectual disability, but improving theory of mind through training does not necessarily improve literacy or working memory.