The relationship between executive functions and the perspective-taking skill of theory of mind: Insights from deaf and hard of hearing children with cochlear implants

Previous research in hearing children has consistently found theory of mind (ToM) is positively associated with executive functions (EF). However, this question has been far less examined in deaf and hard of hearing children (DHH) with cochlear implants. This may be because of the heterogeneity of developmental contexts and especially related to language that DHH children experience. The purpose of the study was to explore developmental differences in the perspective-taking skill of ToM and EF by using cluster analysis to compare groups of DHH adolescents who are CI users with typically developing hearing adolescents, aiming to identify subgroups with similar cognitive and processing profiles. Participants were 88 adolescents (12-16 years old) of which 34 were DHH with cochlear implants. The results showed that in the hearing group EF scores correlated positively with perspective-taking performance but not in the DHH group. The analysis of the hearing children's results revealed there were three clusters based on clear performance levels. In the DHH group, there was much variability and more complex relationships between both abilities. We conclude that DHH children's variable experience with early communication and access to language disrupts the typical coupling of ToM and EF.