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Updated: May 20, 2026

Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Does hearing lead to understanding? Theory of mind in toddlers and preschoolers with cochlear implants
Lizet Ketelaar1, Carolien Rieffe, Carin H Wiefferink
1Developmental Psychology, Leiden University, Leiden, The Netherlands. lketelaar@fsw.leidenuniv.nl
Objective:
Theory of Mind (ToM) refers to the ability to understand the subjectivity of people's intentions, desires, and beliefs. Research shows that ToM in deaf children is delayed, yet the few studies that examined ToM in deaf children with a cochlear implant (CI) report contradictory results. This study examined multiple aspects of ToM in early-implanted children.
Methods:
3 intention tasks were administered to 72 children with CI and 69 normal-hearing children (age, 12-60 months). Furthermore, 3 desire and belief tasks were administered to a subsample of children aged 30 months or over.
Results:
Children with CI showed intention-understanding skills equal to normal-hearing children, but lagged behind on desire and belief understanding, even after excluding children with language delays.
Conclusions:
Children with CI appear to master the initial stages of ToM development, but fall behind on more advanced ToM abilities. Yet, both groups showed similar patterns of development.
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