The Interplay Between Language, Executive Functioning, Theory of Mind and Socio-Emotional Functioning - A Comparison...

Adolescents with developmental language disorder (DLD) are known to be at increased risk for socio-emotional difficulties. Yet, there remains considerable uncertainty about how problems in language abilities, executive functioning (EF), and theory of mind (ToM) contribute to the socio-emotional difficulties observed in this group. In addition, only a limited number of studies have compared adolescents with and without DLD on these underlying cognitive and linguistic domains.

This study examined (1) differences between adolescents with and without DLD in language, EF, ToM, and socio-emotional functioning, (2) associations among these domains, and (3) the unique contributions of language, EF, and ToM to socio-emotional functioning.

Forty adolescents with developmental language disorder (DLD) and 36 typically developing (TD) peers, matched for age and education level, completed measures of receptive vocabulary, visuospatial working memory (Corsi Block-Tapping Task), cognitive flexibility (Berg Card-Sorting Test), cognitive ToM (ToMotion task), and affective ToM (Emotion Recognition Task). Parents completed the IKAN questionnaire, which served as the measure of socio-emotional functioning. Group differences were assessed using independent-samples t-tests and Mann-Whitney U tests. Associations were examined using Spearman correlations. Multiple regression analyses were conducted with the IKAN total score as the outcome variable.

Adolescents with DLD scored significantly lower than their TD peers on receptive language, cognitive ToM, and socio-emotional functioning as measured by the IKAN. They showed significantly reduced scores on seven of the eight socio-emotional subscales. No significant group differences were found for visuospatial working memory, cognitive flexibility, or affective ToM. Receptive vocabulary correlated positively with cognitive flexibility, both ToM measures, and several IKAN subscales. Cognitive ToM showed consistent moderate associations with overall socio-emotional functioning. In the regression model, cognitive ToM was the only significant unique predictor of socio-emotional functioning (R² = 0.23).

This study demonstrates that adolescents with DLD experience more difficulties in receptive language, cognitive ToM, and socio-emotional functioning compared to their TD peers. Moreover, cognitive ToM appears to be a key predictor of socio-emotional functioning across adolescents with and without DLD. Clinical and educational services should therefore extend support beyond language remediation and consider targeted interventions that strengthen cognitive ToM to improve socio-emotional adjustment.

What is already known on this subject Adolescents with developmental language disorders (DLDs) experience significant socio-emotional difficulties, including higher levels of anxiety, depression, and peer victimization. Research highlights the role of cognitive factors, such as Theory of Mind (ToM) and executive functioning (EF), in socio-emotional development, but studies specifically focusing on these constructs in DLD are limited. Language difficulties alone do not fully explain the socio-emotional challenges, indicating that underlying cognitive deficits might play a key role. What this study adds to the existing knowledge This study examines the relationship between language abilities, ToM, EF, and socio-emotional functioning in adolescents with DLD. It explores how these cognitive factors uniquely contribute to socio-emotional problems, providing a deeper understanding of the mechanisms at play in this population. What are the potential or actual clinical implications of this work? This study highlights the need for individualized interventions for adolescents with DLD, given the significant variability in cognitive profiles and socio-emotional functioning within this group. The findings suggest that cognitive factors, particularly ToM, may play a crucial role in predicting socio-emotional difficulties, emphasizing the importance of targeting these areas in therapeutic interventions. Additionally, the lack of significant correlations between receptive language and socio-emotional functioning suggests that both receptive and expressive language should be assessed to develop more comprehensive interventions aimed at improving social skills and emotional regulation.