Exploring Theory of Mind in Specific Learning Disorder: Subtype Differences and the Role of ADHD Comorbidity

Specific learning disorder (SLD) is a neurodevelopmental disorder characterized by impairments in reading, writing and/or mathematics, often accompanied by social and emotional difficulties. Although deficits in theory of mind (ToM) have been observed in children with SLD, the variability of ToM skills across SLD subtypes remains unclear. This case-control study examined ToM skills in children diagnosed with SLD (dyslexia, dysgraphia and dyscalculia) with those of typically developing peers and investigated the effect of attention deficit hyperactivity disorder (ADHD) comorbidity. The sample consisted of 137 children aged 7-12 years (64 with SLD and 73 in the control group). Both groups were assessed using the first, second and advanced ToM tasks (Sally-Anne Task, Ice Cream Story Task, Chocolate Task, Hinting Task and Reading the Mind in the Eyes Test). Clinical characteristics of the SLD group were assessed using the Specific Learning Disorder Extended Neuropsychometric Battery, and intelligence levels of both groups were assessed using the Wechsler Intelligence Scale for Children-Revised. Results showed that children with SLD exhibited significant impairments across all ToM skills compared with controls (p < 0.001). However, ToM skills did not differ among SLD subtypes or between children with and without ADHD comorbidity. These findings suggest that ToM skills are impaired in children with SLD and that these impairments are independent of SLD subtypes or comorbid ADHD.