Social competence,theory of mind,and executive function in institution-reared Turkish children

Abstract

This study had two aims. The first aim was to measure mental state understanding in institution-reared children by using a theory of mind (ToM) scale, and to examine the role of cultural context in sequencing of ToM acquisition. The other aim was to investigate ToM in relation to social competence and executive function (EF). Due to its pronounced role in mental state understanding and social interactions, we assessed receptive language as well. The participants were 107 institution-reared children aged 3 to 5 years in Turkey. Two visits were held within 2 days for behavioral assessments. In the first visit, the ToM scale was administered; in the second visit, the child was given the language test and the EF tasks. The social competence scales were completed by the child’s primary care provider in the institution. Guttman scaling analysis revealed that an understanding of diverse beliefs developed earlier than knowledge access, favoring the “individualistic pattern.” The regression analysis showed that EF was a significant predictor of ToM, but neither of them was associated with social competence when age was controlled. Receptive language predicted social competence and EF directly, and ToM indirectly through EF, pointing to the importance of this ability for early development.

Keywords

executive function institutionalization language social competence theory of mind

The recognition that social behavior in the preschool period continues to later years and predicts subsequent functioning in different areas such as academic achievement and psychological well-being (Bornstein, Hahn, & Haynes, 2010) has led researchers to examine predictors of early social competence and the nature of associations between social competence and other domains, particularly cognition. Theory of mind (ToM), as a sociocognitive ability, has been reported to be related to social behavior (e.g., Jenkins & Astington, 2000) in addition to executive function (EF) (e.g., Hughes & Ensor, 2008). Most of this research was conducted with child samples with at least a middle socioeconomic background (e.g., Watson, Nixon, Wilson, & Capage, 1999). A smaller number of studies examining development in a wide range of socioeconomic backgrounds frequently indicate that children from disadvantaged circumstances display higher levels of aggressive and/or withdrawn behaviors (Berger, Paxson, & Waldfogel, 2009) and are behind in cognitive and language abilities (Cutting & Dunn, 1999). Stating the significance of environment, researchers have emphasized the need to work with diverse child samples to identify the relations between developmental domains and the pathways in each context.

A special underprivileged group is children who live in child-rearing institutions. Limited research available on institutionalized children reveals that they experience difficulties in many areas of development (MacLean, 2003); yet, we have very little knowledge specifically on two main cognitive abilities—ToM and EF—and their relations with social behavior for this group. Thus, in this study, we first aimed to focus on ToM and examine sequential progressions in mental state understanding in Turkish children by using the Theory-of-Mind Scale of Wellman and Liu (2004). The second purpose of this study was to investigate concurrent relations between ToM, social competence, and EF in Turkish preschool children who live in rearing institutions.

Theory of mind

Understanding the minds of others is a sociocognitive ability that has been conceptualized to be necessary for engaging in socially competent behavior (Astington, 2003). ToM is characterized by the acquisition of understanding that people can have various mental states that may contradict reality and lead to different actions. A significant improvement in ToM occurs between 3 and 5 years of age (Jenkins & Astington, 2000), which helps children to form more accurate associations between mental states and behavioral outcomes in social situations.

ToM has a multifaceted nature and includes an interconnected network of basic mental states such as desires, beliefs, knowledge, and feelings. Studies show that English-speaking children in the US (Wellman & Liu, 2004) and Australia (Peterson, Wellman, & Liu, 2005), and children in Indonesia (Kuntoro, Saraswati, Peterson, & Slaughter, 2013) gain insights about the mind in a predictable sequence following a stepwise development: diverse desires (DD), diverse beliefs (DB), knowledge access (KA), false belief (FB), and hidden emotion (HE) understanding, respectively. This sequential progression in ToM means that an understanding that people hold DD is acquired earlier than an understanding that people hold DB; understanding diversity in beliefs is easier than understanding incorrectness of beliefs; understanding ignorance (one can be knowledgeable when the other is ignorant) is attained before understanding false belief, and a correct judgment of people’s hidden emotions develops relatively later in the sequence. Research carried out with Chinese (Wellman, Fang, Liu, Zhu, & Liu, 2006) and Iranian (Shahaeian, Peterson, Slaughter, & Wellman, 2011) children, however, indicated a different sequence where KA preceded DB: DD > KA > DB > FB > HE. These findings, overall, have led the researchers to question the existence of a universal sequence in acquisition of different aspects of ToM and to suggest that gaining understanding about a specific aspect of mind understanding might be more functional, and hence, more imperative in certain cultures than acquiring others. According to this argument (Shahaeian et al., 2011), it might be that understanding the valued and accepted knowledge in the community is more important in collectivistic cultures such as China and Iran, and understanding different opinions and beliefs is more important in individualistic cultures such as the US and Australia, as well as in cultures like Indonesia where a western style may be observed in parenting practices. The aspect of mental state understanding that is more important would consequently be emphasized in socialization practices of that culture, resulting in its faster attainment. Especially, proximal interaction processes between adults and children, such as conversations about mental states, might influence children’s theory of mind development. Close interactions between caregivers and children might enable children to gain insights into caregivers’ beliefs and desires (Harris, 1997). However, these one-on-one social and conversational practices may vary from one community to another. For instance, US parents make their conversations more on “thinking” and individual beliefs, while Iranian and Chinese parents focus on “knowledge” and common beliefs (see Shahaeian et al., 2011; Wellman et al., 2006).

Social competence and theory of mind

One of the mostly-studied ability in relation to ToM has been social competence. Social competence is defined as, “forming and maintaining positive social interactions with others while reaching personal goals” (Rubin & Rose-Krasnor, 1992, p. 285). Socially competent children engage in harmonious interactions, show less antisocial and more prosocial behavior, understand emotion expressions, and remain emotionally and behaviorally organized in challenging situations. After the second year of life, throughout preschool years, there is a general decrease in children’s aggressive behaviors and an increase in their prosocial acts. This is linked to improvement in various domains such as social cognition, language, and self-regulation (Eisenberg & Fabes, 1998).

Despite inconsistencies in the literature, many findings indicate a significant association between social competence and ToM: preschool children with better mental state understanding were found to have higher peer popularity and social skills (Watson et al., 1999) even after controlling for language ability (Astington & Jenkins, 1995). Although the literature provides mixed evidence on the significance (Badenes, Estevan, & Bacete, 2000) and direction of this association (Jenkins & Astington, 2000; Suway, Degnan, Sussman, & Fox, 2011), there is consensus that children become more skilled in understanding minds throughout preschool years and these abilities are reflected in children’s social interactions (Hughes, 1998). Differentiating one’s own and others’ mental states makes children more aware of possible interpretations of situations and helps them shape their social behaviors accordingly. Thus, understanding others’ mental states may not be sufficient by itself, but appears to be necessary for engaging in adaptive and positive behavior (see Astington, 2003).

Executive function, theory of mind, and social competence

A significant correlate of both ToM and social competence is EF, a key cognitive ability that refers to the collection of processes such as attention shifting, working memory, and inhibitory control, which guides behaviors towards a goal (Welsh, Pennington, & Groisser, 1991). EF is conceptualized as the cognitive component of self-regulation that leads to behavioral competence (Rueda, Posner, & Rothbart, 2005). Controlling attention, managing new information, and modulating oneself help children to function more adaptively in the face of social demands. This way, children can attend to exigencies during social interactions and regulate their desires, thoughts, and behaviors appropriately (Hughes & Ensor, 2008).

ToM is considered to be closely related with EF: as the abilities to focus attention and handle more information improve, children become more likely to realize the presence of distinct mental states and to differentiate own minds from others’ (Hala, Hug, & Henderson, 2003; Moses & Tahiroglu, 2010). Empirical studies reveal that EF predicts ToM both concurrently (Carlson & Moses, 2001; Perner, Lang, & Kloo, 2002) and longitudinally (Carlson, Mandell, & Williams, 2004; Hughes, 1998).

Studies have mostly revealed a significant association between EF and social competence in childhood and adolescence (Charman, Carroll, & Sturge, 2001; Landry, Smith, & Swank, 2009; Riggs, Jahromi, Razza, Dillworth-Bart, & Mueller, 2006). In Razza and Blair’s (2009) study, controlling for language, the relation of preschool EF with social competence was significant concurrently (in preschool), but non-significant longitudinally (in kindergarten).

On the whole, the ability to regulate one’s own thoughts, emotions, and behaviors requires multiple and complex cognitive skills. The processes of attention, working memory, and inhibitory control set the stage for identifying different mental states. These cognitive abilities decrease the likelihood of impulsive behavior and increase the chances that the child considers different behavior options and enacts regulated behavior. Considering these relations, Hughes, Dunn, and White (1998) proposed that the association between EF and social competence could be an indirect one that is mediated by ToM. Although theoretically firm, this proposition has not been supported by empirical findings (Razza & Blair, 2009).

Language ability, especially receptive language, is associated with social competency (Gertner, Rice, & Hadley, 1994), mental state understanding (Milligan, Astington, & Dack, 2007), and EF of preschoolers (Hughes & Ensor, 2008). Most conceptualizations of social competence involve good communication skills, which is crucial for understanding the social demands and responding to them effectively (Hart, Newell, & Olsen, 2003; Kaler & Kopp, 1990). Language also allows children to be exposed to various mind expressions and moves them towards the acquisition of ToM (Milligan et al., 2007; Nelson, 2005). Thus, when investigating the relations among social competence, ToM, and EF, receptive language needs to be taken into account.

Institutional rearing

While getting rare in the West, institutionalization is still a very common way in many developing countries like Turkey to provide care for children who are in need of protection due to various reasons including parental death, abandonment, abuse, and severe poverty. Child-rearing institutions are typically deprived environments characterized by high child–staff ratio, limited stimulation, and unstable and restricted interaction with care providers (MacLean, 2003; Rutter, 1981). While research on this population is not abundant, the available findings have shown that children in institutional care have difficulties in many domains (Kaler & Freeman, 1994; van IJzendoorn et al., 2011).

With respect to the social domain, they have been reported to display higher levels of withdrawn behavior, indiscriminately social/disinhibited behavior and/or externalizing problems compared to their counterparts in foster care (Roy, Rutter, & Pickles, 2004). In a study conducted in Turkey (Simsek, Erol, Öztop, & Münir, 2007), elementary school children in institutions showed more attention problems, rule-breaking, and aggressive behaviors than the family-reared children.

Children in institutions have also been indicated to show impairment in the cognitive domain such as working memory, planning, attention shifting, and EF (Colvert et al., 2008). Regarding ToM development, Tarullo, Bruce, and Gunnar (2007) found that 6–7-year-old children under institutional care showed significant delay in FB understanding compared to parent-reared children. Similarly, Yagmurlu, Berument, and Celimli (2005) showed that being reared in an institution negatively predicted Turkish preschoolers’ ToM over and above child’s age, sex, verbal, and nonverbal abilities.

Studies have also revealed that the length of institutionalization is related with more problems in mental-state understanding (Colvert et al., 2008), attention, behavioral inhibition, and peer interactions (Gunnar, Van Dulmen, & The Minnesota Adoption International Project Team, 2007); and early entry to the institution (i.e., in the first 12–18 months) predicts later behavior problems (Hawk & McCall, 2011) and deficits in executive skills (Merz & McCall, 2011).

The present study

A review of the limited literature on children in institutional care shows that these children exhibit difficulties in different areas. Within this limited literature, the studies that investigate ToM and EF are few in number, and they do not focus on the predictive associations between these areas. In the last few decades, researchers have emphasized the multifaceted nature of ToM and focused on developmental progressions of different aspects of mental-state understanding. The first aim of this research was to examine the sequential acquisition of ToM in children in institutional care. Also, given that early adaptive behavior persists into later stages of life and predicts many important outcomes, it is worthwhile to investigate social competence in institution-reared children and its relations with ToM and EF in the preschool period. Examining the role of executive skills in mental-state understanding is another meaningful question to tackle to identify the possible direct and indirect relationships among EF, ToM, and social competence. This was the second aim of the present study.

To achieve these goals, we worked with a large sample of preschool children with varying lengths of institutional experience and measured the research variables via well-established tools. To measure mental-state understanding thoroughly, we used the ToM scale of Wellman and Liu (2004). In this article, we first present the analyses performed to investigate the sequence of steps in ToM development in Turkish preschoolers. This aim contributes to a discussion on the role of cultural context in the acquisition of mental understanding in terms of individualistic/collectivistic countries and home environment, more specifically, the caregiver–child interaction. Due to the paucity of accumulated evidence in the relevant literature and heterogeneity in parental cognitions and practices in Turkish culture, we had no specified predictions in favor of an “individualistic sequence” that was observed in the US, Australia, and Indonesia, nor a “collectivist sequence” observed in China and Iran. Turkey is ranked halfway between individualistic and collectivistic cultures (37th out of 93 countries) on the dimension of individualism (Hofstede, Hofstede, & Minkov, 2010). In Turkish culture, relatedness and emotional ties between family members are valued widely and highly, but the emphasis on autonomy and obedience displays significant within-culture variance. Mothers with low education value compliance highly. On the other hand, mothers with high levels of education endorse autonomy and self-enhancement more, and display more supportive and responsive parenting (Yagmurlu & Altan, 2010).

After presenting the results on ToM sequencing, we present the statistical analyses conducted to investigate the concurrent associations between ToM, social competence, and EF in our sample. We formed our predictions in light of the extant literature which is mainly based on children reared in typical contexts (i.e., family). Therefore, we expected that with the development of EF, children would become more capable of representing other people’s mental states; and better EF and ToM would be related to higher levels of social competence. Given the pairwise associations among EF, ToM, and social competence, and the conceptual background (Hughes et al., 1998), we also wanted to examine the possible indirect relation between EF and social competence through ToM. Due to the pronounced role of receptive language in mental state understanding and social interactions, we controlled for language in all analyses. We also explored age- and sex-related differences in EF, ToM, and social competence as part of the preliminary analyses.

Method

Participants

The data were drawn from 107 preschool children residing in four child-rearing institutions in Turkey (see Table 1). The sample consisted of 21 children aged 3 years, 39 children aged 4 years, and 47 children aged 5 years. Of the participants, 82 were boys (M_age = 57.95 months, SD = 9.14) and 26 were girls (M_age = 53 months, SD = 10.95); reflecting the state that girls are more likely to be adopted than boys in Turkey. Children in the sample had spent on average 37% of their lives in institutions. Primary child-care providers (N = 22) of the children also participated in the study by completing the demographic forms, a screening inventory for child’s general development, and the social competence scales. On average, one child-care provider gave information for 4.86 children (range = 1–10). None of the children had a known chronic physical health problem or developmental disorder. Children (n = 10) who were found to have developmental delay (standard t score lower than 35 from the screening inventory) were not given the tasks measuring ToM and EF, and are not described in this article.

Table 1.

Demographic profile of children (N = 107) and their primary child-care providers (N = 22), and descriptive statistics for study variables.

					3-year-olds		4-year-olds		5-year-olds
					(n = 21)		(n = 39)		(n = 47)
Variable	M	SD	Min	Max	M	SD	M	SD	M	SD
Age of child (in months)	56.75	9.79	36	71
Age of entry in a child-rearing institution (in months)	35.47	16.99	0	65
Duration of stay in the institution (in months)	21.28	17.27	2	70
Duration of stay in the current institution (in months)	18.07	15.29	2	69
Age of primary child-care provider (in years)	25.98	4.58	20	37
Duration of care provided to the child's group (in months)	10.27	8.67	2	36
Executive function^a,b (0–1)	0.5	0.28	0	1	0.24	0.16	0.5	0.25	0.61	0.27
ToM^a,b (0–4)	2.18	1.02	0	4	1.38	0.97	2.23	0.81	2.49	1.02
Social competence^b,c (8–32)	21.58	4.65	11	32	18.93	4.49	21	4.73	23.26	4.04

Note. ^aIndicates significant difference between 3- and 4-year-olds. ^bIndicates significant difference between 3- and 5-year-olds. ^cIndicates a marginally significant difference (p = .06) between 4- and 5-year-olds.

All the four child-rearing institutions were established and operated by the Ministry of Family and Social Policies; therefore, they had very similar environmental characteristics (e.g., furniture, toys) and regulations. Each group had a female teacher who had received high-school education with specialization on child development. There were also three child-care providers for each age group, working on shift system to provide coverage 24/7. They were responsible for the physical care of the children. At the time the study was conducted, the number of children in each age group ranged between 8 and 13, and the mean child–staff ratio, which indicated the number of children per caregiver (both teachers and child-care providers) during a shift time, was 4.84 (SD = 1.08, Min = 3.00, Max = 6.67).¹

Materials

Developmental level

Ankara Developmental Screening Inventory (Savasir, Sezgin, & Erol, 1998) is a valid and reliable screening instrument for 0–6 year-old Turkish children. It includes 154 items that tap language-cognitive, fine motor, gross motor, and social and self-care development. The instrument provides a total raw score, which is converted to a standard t score. A standard t score of 50 represents the mean (SD = 10), and 35 and lower represents developmental delay. Developmental level scores for our sample ranged between 36 and 61, with a mean of 48.49 (SD = 5.93), and were similar for girls (M = 48.69, SD = 7.68) and boys (M = 48.42, SD = 5.31), F(1, 105) = .04, ns.

Theory of mind

The ToM scale included six tasks which were presented in the following order: diverse desires (DD), knowledge access (KA), contents false belief (CFB), diverse beliefs (DB), explicit false belief (EFB), and hidden emotion (HE) (see Wellman & Liu, 2004, for description of each task). The ToM scale was translated into Turkish by the authors and a graduate student (Kahraman, 2012). Similar to the original study, all children who passed both the contrast and control questions and the target question were regarded as having passed the task (0 = incorrect, 1 = correct); all scores were summed to get a total ToM score.

Social competence

Two scales were utilized to assess social competence during peer play and during everyday interactions with peers and teachers. Each scale included 8 items being rated on a 4-point Likert scale (never–always). To assess socially competent behavior during peer play, the Play Interaction subscale (e.g., ‘Shares toys with others’) of Penn Interactive Peer Play Scale (Fantuzzo, Mendez, & Tighe, 1998) was used. The Turkish adaptation of the scale was made by Öztürk (2011). Scores for each item were summed to obtain the play interaction subscale score (M = 20.73, SD = 4.64, Min = 12, Max = 32; α = .78).

To assess socially competent behavior during general peer- and teacher-interactions, the Social Competence subscale of the Social Competence and Behavioral Evaluation Scale (LaFreniere & Dumas, 1996) was used. The Turkish adaptation of this scale was made by Corapci, Aksan, Arslan-Yalcin, and Yagmurlu (2010). Scores for each item (tapping tolerant, socially integrated, prosocial, cooperative behavior) were added to calculate the social competence subscale score (M = 22.44, SD = 5.25, Min = 10, Max = 32; α = .82). The Play Interaction and Social Competence subscale scores were highly correlated (r = .77, p < .001), and were averaged to compose a total social competence score.

Executive function

EF was measured by two commonly-used tasks that require children to hold a new rule in mind, detect the conflict between dominant and subdominant responses, and inhibit the natural dominant response:

Day-night task

In the modified version (Orta, Corapci, Yagmurlu, & Aksan, 2013) of the day-night task (Gerstadt, Hong, & Diamond, 1994), the child was instructed to show the picture of a nighttime sky with a moon and stars when the experimenter says the word ‘day’ and to show the picture of the daytime sky with suns when the experimenter says the word ‘night’. After practice trials, he/she was administered a series of 10 test trials where each correct response was scored as 1 point. A proportion score—the number of correct responses divided by the total number of trials—was calculated as a measure of performance on the task.

Peg-tapping task

In the peg-tapping task (Diamond & Taylor, 1996), a wooden peg was presented and the child was instructed to tap twice right after the experimenter tapped once (Rule 1) and to tap once after the experimenter tapped twice (Rule 2). After practice trials, he/she was administered a series of 12 test trials with each correct tapping response scored as 1 point. Next, a new rule (Rule 3) was added to the task: not to tap after the experimenter tapped three times. After passing the practice trials, the child was administered a new series of 12 test trials and received 1 point for each correct tapping response. A proportion score was calculated as a measure of performance on the task. The day-night and peg-tapping tasks had a positive correlation, r = .48, p < .001; thus, the two task scores were averaged to compute a composite score of EF (see Hughes & Ensor, 2008).

Receptive language

The Turkish Expressive and Receptive Language Test (Berument & Güven, 2010) was used to measure receptive language. It is the Turkish equivalent of the Peabody PVT test. The latent vocabulary scores were obtained by applying a three-parameter Item Response Theory model, which were then regressed on linear and quadratic indicators of age (in months) to obtain the residualized scores (Baydar et al., 2014). The obtained z scores were used as the indicator of receptive language ability level.

Procedure

The data were collected after getting the approval of the University Ethics Committee and the Ministry of Family and Social Policies. Two visits were held within 2 days for behavioral assessments. In the first visit, the ToM scale was given to the child by a female experimenter in a separate and quiet room with no one else present. Since Wellman and Liu (2004) found no effect of task order on ToM performance, the scale was given to all the children in the same order. In the second visit, the child was first given the language test and then the EF tasks by the same female experimenter. No child displayed any discomfort and every child completed each session. The forms and scales were completed by the child’s primary care provider in the institution in the first or the second day.

Results

For preliminary analyses, a ToM score out of six tasks was calculated (M = 2.56, SD = 1.15). Of all the children, 2% had a score of 0; 16% had a score of 1; 35% had 2; 23% had 3; 21% had 4; 5% had a score of 5; and none of the children passed all the six ToM tasks. The 6-item ToM task score was positively correlated with the child’s age, r = .42, p < .001 and did not differ significantly in girls and boys, F(1, 105) = .22, ns.

Two sets of statistical analyses were conducted to examine the developmental sequence of ToM acquisition. First, whether the six ToM tasks were similar or different in terms of difficulty level was explored. Next, scaling of the ToM tasks was analysed.

Pairwise comparisons

Initially, the performance of the children on each task was examined: 91% of children passed DD, 71% passed DB, 44% passed KA, 20% and 12% of children passed EFB and CFB, respectively, and 19% of them passed HE. To examine the difficulty level of the six tasks, McNemar’s chi-square tests were conducted. The pairwise comparisons indicated that all tasks were significantly different from each other in terms of difficulty (p = .0001), except three: EFB, HE, and CFB. 1) The number of pairs where children passed EFB but not HE (51%) was not significantly different from the number of pairs where children passed HE but not EFB (49%), McNemar’s χ²(1) = 0, ns. 2) The number of pairs where children passed HE but not CFB (61%) was not significantly different from the number of pairs where children passed CFB but not HE (39%), McNemar’s χ²(1) = 1.16, ns. 3) The number of pairs where children passed EFB but not CFB (63%) was not significantly different from the number of pairs where children passed CFB but not EFB (37%), McNemar’s χ²(1) = 1.63, ns. These pairwise comparisons showed that EFB, HE, and CFB tasks did not differ from each other in terms of difficulty level. Thus, EFB and HE were excluded from further analysis. Wellman and Liu (2004) found that EFB and CFB were similar in difficulty level, and did not use EFB in further analysis but kept only the CFB task as an indicator of false belief. We preferred to keep FB in the ToM score, rather than HE, since FB is conceptualized as one of the main aspects of ToM (Wellman & Liu, 2004) and it is emphasized to be an important aspect of mind understanding that is related with social competence (Astington, 2003). In the rest of the article, FB is used to refer to the CFB task.

Guttman scale sequences

For this set of analysis, Guttman scale sequences of four tasks (DD, DB, KA, FB) were examined. Guttman scaling is a method used to establish a pattern in a scale in which items are ranked depending on their difficulty; thus, if a respondent passes an item, he/she must pass all previous items (Guttman, 1950). By Guttman scaling, reproducibility of a set of items is estimated to make the items fit the ideal patterns (Green, 1956). As shown in Table 2, responses of 89% of the children (95 of 107) fit this 4-item Guttman scale. Using Green’s method of estimation, the coefficient of reproducibility was calculated to identify the scalable items (values > .90). The coefficient of reproducibility of the data was .97. In addition, Green’s index of consistency, which is regarded as a highly conservative measure, was calculated to test whether or not the observed coefficient of reproducibility was higher than what could be achieved by chance alone (values > .50). The index of consistency of the data was .57. Both coefficients indicated that the 4-item ToM scale was highly scalable. In contrast, for the 5-Item Guttman scale (DD > DB > KA > FB > HE), the coefficient of reproducibility of the data was .94, and the index of consistency was .33. It was not scalable for this data set.

Table 2.

Guttman scalogram patterns for a four-item scale.

Pattern	1	2	3	4	5	Other patterns
Diverse desire	−	+	+	+	+
Diverse belief	−	−	+	+	+
Knowledge access	−	−	−	+	+
Contents false belief	−	−	−	−	+
Participants
3-year-olds (n = 21)	4	8	5	3	0	1
4-year-olds (n = 39)	0	5	19	9	3	3
5-year-olds (n = 47)	1	4	11	15	8	8
Total (N = 107)	5	17	35	27	11	12

Note. A minus sign means the child failed the task; a plus sign means child passed the task. The five focal patterns represent five of the total possible 16 patterns of response encompassing the four items. Child showing any of the remaining 11 patterns was classified as other.

After it was confirmed that the four tasks formed a scalable set with a progressive sequence of DD > DB > KA > FB, the total ToM score was calculated out of 4 tasks (see Table 2). In total, 5% of the children had a score of 0; 20% had 1; 39% had 2; 26% had 3; and 10% had a score of 4. The ToM total score was positively correlated with age, r = .45, p < .001, but did not differ in girls and boys, F(1, 105) = .09, ns.

Age- and sex-related differences

ANOVAs were performed to examine age-related differences in EF, ToM, and social competence of 3-, 4-, and 5-year-old children (see Table 1). Overall differences between the three age groups were significant for EF, F(2, 104) = 16.18, p < .001, ToM, F(2, 104) = 10.22, p < .001, and social competence, F(2, 104) = 7.60, p = .001.

Because boys were significantly older than girls, F(1, 105) = 5.23, sex-related differences were examined via ANCOVAs controlling for age. The results showed that girls were more socially competent than boys, F(1, 104) = 13.53, p < .001, but boys and girls did not significantly differ on ToM, EF, and language.

Correlations among variables

Zero-order correlations revealed that age was strongly and positively correlated with EF, ToM, and social competence (see Table 3). Correlations of language with EF and social competence, and the relation between EF and ToM were significant both before and after age was controlled. When age was controlled, the significant correlation between EF and social competence became marginal, the one between ToM and social competence disappeared (correlations of social competence with any of the six individual aspects of ToM were also non-significant when age was taken into account), and the correlation between language and ToM became significant but still was low. The number of children per caregiver increased as age increased. After controlling for age, the significant correlation of child–staff ratio with EF and social competence faded away. None of the child outcomes were associated with percentage of life in institution.

Table 3.

Zero-order correlations and partial correlations after age is controlled (N = 107).

Variables	1	2	3	4	5	6	7
1. Age	–
2. Percentage of life institutionalized	.12	–	.25**	−.05	.04	.14	.05
3. Child-staff ratio	.36***	.19†	–	−.07	.03	.09	.16
4. Language	.00	.05	.06	–	.37***	.20*	.30**
5. Executive function	.54***	.04	.22*	.31***	–	.30**	.18†
6. ToM	.45***	.18†	.09	.18†	.47***	–	.07
7. Social competence	.38***	.00	.27**	.28**	.35***	.23*	–

Note. Zero-order correlations are presented below the diagonal, and partial correlations controlling for age are presented above the diagonal. The correlation between age and language was 0, since language score was age-standardized.

†p = .06; *p < .05; **p < .01; ***p ≤ .001.

Predictive associations among variables

Two sets of hierarchical regression analyses were conducted to examine the predictive role of 1) EF in ToM, and 2) EF and ToM in social competence (see Table 4). Child’s age and sex were introduced into the equation in the first step in all regression analyses. Because ‘percentage of life spent in institution’ and ‘child–staff ratio’ were not significantly associated with any of the study variables, they were not examined further in the regressions.

Table 4.

Hierarchical regression analysis predicting (1) ToM from language and executive function (2) Social competence from language, executive function, and ToM.

	Step 1			Step 2			Step 3 (regression 1)			Step 3 (regression 2)
	B	SE	β	B	SE	β	B	SE	β	B	SE	β
(1) DV:ToM
Age	.05	.01	.48***	.05	.01	.48***	.04	.01	.34**
Sex	−.32	.21	−.13	−.31	.21	−.13	−.24	.20	−.10
Language				.19	.09	.18*	.11	.09	.10
Executive function							.92	.40	.25*
R ²	.22			.25			.29
F for change in R²	14.62***			4.48*			5.39*
(2) DV:Social Competence
Age	.21	.04	.45***	.21	.04	.45***	.20	.05	.43***	.22	.05	.47***
Sex	–3.48	.95	−.32***	–3.46	.90	−.32***	–3.41	.92	−.32***	–3.52	.92	−.33***
Language				1.28	.38	.27***	1.24	.41	.26**	1.32	.39	.28***
Executive function							.54	1.78	.03
ToM										−.21	.43	−.05
R ²	.24			.32			.32			.32
F for change in R²	16.45***			11.17***			.09			.22

Note. *p < .05; **p < .01; ***p < .001.

The first set of regression analysis revealed that child’s age significantly predicted ToM in the first step and language further contributed to the prediction of ToM in the second step. In the third step, when EF was entered into the equation, the coefficient for language became non-significant, and ToM was significantly predicted by age and EF. Taken together with the result that language and EF were significantly correlated (before and after age was controlled), these findings suggest that EF mediated the relation between language and ToM.

The second set of regressions showed that age and sex (being a girl) and language significantly predicted social competence. And neither EF nor ToM were significant predictors of social competence when individually introduced to the equation in the third step, one at a time.

Discussion

Steps in theory of mind development

Pairwise comparisons showed that the two FB tasks, EFB and CFB tasks, were not significantly different in terms of difficulty level. This finding was similar to the earlier ones obtained by Wellman and Liu (2004) for US children and by Wellman et al. (2006) for Chinese children. Children’s similar performance levels on the FB tasks with different formats and materials suggested that these tasks successfully tap the same concept, and success or failure on them is not mainly an artifact of task features (Wellman & Liu, 2004).

Similar to what Wellman and Liu did, we used CFB in further analysis as the indicator of FB. In the two studies conducted by Wellman and colleagues (Wellman & Liu, 2004; Wellman et al., 2006), FB understanding was significantly easier than HE understanding. In the present study, however, HE did not differ from FB in terms of difficulty level (the same result was obtained with both CBF and EFB). An explanation for this pattern is that both FB and HE tasks require an understanding of conflicting mental representations. The FB task requires recognizing another person’s belief, although this belief contradicts with reality; and the HE task requires recognizing another person’s apparent emotion, although this apparent emotion contradicts with his/her real emotion. Another explanation is about the facilitating role of distinct experiences in the understanding of hidden emotions. Peterson et al. (2005) found that children with autism acquired an understanding of hidden emotions earlier than false beliefs. They suggested that due to differences in neurological functioning and environmental factors, such as instructional strategies used in special education, children with autism may develop techniques to deal with real and apparent emotions without an understanding of mental states. It is possible that, in our sample, understanding hidden emotions was similarly facilitated by children’s non-normative experiences that come with severe poverty, perhaps maltreatment, and certainly parental loss or separation. Exposure to a variety of emotional situations, many of which are probably negative, might have increased both the children’s sensitivity to emotion-eliciting experiences (Trentacosta, Izard, Mostow, & Fine, 2006) and their knowledge of emotions (Harris, 2000). Such a personal history could have facilitated institution-reared children’s awareness that emotions are sometimes masked for social reasons and one’s real emotion can be different from how it looks.

Since understanding hidden emotions and false beliefs had similar difficulty, the 5-item sequence was not scalable. We preferred to keep the FB task in the scale (and the ToM composite score) because it is the central aspect of ToM that is commonly studied in the literature, especially in relation to social competence. The analysis conducted with the four tasks revealed a progressive sequence of DD > DB > KA > FB. This order indicated that our sample of Turkish preschoolers first understood diversity in non-cognitive mental states such as desires; then, they acquired an understanding of cognitive mental states like beliefs and knowledge; and later the conflicting mental representations like FB. This sequence was in line with the “individualistic pattern” (DB > KA) observed in US (Wellman & Liu, 2004), Australian (Peterson et al., 2005), and Indonesian (Kuntoro et al., 2013) children, but not the “collectivistic pattern” (KA > DB) found in Chinese (Wellman et al., 2006) and Iranian (Shahaeian et al., 2011) samples (see the Appendix for a comprehensive summary). This pattern that we found might be due to the specific type of home environment where many of the children had lived together with a large number of children of similar ages for a considerable amount of their lives. Although these children have limited one-on-one caregiver interaction which is critical for ToM development, the relative ease of understanding diverse beliefs could be the outcome of their frequent exposure to various thoughts and opinions during their long-term and rich interaction with many peers in the institution. It might be reflecting just the relative ease of understanding diversity in beliefs than understanding knowledge, as true for many other child samples, such as in the US, Australia, and Indonesia. The pattern revealed in this study has to be replicated with parent-reared samples for reaching a conclusion about the developmental sequence of ToM acquisition in Turkish preschoolers.

Predictors of theory of mind and social competence

In line with the literature (e.g., Carlson et al., 2004; Hughes, 1998; Perner et al., 2002) and our expectations, EF significantly predicted ToM over and above the child’s age and receptive language. Conflict inhibitory control requires the child to hold back a dominant response, to keep a conflicting new response in mind, and to activate it. Similarly, ToM requires inhibiting the actual or own mental representations, holding the other’s mental representations in mind, and activating a response/behavior from the perspective of the other (Carlson & Moses, 2001). As Russell (1996) claimed, this association implies two processes: EF may facilitate the emergence of ToM by assisting the comprehension of mental states, or it may facilitate the expression of ToM by enabling the child to reflect on his/her mental state knowledge in behaviors. Accumulating evidence suggests that improvement in controlling attention and managing new information is necessary for processing different mental states.

The finding that EF mediated the relations between receptive language and ToM is also supportive of the links suggested in earlier empirical and theoretical works. Associations between language and ToM (Carlson et al., 2004), and between language and EF (Hughes & Ensor, 2008) have been widely reported in earlier studies. It seems possible that language contributes to ToM in various ways (see Astington & Baird, 2005). In their meta-analysis, Milligan et al. (2007) also revealed that early language ability, including receptive language, strongly predicted later FB in preschool children. It is no wonder that communication introduces various minds to the child, makes him/her aware of the presence of different desires, beliefs or knowledge that he/she is unfamiliar with (Nelson, 2005). Vocabulary knowledge, in particular, is a way to understand mental states; it helps the child to capture various mind expressions and moves him/her towards the acquisition of ToM.

Studies also showed that vocabulary knowledge is a significant predictor of general cognitive ability (Marchman & Fernald, 2008) and executive skills. Verbalized instructions for the behavior help the child to think aloud about the appropriate behavior and how to activate that behavior. This way, the child develops self-speech for self-regulation. Thus, increased use of self-speech contributes to improvement in the cognitive component of self-regulation, which is EF (Carlson et al., 2004). Receptive language works as a tool for the child to regulate his/her cognitive abilities; it leads to an enhancement in executive functions, which in turn may facilitate the ability to understand others’ mental representations.

The analyses also highlighted the importance of early receptive language for social competence. This result is consistent with earlier findings (e.g., Gertner et al., 1994) and conceptualizations that emphasize communicative ability as crucial for understanding social demands and for responding to them effectively (see Hart et al., 2003). Kaler and Kopp (1990) found that comprehension of requests was associated with compliance to the requests, even as early as 12 months of age. Our finding correspondingly suggests that understanding what others express in words enhances communication and increases the chance that the child will engage in appropriate behavior that matches the social situation.

Our prediction that EF and ToM would be associated with social competence was partly confirmed. The moderate and significant correlations of social competence with EF and ToM both became non-significant when the child’s age and/or language ability were accounted for. These results suggest that the shared variance of both EF and ToM with social competence is partially due to age-related synchronal changes occurring in the child’s cognitive and social abilities. The studies (e.g., Razza & Blair, 2009) that investigated the relation of EF with social competence, but not behavior problems, have likewise revealed that the strength of this association diminished considerably when age or language was controlled.

The literature on social competence and ToM reveals both a positive significant relation (e.g., Watson et al., 1999) and a non-significant relation (e.g., Badenes et al., 2000) between the two abilities. It is, however, acknowledged that understanding other’s mental state (e.g., in the context of need) does not ensure prosocial acts (e.g., helping, sharing) (Astington, 2003), because other factors such as motivation and characteristics of the recipient play a significant part in social behavior. It is also asserted that the links between the two domains can be identified when social competence is measured to really tap the behaviors that require understanding others’ minds (Astington, 2003). For instance, while both comforting and helping daily activities are positive behaviors, comforting behavior requires understanding thoughts or emotions of the other, but helping daily activities is displayed more as part of the learned behavior patterns; hence it is more conventional, requiring little perspective-taking. In the present study, we wanted to investigate a large range of children’s socially competent behaviors, and accordingly, our social competence score reflected various modalities of positive and adaptive behavior, including the ones that probably did not necessitate an advanced mind understanding (e.g., “works easily in groups”). However, even when we picked the social competence items that visibly demanded an understanding of others’ mental states (eight items; e.g., “comforts others when hurt”; α = .85), the association between ToM and social competence was still non-significant (r = .16, p = .09), suggesting that the weak link we found between ToM and social competence was not an artifact of our measurement methods.

Conclusion

Highlighting the strengths and weaknesses of the study is necessary for an accurate interpretation of the findings. A strength was the use of a comprehensive ToM measure that assesses children’s understanding of different mental states, such as diverse desires and beliefs, knowledge access, and false beliefs. So far, studies (e.g., Razza & Blair, 2009) on the associations between social competence, ToM, and EF have mainly focused on FB as the key indicator of mental state understanding. A limitation of the study was, however, related to the measurement of social competence. It depended solely on child-care provider reports, since observation methods could not be employed due to the strict restrictions of the Turkish Ministry of Family and Social Policies on videotaping children.

It must also be acknowledged that the correlational nature of the data does not allow causal inferences to be drawn. We used the term “predictor” in the statistical sense and following from this, discussed some of the findings in terms of one factor having a “role” in another. However, it is recognized that there can be complex feedback loops among developmental domains and it would be more possible to delineate these intricate relationships with longitudinal studies.

The results of this study are also informative about the nature of ToM acquisition in children residing in institutions in Turkey. The investigation of sequential progression in mental state understanding contributes to the accumulating literature on the role of cultural context in ToM development.

The results presented here pertain to institution-reared children who were born into disadvantaged families in Turkey. Our data do not allow arriving at a conclusion on these developmental abilities (e.g., their levels, associations) in average Turkish preschool children who live with their families. Future studies that include both parent-reared and institution-reared samples will be informative in this respect, and will let us identify any lag in development of disadvantaged child groups and spot differences in their developmental pathways, if any. While we presently cannot make comparative statements in this regard, our findings are enlightening, especially for pointing at the importance of early language ability in social competence and EF, and for its indirect role in ToM through enhancing executive skills. An applied implication of this finding is that early linguistic stimulation is critical for development of children coming from deprived environments. Intervention programs that target early receptive vocabulary would benefit various other areas of development as well, sociocognitive, cognitive, and social.

Footnotes

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Note

Appendix

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