Speech-Language Pathologists' Implementation of Theory of Mind Concepts Within Therapy: An Exploratory Survey

Abstract

Purpose: Understanding others' mental states including thoughts (cognitive theory of mind [ToM]) and feelings (affective ToM) is an important component of communication, particularly for individuals with communication challenges. Speech-language pathologists (SLPs) are critical members of the team that supports these individuals; however, little is currently known about how SLPs approach therapy involving ToM components. This exploratory study seeks to establish foundational knowledge about the current practices SLPs use when incorporating ToM. Method: SLP participants completed an online survey ( N = 86) that asked about their incorporation of ToM topics and skills into therapy with a focus on literacy activities. Results: All SLPs reported working on ToM topics to some extent, most frequently on emotional awareness in the self and others and to a lesser extent on understanding others' thoughts. They reported targeting ToM components with different clinical populations: mostly individuals with autism spectrum disorder and social communication disorder, but also those with expressive/receptive language disorders and preschool-age students. The majority of SLPs reported using books to work on ToM skills. We provide a summary of the various features of books that SLPs used in the selection process and with their reported relative importance. Conclusions: Many SLPs reported working on affective ToM and to a lesser extent cognitive ToM with children who have a variety of communication needs. Children's books were a common way in which many SLPs targeted a variety of communication goals in addition to perspective-taking or ToM topics. Understanding the current implementation of ToM topics in therapy can help guide neurodiversity-affirming intervention and literacy practices for currently practicing SLPs. Supplemental Material: https://doi.org/10.23641/asha.24175557