Selective Training of Theory of Mind in Traumatic Brain Injury: A Series of Single Subject Training Studies

Abstract

Primary Objective: To examine the potential for treating deficits in Theory of Mind (ToM), i.e., using a person's beliefs to understand and predict behaviour, and to test the hypothesis that improvements in ToM can be distinguished from performance in other domains such as judging line orientation and executive function. Materials and Methodology: In Study 1, two individuals with TBI participated in a protocol targeting ToM, which was assessed using a cartoon interpretation task. Participants also performed on a short form of the Benton Judgment of Line Orientation Task as a control. In Study 2, a third person with TBI participated in Attention Process Training (APT-1) followed by the ToM protocol. Executive function was assessed using the Paced Auditory Serial Addition Task (PASAT). Results: In Study 1, ToM performance but not judgments of line orientation responded to the ToM training. In Study 2, executive function, but not ToM, showed strong improvement with APT-1. In contrast, ToM but not executive function showed significant improvement with ToM training. Conclusion: ToM is a good candidate for intervention. For three persons with TBI, ToM performance showed selective improvement associated with ToM treatment, which suggests a practical as well as theoretical value for distinguishing ToM from executive function.