Clinical pragmatics and theory of mind

Theory of mind (ToM) describes the cognitive ability to attribute mental states both to one’s own mind and to the minds of others. In recent years, ToM has been credited with playing a significant role in developmental and acquired pragmatic disorders. In this way, ToM deficits have been linked to pragmatic deficits in individuals with autism spectrum disorders (e.g. Martin and McDonald, Journal of Autism and Developmental Disorders, 34, 311–328, 2004), emotional and behavioural disorders (e.g. Buitelaar et al., Development and Psychopathology, 11, 39–58, 1999), intellectual disability (e.g. Cornish et al., Journal of Intellectual Disability Research, 49, 372–378, 2005), right-hemisphere damage (e.g. Winner et al., Brain and Language, 62, 89–106, 1998), schizophrenia (e.g. Brüne and Bodenstein, Schizophrenia Research, 75, 233–239, 2005), traumatic brain injury (e.g. McDonald and Flanagan, Neuropsychology, 18, 572–579, 2004) and neurodegenerative disorders such as Alzheimer’s disease (e.g. Cuerva et al., Neuropsychiatry, Neuropsychology, and Behavioral Neurology, 14, 153–158, 2001). In this chapter, I examine the central role of ToM reasoning in utterance interpretation. The chapter addresses what is known about ToM development during childhood and adolescence as well as changes in ToM skills as part of the aging process. The role of ToM in developmental and acquired pragmatic disorders is discussed. The contribution of ToM research into pragmatic disorders is critically evaluated. Finally, several ToM theories are examined. The question is addressed of which, if any, of these theories is able to capture the pragmatic features of utterance interpretation.