Assessing true and false belief in young children with cerebral palsy through anticipatory gaze behaviours: A pilot study

Children with a clinical description of cerebral palsy (CP) commonly experience cognitive and sensory difficulties that co-occur with motor impairment, and for some children this can include impairments in social communication. While research has begun to examine theory of mind abilities in children with CP, relatively little is known about social communication difficulties in this population. Assessing theory of mind abilities in children with CP using traditional procedures such as the classic Sally-Anne task can be problematic if performance is affected by physical difficulties in signalling responses and/or by cognitive and language demands inherent to the task itself. The central aim of this study therefore was to examine the potential of using a new action anticipation task and eye-tracking technique to assess implicit true and false belief understanding in four developmentally young children with quadriplegic cerebral palsy who had little or no functional speech, and one language age matched child with Down syndrome who did not have severe motor impairment. All children in this study consistently demonstrated anticipatory gaze behaviours in the context of the true belief task. One child with CP and the child with Down syndrome demonstrated anticipatory gaze behaviours indicative of an ability to attribute false belief. The findings are discussed in relation to the application of action anticipation and eye-tracking paradigms in research and clinical practice.