Theory of Mind and referring expressions after Traumatic Brain Injury

Noga Balaban, Michal Biran, Yaron Sacher

Research output: Contribution to journalArticlepeer-review


Background: This study focused on the linguistic consequences of damage to Theory of Mind (TOM) in patients after Traumatic Brain Injury (TBI). It was designed to extend a previous study that tested the consequences of TOM impairment (aTOMia) on referring abilities in right-hemisphere damaged patients. Aims: To explore whether aTOMia in patients with TBI affects their use and comprehension of various referring expressions (definite and indefinite noun phrases, proper names and pronouns). Methods and Procedures: We identified individuals with TOM impairment (aTOMia) in a group of 15 TBI patients using a battery of six types of TOM task. We then tested two groups of TBI patients: participants with aTOMia and participants without aTOMia, compared to a control group of non brain-damaged participants. Four TOM-related language tasks assessed their ability to vary the use of referring expressions according to the knowledge of the discourse partners. Outcomes and Results: Five of the participants showed TOM impairment (aTOMia), whereas ten showed intact-TOM ability. The two groups did not differ according to most neuropsychological measures, or on grammatical performance. On the TOM-related language tasks the participants with aTOMia performed consistently worse than the participants with TBI and intact-TOM, and the control group. Conclusions: Individuals after TBI do not form a homogenous group regarding their TOM abilities. Some patients show TOM-related language impairment, and should be considered for language evaluation and treatment focusing on aspects of language that depend on TOM ability.

Original languageEnglish
Pages (from-to)1319-1347
Number of pages29
Issue number11
StatePublished - 2 Nov 2019

Bibliographical note

Publisher Copyright:
© 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.


  • Hebrew
  • Theory of Mind
  • Traumatic Brain Injury
  • aTOMia
  • language
  • referring

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Language and Linguistics
  • Developmental and Educational Psychology
  • Linguistics and Language
  • Neurology
  • Clinical Neurology
  • LPN and LVN


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