SLI gemiddeld
5.1 Aanbevelingen voor vervolgonderzoek
Een aspect uit het onderhavige onderzoek dat verder onderzocht dient te worden is de mate waarin jongens en meisjes met SLI of PDD-NOS verschillen in hun ToM-vaardigheden en wat de relatie is met taal. Uit het onderzoek van Blijd-Hogewys (2009) blijkt al dat meisjes voorlopen in hun ToM-ontwikkeling en ook het onderzoek van Cheung (2006) wijst uit dat de spiegelneuronen van vrouwen meer uitgesproken reacties vertonen dan de spiegelneuronen van mannen.
Ook het relateren van spiegelneuronen aan ToM en de invloed van taal hierop zou veel duidelijkheid verschaffen over de ontwikkeling van sociaal-emotioneel gedrag.
Zoals eerder aangegeven zou het onderzoek opnieuw uitgevoerd kunnen worden waarbij de twee onderzoeksgroepen gematcht worden op taalniveau. In dit kader kan de relatie tussen ToM en taal verder uitgediept worden. De resultaten zouden bovendien een uitspraak doen over de validiteit van de ToM-test van Steerneman et al. (2003). Ook is het mogelijk om andere testen zoals de Nijmeegse Pragmatiektest in het onderzoek te betrekken om ook andere pragmatische vaardigheden naast de resultaten te kunnen leggen. Het vergroten van de onderzoeksgroepen zou bovendien de betrouwbaarheid van de resultaten ten goede komen.
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Samenvatting
Kinderen met SLI komen in Nederland meestal terecht op scholen voor kinderen met ernstige spraak en/of taalproblemen. Kinderen met PDD-NOS die vooral problemen ondervinden in hun taalontwikkeling en communicatieve vaardigheden worden ook vaak op deze scholen geplaatst waardoor beide groepen kinderen bij elkaar in de klas komen. Hoewel de twee stoornissen verschillende oorzaken en vaak ook uiteenlopende taalontwikkelingspatronen hebben, is er overlap tussen de communicatieproblemen die deze twee groepen kinderen ondervinden. Uit onderzoek is gebleken dat zowel kinderen met SLI (Holmes, 2002; Tucker, 2004) als kinderen met PDD-NOS (Sicotte & Stemberger, 1999; Blijd-Hoogewys, 2008) een vertraagde ontwikkeling van hun Theory of
Mind (ToM) hebben. ToM is het vermogen om een theorie te vormen van de gedachten en emoties
van een ander (Astington, 1998; Astington & Jenkins, 1999). De ToM-ontwikkeling is op te delen in verschillende bouwstenen (Steerneman et al., 2003). Een verstoorde ToM veroorzaakt problemen in de sociale interactie.
Het onderhavige onderzoek heeft tot doel om de patronen van beide groepen kinderen uiteen te zetten wat betreft de relatie tussen hun taalvaardigheden en hun ToM-vaardigheden. Er is een groep kinderen met SLI (n=11) en een groep kinderen met PDD-NOS (n=8) in de leeftijd van 7;04 jaar tot 10;00 jaar onderzocht. Hiervoor zijn diverse taaltesten afgenomen waarmee hun receptieve en productieve semantische en morfosyntactische vaardigheden in kaart zijn gebracht. Deze vaardigheden zijn vervolgens gerelateerd aan de bouwstenen in de ToM-ontwikkeling, die zijn getest middels de ToM-test van Steerneman et al. (2003). Ten eerste is bepaald in hoeverre de twee onderzoeksgroepen van elkaar verschillen wat betreft de taalvaardigheden en de ToM-vaardigheden. Het blijkt dat de groep kinderen met SLI op bijna alle taaltesten en op alle ToM-vaardigheden lager scoort dan de groep kinderen met PDD-NOS. Ten tweede is voor beide onderzoeksgroepen de relatie beschreven tussen hun taalvaardigheden en hun ToM-vaardigheden. Tot slot zijn de groepen met elkaar vergeleken wat betreft de relaties tussen hun taalvaardigheden en hun ToM-vaardigheden. Het blijkt dat er geen overeenkomstige correlaties zijn. De groepen laten dus een verschillend patroon zien. Waar kinderen met SLI mogelijk wel begrijpen wat er in een ander om gaat, maar problemen krijgen wanneer hen verbaal wordt gevraagd hier uiting aan te geven, zit bij kinderen met PDD-NOS waarschijnlijk al een probleem in het zich daadwerkelijk verplaatsen in een ander.
Bij beide groepen blijkt dat diverse taalvaardigheden een rol spelen in de ontwikkeling van ToM. Zowel bij kinderen met SLI als bij kinderen met PDD-NOS zijn zowel receptieve als productieve semantische en morfosyntactische vaardigheden gerelateerd aan de prestaties op de verschillende ToM-vaardigheden. Semantiek lijkt de belangrijkste rol te spelen. De gevonden relaties zijn meestal te verklaren uit de overeenkomst tussen de vraagstellingen waarmee de verschillende bouwstenen getest worden en de desbetreffende taalvaardigheden. Het feit dat de gebruikte ToM-test (Steerneman et al., 2003) een talige test is waarbij gebruik gemaakt is van complexe morfosyntactische constructies, wordt hierbij als kanttekening geplaatst. In aansluiting op Cheung et al. (2004) blijkt uit het onderzoek dat taal in zijn totaliteit een belangrijke bijdrage levert aan Theory
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Summary
In the Netherlands, not only children with SLI attend special schools for children with severe speech and language problems. Also children with PDD-NOS attend these schools, but only on condition that they show problems in social interaction or in their language development. This results in a situation where these groups of children are being placed in the same classes. Between these groups there is some overlap in the problems they experience with communication, although both of the disorders have different aetiologies and vary in their patterns of language development. Both children with SLI (Holmes, 2002; Tucker, 2004) and children with PDD-NOS (Sicotte & Stemberger, 1999; Blijd-Hoogewys, 2008) are found to have a delayed development of Theory of Mind (ToM). ToM is the cognitive ability to attribute mental states, like thoughts and emotions, to oneself and others (Astington, 1998; Astington & Jenkins, 1999). The development of ToM can be divided into various stages (Steerneman et al., 2003). A disabled ToM causes problems with social interaction.
This study examines the patterns of both groups, concerning the relation between their language skills and their ToM-skills. Eleven children with SLI and eight children with PDD-NOS were included in the study. Their ages vary from 7;04 years to 10;00 years. Through different sets of tests their receptive and productive semantic and morphosyntactic skills were tested. These skills were related to the different ToM-skills, which were examined with the ToM-test (Steerneman et al., 2003). The first goal of the study is to asses to what extend the two groups differ in their language skills and their ToM-skills. Results showed lower scores for the children with SLI on almost all of the language tests. They also showed lower scores on the ToM-skills than children with PDD-NOS. A second goal of the study is to describe for both groups to what amount their language skills are related to their ToM-skills. Finally, a comparison is made between both groups concerning these relations. Results show no overlap in the correlations, which means that the two groups show different patterns. Previous research shows that children with SLI are able to attribute a mental state to others, but have problems with expressing these emotions and thoughts verbally. In contrast, children with PDD-NOS experience difficulties earlier in the ToM-process, particularly with understanding the mental states of others.
For both groups, several language skills seem to play a role in the development of ToM. Receptive as well as productive semantic and morphosyntactic skills are found to be related to their performances on various ToM-skills for both groups. The results of this study show an important effect of semantics on this relation.The presented relations could be explained by the structure of the questions in the ToM-test (Steerneman et al., 2003). A similarity is identified in the syntactic structure of these questions and the tested language skills. The ToM-test contains several complex morphosyntactic constructions, which is an important comment on the results. According to Cheung et al. (2004), language as a whole plays an important role in Theory of Mind. It facilitates the ability to attribute emotions, thoughts and ideas to others in order to express them. The results of this study support these findings.
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