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Although children with fetal alcohol spectrum disorders (<jats:styled-content style=\"fixed-case\">FASD<\/jats:styled-content>) are known to have deficits in social\u2010cognitive function, little is known about ToM in <jats:styled-content style=\"fixed-case\">FASD<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>ToM ability was assessed using a developmentally sensitive ToM battery, including the reading the mind in the eyes (<jats:styled-content style=\"fixed-case\">RME<\/jats:styled-content>) test, a measure of mental inferential ability that has been found to be impaired in other clinical populations. <jats:styled-content style=\"fixed-case\">IQ<\/jats:styled-content> and executive function (<jats:styled-content style=\"fixed-case\">EF<\/jats:styled-content>) were assessed as potential mediating variables. The battery was administered to 63 children (aged 9 to 11\u00a0years) from Cape Town, South Africa, whose mothers had been prospectively recruited during pregnancy. Children with fetal alcohol syndrome (<jats:styled-content style=\"fixed-case\">FAS<\/jats:styled-content>;<jats:italic> n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>8) and partial <jats:styled-content style=\"fixed-case\">FAS<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">PFAS<\/jats:styled-content>;<jats:italic> n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>19), as well as nonsyndromal heavily exposed children (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>17), were compared to children born to abstaining or light drinkers (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>19<jats:italic>)<\/jats:italic> from the same community.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No <jats:styled-content style=\"fixed-case\">FASD<\/jats:styled-content> group differences were found on the less challenging ToM tasks. By contrast, children with <jats:styled-content style=\"fixed-case\">FAS<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">PFAS<\/jats:styled-content> performed more poorly than controls on a more challenging ToM task, the <jats:styled-content style=\"fixed-case\">RME<\/jats:styled-content> test. A continuous measure of prenatal alcohol exposure (PAE) was more sensitive than <jats:styled-content style=\"fixed-case\">FASD<\/jats:styled-content> diagnosis in that it was related to 4 higher\u2010order ToM measures, particularly the ability to attribute mental states assessed on <jats:styled-content style=\"fixed-case\">RME<\/jats:styled-content>. <jats:styled-content style=\"fixed-case\">IQ<\/jats:styled-content> only partially mediated the effect of exposure on <jats:styled-content style=\"fixed-case\">RME<\/jats:styled-content> performance, and these effects were not mediated by <jats:styled-content style=\"fixed-case\">EF<\/jats:styled-content>. Hence, the data suggest that these ToM measures tap into a specific alcohol\u2010related social\u2010cognitive deficit that does not merely reflect poorer <jats:styled-content style=\"fixed-case\">EF<\/jats:styled-content>. <jats:styled-content style=\"fixed-case\">FASD<\/jats:styled-content> diagnosis and PAE were each also related to <jats:styled-content style=\"fixed-case\">RME<\/jats:styled-content> after control for attention deficit\/hyperactivity disorder.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These findings suggest that deficits in higher\u2010order ToM function may play a significant role in the social\u2010cognitive behavioral impairment in <jats:styled-content style=\"fixed-case\">FASD<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acer.12961","type":"journal-article","created":{"date-parts":[[2016,2,8]],"date-time":"2016-02-08T02:02:14Z","timestamp":1454896934000},"page":"367-376","source":"Crossref","is-referenced-by-count":44,"title":["Theory of Mind in Children with Fetal Alcohol Spectrum\u00a0Disorders"],"prefix":"10.1111","volume":"40","author":[{"given":"Nadine M.","family":"Lindinger","sequence":"first","affiliation":[{"name":"ACSENT Laboratory Department of Psychology University of Cape Town Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Malcolm\u2010Smith","sequence":"additional","affiliation":[{"name":"ACSENT Laboratory Department of Psychology University of Cape Town Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil C.","family":"Dodge","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioural Neurosciences Wayne State University School of Medicine Detroit Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher D.","family":"Molteno","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Mental Health University of Cape Town Faculty of Health Sciences Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin G. 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