Research in Developmental Disabilities 33 (2012) 426–434

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Research in Developmental Disabilities

(Social) Cognitive skills and social information processing in childrenwith mild to borderline intellectual disabilities

M. van Nieuwenhuijzen a,*, A. Vriens b

a VU University Amsterdam, Department of Clinical Child and Family Studies, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlandsb De Bascule, Academic Centre for Child and Youth Psychiatry, P.O. Box 303, 1115 ZG Duivendrecht, The Netherlands

A R T I C L E I N F O

Article history:

Received 22 September 2011

Received in revised form 23 September 2011

Accepted 26 September 2011

Available online 24 November 2011

Keywords:

Mild intellectual disabilities

Children

Cognitive skills

Social information processing

Behavior problems

A B S T R A C T

The purpose of this study was to examine the unique contributions of (social) cognitive

skills such as inhibition, working memory, perspective taking, facial emotion recognition,

and interpretation of situations to the variance in social information processing in children

with mild to borderline intellectual disabilities. Respondents were 79 children with mild

to borderline intellectual disabilities in the age of 8–12 who were given tasks on social

cognitive skills and social information processing. The results from the present study show

that emotion recognition, interpretation, working memory and inhibition skills predict

social information processing skills. It is concluded that especially emotion recognition

and interpretation skills are important cognitive skills that predict social information

processing, and therefore should be the focus of treatment.

� 2011 Elsevier Ltd. All rights reserved.

1. Introduction

Children with mild to borderline intellectual disabilities (MBID) have problems with adaptive functioning in socialsituations and in peer relations. They are less accepted or even rejected by peers and have problems building social relations(Freeman, 2000; Gresham & MacMillan, 1997; Gresham, MacMillan, & Bocian, 1996; Guralnick, 1997; Hall et al., 2005;Maughan, Collishaw, & Pickels, 1999). When confronted with these problems developing adequate social skills from socialinteractions with peers is problematic. In fact, children with MBID are characterized by a lack of adequate social skills(Schalock et al., 2010). As a consequence, they are more likely to show aggressive behavior problems (Dekker, Koot, Van derEnde, & Verhulst, 2002; Einfeld & Tonge, 1996), and antisocial and delinquent behavior than their typically developing peers(Douma, Dekker, De Ruiter, Tick, & Koot, 2007). In addition, 30–40% of youth with MBID is diagnosed with a psychiatricdisorder (Dekker & Koot, 2003; Linna et al., 1999).

Because of these problems a growing number of youth with MBID is indicated to youth care services and disabilityservices. In the Netherlands, 20–25% of the youth receiving care and treatment from these services has a mild to borderlineintellectual disability (Van Nieuwenhuijzen, 2010), as opposed to only 3% of the total population (Leonard & Wen, 2002;McLaren & Bryson, 1987; Roeleveld, Zielhuis, & Gabreels, 1997). International studies indicate that the prevalence of youthwith MBID in the criminal justice system is estimated even higher, and ranges from 35% to 70% (Brand & Van den Hurk, 2008;Herrington, 2009; Kroll et al., 2002; Lenssen, Doreleijers, Van Dijk, & Hartman, 2000).

Despite of the clear overrepresentation of youth with MBID in special services, there is a lack of knowledge of thecompetences and limitations of youth with MBID among care providers, and services are not yet adjusted to the needs of

* Corresponding author. Tel.: +31 20 5988900; fax: +31 20 5988894.

E-mail addresses: m.van.nieuwenhuijzen@vu.nl (M. van Nieuwenhuijzen), a.vriens@debascule.com (A. Vriens).

0891-4222/$ – see front matter � 2011 Elsevier Ltd. All rights reserved.

doi:10.1016/j.ridd.2011.09.025

M. van Nieuwenhuijzen, A. Vriens / Research in Developmental Disabilities 33 (2012) 426–434 427

youth with MBID and additional psychiatric and behavior problems (Baecke et al., 2009; Barron, Hassiotis, & Banes, 2002;Cockram, 2005; Kroll et al., 2002). For prevention and treatment purposes it is highly necessary to gain more knowledge onthe processes that explain social adaptive and behavior problems of these children and youth. The aim of the present study istherefore to examine the underlying factors of social adaptive behavior problems.

To function socially adaptively, complex social cognitive skills are needed. Ample studies with typically developingchildren have shown that the extent in which youth show adaptive or problematic social behavior depends on several socialcognitive processes, so called social information processing (SIP) (e.g. Crick & Dodge, 1994; Dodge & Pettit, 2003). In a socialsituation social information is encoded, behavior of others is interpreted, own emotions are regulated, responses to theproblem situation are generated, selected and enacted. Disturbances in this process lead to problematic functioning.

Also in youth with MBID inadequate SIP seems to play an important role in psychosocial problems (Leffert & Siperstein,1996; Van Nieuwenhuijzen, Orobio de Castro, Wijnroks, Vermeer, & Matthys, 2004, 2009; Van Nieuwenhuijzen et al., 2005,2006). Youth with MBID differ from their typically developing peers in SIP; they encode more negative information, have lessassertive but more submissive and aggressive problem solving skills (Van Nieuwenhuijzen et al., 2004, 2005). In addition,aggressive and externalizing behavior in youth with MBID can be predicted by encoding negative cues, hostile intentattribution, aggressive response generation, negative evaluation of assertive responses and a lack of inhibition (VanNieuwenhuijzen, Orobio de Castro, Van Aken, & Matthys, 2009; Van Nieuwenhuijzen, Orobio de Castro, Wijnroks, et al.,2009).

However, to date there is a lack of knowledge on the development of social information processing of youth with MBID.Dodge and Pettit (2003) propose in their biopsychosocial model that biological factors, such as cognitive limitations, areimportant factors to explain social information processing. From previous research we have indications that cognitivelimitations explain inadequate SIP, as IQ has been found to explain differences in SIP between children with MBID and theirtypically developing peers (Van Nieuwenhuijzen et al., 2004). However the specific cognitive and social cognitive skills toexplain inadequate SIP are not known.

The cognitive capacities that we assume to be the most important for SIP are selective attention, working memory, andinhibition, which are the advanced executive functions that are limited developed in youth with MBID (Masi, Marcheschi &Pfanner, 1998). So far, there is a lack of knowledge on the relation between executive functions and SIP, but preliminaryresults of our own work show a problem with capacity of the working memory to be related to the encoding of less socialinformation in youth with MBID (Van Oers & Van Nieuwenhuijzen, 2009). In addition, problems with inhibition were foundto predict aggressive problem solving skills in children with MBID and behavior problems (Van Nieuwenhuijzen, Orobio deCastro, Van Aken et al., 2009).

Next to these executive functions, social cognitive skills such as perspective taking, emotion recognition and theunderstanding and interpretation of social situations in general, are important conditions to be able to process socialinformation adequately. Perspective taking, or theory of mind, is the ability to see the world through the eyes of someoneelse, and is needed to interpret other people’s behavior and intentions. Research has indicated that perspective taking inchildren with MBID is underdeveloped (Benson, Abbeduto, Short, Nuccio, & Maas, 1993), which may explain their problemsin interpretation and intent attribution.

A second important social cognitive skill is the interpretation of emotional facial expressions. Researchers have shownthat people with MBID have problems with recognizing emotional signals in facial expressions (Dimitrovsky, Spector, &Levy-Shift, 2000; Hetzroni & Oren, 2002; Leung & Singh, 1998; Rojahn, Lederer, & Tasse, 1995; Stewart & Singh, 1995), andthat problems in recognition of emotions in facial expressions are related to behavior problems (Ellis et al., 1997). In fact,adequate recognition of facial expressions is crucial for social information processing. Research has indicated that intentattribution depends on the interpretation of emotional facial expression (Lemerise, Gregory, & Fredstrom, 2005). In a recentstudy by Nieuwenhuijzen, Vriens, Scheepmaker, Smit and Porton (2011), children with MBID were found to score lower onthese skills than their typically developing peers. Thus, because of their problems with recognizing emotions people withMBID may be at higher risk for inadequate interpretation of others intentions and therefore inadequate SIP.

The aim of the present study was to examine the relations between (social) cognitive skills such as inhibition, workingmemory, perspective taking, facial emotion recognition, and interpretation of situations on the one hand and socialinformation processing on the other. The question was whether these cognitive skills have a unique contribution inpredicting social information processing skills in children with MBID, considering the influence of gender, age, intelligenceand behavior problems.

2. Methods

2.1. Participants

The study population was derived from the study on social information processing in children with MBID (VanNieuwenhuijzen et al., 2011) and concerned a sample of children with MBID both with and without behavior problems. Inthe present study a total of 79 children in the age of 8–12 participated. Participants were 63 boys and 16 girls with a mean ageof 10.71 (SD = 1.47) and a mean IQ of 78.72 (SD = 10.57).

The children were selected from special schools, and from an academic center for child and youth psychiatry De Bascule,in order to obtain two groups differing in behavior problems. The children in the first group, the Bascule group, have mild to

M. van Nieuwenhuijzen, A. Vriens / Research in Developmental Disabilities 33 (2012) 426–434428

borderline intellectual disabilities and behavior problems, and were selected from De Bascule, section intellectualdisabilities, which offers ambulant treatment to children with MBID and disruptive behavior problems. Children in thesecond group, the mild to borderline intellectual disabilities group (MBID), were selected from special schools for intellectualdisabilities. Criteria for these schools are below-average intellectual functioning and limitations in social and adaptivebehavior, which is in line with the most recent definition of intellectual disability provided by the American Association onIntellectual and Developmental Disabilities (AAIDD) (Luckasson et al., 2002).

As can be seen in Table 1, these two groups differ in behavior problems. Children in the Bascule group have higher scoreson almost all TRF scales than the MBID group. Their scores on Aggression, Internalizing, Externalizing and Total Problems areeven in the borderline or clinical range. In addition, the groups differed in age; the children in the MBID group are older thanthe Bascule group (see Table 1).

2.2. Measures

2.2.1. Behavior problems

For each child, the teacher completed the Teacher’s Report Form (TRF) of the Child Behavior Checklist (CBCL) (Achenbach,1991; for the Dutch version see Verhulst, Van der Ende, & Koot, 1997). The Dutch version of the TRF has been shown to havegood reliability and validity for the population in general (Verhulst et al., 1997) and for MID children in particular (Dekkeret al., 2002). Using the Dutch norms, T-scores were obtained for the syndrome and broadband scales. For the syndromescales, T-scores higher than 70 fall in the clinical range (98th percentile), and T-scores between 67 (95th percentile) and 70fall in the border range. For the broadband scales Externalizing, Internalizing and Total Problems, T-scores higher than 63 fallin the clinical range, and T-scores between 60 and 63 fall in the border range.

2.2.2. Cognitive functioning

An estimate of the intelligence of the participants was obtained using the Vocabulary and Block Design subtests from theDutch version of the WISC-III (Kort et al., 2005). These two subtests were selected because, together, they strongly correlatewith the complete WISC (r = .86) (Silverstein, 1970a). Estimates of the full scale IQ were made on basis of the sums of thescaled scores on Vocabulary and Block Design (Silverstein, 1970b). In schools where the WISC-IIINL had been administered inthe previous year, the scores from the files were used and the test was not re-administered.

2.2.3. Social information processing

The different SIP steps were measured by using hypothetical situations, presented by both cartoons, pictures and videovignettes, and a structured interview from the SPT-MID, as described in Van Nieuwenhuijzen et al. (2011). In each vignette, aproblem of being placed at a social disadvantage was depicted. All vignettes included both peer-entry and provocationsituations, that have shown to be part of a single factor ‘Being disadvantaged’ (Matthys, Maassen, Cuperus, & Van Engeland,2001). The behavior of the antagonist is intentional in some vignettes and ambiguous or accidental in others.

Encoding was measured by asking ‘What happened in this cartoon/card/video clip?’ When respondents repeated whatwas said in the vignette, or described what they saw in the cartoon or card, this was scored as realistic. When the respondent

Table 1

Means and Sd’s of the descriptive variables by group.

Bascule N = 40 MBID N = 39 Fa p

M Sd M Sd

TRF

Fear 59.16 8.88 56.42 6.26 5.40 .02

Withdrawn 61.68 7.00 55.61 6.71 6.01 .02

Somatic 54.76 6.39 52.79 5.00 .95 ns

Social problems 66.60 9.22 59.61 7.68 13.62 .001

Thought problems 59.44 7.64 54.82 7.96 2.78 ns

Attention 64.72 8.72 56.50 6.75 14.04 .000

Rulebreaking 63.76 8.22 55.45 6.92 12.65 .001

Aggression 72.24 14.28 59.89 9.441 23.25 .000

Internalizing 61.46 9.14 52.97 10.57 6.50 .01

Externalizing 68.75 11.18 56.84 10.29 22.16 .000

Total Problems 68.33 8.81 57.34 7.95 21.65 .000

WISC-IIINL

Vocabulary 6.55 2.46 6.57 2.40 .001 ns

Block Design 5.44 2.33 5.85 2.54 .32 ns

Digit span 7.67 2.55 6.83 3.00 1.10 ns

IQ 77.61 11.08 80.48 9.72 .95 ns

Age 10.27 1.63 11.15 1.34 7.67 .01

% male 77.5 82.1 .25 nsb

a F and p values on the basis of raw scores.b Chi square

M. van Nieuwenhuijzen, A. Vriens / Research in Developmental Disabilities 33 (2012) 426–434 429

made remarks that were based on interpretations or they mentioned information that was not present in the vignette, thiswas scored as interpretation cues. Descriptions of the character’s emotions were scored as emotional cues. Total scores ofrealistic, interpretation and emotion cues over the different materials were assessed by counting whether they occurred ornot in the nine different situations. Minimum scores were 0 (=never), and maximum scores were 9 (=always).

Hostile intent attribution was assessed in the three different material conditions by asking: ‘X happened. Did it happen onpurpose or accidentally?’ A total score for hostile intent attribution was obtained by summing the number of vignettes (outof nine) receiving a hostile answer.

Goals were measured by asking: ‘Why would you do what you just said?’ Answers were coded by the research assistant inthe following categories: (1) internal revenge (because they deserve it), (2) internal submissive (because I do not like toargument, or (3) external social positive (so they will be my friends again). For each goal a total score was obtained bycounting the different goals across the total situations with a minimum of 0 (=never given) and a maximum of 6.

Response generation was measured by the question ‘If you would be [the antagonist] from the vignette, what would youdo?’ After mention of a first response, the participant was asked to think of other ways of responding to the situation. Thenumber of responses provided by the respondent were coded by the research assistant along with the quality of eachresponse: pro-social/assertive, antisocial/aggressive, and passive/submissive. Spontaneous response scores weredetermined by counting the number of times that an aggressive response, for example, was provided by the child as hisor her first response. A total score was obtained by summing the responses across the total situation with a minimum scoreof 0 (=never given) and maximum score of 9 (total situations). A total response repertoire score was calculated by countingthe amount of different responses across the total situations and dividing them by 6. Minimum scores were 0 (=noneresponse given) and maximum scores were 5 (=five different responses given).

Evaluation was assessed by first presenting three responses (assertive, aggressive, and submissive), as enacted by theprotagonist on the video, or by reading out loud in case of the cards. The presentation of each response was followed byquestions intended to assess the participant’s response evaluation ‘was this a good way to respond?’ The participating childcould respond either ‘yes’ or ‘no.’ For each of the three response types a total evaluation score was obtained by summing thenumber of positive answers across the total situations with a minimum of 0 (=never positive) and a maximum of 6.

Self-efficacy was measured by asking a question about the respondent’s confidence that he or she would be able to behavein such a manner: ‘Would you be able to behave in the same way?’ The participating child could respond either ‘yes’ or ‘no.’For each of the three response types a total self-efficacy score per child was obtained by summing the number of positiveanswers across the total situations, with a minimum of 0 (=never positive) and a maximum of 6.

Response selection was assessed by presenting the three videotaped solutions again one after the other and asking therespondent: ‘Which of the three responses would you choose?’ In order to obtain a total score the number of assertive,aggressive and submissive responses were summed across the total situations to determine assertive, aggressive andsubmissive response selection, respectively, with a minimum score of 0 (=never chosen) and a maximum of 6.

2.2.4. Inhibition

Inhibition was measured by the Dutch version of the Stroop Color-Word Test (Hammes, 1978). The Stroop test consists ofthree cards, each containing 100 stimuli that has to be read out loud as quick as possible. Card 1 shows the names of thecolors red, green, yellow and blue. Card 2 shows rectangles in these colors, and Card 3 the names of the colors printed in non-corresponding colors. Respondents have to name the color of the words instead of reading the word. Thus, the automatedbehavior, reading the word, has to be inhibited. The inhibition score was obtained by using Dutch norm scores, with a rangefrom 0 to 3, the higher score meaning more problems with inhibition.

2.2.5. Working memory

To measure working memory the subtest Digit Span of the WISC-IIINL (Kort et al., 2005) was used. The respondent has torepeat the digits in the same order as presented, starting with two digits with a maximum of seven. Then, the respondent hasto repeat the digits in reverse order. The working memory score was obtained by using Dutch norm scores (Kort et al., 2005).

2.2.6. Perspective taking

Perspective taking was measured by a tasks developed by Ise (2004), which consists of a picture of a mouse. First, therespondent is shown the whole picture and is asked what he sees. Then, the picture of the mouse is partly covered so thatonly the tail is visible, and the respondent is asked ‘What would another child say this is, if he only saw the tail of the mouse?’The answers were coded by a research assistant in (0) no perspective taking, if the answer contained an animal, and (1)perspective taking, if the answer did not contain any animals. The percentage of respondents was calculated who were ableto take perspective.

2.2.7. Emotion recognition

To measure emotion recognition respondents were shown a variety of cards and pictures with the basic emotionshappiness, fear, anger, sadness. A selection was made of four drawings of a child that shows each basic emotion with thewhole body from Een doos vol gevoelens [A Box Full of Emotions] (Kog & Moons, 1996), four pictures of single faces showingbasic emotions, four pictures of several people showing basic emotions, and two pictures of several people showing a mix ofemotions from the Emotions Color Cards Collection (Harrison, 1996). A total emotion recognition score was obtained by

M. van Nieuwenhuijzen, A. Vriens / Research in Developmental Disabilities 33 (2012) 426–434430

summing the scores of all emotions over all materials, with a minimum of 0 (=never recognized), and a maximum of 28(=always recognized).

2.2.8. Interpretation

To measure interpretation four pictures were used in which one or more aspects of the situation are incorrect (Feuerstein& Feuerstein, 2003). For instance, an old man wears a baby outfit and has a milk bottle in his hand, whereas a baby wears asuit and a hat. The other pictures are (1) two tables with people and non-corresponding amount of fruit and emotions, (2) acar and truck with non-corresponding velocity, luggage and drivers, and (3) a toddler and an athlete running with a non-corresponding result. After showing each picture, the respondent is asked ‘what is wrong in this picture?’ For each correctlymentioned aspect three points are given. The total minimum score is 0 and the maximum score is 24. In case the respondentis clueless, standardized sentences can set him on track, which cost one point each.

2.3. Statistical analyses

In order to answer the question whether these cognitive skills have a unique contribution in predicting social informationprocessing skills in children with MBID, considering the influence of gender, age, and behavior problems, several analyseswere conducted. First, Pearson’s product moment correlations were conducted between SIP variables, age, gender and group.When age, gender or group was significantly related to a SIP variable, they were entered in the regression model as acovariate. Second, Pearson’s product moment correlations were conducted between SIP variables and the cognitive variablesinhibition, working memory, perspective taking, emotion recognition, and interpretation. When cognitive variables weresignificantly related to a SIP variable, they were entered in the regression model as predictor. Finally, hierarchical linearregression analyses were conducted with the SIP variables entered in the models as dependent variables, age, gender orgroup as covariate in the first step of the models and the cognitive variables in the second step of the models as independentvariables.

3. Results

As can be seen in Table 2, age, gender and group are related to several SIP variables.Therefore, age, gender and group are entered in the various regression models as covariates (see models in Table 4). In

addition, social cognitive skills are related to the SIP variables as well (see Table 3). Only those skills that are related to SIPvariables are entered in the regression model (see models in Table 4).

As can be seen in Table 4, over and above age, gender and group the cognitive skills working memory, emotionrecognition, and interpretation have unique contributions to social information processing. More specific, over and aboveage and group, working memory, perspective taking and emotion recognition have unique contributions to the variance inthe encoding cues. Good working memory and emotion recognition skills predict the encoding of interpretation and

Table 2

Correlations between SIP variables, sex, age, and group (N = 143).

SIP step Variable Gender Age Group

Encoding Realistic .13 .03 .27*

Interpretation .04 �.08 �.27*

Emotion �.03 �.23* �.25*

Interpretation

Goal setting

Hostile intent attr. .01 �.21 �.02

Revenge �.18 �.15 �.05

Submissive �.08 .04 �.11

Social positive �.10 �.05 .20

Response generation Repertoire .22* .20 .07

Assertive .34** .24* .19

Aggressive �.17 �.08 �.02

Submissive �.26* �.08 �.12

Positive evaluation Assertive .06 .04 .01

Aggressive �.04 �.20 �.01

Submissive .17 �.27* �.19

Self-efficacy Assertive .15 �.01 �.03

Aggressive �.04 �.14 .00

Submissive .08 �.27* �.02

Response selection Assertive .05 �.05 �.06

Aggressive .15 .19 .27*

Submissive �.06 �.07 �.01

* p < 05.** p < .01.

Table 3

Correlations between SIP variables, inhibition, working memory, perspective taking, emotion recognition, interpretation (N = 79).

SIP step Variable Inhibition Working memory Perspective taking Emotion recognition Interpretation

Encoding Realistic �.06 �.05 �.14 .09 .19

Interpretation .19 .39** .25* .34** .03

Emotion .21 .03 .08 .29* .08

Interpretation Hostile intent attr. .33* �.01 �.06 �.11 �.12

Goal setting Revenge .04 .10 �.05 �.16 �.19

Submissive �.06 �.03 .07 .01 .17

Social positive �.04 �.14 �.09 .04 �.01

Response generation Repertoire .06 �.07 .17 .38** .21

Assertive �.14 .10 .07 .20 .06

Aggressive .26 .02 .03 �.11 �.26*

Submissive �.07 �.13 �.03 �.10 .26*

Positive evaluation Assertive �.14 �.15 .12 .25* .12

Aggressive .17 .20 �.11 .01 �.17

Submissive �.08 �.02 .00 �.08 �.16

Self efficacy Assertive �.05 �.14 .15 .18 .08

Aggressive .07 .20 �.12 �.05 �.18

Submissive �.14 .17 �.00 �.09 �.15

Response Selection Assertive .13 .01 .07 .26* .27*

Aggressive �.01 �.12 .07 .13 .05

Submissive �.14 .01 �.14 �.33** �.32**

* p < 05.** p < .01.

Table 4

Hierarchical linear regression models with SIP variables as dependent variables and cognitive skills as predictors (N = 79).

Dependent variables Step Predictors R2 change F change (df) p Beta p

Encoding interpretation cues Step 1 Group .05 2.55 (1, 49) .12

Step 2 Working memory

Perspective taking

Emotion recognition

.20 4.19 (3, 46) .01 .35

.08

.26

.01

ns

.05

Encoding emotion cues Step 1 Group

Age

.10 3.95 (2, 45) .02 �.16

�.26

ns

.03

Step 2 Emotion recognition .11 9.71 (1, 74) .003 .34 .003

Interpretation Step 1 Inhibition .11 5.52 (1, 46) .02 .33 .02

Response repertoire Step 1 Gender .05 3.84 (1, 76) .05 .21 .05

Step 2 Emotion recognition .14 12.89 (1, 75) .001 .37 .001

Response generation aggressive Step 1 Interpretation .07 5.37 (1, 76) .02 �.26 .02

Response generation submissive Step 1 Gender .08 6.12 (1, 76) .02 �.26 .02

Step 2 Interpretation .06 5.23 (1, 75) .03 .25 .03

Positive evaluation assertive Step 1 Emotion recognition .06 4.84 (1, 76) .03 .25 .03

Response selection assertive Step 1 Emotion recognition

Interpretation

.11 4.59 (2, 75) .01 .21

.20

.07

.09

Response selection submissive Step 1 Emotion recognition .16 7.23 (2, 75) .001 �.24 .03

Interpretation �.26 .02

M. van Nieuwenhuijzen, A. Vriens / Research in Developmental Disabilities 33 (2012) 426–434 431

emotional cues. Second, inhibition contributes to the variance in hostile intent attribution. Problems in inhibition predictsmore hostile intent attributions. Third, over and above gender, emotion recognition has a unique contribution to the variancein response repertoire. Good emotion recognition predicts a large repertoire of generated responses. Fourth, over and abovegender, interpretation contributes to the variance in aggressive and submissive response generation. Good interpretationskills predict fewer aggressive and more submissive responses. Fifth, good emotion recognition skills predicts positiveevaluation of assertive responses. Finally, emotion recognition and interpretation skills contribute to the variance inresponse selection. Emotion recognition and interpretation skills seem to predict selection of assertive skills, whereas pooremotion recognition and poor interpretation skills predict selection of submissive responses.

4. Conclusions and discussion

The aim of this study was to examine the relations between (social) cognitive skills such as inhibition, working memory,perspective taking, facial emotion recognition, and interpretation of situations on the one hand and social information

M. van Nieuwenhuijzen, A. Vriens / Research in Developmental Disabilities 33 (2012) 426–434432

processing on the other. The main question was whether these cognitive skills have a unique contribution in predicting socialinformation processing skills in children with MBID, considering the influence of gender, age, and behavior problems.

The results from the present study show that cognitive skills predict social information processing in children with MBID.Especially emotion recognition and interpretation skills have proved to be important cognitive skills that predict SIP indifferent steps of the process.

When working memory and emotion recognition skills are well developed, children tend to use more information andknowledge not present in the given situation. It seems that they have the ability to use their knowledge stored in memory inencoding information from new situations. In addition, when emotion recognition skills are well developed, children tend toencode more emotions from the situation. Thus, emotion recognition and working memory skills help children to encodeinformation more thoroughly. In addition, good emotion recognition and interpretation skills are predictive of adequateresponse generation, evaluation and selection. Understanding and interpretation of social situations in general and others’facial emotion expressions seems to be very important in solving social problems. The findings are in line with other studieson relations between SIP and executive functions (Van Oers & Van Nieuwenhuijzen, 2009; Van Nieuwenhuijzen, Orobio deCastro, Van Aken et al., 2009) and on relations between SIP and emotional facial expressions (Lemerise et al., 2005).

When interpreting the results of our study, its strengths and limitations should be taken into account. One importantstrength is that the present study is the first to examine the relation between SIP and cognitive skills in children with MBID,and has unraveled the unique contribution cognitive skills have in explaining social information processing steps. A potentiallimitation concerns the fact that executive functioning skills such as working memory and inhibition should be measured bycomputerized reaction time tasks, which provides more reliable information than the paper and pencil tasks used in thepresent study. A second potential limitation concerns the fact that in our sample the respondents were between 8 and 12years old. Therefore, the conclusions of the present study are limited to children and cannot be transferred to adolescents. Inaddition, of the children with MBID in the present study 75–80% was male. The conclusions about children with MBID, thus,concern mainly males. However, the gender ratio of the group with MBID is representative for the total population.

Although recently some studies have been published on cognitive skills and SIP (Lemerise et al., 2005; VanNieuwenhuijzen et al., 2011), there still has to be done a lot of work on improving our knowledge on the relation betweensocial cognitive skills and SIP. With the present study the evidence that children with MBID have problems with socialcognitive skills and these are affecting social information processing becomes stronger. In addition, the present study makesa difference by examining several social cognitive skills and linking these to several social information processing steps,taking into account age, gender and behavior problems.

The present study indicates that when a child has problems with emotion recognition, interpretation, working memoryand inhibition skills, it is more likely that he or she has problems in social information processing and problem solving.Therefore, it is important for clinicians to examine both social information processing skills and social cognitive skills, inorder to be able to unravel the underlying causes of behavior problems and inadequate social information processing, andadjust the treatment to the disabilities of these children. Although social skills training and aggression regulation trainingaddress symptoms of the problems, effects are often limited because limitations in SIP are not addressed. Understanding SIPand psycho-education leads to more understanding in parents and teachers and changes their attitude towards the child,which leads to thinking in possibilities of the child. In clinical practice positive results have been experienced, but moreresearch is needed on the effect on training SIP in children with MBID and their parents (Schuiringa, Van Nieuwenhuijzen,Orobio de Castro, & Matthys, 2011).

Second, it is of great importance that treatment is focused on emotion recognition and understanding and interpretationof the world, as these skills are important in predicting social information processing problems. When the encoding ofinformation is inadequate due to problems in social cognitive skills, it is highly likely that the following steps of SIP areprocessed inadequately as well.

The results of the present study, that social cognitive skills of children with MBID are related to social informationprocessing, indicate that social cognitive skills are highly important. Therefore, more knowledge is needed on socialcognitive skills in children with MBID, using better measures.

Acknowledgements

The authors would like to thank the children, their parents and teachers and De Bascule for their participation in thisstudy. The authors also gratefully acknowledge the contributions of all their graduate students to the collection of the data.

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