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Public Health Perspectives on Preschoolers: How Early Theory of Mind and Peer Interactions Predict Educational Adjustment

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Dahlia Kirov
Edited by Aiza Islam
October 1, 2025
​Public Health
Like many other cognitive and socioemotional processes, the ability to understand others and maintain successful relationships traces back to formative childhood years. Not only do the foundational behaviors implicated in empathy and friendship develop in early life, but they also reciprocally influence one another’s development and simultaneously exert effects upon adjustment to various environments encountered throughout adulthood.

Despite the known significance of early childhood in establishing the framework for social cognitive trajectories, relatively little is known about the mechanisms that underlie their development, or how the developmental paths relate to one another and subsequently inform outcomes later on in life. Such limitations have inspired research within the realm of developmental psychology to specifically examine children’s acquisition of the skills that are so vital for cognitive, social, and emotional gains. 

Within this realm of research are studies evaluating preschool children, since the preschool period marks a significant transitional stage as they enter the school environment and gain exposure to social conventions as well as emotional capabilities. The socioemotional skills children begin to form during this stage are significantly correlated with social adaptation in teenage and adult years, as well as struggles to productively respond to related challenges have been correlated with adverse outcomes in terms of adjustment and relational health in adulthood. 

A 2024 study conducted in Turkey specifically sought to examine relationships between theory of mind, peer relationships, and educational adjustment in preschool-aged children, to determine whether children’s ability to understand the internal state of others and sustain friendships significantly predicted their capacity to adapt to their school setting. This study was the first of its kind to simultaneously examine these variables and the significance of correlations among them, setting a precedent for future psychological research to take into consideration reciprocal influences of sociocognitive, socioemotional, and educational developmental trajectories in children. 
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Social-emotional learning programs are evidence-based activities implemented in school settings that seek to support children's ability to understand others' internal states and successfully interact with peers.
Image Source: Vanessa Loring
Theory of mind, the potential to conceptualize internal states and mental desires of others as separate from oneself, was assessed in children based on their performance on false belief, appearance reality, and pretend representation tasks. Educator reports evaluated through profiles of peer relations were taken to assess typical social behavior with peers, incorporating their prevalence of cooperative play, verbal aggression, and physical aggression to determine overall competence in peer interactions. Finally, school liking and avoidance questionnaires, with subscales for positive desires toward school or desires to avoid school, served as a representation of children’s school adjustment. 

Significant relationships were reported amongst all investigated variables, even when controlling for age and demographic features. In particular, results revealed that dimensions of peer relationships and aggressive behaviors observed in social interaction significantly impacted school liking such that prosocial behaviors positively predicted school adjustment, while aggressive behaviors negatively predicted school liking. Moreover, theory of mind significantly predicted school adjustment regardless of age, such that children with relatively more developed theory of mind skills were significantly more likely to adjust to the school environment. 

Ultimately, this study found that preschool children’s developing ability to understand mental states of others and emerging capacity to sustain peer relationships not only correlated with one another but also simultaneously predicted their success in adjusting to their educational environments. 

While researchers primarily investigated these developmental phenomena from psychological perspectives, the findings present significant implications within the realm of public health, such that prevention and early intervention models ought to be implemented for children who exhibit underdeveloped theory of mind abilities or struggle with relationships relative to their peers. Indeed, children who struggle with theory of mind concepts and experience difficulties with peer relationships are at greater risk for conditions such as autism spectrum disorder, which particularly involve deficits in social functioning as well as internalizing conditions such as anxiety. Such psychiatric conditions, if not identified and responded to, may exacerbate children’s struggles in the school environment and increase the likelihood of adverse outcomes in terms of social-emotional health and academic attainment. Social-emotional learning programs and school-based programs specifically addressing theory of mind and peer relationships may serve as promising interventions to support children’s development and later success in adulthood.
Featured Image Source: Tara Winstead

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  • Home
  • Health & Wellness
  • Public Health
  • Research
    • Common, Over-the-Counter Supplement Reduces Skin Cancer Recurrence
    • How Social Connections Lead to Healthier Aging
    • Diet-controlled Probiotics Show Promise With Clear Limits
    • New Cell Line Research Leads to Promising Source for Regenerative Medicine
    • Lead Contamination - What is It and Identifying it in Your Home
    • Approaching Suicide Prevention: Connection Before Crisis
    • The Silver Lining: Gray Hairs As Secret Superheroes
  • Get Involved
    • Apply
    • Contact Us
  • Archives
    • COVID-19 >
      • Origins
      • Risk Factors
      • Clinical Course and Symptoms
      • Current Research and Therapies
      • Vaccines
      • Testing Positive: The Next Steps
      • Quick Facts
    • Health & Wellness Archive
    • Public Health Archive
    • Research Archive
  • About Us
    • Officers
    • Who We Are
  • OUTREACH
    • Podcast
    • Translations