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Understanding multilevel risk and causes in developmental disorders (Week…
Understanding multilevel risk and causes in developmental disorders (Week 5)
Autism
Kanner (1943)
Extreme autistic aloneness
Anxiously obsessive desire for the preservation of sameness
Excellent rote memory
Delayed echolalia (repeating things)
Oversensitivity to stimuli
Limitation in the variety of spontaneous activity (constrained in behaviours)
Good cognitive potentialities (in high functioning)
High intelligent families (in high functioning autism)
He concluded that "...these children had come into the world with an innate inability to form the usual, biologically provided affective contact with people"
He focused on the social dimension
Wing's triad (1981)
(A) Qualitative impairment in reciprocal social interactions
(B) Qualitative impairment in verbal and non-verbal communication and in imaginative activity
(C) Markedly restricted repertoire of activities and interests
DSM IV
Took these criteria (A; B; C) as a areas in their diagnostic system
to be diagnosed - must demonstrate 8 symptoms with at least two in each area
:warning:very heterogenous
... detailed in lecture
DSM V (2013)
Reasons why they changed it:
lack of genetic/psychological evidence for subgrouping (combined disorders to "ASD")
clinicians were inconsistent in diagnosisn "high-functioning autism" and Asperger syndrome
sensory issues not taken into account in previous diagnostic criteria
Outcomes or Causes
Developmental Causal Modeling (DCM)
Morton, (2004)
Includes: Environmental, Biological, Cognitive and Behavioural factors
does not include a time dimension (mixing together causes and time)
different models / theories of autism - look at paper by Morton
Strength:
Gives a clear and comprehensive "conceptual frame"
Clearly accounts for different "levels"
Is able to make clear links between causes and specific outcomes
Limitations:
Does not allow for systematic temporal progression and change
Represents environment as separated
many pathways of causes and effect
a single cause may lead to differet outcomes
similar outcomes may have different causes
Represtntational account
Leslie (1987)
proposes ToMM underpinning abilities (Sally Ann task)
Autistic children having problems in pretending
suggested that in pretend play autistic traits can be firstly seen
thought that mentalising might cause other deficits ( :warning: however - there could be other explanations)
Executive function problem
Russell (1991)
suggested that deficits in EF may underpin deficits in performing false-belief tasks, because false belief tasks require inhibition
in TD children inhibition tasks seem to be mastered at around the same age as false belief tasks
Central coherence
Frith and Happe
proposed that core problem is: "an inability to experience wholes without full attention to the constituent parts"
tendency to see the detail but not the whole picture - they called: "detail focused processing"
:warning: these accounts argued that cognitive processes have a primacy in explaining autism
:!!: but probably not that simple
non of these theories explain all outcomes
even with clear genetic cause there is still much variability in developmental outcome
not all aspects of dev. affected in the same way
Down Syndrome
Most common chromosomal abnormality
12 -13 per 10,000 life births (1998)
number has dropped due to screening and terminations
60 -70 % of conceptions are miscarried
Makes up 1/3rd of all children with learning difficulties
Behavioural Phenotype
Chapman and Hesketh (2000)
Neural differences and delays in cognitive development plus:
Differences in temperament - reduced distress
Different attentional profiles
Possible relative sparing in imitative abilities
Delays in motor development
Selective deficits in short term memory
Slower speech
Selective problems in expressive language and syntax
Specific problems with aspects of social communication
Well known genetic cause - think know quite a lot about it
:warning: however - there is a lot of variability in outcomes in the syndrome
common view that impairments in cognition colely caused by genetics
believed that social abilities are "spared"
:warning: However: Study showed contravery
Moore et al. (2008)
Behaviour of infants with DS and their mothers in the still-face paradigm (interacting; still face; interacting)
6-months old DS vs. 4-months old TD
Found:
similar pattern between DS and TD in looking responses
BUT: DS not as much fussing/crying
:!: Also: mothers seem to be working harder to maintain attention (e.g. showing more directiveness/initiating interactions)
:red_flag: This might not necessarily be negative at this stage... but may have later effects
Social cognition in a developmental framework
Cebula, Moore & Wishart (2010)
Reviewed literature on social cognition in people with DS
large gaps in knowledge (in relation to social environments)
tend to focus on specific aspects of social or cognitive but not theory driven
Fidler
"At this point, we have very little understanding of the processes of change that lead to the unfolding of the Down syndrome behavioural phenotype throughout early childhood and beyond."
Lack of longitudinal data
Lack of cross-domain studies targeting DS
Lack of theoretical models of how it all firs together
Karmiloff-Smith (1998)
"Understanding development itself is the key to understanding developmental disorders"
To understand development we need dynamic developmental models and theories
Not about just understanding e.g. genes - but the interactions of different processes
Transactional models
Transactional models of child development hypothesise bi-directional influences with an individual and their environment mutally affecting each other over time...
... while the capacities and environment themselves also change
Do infants with DS and their caregivers create different (initially highly adaptive) environmental contexts in whcih cognitive development unfolds?
Could this then later lead to sub-optimal effects on other aspects of development?
Model outlined in slides!!
ACORNS
Accessible Cause-Outcome Representation and Notation System
Moore & George (2011)
Makes complex data more accessible
Gives clearer visualisation of transactional change over time
Simultaneously represents different levels of cause and effect
Represents development in different domains within a level
Is more precise about level of functioning over time
Is more precise about relative timing of development
Shows development over long periods of time in detail
The cause and effect must be continguous in space and time
The cause must er prior to the effect
This approach can inform early interventions by identifying specific areas that require attention
It allows us to be more explicit about the nature of problems that exist
It will allow us to be better at identifying to parents problems from the beginning, before it is too late
Can be applied to whatever age group across the life-course
can possible account for the variability/heterogeneity found within diagnosed groups
