Week 7-Clinical Aspects of Social Development

Question 1

Why is a core diagnostic feature of autism that it’s defined at a behavioural level?

Answer 1

Currently, there are no reliable diagnostic biological indicators (e.g. specific brain abnormalities)
■ Earliest possible age of diagnosis: 2-3 years; More commonly: 4-5 years

Question 2

What does the DSM-IV criteria based on “The triad of atypical behaviours” (Wing & Gould, 1979) include in diagnosis?

Answer 2

-impairments in social interaction
-impairments in communication
-repetitive behaviours within a narrow set of interest

Question 3

True or false: Studies have shown these subtype distinctions in autism are not entirely useful for research purposes or in clinical practice (e.g., Huerta et al., 2012; Ozonoff, 2012)

Answer 3

True

Question 4

What are the requirements to meet diagnostic criteria for ASD in children?

Answer 4

a child must have persistent deficits in each of 3 areas of social communication and interaction + at least 2 of 4 types of restricted, repetitive behaviours

Question 5

What are the symptom severity levels used in ASD diagnosis?

Answer 5

Level 3:”Requiring very substantial support”
Level 2:”Requiring substantial support”
Level 1:”Requiring support”
–Important for clinical planning
–Explicit recognition of the quantitative variability of the
condition (i.e. spectrum)

Question 6

Explanations for autism: Define Central Coherence Hypothesis (Frith, 1989)

Answer 6

–Autism is related to a lack of central coherence, reflected in the tendency to process information piecemeal, rather than to integrate it (Frith & Happé, 1994).

Question 7

Explain the embedded figures test

Answer 7

-locating a ‘hidden’ figure (e.g. triangle) in a larger, more complex design.
“Field-Independent” individuals= locate the shape more quickly, being more ready to perceive the constituent parts.
“Field-dependent” individuals= process the “whole”, and are less likely to perceptually deconstruct the visual array into constituent parts.
Individuals with autism tend to be “field-independent” (their tendency towards processing the details is viewed as a processing bias, though not necessarily an impairment.)

Question 8

What did Happé & Frith, 2006 find?

Answer 8

–Some abilities to integrate at a “global” (bigger picture) level but there is a processing bias for local>global levels of info.
–This is not reducible to executive dysfunction, and is only weakly related to social cognition deficits.

Question 9

Explaining autism: Define the Executive Function Hypothesis (Ozonoff, Pennington, & Rogers, 1991):

Answer 9

autism might be related to a deficit in executive function.

Question 10

What is executive function?

Answer 10

the ability to maintain an appropriate problem-solving mindset for the attainment of a future goal., including behaviours such as:
■ planning
■ impulse control, and inhibition of irrelevant responses
■ problem-solving mindset maintained
■ organized search
■ flexibility of thought and action

Question 11

What is the behaviour of autistic children in relation to executive function deficits?

Answer 11

1.rigid and inflexible:they often become distressed over trivial environmental changes, and insist on following routines in precise detail.
2.perseverative: often focus on one narrow interest or repetitively engage in one stereotyped behaviour.
3.not future-oriented:they do not anticipate long-term consequences of behaviour well, and have great difficulty self-reflecting and self-monitoring.
4.impulsive: they seem unable to delay or inhibit responses.

Question 12

Explaining autism: Define the Theory of mind hypothesis (Baron-Cohen, Leslie, & Frith, 1985)

Answer 12

the view that people with autism have difficulties in understanding that others have thoughts and beliefs.

Question 13

Explain what the False Belief Test demonstrates

Answer 13

typically developing children will pass this around 4 yrs old those with autism generally fail indicating that they have an impoverished level of social understanding.

Question 14

What are the 3 impairments in Wing’s triad of impairments characteristic of autism (Wing & Gould, 1979)?

Answer 14

■ Social relationships
■ Communication
■ Imagination

Question 15

How is a lack of imagination seen in children with autism?

Answer 15

-Autistic children are severely impaired in their pretend play production.
Leslie (1987) suggested a correspondence between:
■The imaginative disengagement from current reality needed for false belief/exhibited in pretend play.

Question 16

How is socialisation and communication seen in children with autism?

Answer 16

–Individuals would be in danger of misjudging social situations,
of acting in an inappropriate way, and of saying inappropriate
things. (underdeveloped ToM)
-Social skill often depends on being able to diagnose
other people’s sensitivities, attitudes and knowledge

Question 17

What was found in Baron-Cohen, Leslie and Frith (1985) false belief test success wise?

Answer 17

–20 participants with autism
(mental age ≥ 4 years)=20% success
–14 participants with Down’s syndrome (mental age ≥ 4 years)=86%
–27 typically developing participants (chronological age ≥ 4 years)=85%
-The difficulty in acknowledging false belief therefore seemed to arise from autism rather than any associated learning disabilities.

Question 18

Explain the false photo test

Answer 18

■ a doll sat on a box (scene 1) and the participant took a photo of it.
■ the doll was then moved to a mat (scene 2).
■ participants were asked which scene (1 or 2) would show in the developed photo.

Question 19

What did Leslie and Thaiss (1992) find in both types of false tests?

Answer 19

–Typically developing children would pass both tests.
–Autistic children would only pass the False Photo Test.
ALSO
Cassidy, Ropar, Mitchell, & Chapman, 2014:
–Adults with autism found to be less capable of retrodicting (guessing what causes a reaction) events involving recognition of genuine and feigned positive emotions.

Question 20

What about autistic individuals who pass the false belief test?

Answer 20

Baron-Cohen (1989) suggested second-order belief attribution: Not what a person thinks about an aspect of reality (e.g., where Sally thinks her ball is)
BUT what a person thinks another person thinks about an aspect of reality (e.g., where Mary thinks Sally thinks her ball is)
■ Individuals with autism who passed a simple false belief test failed this complex test more frequently than those typically developing, or with Down’s syndrome.

Question 21

Give contradictory evidence on the false belief test results seen given by Bowler, 1992

Answer 21

–Some high functioning adults with autism pass both belief tests.
–Although they can process simple and complex beliefs, these individuals still present the defining features of
autism.

Question 22

Give 3 facts about social anxiety

Answer 22

1.One of the most common anxiety disorders, with a lifetime prevalence of 13.3% (Kessler et al., 1994)
2.Severe and disabling and, without treatment, tends to run a chronic course(Solyom et al., 1986)
3.Characterised by a marked fear of scrutiny and evaluation by others(Rapee, 1995)

Question 23

What does social anxiety result in?

Answer 23

–severely restricted social functioning
–significant somatic(body), affective(emotions) and cognitive disturbances

Question 24

What can be some causes/contributors to social anxiety?

Answer 24

■ Aggregates in families
– 25% children of affected parents develop anxiety disorder
■ Genetic contribution is modest
■ Parenting likely to be important(Murray, Creswell, & Cooper, 2009)

Question 25

Maternal Social phobia effects: what was the process used?

Answer 25

■ Mother-infant face-to-face=5 mins
■ Stranger=2.5 mins where the stranger approaches, pauses and picks-up
-infants were 10 weeks old

Question 26

True or false: maternal behaviour with the infant is similar in both the control/social phobic mothers in relation to sensitivity (responsiveness)

Answer 26

True

Question 27

True or false: infant behaviour with the control/social phobic mother is the same in relation to positive communication/distress shown

Answer 27

True

Question 28

What were the results of the maternal social phobic effects experiment?

Answer 28

-Infants of mothers with social phobia showed diminished social
responsiveness by 10 weeks (decrease in positive communication during interactions with a stranger)
-mum showed less engagement to stranger and infant paid more attention to mum when she had social phobia

Question 29

What may be the cause of these socially phobic maternal effects?

Answer 29

– Infants highly sensitive to adult communication in first few
months (voice quality, gaze direction, contingency, facial expressions of emotion)
–Mothers tend to modulate these behaviours to maintain + regulate infant engagement and affect
–reduced social responsiveness seen in infants with socially phobic mums might be a consequence of the attenuation of these regulatory maternal behaviours
■ socially phobic mothers=more withdrawal and less encouraging
ostensive marking in the presence of the stranger

Question 30

When do infants typically develop a fear of strangers?

Answer 30

9-12 months

Question 31

What does social referencing show about infants?

Answer 31

■ Infant sensitivity to maternal signals seen around 12m (Feinman, Roberts, Hsieh, Sawyer, & Swanson, 1992; Baldwin & Moses, 1996)
■ Infants sensitive to both +/-maternal messages to a non-social referent
–Gerull and Rapee (2002) trained mothers to either express fear/disgust to possible fear-provoking toys OR display neutral expressions, when toddler was present
■ Infants sensitive to positive maternal messages to a social referent(Feiring, Lewis, & Starr, 1984)

Question 32

Explain the social referencing (observational learning)
paradigm experiment

Answer 32

10 14 months
– Episode 1:mother interacts with stranger (2 min) infant observes
– Episode 2:stranger makes graded approach to infant (2 min) infant observes mum’s response
Behavioural Inhibition (fearful/inhibited/withdrawn behaviour towards novelty) may influence this
-It’s a temperamental trait with a genetic component

Question 33

What were the results with the social referencing (observational learning) paradigm from 10-14 months?

Answer 33

Mothers with Social Phobia vs. Control:
–Sig. more socially anxious in Episode 1 and 2 at 10- and 14-
months
–Sig less engaged with the stranger at 10- and 14-months
–Tendency to be less encouraging of their infant’s interaction with the stranger at 10-months (p = .07)

Question 34

True or false: The level of maternal positive encouragement in engaging the stranger (10 months) was found to mediate (explain) these differences in infant avoidance to the stranger

Answer 34

True

Question 35

How can infant behaviour change around strangers from 10-14 months in the presence of socially phobic mums?

Answer 35

■Inhibited infants of mums with social phobia became more avoidant during the stranger approach over time(mediated by low levels of encouragement by mums with social phobia)
-Also become more avoidant of the stranger during the pick-up over time (mediated by maternal expressed anxiety during the infant-stranger interaction) at 10-months

Question 36

How can infant behaviour change around strangers from 10-14 months in the presence of socially phobic mums?

Answer 36

■Inhibited infants of mums with social phobia became more avoidant during the stranger approach over time(mediated by low levels of encouragement by mums with social phobia)
-Also become more avoidant of the stranger during the pick-up over time (mediated by maternal expressed anxiety during the infant-stranger interaction)

Question 37

Define parental narratives

Answer 37

specific types of conversation where a story is related about
experiences
■Experiences undergo cognitive + affective (emotional) processing, children need to make sense of what happens to them (parental narratives can support this)

Question 38

What do parental narratives provide?

Answer 38

–Coherence
–Temporal and causal structure
–Links between internal states and behaviours
–Highlighting of salient experiences
–Socialisation regarding circumstances for different emotions
–Meaning-making function

Question 39

What could be the potential challenges for the mother when her child starts school?

Answer 39

–Mother encounters unfamiliar people
–Needs to help child adjust to new situation, including social relationships

Question 40

What assessments were done in the study of social phobic mothers/children starting school?

Answer 40

1)Preschool
■Maternal mental state
■Mother-child narrative about starting school
–Picture book as prompt, showing preparation, arrival, classroom, playground
■Child Doll Play representations
–Scenarios depicting range of school experiences, as above
2)2nd half term
■ Child’s mental state
■Internalising problems (e.g., withdrawn, anxious-depressed behaviour)

Question 41

What narrative coding for anxiety-relevant maternal cognitions were used?

Answer 41

■Encouragement/autonomy promotion (to navigating new experience)
■Attribution of threat to the environment
■Attribution of vulnerability to the child (giving impression child may not be able to navigate)
■Promotion of avoidance

Question 42

True or false: 57.53% of index group mothers no longer met full DSM-IV criteria for Social Phobia in school experiment

Answer 42

True BUT their symptoms for social phobia were much higher than the control group so were still included in the group overall

Question 43

School study: what was found about maternal narratives

Answer 43

-control group much higher in + encouragement
-social phobia group much higher on attribution of threat/vulnerability and avoidance promotion
Independent of maternal anxiety, behavioural inhibition was associated with higher attribution of threat

Question 44

School study: what was found with child doll play representations? (re-enacts potential school situations with dolls)

Answer 44

■Negative representation about school:sig more likely in children of mothers with Social Phobia than controls
■Children with negative representations:mothers showed sig less positive encouragement in their narratives
■Relationship between representation/maternal + encouragement: dependent on the child’s behavioural inhibition (high=+ encouragement has a huge effect reducing this)

Question 45

Explain Differential Susceptibility

Answer 45

Belsky and Pluess (2009):
–Go beyond the ‘diathesis-stress’ model
–Certain temperamental/genetic traits may cause a greater vulnerability to negative environments BUT a greater capacity to benefit from positive environments
■Child behavioural inhibition could be seen as a kind of sensitivity, with its +/- connotations.

Question 46

True or false: Child Social Anxiety cause wise has an association with positive maternal encouragement

Answer 46

False it doesn’t, the attribution of threat tends to play a larger role (+ encouragement more a mediator rather than a cause)

Question 47

What were the maternal ratings with children’s internalising problems?

Answer 47

-social phobic mums had kids with higher internalising problems compared to the control
■ The level of positive encouragement in maternal narratives was found to mediate (explain) this difference.

Question 48

What were teacher’s ratings with children internalising problems?

Answer 48

■Internalising problems only with high behavioural inhibition:
–Low maternal encouragement
was associated with higher
teacher-reported internalising
scores