I am interested in inner speech and cognition in typical and atypical development. This includes research on the development of auditory verbal hallucinations, executive function in autism spectrum disorders, and problem-solving skills in deafness.
Despite the recent proliferation of scientiic, clinical, and narrative accounts of auditory verba... more Despite the recent proliferation of scientiic, clinical, and narrative accounts of auditory verbal hallucinations (AVHs), the phenomenology of voice hearing remains opaque and undertheorized. In this article, we outline an interdisciplinary approach to understanding hallucina- tory experiences which seeks to demonstrate the value of the humanities and social sciences to advancing knowl- edge in clinical research and practice. We argue that an interdisciplinary approach to the phenomenology of AVH utilizes rigorous and context-appropriate method- ologies to analyze a wider range of irst-person accounts of AVH at 3 contextual levels: (1) cultural, social, and historical; (2) experiential; and (3) biographical. We go on to show that there are signiicant potential beneits for voice hearers, clinicians, and researchers. These include (1) informing the development and reinement of subtypes of hallucinations within and across diagnostic categories; (2) “front-loading” research in cognitive neuroscience; and (3) suggesting new possibilities for therapeutic inter- vention. In conclusion, we argue that an interdisciplin- ary approach to the phenomenology of AVH can nourish the ethical core of scientiic enquiry by challenging its interpretive paradigms, and offer voice hearers richer, potentially more empowering ways to make sense of their experiences.
The 1 year prevalence of depression in adolescents is about 2%. Treatment with antidepressant med... more The 1 year prevalence of depression in adolescents is about 2%. Treatment with antidepressant medication is not recommended for initial treatment in young people due to concerns over high side effects, poor efficacy and addictive potential. Evidence suggests that cognitive behaviour therapy (CBT) is an effective treatment for depression and is currently one of the main treatment options recommended in adolescents. Given the affinity young people have with information technology they may be treated effectively, more widely and earlier in their illness evolution using computer-administered CBT (CCBT). Currently little is known about the clinical and resource implications of implementing CCBT within the National Health Service for adolescents with low mood/depression. We aim to establish the feasibility of running a fully powered randomised controlled trial (RCT). Adolescents aged 12-18 with low mood/depression, (scoring ≥20 on the Mood and Feelings Questionnaire (MFQ)), will be approa...
Auditory verbal hallucinations (AVH) are complex experiences that occur in the context of various... more Auditory verbal hallucinations (AVH) are complex experiences that occur in the context of various clinical disorders. AVH also occur in individuals from the general population who have no identifiable psychiatric or neurological diagnoses. This article reviews research on AVH in nonclinical individuals and provides a cross-disciplinary view of the clinical relevance of these experiences in defining the risk of mental illness and need for care. Prevalence rates of AVH vary according to measurement tool and indicate a continuum of experience in the general population. Cross-sectional comparisons of individuals with AVH with and without need for care reveal similarities in phenomenology and some underlying mechanisms but also highlight key differences in emotional valence of AVH, appraisals, and behavioral response. Longitudinal studies suggest that AVH are an antecedent of clinical disorders when combined with negative emotional states, specific cognitive difficulties and poor coping,...
Journal of autism and developmental disorders, 2013
Nine low-functioning children with profound expressive language impairment and autism were studie... more Nine low-functioning children with profound expressive language impairment and autism were studied in terms of their responsiveness to a computer-based learning program designed to assess syntactic awareness. The children learned to touch words on a screen in the correct sequence in order to see a corresponding animation, such as ‘monkey flies’. The game progressed in levels from 2 to 4 word sequences, contingent upon success at each stage. Although performance was highly variable across participants, a detailed review of their learning profiles suggested that no child lacked syntactic awareness and that elementary syntactic control in a non-speech domain was superior to that manifest in their spoken language. The reasons for production failures at the level of speech in children with autism are discussed.
Background Behavioural studies have highlighted irregularities in recognition of facial affect in... more Background Behavioural studies have highlighted irregularities in recognition of facial affect in children and young people with autism spectrum disorders (ASDs). Recent findings from studies utilising electroencephalography (EEG) and magnetoencephalography (MEG) have identified abnormal activation and irregular maintenance of gamma (> 30 Hz) range oscillations when ASD individuals attempt basic visual and auditory tasks.
Twenty-two children with autism spectrum
disorders who had not responded to supported behaviour
m... more Twenty-two children with autism spectrum disorders who had not responded to supported behaviour management strategies for severe dysomnias entered a double blind, randomised, controlled crossover trial involving 3 months of placebo versus 3 months of melatonin to a maximum dose of 10 mg. 17 children completed the study. There were no significant differences between sleep variables at baseline. Melatonin significantly improved sleep latency (by an average of 47 min) and total sleep (by an average of 52 min) compared to placebo, but not number of night wakenings. The side effect profile was low and not significantly different between the two arms.
Children with autism spectrum disorders (ASD) adopt less efficient strategies than typically deve... more Children with autism spectrum disorders (ASD) adopt less efficient strategies than typically developing controls (TD) on verbal problem-solving tests such as the Twenty Questions Task. This study examined the hypotheses that this can be explained by differences in (i) planning processes or (ii) selective attention. Twenty-two children with ASD and 21 TD controls matched for age (M Age513:7) and cognitive ability (M FSIQ596.42) were tested on an adapted version of Twenty Questions and two planning tasks. ASD participants could recognize effective questions as well as TD participants on a forced-choice question discrimination task, but were observed to construct plans that were significantly less efficient. ASD performance was also specifically reduced when items could not be physically removed from the testing array, although this effect could be ameliorated by keeping a written record of participant questions during search. These findings indicate that ASD participants are sensitive to the within-task executive demands of Twenty Questions, but that their inefficiency in strategy relates to planning processes and question selection pretask. The implications for understanding ASD problem-solving skills and their impact on everyday functioning are discussed.
Fourteen children with autism spectrum disorders
(ASD) and fourteen age-matched typically-develop... more Fourteen children with autism spectrum disorders (ASD) and fourteen age-matched typically-developing (TD) controls were tested on an adapted version of the Twenty Questions Task (Mosher and Hornsby in Studies in cognitive growth. Wiley, New York, pp 86–102, 1966) to examine effects of content, executive and verbal IQ factors on category use in problem-solving (age range 8–17). Across conditions participants with ASD asked questions that focussed on smaller categories than controls. Specific group differences were observed in the handling of abstract content and response to additional working memory demands. In addition, post hoc regression analysis indicated that VIQ predicted performance in ASD but not TD participants. The implications for theories of category processing in autism are discussed.
There is relatively little evidence about the effectiveness of parent-training programmes for chi... more There is relatively little evidence about the effectiveness of parent-training programmes for children with autism spectrum conditions (ASCs). Here we evaluate a programme developed to fill a gap in the provision of parent interventions after EarlyBird, which is only available for parents of pre-school ASC children. This programme (ASCEND) has now been running for five years. Questionnaires were used to evaluate seven consecutive 11-session programmes from 2004 to 2007, involving 79 parents representing 58 children. We measured satisfaction ratings in all seven groups; the latter five groups (59 parents representing 44 children) were given Developmental Behaviour Checklists (DBCs) and parental knowledge questionnaires pre- and post-course. Eighty-eight per cent of respondents found the course useful or very useful while parental knowledge and skills improved significantly across a range of learning outcomes. DBC scores showed significant changes postcourse for total problem behaviours and disruptive/antisocial behaviours, with a trend towards reductions in anxiety as reported by parents. Changes in behaviour scores moderately correlated with specific learning items relating to improved skills in behaviour management. This preliminary evaluation suggests that the course produces positive outcomes in terms of parent satisfaction, parent learning and perceived changes in child behaviour, although further independent analysis is required in the form of a randomized controlled trial.
Despite the recent proliferation of scientiic, clinical, and narrative accounts of auditory verba... more Despite the recent proliferation of scientiic, clinical, and narrative accounts of auditory verbal hallucinations (AVHs), the phenomenology of voice hearing remains opaque and undertheorized. In this article, we outline an interdisciplinary approach to understanding hallucina- tory experiences which seeks to demonstrate the value of the humanities and social sciences to advancing knowl- edge in clinical research and practice. We argue that an interdisciplinary approach to the phenomenology of AVH utilizes rigorous and context-appropriate method- ologies to analyze a wider range of irst-person accounts of AVH at 3 contextual levels: (1) cultural, social, and historical; (2) experiential; and (3) biographical. We go on to show that there are signiicant potential beneits for voice hearers, clinicians, and researchers. These include (1) informing the development and reinement of subtypes of hallucinations within and across diagnostic categories; (2) “front-loading” research in cognitive neuroscience; and (3) suggesting new possibilities for therapeutic inter- vention. In conclusion, we argue that an interdisciplin- ary approach to the phenomenology of AVH can nourish the ethical core of scientiic enquiry by challenging its interpretive paradigms, and offer voice hearers richer, potentially more empowering ways to make sense of their experiences.
The 1 year prevalence of depression in adolescents is about 2%. Treatment with antidepressant med... more The 1 year prevalence of depression in adolescents is about 2%. Treatment with antidepressant medication is not recommended for initial treatment in young people due to concerns over high side effects, poor efficacy and addictive potential. Evidence suggests that cognitive behaviour therapy (CBT) is an effective treatment for depression and is currently one of the main treatment options recommended in adolescents. Given the affinity young people have with information technology they may be treated effectively, more widely and earlier in their illness evolution using computer-administered CBT (CCBT). Currently little is known about the clinical and resource implications of implementing CCBT within the National Health Service for adolescents with low mood/depression. We aim to establish the feasibility of running a fully powered randomised controlled trial (RCT). Adolescents aged 12-18 with low mood/depression, (scoring ≥20 on the Mood and Feelings Questionnaire (MFQ)), will be approa...
Auditory verbal hallucinations (AVH) are complex experiences that occur in the context of various... more Auditory verbal hallucinations (AVH) are complex experiences that occur in the context of various clinical disorders. AVH also occur in individuals from the general population who have no identifiable psychiatric or neurological diagnoses. This article reviews research on AVH in nonclinical individuals and provides a cross-disciplinary view of the clinical relevance of these experiences in defining the risk of mental illness and need for care. Prevalence rates of AVH vary according to measurement tool and indicate a continuum of experience in the general population. Cross-sectional comparisons of individuals with AVH with and without need for care reveal similarities in phenomenology and some underlying mechanisms but also highlight key differences in emotional valence of AVH, appraisals, and behavioral response. Longitudinal studies suggest that AVH are an antecedent of clinical disorders when combined with negative emotional states, specific cognitive difficulties and poor coping,...
Journal of autism and developmental disorders, 2013
Nine low-functioning children with profound expressive language impairment and autism were studie... more Nine low-functioning children with profound expressive language impairment and autism were studied in terms of their responsiveness to a computer-based learning program designed to assess syntactic awareness. The children learned to touch words on a screen in the correct sequence in order to see a corresponding animation, such as ‘monkey flies’. The game progressed in levels from 2 to 4 word sequences, contingent upon success at each stage. Although performance was highly variable across participants, a detailed review of their learning profiles suggested that no child lacked syntactic awareness and that elementary syntactic control in a non-speech domain was superior to that manifest in their spoken language. The reasons for production failures at the level of speech in children with autism are discussed.
Background Behavioural studies have highlighted irregularities in recognition of facial affect in... more Background Behavioural studies have highlighted irregularities in recognition of facial affect in children and young people with autism spectrum disorders (ASDs). Recent findings from studies utilising electroencephalography (EEG) and magnetoencephalography (MEG) have identified abnormal activation and irregular maintenance of gamma (> 30 Hz) range oscillations when ASD individuals attempt basic visual and auditory tasks.
Twenty-two children with autism spectrum
disorders who had not responded to supported behaviour
m... more Twenty-two children with autism spectrum disorders who had not responded to supported behaviour management strategies for severe dysomnias entered a double blind, randomised, controlled crossover trial involving 3 months of placebo versus 3 months of melatonin to a maximum dose of 10 mg. 17 children completed the study. There were no significant differences between sleep variables at baseline. Melatonin significantly improved sleep latency (by an average of 47 min) and total sleep (by an average of 52 min) compared to placebo, but not number of night wakenings. The side effect profile was low and not significantly different between the two arms.
Children with autism spectrum disorders (ASD) adopt less efficient strategies than typically deve... more Children with autism spectrum disorders (ASD) adopt less efficient strategies than typically developing controls (TD) on verbal problem-solving tests such as the Twenty Questions Task. This study examined the hypotheses that this can be explained by differences in (i) planning processes or (ii) selective attention. Twenty-two children with ASD and 21 TD controls matched for age (M Age513:7) and cognitive ability (M FSIQ596.42) were tested on an adapted version of Twenty Questions and two planning tasks. ASD participants could recognize effective questions as well as TD participants on a forced-choice question discrimination task, but were observed to construct plans that were significantly less efficient. ASD performance was also specifically reduced when items could not be physically removed from the testing array, although this effect could be ameliorated by keeping a written record of participant questions during search. These findings indicate that ASD participants are sensitive to the within-task executive demands of Twenty Questions, but that their inefficiency in strategy relates to planning processes and question selection pretask. The implications for understanding ASD problem-solving skills and their impact on everyday functioning are discussed.
Fourteen children with autism spectrum disorders
(ASD) and fourteen age-matched typically-develop... more Fourteen children with autism spectrum disorders (ASD) and fourteen age-matched typically-developing (TD) controls were tested on an adapted version of the Twenty Questions Task (Mosher and Hornsby in Studies in cognitive growth. Wiley, New York, pp 86–102, 1966) to examine effects of content, executive and verbal IQ factors on category use in problem-solving (age range 8–17). Across conditions participants with ASD asked questions that focussed on smaller categories than controls. Specific group differences were observed in the handling of abstract content and response to additional working memory demands. In addition, post hoc regression analysis indicated that VIQ predicted performance in ASD but not TD participants. The implications for theories of category processing in autism are discussed.
There is relatively little evidence about the effectiveness of parent-training programmes for chi... more There is relatively little evidence about the effectiveness of parent-training programmes for children with autism spectrum conditions (ASCs). Here we evaluate a programme developed to fill a gap in the provision of parent interventions after EarlyBird, which is only available for parents of pre-school ASC children. This programme (ASCEND) has now been running for five years. Questionnaires were used to evaluate seven consecutive 11-session programmes from 2004 to 2007, involving 79 parents representing 58 children. We measured satisfaction ratings in all seven groups; the latter five groups (59 parents representing 44 children) were given Developmental Behaviour Checklists (DBCs) and parental knowledge questionnaires pre- and post-course. Eighty-eight per cent of respondents found the course useful or very useful while parental knowledge and skills improved significantly across a range of learning outcomes. DBC scores showed significant changes postcourse for total problem behaviours and disruptive/antisocial behaviours, with a trend towards reductions in anxiety as reported by parents. Changes in behaviour scores moderately correlated with specific learning items relating to improved skills in behaviour management. This preliminary evaluation suggests that the course produces positive outcomes in terms of parent satisfaction, parent learning and perceived changes in child behaviour, although further independent analysis is required in the form of a randomized controlled trial.
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disorders who had not responded to supported behaviour
management strategies for severe dysomnias entered a
double blind, randomised, controlled crossover trial
involving 3 months of placebo versus 3 months of melatonin
to a maximum dose of 10 mg. 17 children completed
the study. There were no significant differences between
sleep variables at baseline. Melatonin significantly
improved sleep latency (by an average of 47 min) and total
sleep (by an average of 52 min) compared to placebo, but
not number of night wakenings. The side effect profile was
low and not significantly different between the two arms.
ASD performance was also specifically reduced when items could not be physically removed from the testing array, although this effect could be ameliorated by keeping a written record of participant questions during search. These findings indicate that ASD participants are sensitive to the within-task executive demands of Twenty Questions, but that their inefficiency in strategy relates to planning processes and question selection pretask. The implications for understanding ASD problem-solving skills and their impact on everyday functioning are discussed.
(ASD) and fourteen age-matched typically-developing
(TD) controls were tested on an adapted version of the
Twenty Questions Task (Mosher and Hornsby in Studies in
cognitive growth. Wiley, New York, pp 86–102, 1966) to
examine effects of content, executive and verbal IQ factors
on category use in problem-solving (age range 8–17).
Across conditions participants with ASD asked questions
that focussed on smaller categories than controls. Specific
group differences were observed in the handling of abstract
content and response to additional working memory
demands. In addition, post hoc regression analysis indicated
that VIQ predicted performance in ASD but not TD
participants. The implications for theories of category
processing in autism are discussed.
disorders who had not responded to supported behaviour
management strategies for severe dysomnias entered a
double blind, randomised, controlled crossover trial
involving 3 months of placebo versus 3 months of melatonin
to a maximum dose of 10 mg. 17 children completed
the study. There were no significant differences between
sleep variables at baseline. Melatonin significantly
improved sleep latency (by an average of 47 min) and total
sleep (by an average of 52 min) compared to placebo, but
not number of night wakenings. The side effect profile was
low and not significantly different between the two arms.
ASD performance was also specifically reduced when items could not be physically removed from the testing array, although this effect could be ameliorated by keeping a written record of participant questions during search. These findings indicate that ASD participants are sensitive to the within-task executive demands of Twenty Questions, but that their inefficiency in strategy relates to planning processes and question selection pretask. The implications for understanding ASD problem-solving skills and their impact on everyday functioning are discussed.
(ASD) and fourteen age-matched typically-developing
(TD) controls were tested on an adapted version of the
Twenty Questions Task (Mosher and Hornsby in Studies in
cognitive growth. Wiley, New York, pp 86–102, 1966) to
examine effects of content, executive and verbal IQ factors
on category use in problem-solving (age range 8–17).
Across conditions participants with ASD asked questions
that focussed on smaller categories than controls. Specific
group differences were observed in the handling of abstract
content and response to additional working memory
demands. In addition, post hoc regression analysis indicated
that VIQ predicted performance in ASD but not TD
participants. The implications for theories of category
processing in autism are discussed.