Developmental Coordination Disorder in the Classroom

 

Elisabeth-Hill-photo-2Laura-Crane-2

 

 

 

 

 

 

 

 

Elisabeth Hill, Laura Crane and Emma Sumner are based in the Department of Psychology’s Goldsmiths Action Lab.  Their research focuses on a range of neurodevelopmental conditions, particularly autism and developmental coordination disorder. Here, they discuss Developmental Coordination Disorder in the Classroom, which was the topic of a recent ESRC Festival of Social Science event that they organised at Goldsmiths.

 

What did you do in the first five minutes that you were awake this morning?  Perhaps you hit snooze on the alarm? Buried your head into the pillow? Got out of bed and walked to the bathroom? Turned on the lights? Put some clothes on and went downstairs? Whatever you did, it would have involved motor skill (in some way, shape or form) before anything else. For most of us, motor skills are rather effortless. However, for others, motor skills can be a source of constant difficulty, and can have far reaching implications on their everyday lives. In this blog post, we focus specifically on children who have a diagnosed motor difficulty termed Developmental Coordination Disorder.

(c) Serhiy Kobyakov

(c) Serhiy Kobyakov

Developmental Coordination Disorder (abbreviated to ‘DCD’, and often referred to as dyspraxia) is characterised by impairments in motor skill (including coordination problems, poor balance and clumsiness), as well as delays or difficulties in achieving or acquiring motor milestones (such as crawling, walking, and running). DCD is not merely a childhood condition – it persists throughout adolescence into adulthood – and it can have a significant effect on aspects such as quality of life, academic achievement, and self-esteem.

DCD affects between 2-6% of children, which means that at least one child in every classroom (of 30 children) will meet the criteria for a diagnosis of DCD. Recent initiatives have highlighted the need for training to improve teachers’ awareness of the difficulties faced by children with a range of conditions such as  autism spectrum disorder and developmental language disorder, with a focus on how best to support them in the classroom. However, teachers receive very little advice, guidance or input regarding children with motor difficulties such as DCD.

What needs to be done?

It is important for there to be greater awareness of the different ways in which movement difficulties can present themselves in children. For example, children with DCD may have difficulties with one or more of the following:

  • Fine motor (e.g., grasping, pinching, handwriting) or gross motor (e.g., posture, reaching) skills;
  • Locomotive (e.g., walk, run, jump, hop, skip) or non-locomotive (e.g., stretch, curl, pull, balance, swing) movement;
  • Speed (e.g., writing quickly when taking notes) or accuracy (e.g., throwing a ball towards a target);
  • Unilateral tasks (requiring one-handed, e.g., brushing teeth, using a computer mouse) or bilateral tasks (requiring two-hands, e.g., holding a bottle with one hand whilst twisting the lid with the other).

Parents and educators should be aware of all of the potential areas in which children may experience motor difficulties, and who to turn to for help.

(c) Tatyana Gladskih

(c) Tatyana Gladskih

There should also be greater awareness of the fact that difficulties may be apparent very early on in development. Looking at early motor milestones of children with DCD – including crawling, standing unassisted and walking unassisted – our research found that children with DCD were significantly delayed relative to their typically developing peers.  For example, whilst typically developing children tend to crawl at around 8 months of age, children with DCD (on average) tend to crawl for the first time at 10 months, if at all (23% of parents of children with DCD reported that their child never crawled, whereas all children in typically developing comparison group acquired this skill). Whilst there is considerable variation in the age at which all children acquire key motor milestones, parents and caregivers should be astute to possible ‘red flags’ in these areas.

This is particularly important given that poor motor skills may have knock-on effects in other areas of development. Recent research conducted within the Goldsmiths Action Lab has shown that poor motor skills may be linked to both social skills and language abilities in school-aged children. Motor skills have also been linked to broader cognitive skills such as executive functions, which refer to aspects such as planning, mental flexibility, and inhibition. Executive functions are crucial in the classroom; for example, teachers often provide a series of instructions that children have to follow, before the child must decide on an appropriate course of action, and then carry out the tasks. Unsurprisingly, many children with DCD find the classroom environment difficult; due to both motor aspects and related difficulties in broader areas of functioning. This ties in with our preliminary findings suggesting that teachers identify children with poor motor skills as being more anxious and downhearted, and highlights the negative effects poor motor skills can have.

It is important for motor difficulties to be detected and addressed early in development – by both parents and by teachers – so that appropriate support can be given to these children. Studies in adults with DCD have shown that they report significantly lower satisfaction with quality of life and also experience difficulties with aspects such as mood, general health, wellbeing and employment. If DCD is picked up early, and appropriate support given, this will have a positive effect throughout development and into adulthood, allowing those with DCD to better fulfill their true potential.

For more discussion on DCD, look up the authors of this piece on Twitter:

Laura Crane – @LauraMayCrane 

Elisabeth Hill  @ElisabethLHill

Emma Sumner @EmmaJSumner

What happens when people with autism grow old?

14_rebeccacharltonDr. Rebecca Charlton is Senior Lecturer (Associate Professor) in the Department of Psychology at Goldsmiths University of London. Her research focuses on age-related conditions and falls into three areas: Typical Ageing, Depression, and Ageing in Developmental Disorders. Using cognitive and neuroimaging methods, she examines the relationship between cognitive decline and changes in the brain. She conducts research into ageing with developmental disorders, in particular how individuals’ with Autism Spectrum Disorders will be affected by age-related brain, cognitive or social changes. Here she talks to The Conversation about just that.

If you mention autism to most people they will think about children, but it is a lifelong diagnosis. Children with autism grow up to be adults with autism. Little is known about how the symptoms change with age. This is because autism is a relatively new disorder, first described in 1943 and not regularly identified until the 1970s. It is only now that those people first diagnosed are reaching older age that we can start to learn whether the disorder changes over a lifetime.

There have been some suggestions that symptoms may reduce as people get older. These reports, describing fewer difficulties with older age, are often from people with autism themselves and from their families. But how much evidence is there for this? Our latest research provides some answers, and also raises some new questions.

Working with the Autism Diagnostic Research Centre in Southampton we assessed 146 adults who were referred to the centre seeking a diagnosis of autism between 2008 and 2015, and who consented to take part in the research. People were aged between 18 and 74 years old. A hundred of these adults were diagnosed with autism, and 46 people did not receive a diagnosis. This gave us an opportunity to explore the subtle differences between people who receive a diagnosis and those who don’t, even though they may have some other similar difficulties.

Our analysis showed that age and severity of autism were linked; that is, as age increased so did the severity of autism symptoms in social situations, communication and flexible thinking (such as coping with change or generating new ideas or solutions). We also found that older people with autism were more likely than younger people to extract rules from situations or prefer structure (for example, wanting to know how committees are organised or always following the same routine during a task).

This pattern did not occur in the group of 46 people who didn’t have autism. Whether this tendency to extract rules is a “worsening” of autism symptoms or a general trend among all older people is not yet clear.

Strategies for life

It may seem surprising that people who received a diagnosis much later in life had more severe symptoms, as we might expect people with severe symptoms to be more likely to seek a diagnosis earlier in life. What we found was that the older adults with autism performed better than the young adults with autism on some cognitive tests we carried out. The group diagnosed with autism were faster on tests measuring speed of thinking during a task and did better when dealing with visual and shape information. Perhaps these abilities have helped adults with autism develop strategies across their lives that have helped them to cope with their symptoms which may explain why they were not diagnosed until adulthood.

Older adults with autism performed better on cognitive tests than younger adults.
Jirsak/Shutterstock.com

When the group with autism was compared with the group without autism, we found that rates of depression and anxiety were high in both groups. A third of adults diagnosed with autism report high levels of depression or anxiety – rates much higher than in the general population. Depression among older adults is a risk factor for developing problems in memory and cognition. Given the high rates of depression among people with autism, it may be important for doctors to monitor mood during ageing to ensure that individuals are not at risk for cognitive decline due to depression.

The people described in our research are not typical of people with autism. They all had cognitive abilities in the normal range and did not receive a diagnosis in childhood when autism is most often recognised. Despite this, older people in the study showed more severe symptoms of autism. This might suggest that symptoms of autism become more severe with age. However, reporting more symptoms could also reflect a change in self-awareness. Better self-awareness is generally a good thing, but might lead to greater realisation of one’s own difficulties.

It isn’t yet clear whether people with autism age in the same way as people without autism – it’s still early days, given the relative age of the disorder. Ageing may also be different for each person with autism. People with autism may have developed strategies to help them age better, or may be at risk for depression and cognitive decline. In future work, we aim to see people every few years so we can understand how they change over time.

We all deserve to age as well as we can. It’s only by understanding how people with autism change as they get older, that we can start to put services in place to support them.

The Conversation

Rebecca Ann Charlton, Senior Lecturer, Goldsmiths, University of London

This article was originally published on The Conversation. Read the original article.

Memory and sense of self may play more of a role in autism than we thought

lornaimageLorna Goddard, Goldsmiths, University of London

It’s well-known that those with autism spectrum disorders including Asperger’s syndrome develop difficulties with social communication and show stereotyped patterns of behaviour. Less well-studied but equally characteristic features are a weaker sense of self and mood disorders such as depression and anxiety. These are connected with a weaker ability to recall personal memories, known as autobiographical memory.

Research now suggests that autobiographical memory’s role in creating a sense of self may be a key element behind the development of autistic characteristics.

Autism is much more common in men than in women, to the extent that one theory of autism explains it as the result of an “extreme male” brain, where autistic females are assumed to be more masculinised. Historically, however, research participants have been predominantly male, which has left gaps in our knowledge about autism in women and girls. Psychologists have suggested that the criteria used for diagnosing autism may suffer from a male bias, meaning that many women and girls go undiagnosed until much later in life, if at all

What we remember of ourselves

This is supported by research that suggests women with autism develop different characteristics than autistic males – particularly in respect to autobiographical memory.

Personal memories play a key role in many of the psychological functions that are affected in those on the autistic spectrum. Personal memories help us form a picture of who we are and our sense of self. They help us predict how others might think, feel and behave and, when faced with personal problems, our past experiences provide insight into what strategies we might use to cope or achieve our goals. Sharing personal memories in conversation helps us to connect with others. Recalling positive memories when we feel down can help lift us up, while dwelling on negative personal memories can induce depression.

What’s become clear from studies of autobiographical memory in autism is that while those with autism may have an excellent memory for factual information, the process of storing and recalling specific personal experiences, such as those that happened on a particular day in a particular place, is much more difficult. Instead, their memories tend to record their experience in general terms, rather than the specifics of the occasion. This might be due in part to their more repetitive lifestyle, in which there are less occasions that stick out as memorable, but also because they are less self-aware and less likely to self-reflect. However, our research suggests that this memory impairment may be exclusive to autistic males.

Missing or indistinct memories can add to the sense of otherness, confusion and anxiety experienced by autistic people.
Lightspring/shutterstock.com

Divided by memory

We examined the personal memories of 12 girls and 12 boys with autism, and compared them with an equal number of girls and boys of similar IQ and verbal ability without autism. We asked them to remember specific events in response to emotional and neutral cue words such as “happy” and “fast”. We also asked them to recall in as much detail as they could their earliest memories, and recollections from other periods of their life.

We know that girls tend to demonstrate better verbal skills and are better at recognising emotions. Might this affect the content and degree of detail they could recall from their own memories? We also wondered whether any gender differences we might find would be replicated between boys and girls with autism, or whether autistic girls would be more like boys – as predicted by the extreme male brain theory.

What we found was that autism did lead to less specific and less detailed memories, but only for the boys. The girls with autism performed more like non-autistic girls – not only were their memories more specific and more detailed than the autistic boys, but like the girls without autism, their memories contained more references to their emotional states than both the autistic and non-autistic boys. So rather than an extreme male brain, the girls with autism were more like girls without autism.

This better autobiographical memory might be one reason why autistic females are often better at masking the difficulties they have with communication and socialising with others, and so are more likely to go undiagnosed. Of course, this poses the question that if they have the building blocks of good communication – access to detailed personal memories – why are they still autistic?

There is some evidence to suggest that the automatic connection between our memories and knowing who we are, and how to use this information to inform how we act in problematic situations, is weaker in those with autism. This means that while women with autism can recall the past, they may not be using their experience to help them understand themselves and solve personal problems.

Even though they may be better able to socialise than boys with autism, this may come at a cost, as greater social interaction brings with it more personal problems, and when problems seem overwhelming this can lead to depression. Indeed, recent research suggests that among those with autism, depression in more common in women than men. This gender difference with respect to personal memories is an aspect of autistic characteristics that has been little studied, and should be explored further.


Lorna Goddard, Lecturer in Psychology, Goldsmiths, University of London

This article was originally published on The Conversation. Read the original article.

An end to sleepless nights? New hope for families raising children with ADHD

Alice_Gregory_Oct_2015Alice M. Gregory, Professor of Psychology at Goldsmiths, University of London. She is a member of the Advisory Board for a digital parent education endeavor on infant and toddler sleep that is being supported by Johnson’s Baby. She is a Corresponding Editor (Sleep) for the Journal of Child Psychology and Psychiatry. She has previously received funding to support her work from multiple sources including the MRC, ESRC, Leverhulme Trust and the British Academy. She is a member of the Labour Party. She is currently writing a book (Nodding Off: Sleep from Cradle to Grave) to be published by Bloomsbury Sigma in Spring 2018.

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Raising a child with Attention Deficit Hyperactivity Disorder (ADHD) can be difficult. Some days feel long and the respite of a peaceful night, so rejuvenating for many, may not come at all. Parents often struggle to get their child to sleep, and once they do, they can’t be sure that they won’t wake up repeatedly during the night. But there’s good news for children with ADHD and their parents. In a recent study, we found that most cases of childhood ADHD resolve over time, and when that happens, sleep quality is no worse than in the rest of the population.

ADHD is a disorder that is widely considered to start in childhood and is characterised by symptoms of inattention and hyperactivity. Although many children seem to have endless energy, ADHD is different in that it gets in the way of a child’s development and functioning.

Parents of children with ADHD sometimes feel that they have a lot to worry about, including school performance and friendships. However, one particular issue that comes up time and time again is sleep. It seems that children with ADHD are more likely than others to have sleep problems such as sleeplessness.

So, what does the future hold for children with ADHD? Do they grow up to become adults who sleep poorly, with all of the possible knock-on negative effects? This was not clear from previous literature, so we investigated this question in a study of 2,232 twin children from England and Wales. We followed them from age five to 18. Of these children, 12% had ADHD during childhood.

Good news

Our findings indicate that people with ADHD as children as compared to those without, slept significantly more poorly at the age of 18. However, 78% of the children in our sample who had ADHD as a child, no longer had the disorder when they were 18. Their ADHD had resolved over time. What’s more, the sleep quality of those participants who no longer had ADHD was no worse than those who have never had it.

We think that this provides a positive message for families struggling to cope with sleep problems in children with ADHD. This disorder may resolve over time and, if it does, it is likely that the associated poor sleep will also be a thing of the past. Yes, by 18, they may be too old to spare their parents the wakeful nights, but parents want the best for their children and it will give many some welcome solace to know that things could improve in future.

Of course, there’s an element of what comes first: ADHD or sleeplessness? The story can be complex, and it is possible that the ADHD is driving the poor sleep. However, equally, poor sleep and exhaustion in children may be expressed by restlessness, and other symptoms typical of ADHD. Also, once a sleep problem, such as sleep apnoea (where breathing may stop for alarming seconds during sleep), is resolved there can be an incredibly positive knock-on effect on behaviour and concentration during the day.

We also wanted to understand the association between ADHD and poor sleep by testing another possibility: that these associations are due to influences that run in the family. So we also investigated this. We used our twin design (comparing identical and non-identical twins) to work out the extent to which genetic and environmental factors played a role in the association between ADHD and poor sleep.

Twins showed what was nature and what was nurture.
JGA/Shutterstock

Our analysis showed that the magnitude of genetic (55%) and environmental (45%) influences on the association were roughly the same. This suggests that to fully understand this association we need to consider both influences.

Despite spending a third of our lives asleep, historically, sleep has been somewhat neglected by scientists. We now know that sleep matters for many aspects of our mental health and well-being. Once we understand better the genetic and environmental influences – and use this information to predict who are vulnerable to these difficulties and how best to prevent and resolve them – we will be well placed to help families who are struggling to cope with ADHD, allowing restful nights to follow restful days.


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Alice M. Gregory, Professor of Psychology, Goldsmiths, University of London

This article was originally published on The Conversation. Read the original article.

Stakeholder engagement, Brexit and beyond

As the prospest of a Brexit makes waves across the UK and beyond, this is the first of two posts this week from our Department, focussing on its impact and meaning. 

Elisabeth-Hill-photo-2The first post is from Elisabeth Hill, a Professor of Neurodevelopmental Disorders in the Department of Psychology where she heads up Goldsmiths Action Lab. She is also ProWarden (or elsewhere PVC) Learning Teaching Enhancement at Goldsmiths. Her work focuses on the importance of motor development for the development of cognitive domains and daily life outcomes in those with and without a range of developmental disorders. Here, she takes us from an early foray into stakeholder engagement to Brexit and beyond.

 

Around 20 years ago, towards the end of my PhD at the MRC Applied Psychology Unit (APU; now the Cognition & Brain Sciences Unit), I gave a talk to a group of professional stakeholders in my field. My focus that day was the motor skills of children with specific language impairment (SLI). One or two children in every school class meet criteria for this condition, which is diagnosed entirely on the basis of language skill. However, my research highlighted that a large proportion of children with SLI struggle with motor development and experience the same difficulties as children diagnosed with developmental coordination disorder (a motor disorder that also affects 1-2 children in every school class). These days we know that motor development has a very significant impact on early and later development of a range of areas including language and social skills. It also has an impact on longer term outcomes – at school, at work and on mental health. However, that’s now. The striking memory that I want to share is that of a speech therapist (let’s call her Joanna) speaking to me after the talk. I remember her exact words:

“your work turned on a light bulb for me. My team will now assess motor skill in every child that comes to us for a detailed language assessment. We’re failing them if we don’t”.

Fast forward a couple of years and Joanna was in another audience that I spoke to where she told me that motor screening had been implemented in her team and, as a result, a great proportion of the children assessed now received occupational therapy as well as language interventions. At the time I was astounded. It turned out that my work as a PhD student was not only well received by stakeholders, but had effected a change. It was needed on the ground and it made a difference, even though it was invisible to the great majority of those who benefitted. I’d like to think that it played a small part in improving the lives of hundreds of children seen in that one service and that those children who are now adults will have had better life outcomes because of it.

Great Britain design with 3d shape of United Kingdom map colored in blue and isolated on white background.

Great Britain design with 3d shape of United Kingdom map colored in blue and isolated on white background.

I was reminded of Joanna on the morning of 24th June 2016, as I sat bleary-eyed watching the results of the EU referendum. I was reminded of her again, later in the day, as I scoured articles and images of the night before and wondered what the Brexit vote meant for the future. I was also reminded of her when thinking about the unusually unified response of universities (coordinated by Universities UK) in their campaign to Remain. And I was further reminded of Joanna when I looked at the Leave/Remain map of the UK. One of the interesting features of this map concerns the disconnect between the pro-EU views of universities and the pro-Brexit views of their local communities. With the odd exception, only universities in London, Cambridge, Oxford and Scotland seem exempt from this. This despite universities making a significant impact on their local communities: employing a significant proportion of their workforce from the local area; providing education and opportunity for the local community; and playing a significant part in advances that make a difference to these communities (in the present and the future). The reason I thought of Joanna was that the referendum results made me realise just how much we – as academics and researchers – need to do to bridge the divide between universities and their local communities. Sitting in Lewisham, a strong Remain voting community in South East London, it is easy to forget this disconnect. Yet we should not forget that we need to engage with our local community – within Lewisham, within London and within the world – and we are in a strong position to do so.

Human head on a blackboard with the word Autism on the brain

Take, for example, the work that my colleagues (Laura Crane, Lorna GoddardLucy Henry) and I have been conducting concerning the diagnosis of autism. Autism is a developmental condition affecting the way a person experiences the world around them, and it affects around 1% of the population. This means that over 700,000 people in the UK have an autism diagnosis, and hundreds of thousands more people will be affected by the condition indirectly (e.g., parents, siblings, carers, colleagues etc). Close to 1300 people participated in our research, which identified long delays in accessing a diagnosis, dissatisfaction with the diagnostic process as a whole, and a shameful lack of support post-diagnosis. As well as publishing this work in academic articles, we have tried to make this work accessible to the broader community. We have achieved this by: writing articles for lay audiences; making short accessible videos about our findings; speaking at conferences for academics and for stakeholders; setting up a project website; and engaging with stakeholders such as the National Autistic Society and Network Autism to ensure our findings are heard. Importantly, we are also preparing a short summary of the project and its findings for the participants that so generously gave up their time to take part in the research. The fact that we had collected comprehensive and high-quality data from three key stakeholder groups (adults, parents, clinicians) allowed the National Autistic Society to run a stronger and successful campaign to reduce autism diagnosis waiting times – the Autism Diagnosis Crisis campaign. A key outcome of this campaign was that it led to the NHS receiving new recommendations to consider waiting times for autism diagnosis as a key measure of how local NHS services perform.

identität

Research can have an impact in different ways. Sometimes the research will be invisible by the time it is fully embedded (as for my PhD research, which most of the families that it benefitted will never have come across). In other cases, we – as researchers – need to find ways to engage with stakeholders, to help them see our work as relevant to them. We must also reflect on how we can ensure that we conduct research in a way that is relevant and accessible to others. One of our many challenges is how we articulate the relevance of our work to a wide array of communities in such a way that they are able to see the value of the work we do and to consider that it contributes to a brighter future. We may not have achieved this regarding Brexit, but perhaps lessons will be learned from this.


Prof. Elisabeth Hill widens the accessibility of her research on Twitter: @ElisabethLHill, and @GoldActionLab

You can also find her research on the web at: www.goldactionlab.co.uk and at www.autismdiagnosis.info

One like me! Toying with the Doll Industry

JonesSianE

Dr. Sian Jones is a Teaching Fellow at Goldsmiths, University of London. Her research focuses on discrimination and prejudice among children and adults based on membership of a given group – and how friendships may be encouraged between children from different groups. Here, she looks at the Psychology behind the importance of representing disability in the toy industry. 

 

A lot of attention has focused on the toy industry of late, alongside changes in what is available and who it is targeted at. This ranges from the “let toys be toys” campaign pressuring for non-gendered marketing of products, to a plethora of companies like this one  marketing toys specifically designed to eradicate ethnic bias in dolls. This is coupled with changes to Barbie dolls both to make their shape more realistic, and to represent the careers that women may pursue.

Another avenue of change has been led by the #toylikeme campaign, with a recent petition garnering over 800 000 signatures, pressuring the industry to represent disability in their product line. Watching the video below, one could accuse anyone not able to see the joy of representation of being utterly cold-hearted.

doll

Anecdotally, I know that my mother, and many others, banned Barbies from my toy collection . This only served to make them more attractive to me, in spite of not really being a “doll-playing” child  ( I persuaded a friend to gift me one). And I can’t tell you how I would have reacted to a toy like the one above, because I never had one. But – as a scientist – I know that the plural of anecdote (be it from my own experience, or the video above) is not data – not evidence.  So are the  changes in the toy  industry worhwhile psychologically? Are they grounded in research evidence?  Or should we retire the representative toy box to the attic?

A review of the evidence suggests not. Firstly,  it turns out that what a doll looks like matters. Ditmar (2006) took 162 girls, from age 5 to age 8, and exposed them to images of either Barbie dolls, Emme dolls (U.S. size 16), or no dolls (baseline control). Girls exposed to Barbie reported lower body esteem and greater desire for a thinner body shape than girls in the other  conditions. Moreover, the careers that dolls are depicted as having does have a real influence on children’s conceptions of the career paths that are open to them (Coyle, 2010). Coyle took girls aged 4-5 years, and interviewed them, using Barbies dressed in gender traditional and non-traditional career outfits. She found that girls identified more often with the dolls in gender traditional career clothes. However, following exposure to the  dolls with gender non-traditional careers, girls saw themselves being able to engage in a greater proportion of gender non-typical careers as an adult than before exposure. This study has since been replicated (see Sherman & Zubriggen, 2014, for example) with consistent findings.

The Seminal Doll Studies 

Next, let’s look at the question of ethnicity. This is actually where the central debate started, with a study by Clark & Clark (1947) that has become a classic in Psychology.

In what became a series of experiments, Clark and Clark showed Black children between the ages of six and nine years two dolls, one white and one black, and then asked them questions, like “show me the doll that you like best or that you’d like to play with,”or “show me the doll that looks ‘bad’.” In these studies,  around 44% said the White doll looked like them. In one version of the study Clark gave the test to 300 children in different parts of the country. He found that Black children who went to segregated schools were more likely to pick the white doll as the nice one. These findings carried considerable weight. They became part of Brown v Board of Education case. And they began the start of a movement towards multiracial education. A study by Powell-Hopson and Hopson (1988) showed that in a post-intervention aimed at tackling negative stereotypes, children chose a black doll. And like the gender / career studies, this one has also been replicated, ad infinitum.  For example, in 2005, Davis asked 21 children and 71% told her that the white doll was the nice one.

Dolls are not us

In spite of the compelling findings above, the eagle-eyed among you may have started to critique them. Recent replications of the Clark doll test have used very small samples, and were not published academically. And, it has also been noted that the contact children had with different ethnicities was not controlled, and the study lacked a control for ethnicity, of both the dolls, and the experimenters. Moreover, children don’t actually play with the dolls, and this is a forced-choice task.

In the most critical appraisal, Bergner (2009) noted that these studies show very little beyond preference: they have been used to make claims about self-esteem, but self-esteem has not actually been measured. Further, since Black children do have commensurate self-esteem to white children these preference studies are just that – about preference – representing the political and capitalist culture of the time. Wanting that to change, requires much more than raising self-esteem among Black children.

In sum, there is little in the ethnicity  “doll studies” to suggest that there is a psychological need for investment in representative toys to boost children’s self-esteem. But that is because there is no evidence – not because the evidence suggests otherwise.

Back to the toy box

Before we grow disilusioned, and throw out the doll with the bath water, let’s return to disability. Here, the  toy box is less replete with resources. The market simply doesn’t prodce so many toys – although Playmobil and Lego are  due to bring out such examples this year. “Doll” study findings are consistent with the above (and the above caveats). For example, Saha et al. (2014)  showed children with Down Syndrome two dolls, one with a “typically developing” appearance and one with the phenotypic features of Downs Syndrome. Fifty four children participated in play sessions with both dolls and were then interviewed. They prefered to play with, and attributed more positive traits to, the typical doll than the doll with Downs Syndrome.

That’s all very well, but, as noted earlier, it takes two to tango. And going back to the market, isn’t it important that toys represent diversity to all  children? In a study by Srinivasan and  Cruzhis (2015) children between 6 and 13 years of age used ethnically diverse dolls to explore and verbalise their knowledge of ‘race’. Children were able to articulate how they related to these dolls. Dolls, it seems, may be an important educational tool, for opening up dialogue. Further studies with such dolls (e.g., Smith, 2013) indicate that such dolls support the development of young children in increasing their empathy and in opening discussion about treatment of stigmatized groups. A project evaluating their use is underway.

Where now?

It seems from this review that – as far as gender is concerned – there is  strong evidence for the psychological impact of (poor) representation on children’s Psychology. There is less evidence of impact from ethnic doll studies – but this is largely because the studies have measured only ethnic preference, and not looked at outcomes like career aspirations or race-related self-esteem. Studies that have, have noted an impact. The research agenda might turn to closing this gap: to measuring the self-image, aspirations, empathy and anxiety (as well as prejudices) of those  from all groups exposed to representative toys. As it stands, in a world of White privilege, it is arguably hardly surprising that a white doll is preferred.

When it comes to disability, unlike with ethnicity, one finds that such research has not been an option until very recently: the toys themselves are, relatively speaking, all-but absent.  We know that children most easily discuss issues in contexts that are familiar to them – such as play (Srinivasan &  Cruzhis, 2015). In this regard, there is growing evidence that representative dolls are a good thing. They open dialogue around prejudice and enable discussion and empathy. If such toys are not there, the opportunity for this discussion is lost. At a broader level, if we do want to change the status quo in our society – we know that acceptance of prejudice and inequality doesn’t magically appear at 18 years of age. When it comes to fairer representation, there might be no better place to start than the toy box.

 

Schools without sanctions

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Alice Jones is a Senior Lecturer, and Director of the Unit of School and Family Studies. Her work focuses on understanding how students with behavioural difficulties can achieve their potential in school, as well as developing methods of promoting social and academic inclusion.

Here, she provides an update on an on-going project that explores one school’s aim to learn without sanctions.

 

Spring was a busy term for the Unit of School and Family Studies. Two of our current PhD students (Hannah Smith and Dawn Rose) were offered exciting postdoctoral positions, and another (Guilherme Wendt) will represent Goldsmiths at the World Congress of Psychology in Japan in July after being awarded an ‘Emerging Psychologist’ award. Dawn Rose, one of our PhD students, also received a commendation from the Warden in Goldsmiths first Public Engagement Awards for her role in The Happiness Project, a collaboration between theatre, scientists and school students put on at the Edinburgh Festival and the Camden Roundhouse last year.

We’re currently working with schools across the UK, on a range of projects exploring mental health, bullying and behaviour; but we’re particularly interested in working with schools to develop research projects that are timely and contribute to the development of evidence-based practice.

 

Translational research in action

We can’t carry out the sort of work that we do without working closely with teachers, educational psychologists and other professionals working in schools. Our previous work (Frederickson, Jones, Warren, Deakes & Allen, 2013; authored by academic researchers, educational psychologists and teachers) sets out how we can combine teacher feedback with the most appropriate available research to help provide solutions to school problems. Working in such a way means that we are able to translate the available research into practice quickly, while also carrying out work that we can feed back into that evidence-base.

This project examined the existing research about the differing profiles of social and emotional abilities of children with severe behavioural difficulties, and used it to think about why existing practice wasn’t as effective as it could be, and how we might improve things. For example, some school-based initiatives for behavourial difficulties focus on empathy, but if a child has difficulties empathizing with others (Jones, Happe, Gilbert, Burnett & Viding, 2010), then that strategy might be rather limited in its effectiveness. Similarly, it is important to understand that not all children are motivated by the same outcome – not all students seek social approval and friendship (Warren, Jones & Frederickson, 2014). One group of young people that we are particularly interested in are commonly described as having ‘limited prosocial emotions’ (DSM-V), or ‘callous-unemotional traits’ (Frick, Ray, Thornton & Kahn, 2014). In our 2013 study, we developed and examined a new method of working with students based on our profiling of their abilities and difficulties. After a year, we were able to demonstrate behavioural improvement alongside reductions in fixed-term exclusions from the school and a positive acceptance of the programme by school staff.

 

Can schools work without sanctions? What we’re doing now

Our current work is interested in how far school sanctions really influence behaviour, and whether schools can exist without them. Working with schools for children with social, emotional and mental health difficulties allowed us insight into how effective traditional methods of classroom behaviour management are for children who find being in school tougher than most. We partnered up with outstanding Kilgarth School in Birkenhead, a secondary school catering for the needs of students with social, emotional and mental health difficulties (a range of difficulties previously labeled as social, emotional and behavioural difficulties). Our collaboration was covered by The Telegraph last year, and you can read about it here. Kilgarth are a brilliant model of reaching out to use research, but also giving back through research and training opportunities for educational and other agencies, including the police and prison service.

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For some children punishment, or more commonly, the threat of punishment is ineffective. Young children who are considered to have a fearless temperament are typically resistant to punishment (Fanti, Panayiotou, Lazarou, Michael & Georgiou, 2016). Similarly, children who have behavioural problems and difficulties with empathy are similarly uninfluenced by sanctions – time out has little effect on their behaviour, and these children don’t seem to be made as sorry or upset by strategies like time-out (Hawes & Dadds, 2005; Miller et al., 2014). More recently, teachers have also reported an association between callous-unemotional traits and insensitivity to punishment (Allen, Morris & Chhoa, 2016). In contrast, it may be the case that certain types of rewards are a useful motivating factor in developing desired behaviour.

We worked with Kilgarth School to develop a whole-school system that was built on the available research relevant to their students, and that met the needs of the students, teachers, governors and everyone else involved with the school. The result is a school system that works to positively exploit and develop strengths. Students report that they feel a greater sense of responsibility, and are motivated by the potential for their behaviour to be rewarded. (This has been an exciting opportunity of seeing earlier research being put into action and is also generating interest in collaboration with partners beyond education) Our evaluation of the evidence-based school system is on-going, but preliminary feedback seems to be positive (not only for the students but also teachers). We’ll let you know once our final results are published…

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This work couldn’t happen without excellent student researchers involved in the project; thanks particularly to Bethan Carter (MSc FCP, 2015) and Elizabeth Booker (BSc PCN, 2016) for your involvement.

Alice tweets without sanction @dralicejones

Community Involvement In Research: Are We Doing Enough?

Laura-Crane-2Dr Laura Crane completed her undergraduate and postgraduate (MSc and PhD) degrees within the Department of Psychology at Goldsmiths.  Laura now works as a Postdoctoral Research Associate and Associate Lecturer within the Department.  She is also an Honorary Lecturer at UCL’s Institute of Education, and a Research Fellow at City University London.

Here she talks about what it means to participate in research. 

Recently, I was invited to an event on autism and the criminal justice system (my area of expertise).  The delegate list was impressive, including academics, legal professionals and charity representatives (all with extensive experience in the area).  The day was interesting and varied.  At one particular point in the day, the delegates were asked to work in groups to identify the issues faced by autistic people[1] when encountering the criminal justice system, as well as some potential solutions to these issues.  Each group was busy generating ideas, before I raised what I thought was a very obvious question: ‘If we want to know what the issues people with autism face in the criminal justice system, shouldn’t we start by involving them in these discussions?’

In our inaugural blog post, Prof. Andy Bremner (our Head of Department) discussed how ‘working together is welcome’ at Goldsmiths.  Indeed, working together is welcome, and commonplace…amongst academics.  I should stress that one of the strengths of Goldsmiths’ Psychology Department is that there are several examples of academics working collaboratively with non-academic stakeholders (e.g., police officers, musicians).  However, in this blog post I want to question whether we are really doing all we can to engage the communities that we study in our research.

A few years ago, Pellicano, Dinsmore and Charman (2013) published a thought provoking paper on researcher-community engagement in autism.  They conducted a survey of over 1500 stakeholders interested in autism research – gathering the views and opinions of researchers, professionals (e.g., teachers, therapists), and the autism community (autistic people and their families).  The results revealed that whilst researchers perceived themselves as engaged with the autism community (in terms of dissemination, dialogue and research partnerships), autism community members did not share this view.  In addition, whilst professionals were fairly satisfied with their involvement in research, those on the autism spectrum and their families were not.

Following up these survey results with focus groups and interviews, Pellicano et al. (2013) highlighted the variable nature of autistic community involvement in research.  For example, autism community members expressed dismay about giving up their time to take part in research but not finding out the outcomes, with one participant commenting: “they only want us as guinea pigs”.  Further, community members felt that their contributions were not valued by researchers, and they expressed scepticism about whether their views would have any influence on future research or policy.

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“They only want us as guinea pigs”

These issues are not unique to the field of autism.  From recent discussions with colleagues, they also apply to work in other neurodevelopmental conditions (e.g., Developmental Coordination Disorder), as well as psychology more broadly.  Nevertheless, there have been several examples of successful researcher-community partnerships in some research areas, particularly in the field of learning disabilities (e.g., Powers et al., 2007; Richardson, 2000).  ‘Participatory research’, as it is termed, also forms the basis of ‘INVOLVE’ – a government-funded programme aiming to advance public involvement in research, in order to make it an ‘essential’ part of the way in which research priorities are identified, and the way in which research is designed, conducted, and disseminated.

But how does participatory research work?   

There are several different ways in which stakeholders can be involved in the research process, and these are highlighted in Arnstein’s (1969) ladder of citizen participation.  Arnstein notes that the bottom rungs of the ladder describe levels of ‘non-participation’, in which researchers have control over the participants in the study.  This tends to be the kind of involvement that is commonplace in psychology research studies with clinical groups (e.g., people with autism).  Further up the ladder are varying degrees of ‘tokenism’, in which the participant is given a voice but they are not conferred any power over the research (and there is no change in the status quo).  There has been a move towards this kind of participation in recent years, especially in terms of ‘informing’ participants about research findings; for example, researchers are encouraged to disseminate their findings in outlets for non-academic audiences (e.g., The Conversation), and many academic journals (e.g., Autism) require authors to produce easy-read summaries of research findings to accompany their articles.  Moving even further up the ladder, community members can engage in research partnerships, or even have control over the research process (i.e., having managerial power, or holding the majority of decision-making roles) – these are referred to as instances of ‘citizen control’.  However, these tend to be relatively rare occurrences.

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There are several benefits to adopting a ‘participatory’ research design and involving stakeholders in the research process.  For example, it ensures that the research priorities are valuable and have a genuine impact on the lives of the people being studied.  In addition, the involvement of community members is likely to aid the recruitment of participants and in subsequent dissemination activities.  Community involvement would also provide important insights into the area under study (perhaps ones that are overlooked by researchers who do not have this ‘insider’ knowledge).

Despite my enthusiasm for participatory research, I openly acknowledge that the majority of my current and previous research projects (on autism in the criminal justice system, as well as autism diagnosis) have been researcher-led.  Although my work is often conducted in collaboration with professionals (e.g., police officers, clinicians), the involvement of community members has tended to be limited to the bottom or middle rungs of the ladder.  This is because participatory design is not without its challenges, such as the additional time and effort (and often funding) required to engage in researcher-community partnerships (Pellicano et al., 2013), along with the lack of training opportunities available for early career researchers (during my seven years of study within Goldsmiths’ Psychology Department, I wasn’t even informed of participatory research, yet alone had any opportunities for training!).  As proud as I may be of the research projects I’ve been involved in, and the outcomes of that work, I wholeheartedly feel they could have been improved with greater community input and involvement.

The research projects I’m developing at the moment have a much greater focus on collaboration with community members and I’m really excited to see how they progress.  For example, I’m about to begin an evaluation of an autistic-led post-diagnostic support programme, in collaboration with the (autistic) developer of the programme.  We’ve jointly decided on the focus of the research, and will be working together throughout to achieve the aims of the evaluation.

Partnerships like this take time to come to fruition, and I’m particularly struggling to ‘move up the ladder’ for areas in which I’m only just starting to conduct research (e.g., Developmental Coordination Disorder).  However, I hope this blog post encourages researchers (and students) to reflect on the involvement of the communities they study in their work, and to consider how they might start working their way further up the rungs.

Laura is on Twitter : @lauramaycrane    @GoldActionLab

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[1] There is a debate regarding the most appropriate way to refer to individuals on the autism spectrum.  Whilst person-first language (i.e., ‘person with autism’) has typically been advocated, many autistic individuals prefer disability-first language (i.e., ‘autistic person’).  Throughout this blog post, both terms are used, to respect this diversity of views (see Kenny, Hattersley, Molins, Buckley, Povey & Pellicano, 2015, for further discussion of such issues).

Psychology research and impact: What about autism and employment?

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Lisa Dockery is a PhD student and Associate Lecturer at Goldsmiths, University of London. She has previously worked within small charities and non-profit organisations as well as the NHS. Her research focuses on social inclusion, mental health and neurodevelopmental disorders. 

Here she considers the impact of research for employment for those with autism.

 Impact,  ‘the demonstrable contribution that excellent research makes to society and the economy’, (RCUK) is something researchers are continually encouraged to explore in their work. At Goldsmiths, we strive towards demonstrating impact in our work by considering how findings can be applied within a wider economic and societal context. For instance, the Goldsmiths Action Lab (GOAL) has recently been set up to bring together researchers and research users involved in several projects investigating typical and atypical development. Part of this research includes autism and employment.

What about autism?

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterised by impaired social communication and social interaction; and restrictive or repetitive behaviours, activities or interests (American Psychiatric Association, 2013). Individuals with autism may have difficulties interacting with peers or taking turns in conversations and may excessively adhere to routine or have high levels of resistance to change. Around 1% of the population in England has a diagnosis of autism (Brugha et al., 2011) with a male to female ratio of approximately 4:1 (Chakrabarti & Fombonne, 2001). Autism is considered a spectrum with individuals, like everyone else, demonstrating peaks and troughs in abilities (Hill, 2014).

Despite most individuals with autism now being aged 18 years or above, we know very little about life for these adults (Howlin, 2013). This is worrying because adults with autism report feeling socially isolated (Balfe & Tantam, 2010) and may experience poorer mental health than those without autism (Hirvikoski & Blomqvist, 2014; Joshi et al., 2013) with depression commonly reported (Moss et al., 2015). Low levels of employment are also reported for adults with autism (Shattuck et al., 2012). This is an economic issue as the national annual cost for adults with autism in the United Kingdom has been calculated at £25 billion with 36% of this total attributable to lost employment for the individual with autism (Knapp et al., 2009). Individuals with autism often fall into the gaps in-between mental health and learning disability services and may lack specialist support once formal education finishes. This places these adults at risk of social exclusion. However, employment may be a major route to independence and social inclusion – and this has important consequences for quality of life (Parr & Hunter, 2014).

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What about impact?

Legislative changes have recently appeared alongside autism and employment research. In 2009, The Autism Act was introduced as the first disability-specific law in England. A duty was placed on the government to produce an Adult Autism Strategy called ‘Fulfilling and Rewarding Lives’ (which emerged in March 2010) and to produce guidance for local councils and health authorities to implement this. The strategy revealed that helping adults with autism into employment is a key priority. However, an independent report in July 2012 (National Audit Office, 2012) claimed the impact of helping adults with autism into work is ‘not clear’. After feedback from adults with autism, parents, carers and professionals, the government published a new strategy (Think Autism) in April 2014. New statutory guidance was published in March 2015 which indicated local authorities and the NHS must now include employment in needs assessments.

 

What happens next?

Considering autism and employment from a research perspective could have many implications for future research, clinical practice and government legislation. This research could contribute to the current limited knowledge surrounding autism in adulthood. Furthermore, this research aligns with clinical guidelines recommending individual supported employment as a psychosocial intervention for adults with autism (National Institute for Care and Health Excellence, 2012). This also links to funding opportunities for specialist adult autism and employment services. Few of these services exist and evidence-based support from research within autism and employment means adults with autism could benefit from specialist supported employment services. Finally, if local authorities and the NHS are obliged to support adults with autism to gain and maintain employment (for instance, through supported internships and apprenticeships) then research findings could provide a strong basis for the creation of specialist employment services. The impact from this really could support individuals with autism into fulfilling and rewarding lives.

 Find out more here: https://thedockeryexpress.wordpress.com/ and on Twitter: @lisadockerygold.