Profound Difficulties Research Articles

Anticipated and imagined futures: prospective cognition and depressed mood following brain injury.

ObjectivesDepression, which is common following acquired brain injury (ABI), has been shown to predict cognitive impairment, rehabilitation outcome, and quality of life. Whilst many studies have examined links between depression and cognitive–affective processing in the non‐ABI population, their applicability to this important clinical group, where cognitive difficulties can be marked, remains unknown. Here, we investigated biases in prospective cognition, which is known to be disrupted in (non‐ABI) depression yet important for well‐being.DesignCross‐sectional design with three groups (depressed ABI, non‐depressed ABI, and non‐ABI control participants). Continuous data were additionally analysed in correlation analyses.MethodsIndividuals with ABI varying in extent of self‐reported depression and matched non‐ABI control participants completed assessments of mood and prospective cognition (anticipating and imagining future events), alongside background tests of executive function and fluid intelligence.ResultsRelative to non‐depressed ABI and control participants, depressed ABI individuals demonstrated a reduced positive bias in prospective cognition: whereas non‐depressed ABI and control participants generated more examples of likely or possible positive versus negative future events, there was no evidence for such a positive bias in depressed ABI participants. Non‐depressed ABI and control participants also reported more vivid mental imagery for positive versus negative future scenarios, whereas such a pattern was not evident in depressed ABI participants. This pattern emerged despite background impairments in fluid intelligence and executive function associated with ABI.ConclusionsThese findings (1) elucidate depression‐linked cognitive–affective processes following ABI, where cognitive difficulties are common, and (2) highlight psychological processes associated with depression that are common to ABI and non‐ABI populations.Practitioner points Clinical implications A relative negative bias in future‐directed cognition is associated with depressed mood in individuals with chronic ABI.Such processes may contribute to the onset and maintenance of depression following ABI.These findings suggest it may be important to consider a role for prospective cognition in psychological interventions for depression following ABI. Limitations of the study The extent to which depressed mood following ABI is associated with biases in other cognitive domains remains unclear.Whether similar patterns would be observed in acute patients with more profound cognitive difficulties requires further investigation.Despite large effect sizes, our sample size is modest; these effects thus require replication in larger groups.

Developing an Individualised Assessment for KS1 & 2 pupils with profound and multiple learning difficulties

This article charts one school's journey in securing an assessment regime aligned with its vision for its learners with profound and multiple difficulties (PMLD). Previous iterations, based on commercially‐based systems, as well as lessons learned from reflecting on the school's own assessment practices, were used as catalysts for the development of a whole‐school, whole‐curriculum approach which reflects both the short‐ and long‐term targets incorporated in education, health and care plans (EHCPs). The article, contributed by a member of the school's senior leadership, adopts a narrative style in reporting the success of a bespoke assessment scheme, which makes an innovative contribution to individualised learning. [ABSTRACT FROM AUTHOR]

To what extent have learners with severe, profound and multiple learning difficulties been excluded from the policy and practice of inclusive education?

ABSTRACTThe article is a position paper on inclusive practice in education with respect to students with severe or profound and multiple learning difficulties (sld/pmld). It asks if children and young people with sld/pmld have been excluded from the policy and the practice of inclusive education. A review of the literature found that there is a research gap around inclusive education for learners with sld/pmld, and a review of historical and current practices indicated that this group of learners has indeed been excluded from both the policy and practice of inclusion in the United Kingdom with the use of curricula based on a mainstream linear and academic model reinforcing this exclusion. The study makes a theoretical and practical contribution to the continuing debate about inclusive education and will be of interest to teachers, parents, policy-makers and the learners themselves.

Participatory Research: Working with Vulnerable Groups in Research and Practice

This book examines the nature of participatory research in the social sciences and its role in increasing participation among vulnerable or marginalised populations. Drawing on engaging in-depth case studies, it examines the ways in which inclusion and collaboration in research can be enhanced among vulnerable participants, such as those with profound learning difficulties, victims of abuse and trauma and multiply vulnerable children and young people, and shows how useful it can be with these groups. The book will be an invaluable resource for students, researchers and academics in many countries who want to put participatory research methods into practice.

‘Because my brain isn’t as active as it should be, my eyes don’t always see’: a qualitative exploration of the stress process for those living with posterior cortical atrophy

ObjectivesTo explore the stress process for individuals living with posterior cortical atrophy (PCA) and their families.DesignA qualitative study using in-depth semi-structured dyadic and individual interviews with people living with a...

Delayed processing of global shape information in developmental prosopagnosia.

There is accumulating evidence suggesting that a central deficit in developmental prosopagnosia (DP), a disorder characterized by profound and lifelong difficulties with face recognition, concerns impaired holistic processing. Some of this evidence comes from studies using Navon’s paradigm where individuals with DP show a greater local or reduced global bias compared with controls. However, it has not been established what gives rise to this altered processing bias. Is it a reduced global precedence effect, changes in susceptibility to interference effects or both? By analyzing the performance of 10 individuals with DP in Navon’s paradigm we find evidence of a reduced global precedence effect: The DPs are slower than controls to process global but not local shape information. Importantly, and in contrast to previous studies, we demonstrate that the DPs perform normally in a comprehensive test of visual attention, showing normal: visual short-term memory capacity, speed of visual processing, efficiency of top-down selectivity, and allocation of attentional resources. Hence, we conclude that the reduced global precedence effect reflects a perceptual rather than an attentional deficit. We further show that this reduced global precedence effect correlates both with the DPs’ face recognition abilities, as well as their ability to recognize degraded (non-face) objects. We suggest that the DPs’ impaired performance in all three domains (Navon, face and object recognition) may be related to the same dysfunction; delayed derivation of global relative to local shape information.

Models of disability and the categorisation of children with severe and profound learning difficulties: Informing educational approaches based on an understanding of individual needs

Aim:This paper will explore the influence of dominant models of disability on the categorisation of children with severe and profound learning disabilities.Rationale:Whilst the medical model continues to characterise views of disability within medical settings, the adoption of the social model in education has led to a reluctance to use labelling (Norwich, 2002) and to the application of pedagogy which adheres to common ‘age and stage’ conceptions of progress (Lawson et al., 2005).Findings:The reticence to refer to a child’s diagnosis exacerbates a lack of understanding of the development of this group of learners and prevents the level of assessment necessary to inform robust individual education plans and child-centred teaching approaches. More recent approaches to curricular practice (Lacey, 2011) aim to achieve a balance between understanding a child’s individual needs and providing a range of learning experiences. This is consistent with the recently proposed ‘cultural-historical model of disability’ (Bottcher & Dammeyer, 2016) which attempts to realign the social and medical model of disability by reducing ‘developmental incongruence’ – a mismatch between a child’s impairment and proposed learning activities.Conclusions:The paper outlines how the application of this model may be facilitated by educational psychologists to ensure that information about a child’s ‘label’ is used positively, as a means of providing further information about a child’s cognitive profile and increasing the likelihood that learning activities will optimise outcomes.

‘Forest School is muddy and I like it’: Perspectives of young children with autism spectrum disorders, their parents and educational professionals

Background:Forest School was introduced in Sweden and elsewhere in Europe in the 1950s and became a part of the Danish Early Years curriculum in the 1980s as a way of supporting children to understand the natural world while learning academic and practical skills. Since the introduction of the first Forest School in the United Kingdom (UK) in the early 1990s its popularity has been increasing.Method:The context of the study was an inner city special school catering for children with severe, profound and multiple learning difficulties or autism spectrum disorders (ASD). The aim was to explore the views of young children with ASD, parents and educational professionals about their Forest School experience. Four children, their parents and two educational professionals participated. All of the children had a primary diagnosis of ASD and additional severe learning difficulties. Thematic analysis of the data was carried out.Findings:Common themes which emerged were learning outcomes and the benefits of engaging in challenge and risk-taking. Additional common themes were experiencing success (parents/professionals) and the opportunity to make friends (children). When asked how Forest School made them feel the children were able to articulate or depict a range of subtly differentiated emotions.Conclusions:The indications from this small-scale, exploratory study are that Forest School has the potential to offer positive academic, social and practical experiences to young children with ASD. The need for larger scale research is indicated and the employment of flexible and creative methodologies is recommended.

‘Trying, failing, succeeding, and trying again and again’: perspectives of teachers of pupils with severe profound multiple learning difficulties

This article explores the perspectives of seven teachers in England who teach pupils with severe profound and multiple learning difficulties about their learning to teach this group of students. Teachers’ views were captured through a combination of synchronous and asynchronous online communications. Four themes emerged from teachers’ perspectives about their own learning: learning through doing in the classroom, learning through self-inquiry and research, learning from and with others and more formal learning opportunities. A constructivist approach to teacher learning is affirmed as a helpful lens to further understand how teachers learn to teach pupils with complex learning profiles. The article supports teacher learning as a holistic process that takes place throughout teachers’ careers. It highlights the value teachers place on learning through doing in the classroom, learning through self-inquiry and research, learning from and with others, as well as formal learning.

Scoping review of the development of artificial eyes throughout the years

Losing an eye following trauma can lead to profound psychosocial difficulties making it imperative for the wearer to be fitted with an aesthetically pleasing custom-made artificial eye. Despite recent technological advancements, current design and manufacturing processes have remained unchanged in over 55 years. With the aim of portraying current knowledge regarding the development of artificial eyes in order to aid future development, a scooping review was conducted. Six online search engines were used: Scopus, PubMed, MedLine Complete, Web of Science, Science Direct and Google Scholar. Thirty-eight articles met the inclusion criteria and underwent numerical and thematic analysis with three thematic themes emerging. History and the current process of artificial eyes has been well documented, however, the impact of wearing artificial eyes is sparse. On-going research and development into the design and manufacturing processes of artificial eyes and the psychosocial impact of wearing an artificial eye is needed.

Children with profound and multiple learning difficulties: laughter, capability and relating to others

There are numerous ways in which human beings respond to humour: they smile, grin, laugh, giggle or guffaw, and their behaviour might include anything from a glint in the eye to an uncontrollable heaving of the whole body. We consider how laughter is displayed in the lives of four children with profound and multiple learning difficulties and disabilities (PMLD), and reflect on what this reveals about their capabilities and relationships. We look at examples of absurdity and incongruity as elements of humour, and we explore how these create a space for ‘relational commonality’ between people whose differences are many and profound. We suggest that laughter, and involvement in humorous interaction, enables children with PMLD to express themselves, to develop relations with others and to be seen as fully our fellow human beings.

Linking schools, universities, and businesses to mobilize resources and support for career choice and development of students who are visually impaired

This study documents how linking schools, universities, and local organizations can make school curriculum more relevant for career development for students who are visually impaired. Two schools, one for the visually impaired with students aged 4–19 years and another school for students aged 11–19 years who have severe or profound learning difficulties, were part of the collaboration, along with local university students who were teachers in training. Outcomes included new curriculum material for use in public schools to sensitize sighted students on visual impairment. The project also initiated employment apprenticeships for two students who are visually impaired. Our findings suggest that we can educate multiple groups of students simultaneously while building stronger ties between schools, universities, and local public and private employers. Using an outreach approach results in building relationships that facilitate education and employment for students who are visually impaired. St. Vincent’s School obtained consent for all participants in this study and participants chose to be identified, rather than have a pseudonym used.

Does the High School Geography Experience Influence Enrollment in University Geography Courses?

The literature suggests that owing to profound difficulties with high school geography curricula, teachers play a vital role in stimulating student interest and in providing a platform for continuation in the study of geography at university. Yet, with little empirical evidence offered in support, it is unclear why students select geography at university and if their high school experience informs their decision. Through a survey of students enrolled in an introductory geography course at an Ontario university, this research questions the relationship between students' high school experience and their enrollment in the course and ponders the implications for the health of the discipline.

PENGUASAAN BUNYI BAHASA ANAK DISABILITAS TUNARUNGU USIA 10-12 TAHUN PADA KATA PASANGAN MINIMAL DI SDLB SANTI RAMA JAKARTA: SUATU KAJIAN PSIKOLINGUISTIK

The sounds of language are the essence that must be mastered in human speech communication. The reality on the ground shows that there are a number of deaf children who are able to communicate verbally with normal people, despite having profound hearing obstacles and difficulties in uttering a few sounds. This experimental study attempts to explain the mastery of sounds of language that occurs in deaf children at the age 10-12 years in SDLB Santi Rama Jakarta, by using 300 words at 150 minimal pairs qualitatively. The results of analysis on phonological aspects and synthesis in this study show that deaf children actually still have the ability to perceive and produce sounds of language, although there are several obstacles in the process of mastering the sounds of language.

Learning in a new key: an Erasmus+ project developing therapeutic music resources for children affected by trauma

Background: Children with traumatic life histories face profound difficulties accessing educational curricula and forming healthy relationships alongside the risks of mental health issues. Music therapists are too thinly spread to work directly with all. Creative ways of collaborating with educators will enable more sharing of resources.Methods: Presenters will report on the early findings of a European-funded project featuring collaboration between music therapists, educators, and researchers from nine different European educational, training, and research institutions. The project empowers teachers by developing practical, therapeutic musical resources through training events, resource tool-kits, evaluation, and impact studies and dissemination.Discussion: Three music therapist researchers present initial findings from participating mainstream schools in Poland and Italy and a residential special school in the UK.Conclusions: There will be an opportunity to explore ethical and cultural complexities of t...

Functional abilities in aging women with Rett syndrome – the Danish cohort

Rett syndrome (RTT) is a neurodevelopmental disorder, which mainly affects females and results in multiple disabilities. Many clinical descriptions of the symptoms and functional abilities have been made medically, though mainly in children with RTT. Previous reports have established that even though the syndrome causes severe psychomotor disability, women with RTT can live long into adulthood.Purpose: We aim to describe what to expect from aging women with RTT regarding some of the basic functional abilities that are used in daily activities and that could have an impact on quality of life in these women.Methods: A team of two medical doctors, a physiotherapist and an educational psychological adviser, performed clinical evaluations of 27 women with RTT in Denmark above 30 years of age and confirmed MECP2 mutation.Results: We found that 63% of the women were able to walk outside their homes and only 11% were not able to walk at all. However, 67% could not transfer from sitting to standing position without support. There was profound difficulties communicating, but 85.1% of the women could either consistently point with their hand or eyes to things of their interest.Conclusions: Women with RTT are very dependent on caregivers who maintain and rehabilitate their functional abilities. They can often walk short distances unassisted, but do have trouble transferring and thus getting up from a chair on their own. They have severe problems communicating and they often perform subtle signs that can be difficult to recognize.Implications for rehabilitation3/4 of aging RTT women are household ambulators – daily training of motor functions and focus on assisting the initiation of movements are needed lifelong to maintain walking ability and participation in daily activitiesMore than half of aging women with RTT can grab on to things – persons with hand function should be motivated to use this ability in the context of eatingCommunication is a difficult task especially for the aging RTT women – Communicative signs, their meaning and how to react to them should be written down for every woman in an easy accessible way to all caregiversThe majority of aging RTT women can point out things of interest – they should be given the opportunity to participate in choice making

The future study of terrorism

AbstractThis article reflects on the central problems to be faced over the next fifty years of the academic study of terrorism. It discusses a series of problems that are sometimes raised (regarding definition, the division between Critical Terrorism Studies and Orthodox Terrorism Studies, and the supposed stagnation in contemporary terrorism research), and argues that these present rather limited difficulties, in reality. It then identifies a greater problem, in the form of a five-fold fragmentation of the current field, before offering suggested means of addressing in practice these latter, more profound difficulties.

Sharing in a Common Life: People with Profound and Multiple Learning Difficulties

There is a view that what we owe to other people is explained by the fact that they are human beings who share in a common human life. There are many ways of construing this explanatory idea, and I explore a few of these here; the aim is to look for constructions that contribute to an understanding of what we owe to people with profound and multiple learning difficulties and disabilities (PMLD). In exploring the idea of sharing in a common life I construe ‘sharing’ as ‘participating in’, and ‘common life’ as the social life characteristic of the environment that someone lives in. My principal purpose is to render the idea of sharing in a common life in terms that help explain its eligibility as a ground for establishing the moral status of people with PMLD. The participatory options I examine each make some call on agency, if only as something hoped for in the future, including when hope flies in the face of expectation. Accordingly I look at conceptions of actual and potential participation in social life, and at the idea of treating people as if they have the potential to participate, even when the existence of any such potential is unlikely. I conclude with some thoughts on the relation between participation and the moral status of profoundly disabled people, and about how much, and how little, the argument has achieved.

Kurt Goldstein on autism; exploring a person-centered style of psychiatric thought.

Autism research is facing profound difficulties. The lack of clinically valuable translations from the biomedical and neurosciences, the variability and heterogeneity of the diagnostic category, and the lack of control over the 'autism epidemic,' are among the most urgent problems facing autism today. Instead of encouraging the prevailing tendency to intensify neurobiological research on the nature of autism, I argue for an exploration of alternative disease concepts. One conceivable alternative framework for understanding disease and those we have come to call autistic, can be found in the work of neurologist Kurt Goldstein (1878-1965). His person-centered approach provides radically new ways to investigate and intervene with the behavior we are accustomed to explain by the elusive entity called autism.

Theory of Mind and Executive Control Deficits in Typically Developing Adults and Adolescents with High Levels of Autism Traits

Autism spectrum disorder (ASD) is characterised by profound difficulties in empathic processing and executive control. Whilst the links between these processes have been frequently investigated in populations with autism, few studies have examined them at the subclinical level. In addition, the contribution of alexithymia, a trait characterised by impaired interoceptive awareness and empathy, and elevated in those with ASD, is currently unclear. The present two-part study employed a comprehensive battery of tasks to examine these processes. Findings support the notion that executive function and theory of mind are related abilities. They also suggest that individuals with elevated levels of autism-like traits experience a partially similar pattern of social and executive function difficulties to those diagnosed with ASD, and that these impairments are not explained by co-occurring alexithymia.