Novel Research Paradigms to Investigate Social Development in Typically Developing Infants and Infants at Elevated Risk for Autism Spectrum Disorder

A large body of research has examined social developmental processes in typically developing infants in the first year of life, and more recently in infants at higher familial risk for autism spectrum disorder (infant siblings) in order to uncover early behavioural markers for the disorder, essential for early diagnosis. The social stimuli presented in earlier research were often not representative of social experiences in the real world. For studies focussing exclusively on typical development, the use of inadequate stimuli means that the extent to which they produce findings that generalize to 'real world' social interactions is unclear. For the line of research involving infant siblings, these methodological issues have resulted in an ambiguous pattern of results. To address these issues, this thesis presents novel research methods that more closely approximate the interactive context in which social interaction typically occurs. This was achieved by developing a novel face scanning method - the gaze-contingency eye-tracking paradigm - in which infants could 'interact' with on-screen faces by fixating certain pre-specified regions of the face, providing a more realistic and socially demanding experience. Norms for typical behaviour within this paradigm were established (Chapter 3) and contrasted with behaviour from a sample of infant siblings (Chapter 3 & 4). The findings indicate that infant siblings show reduced social responsiveness relative to typically developing infants in this paradigm. These results were corroborated in an infant-parent free play task (Chapter 5), validating the efficacy of the gaze-contingency paradigm. Finally, infants' ability to follow human conversations as an observer was tested with novel cartoon stimuli providing evidence of early social understanding in typical development (Chapter 6). The novel methods are reviewed in terms of their added value to the field and findings are discussed in relation to their implications for typical and atypical development

Effectiveness of an LGBTQ+ E-Learning Module for Social Workers:A Randomized Controlled Trial

Purpose: To evaluate the effectiveness of an e-learning training module for improving children's social workers’ knowledge of, and attitudes toward, LGBTQ+ young people. Methods: A pragmatic randomized, CONSORT-compliant controlled trial to compare an intervention group ( N = 304) with a business-as-usual comparison group ( N = 310). After attrition, the analysis included 188 (intervention) and 278 (comparison) participants. The main outcome measures were the Heteronormative Attitudes and Beliefs Scale and a perceived LGBTQ+ knowledge measure, controlling for several covariates. Results: A significant effect of intervention on both outcome measures, using several rigorous analysis approaches and missing data imputation methods. Participants who undertook the training decreased their heteronormative attitudes and beliefs and increased their perceived LGBTQ+ knowledge compared to business as usual. Conclusion: This study demonstrates the effectiveness of an e-learning training intervention in improving knowledge of, and attitudes toward, LGBTQ+ young people. Implications for research, practice, and policy are outlined

Caucasian Infants’ Attentional Orienting to Own- and Other-Race Faces

Infants show preferential attention toward faces and detect faces embedded within complex naturalistic scenes. Newborn infants are insensitive to race, but rapidly develop differential processing of own- and other-race faces. In the present study, we investigated the development of attentional orienting toward own- and other-race faces embedded within naturalistic scenes. Infants aged six-, nine- and twelve-months did not show differences in the speed of orienting to own- and other race faces, but other-race faces held infants’ visual attention for longer. We also found a clear developmental progression in attentional capture and holding, with older infants orienting to faces faster and fixating them for longer. Results are interpreted within the context of the two-process model of face processing

Infants show pupil dilatory responses to happy and angry facial expressions

Facial expressions are one way in which infants and adults communicate emotion. Infants scan expressions similarly to adults, yet it remains unclear whether they are receptive to the affective information they convey. The current study investigates six-, nine- and twelve-month infants’ (N = 146) pupillary responses to the six ‘basic’ emotional expressions (happy, sad, surprise, fear, anger, and disgust). To do this we use dynamic stimuli and gaze-contingent eye-tracking to simulate brief interactive exchanges, alongside a static control condition. Infants’ arousal responses were stronger for dynamic compared to static stimuli. And for dynamic stimuli we found that, compared to neutral, infants showed dilatory responses for happy and angry expressions only. Although previous work has shown infants can discriminate perceptually between facial expressions, our data suggest that sensitivity to the affective content of all six basic emotional expressions may not fully emerge until later in ontogeny

The role of adult social care in the prevention of intensive health and care needs: a scoping review

Context: Despite the strong emphasis on prevention in social care policy, there is a lack of evidence on the effectiveness of preventive social care interventions to delay escalation of intensive care needs. Objective(s): We reviewed the literature relating to the role of Adult Social Care to prevent escalation of care needs. We aimed to identify mechanisms in service delivery that prevent development of long-term care needs. Method(s): We used the PRISMA-ScR framework to review papers reporting the (cost)effectiveness of preventative services. Findings were qualitatively synthesised using elements of realist synthesis. Findings: Thirty-one papers were included covering: integrated care, intermediate care, rehabilitation, post-discharge services, community-based care, and domiciliary care. Overall, we found few studies with conclusive results to inform policy and practice. Moreover, the evidence was mostly concerned with the impact of social care on health care utilisation, with relatively few studies addressing the impact on social care utilisation. There was some preliminary evidence for the effectiveness of multi-faceted support set within the community, and improvements were observed for patients’ Quality of Life. Limitations: The variety of papers we included reflects the complexity of the social care landscape but prevents robust assessment of the impact of services to delay advancing care needs. Implications: Greater investment in research in this field will help policy makers and families target scarce resources and invest in the most effective prevention services. We emphasise the impact of prevention services can take several years to realise, which must be reflected in research design and social care funding

Identifying Regional Stakeholder-Informed Priorities for Adult Social Care Research: A Mixed-Method Study in Kent, Surrey, and Sussex

Context: There is an urgent need for sustainable change in the social care sector, and research plays an essential role in the identification of priority areas. Thus far, there have been few priority setting exercises within adult social care research. The current study explores regional priorities for adult social care research in Kent, Surrey, and Sussex. Stakeholders were consulted from the starting point of the project, ensuring that the identified research priorities were fully informed by the people that the subsequent research will have an impact on. Objectives: Our main aim was to identify research priorities for adult social care within the region, and more specifically, relevant activities within these priority areas that could benefit from evaluation. Methods: We employed a mixed-method design using online focus groups with social care professionals (N = 37) and members of the public (N = 7), and an online survey following the focus groups (N = 28). Focus group discussions were informed by themes based on The Care Act 2014. Findings: Content analysis was used to analyse discussions, which yielded a list of 46 actionable research questions. Rankings of discussion themes were produced to establish order of importance. Limitations: We approached the ranking of priorities only at a higher-order theme level, and not at the level of the specific questions. Implications: The extensive list of research questions produced in this study supports social care researchers to conduct studies that address pressing issues for care systems and the public

Reflections on the Use of Synchronous Online Focus Groups in Social Care Research

Focus groups are an extensively employed research method for the collection of qualitative data. Recent developments in teleconferencing platforms have produced a substantial increase in online research, including online focus groups. The current study is the first to discuss methodological reflections on the conduct of online focus groups in adult social care research. Previously reported research on the use of online focus groups in healthcare research cannot readily be applied to the significantly distinct social care sector. Unique characteristics of the social care sector, such as the dispersion of social care services, the significant funding gap, ongoing recruitment and retention issues, and an ageing population becoming increasingly reliant on social care have consequences for the design, conduct and appropriateness of the online focus group method. In this article, we review the use of synchronous online focus groups in social care research. We conducted six online focus groups with social care professionals (total N = 37). The online focus group method is evaluated by analysing and reporting data from a participant experience survey and researcher reflection logs. Additionally, this article reviews Microsoft Teams as a platform for online focus groups. It is concluded that the benefits of increased accessibility and representation significantly outweigh the limitations related to online social communication. We suggest that the use of the online focus groups method could enhance the relatively scarce research capacity in social care, and we provide practical recommendations for the design and conduct of online focus groups in social care research

The Role of Adult Social Care in the Prevention of Intensive Health and Care Needs: A Scoping Review

Context: Despite the strong emphasis on prevention in social care policy, there is a lack of evidence on the effectiveness of preventive social care interventions to delay escalation of intensive care needs. Objective(s): We reviewed the literature relating to the role of Adult Social Care to prevent escalation of care needs. We aimed to identify mechanisms in service delivery that prevent development of long-term care needs. Method(s): We used the PRISMA-ScR framework to review papers reporting the (cost)effectiveness of preventative services. Findings were qualitatively synthesised using elements of realist synthesis. Findings: Thirty-one papers were included covering: integrated care, intermediate care, rehabilitation, post-discharge services, community-based care, and domiciliary care. Overall, we found few studies with conclusive results to inform policy and practice. Moreover, the evidence was mostly concerned with the impact of social care on health care utilisation, with relatively few studies addressing the impact on social care utilisation. There was some preliminary evidence for the effectiveness of multi-faceted support set within the community, and improvements were observed for patients’ Quality of Life. Limitations: The variety of papers we included reflects the complexity of the social care landscape but prevents robust assessment of the impact of services to delay advancing care needs