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Title: Characterisation and cognitive mechanisms of compensation in autism spectrum disorder
Author: Livingston, Lucy
ISNI:       0000 0004 9351 5379
Awarding Body: King's College London
Current Institution: King's College London (University of London)
Date of Award: 2020
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Autism Spectrum Disorder (ASD) is characterised by impairments in social communication and interaction and repetitive and restricted behaviours and interests. Developmental trajectories in ASD are highly heterogeneous; for example, there is vast variability in the extent to which individuals’ social skills improve over development. The underlying mechanisms for this, however, are poorly understood. This thesis characterises and explores the cognitive features of a candidate mechanism to explain this; namely ‘compensation’. In particular, this thesis focuses on compensation in the social domain; for example, how autistic people can compensate for core difficulties in theory of mind (the ability to understand other people’s minds), to demonstrate good social skills. First is a review of the literature on compensation in other areas of psychology, before conceptualisation of a preliminary framework for understanding the phenomenon in neurodevelopmental disorders, with a specific focus on ASD (Chapter 2). This is followed by empirical evidence for compensation in autistic adolescents, demonstrating that compensation is associated with greater intellectual ability and better executive function, but also greater anxiety (Chapter 3). Chapter 4 is a qualitative investigation into self-reported compensatory strategies in autistic adults, indicating that compensation has multiple forms (shallow and deep compensation) and both positive (e.g., employment, social relationships) and negative (e.g., poor mental health, late diagnosis) consequences for autistic people. This is followed by the first quantitative measure of compensatory strategies in adults with and without diagnosed ASD and exploration of its relationship with autistic traits, ASD diagnosis, age at diagnosis, sex and intellectual ability (Chapter 5). Chapter 6 is a theoretical commentary pertaining to the role of social motivation as an individual difference driving compensation in ASD. Chapter 7 then lays out current issues with theory of mind tasks, which stymy measurement of compensation in ASD, followed by Chapter 8, which outlines and validates a novel sensitive measure of theory of mind in autistic and non-autistic adults. The General Discussion (Chapter 9) includes i) a synthesis of the research findings and their implications for theory, methodology and clinical practice, and ii) a discussion of the overall strengths and limitations of the thesis, as well as ongoing issues and avenues for future research in the field.
Supervisor: Happe, Francesca ; Bird, Geoffrey Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available