Paediatrics (RCH) - Research Publications
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ItemSocial cognition in autism spectrum disorder and neurogenetic syndromes(Routledge, 2021)Autism spectrum disorder (ASD) is a common neurodevelopmental disorder characterised by impairing social communication deficits and restricted and repetitive behaviours. Over the past few decades, a growing body of research has proposed that social cognitive deficits are a key psychological driver of ASD. In the following chapter, we review evidence for this and show that while social cognitive deficits are common in individuals with ASD, they do not hold clear relationships with ASD symptoms and are not necessary nor sufficient for a diagnosis of ASD. We consider several reasons for this, including the heterogeneity inherent within individuals with ASD, at the symptom, cognitive and aetiological levels. We then discuss the utility of examining ASD and social cognition within syndromic ASD populations which reduce the heterogeneity in the idiopathic population and can be thought of as human ‘genetic models’ of ASD. These syndromic cases of ASD offer a valuable opportunity to elucidate the neurobiological and developmental pathways that lead to both ASD symptoms and aberrant social cognitive processing that are due to a single gene mutation. The possibility of this research to translate into targeted treatments is also explored.
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ItemImpact of early brain insult on the development of social competence(Routledge, 2021)There is growing interest in the social consequences of paediatric brain insult. While current evidence is relatively scarce, findings consistently demonstrate that brain injury in early life confers an elevated risk of social dysfunction across a range of dimensions – social adjustment, social interaction and participation and social cognition. Interactions across these domains and their impact on the child’s other skills is poorly understood. In addition, it appears that the injury-related risk factors that are predictive of cognitive and physical outcomes from early brain insult (injury severity, lesion location, age at insult) are less reliable indicators of social outcomes. Rather, pre-insult child status and environmental factors play a larger role. In particular, social context, family function, child temperament and adjustment to brain insult are all important in determining the child’s social recovery and outcome. Emerging findings from longitudinal studies of childhood ABI show great promise and will facilitate the design of evidence-based interventions in this field. Further, the advent of recent theoretical models of social function and early brain insult, integrating social neuroscience, developmental and developmental psychopathology literatures, provide a strong bio-psychosocial framework for future research.
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ItemNontyphoid Salmonella Disease(Elsevier, 2020)Nontyphoidal Salmonella (NTS) typically causes self-limiting enterocolitis in high-income settings. In sub-Saharan Africa (SSA), however, NTS is a major cause of bloodstream infections, termed invasive nontyphoidal Salmonella (iNTS) disease, causing an estimated 1.9 million cases and 388,000 deaths annually. In SSA, specific clades of Salmonella Typhimurium and Salmonella Enteritidis associated with genomic degradation and multi-drug resistance have emerged. iNTS disease disproportionately affects adults with advanced HIV infection and young children with immature immunity, HIV, and malaria. Children in SSA bear two-thirds of the burden of disease. The non-specific nature of iNTS disease makes it difficult to differentiate from other causes of non-focal febrile illness, and the widespread emergence of multi-drug resistance and emerging cephalosporin resistance presents increasing treatment challenges. iNTS disease causes a large burden of morbidity and mortality in SSA, and there is much that is still unknown about environmental and host reservoirs and transmission of the pathogen and about optimal therapy for this condition. iNTS is also a problem in other resource-limited areas among individuals with HIV, malaria, and compromised or immature immune systems, although SSA accounts for the largest global burden. Vaccine acceleration is a high priority.