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The attention test batteries currently available for developmental assessment are mostly too challenging for children younger than 6 years, and are often unsuitable for children with developmental delay or attention deficits. With younger children, the process of assessing complex functions of attention is challenging. However, the emergence of attention mechanisms is a key developmental issue, which would benefit from more suitable tools for the assessment of attention in early childhood. This thesis describes the development of a battery designed to test multiple components of attention in children with a mental age between 3 and 6 years, including children with developmental disorders as well as typically-developing children. A considerable literature devoted to the nature and organisation of attention functions has suggested separable components of selective attention, sustained attention and attentional control (e.g. Posner & Petersen, 1990 Mirsky et al., 1991 Manly et al., 2001 Fan et al., 2002). However, most of this work has used adult or school-age participants. This study used the new battery to explore whether this model provides an accurate description of attention in early childhood. Factor analysis provided support for the hypothesised model, but suggested that changes in the structure of attention occur over the preschool age range. The battery was also used to examine how attention is affected in two developmental disorders where attention problems are common: Williams syndrome and Down's syndrome. By using a range of tests to assess different aspects of attention, it is possible to establish whether observed attention problems are global or specific to particular components. Both groups showed patterns of impairment that varied across subtests, with some deficits common to both groups, and others present only in one group. These results are considered in relation to what is known about the structure of attention in adults and older children, its neuroanatomy and the atypical development of attention in childhood disorders. This thesis highlights the need for a more developmental perspective that takes into account changes in the structure and function of attention over the lifespan.

This study set out to explore the nature of deaf children’s lexical representations and how these may be updated as new speech skills are acquired, through an investigation of speech processing skills and responses to intervention in three deaf children. A computer-based psycholinguistic profiling procedure was developed to examine the relationships between input skills, lexical representations and output skills for a range of consonant contrasts, with the expectation that input skills were important in determining output skills. Using this procedure, consonants or consonant clusters that were not accurately realised by the participants were classified according to responses to real word and nonword input testing in audio-visual and audio-alone conditions. By comparing how the differently classified consonants responded to intervention, the role of input skills in the updating of lexical representations was discovered to be less important than other sources of information, including phonological awareness and knowledge of orthography and grapheme-phoneme links. There was some evidence that articulatory knowledge, acquired through phonetic instruction and tactile feedback, was enriching segments of input representations so that the corresponding segments became easier to detect in input tasks. This questions the assumption that output representations depend on input representations for their specification. Further intervention involving repeated practice of new motor patterns and use of feedback from the therapist to encourage motor planning facilitated generalisation of the acquired speech skills to a wide range of speaking tasks. There was evidence that one of the participants was accessing the orthography of what he was about to say in order to generalise his speech skills and that he could eventually do this, even when conversing at an acceptable rate of speech. The implications for combining the teaching of phonics with speech production training for deaf children are discussed.

The thesis investigates the relationship between spoken and written language difficulties. Two children aged eleven and twelve years were studied. Both were of average intelligence but had a persisting speech difficulty of a dyspraxic nature. Normal control data was collected on each area tested so that the casescould be viewed from a developmental perspective. First, a detailed analysis of speech errors was carried out. Compared to Articulation Age matched controls, the speech disordered children made multiple errors, had difficulty assembling the articulatory programme for unfamiliar words and relied upon word specific knowledge. Second, on tests of auditory discrimination, lexical decision and segmentation skills, the speech disordered children performed less well than Reading Age matched controls. Their difficulties were most pronounced in the auditory modality and when non word material was used. Third, their reading and spelling performance was compared to low Reading Age dyslexic children without obvious speech difficulties. The speech disordered children were more deficient in their use of phonological strategies and had not broken through to the alphabetic phase of literacy development. The cases were followed up after three years. Although the children had improved their performance quantitatively, they still exhibited the same pattern of errors overall. They had become "trapped" in the logographic phase of literacy development and were adopting compensatory strategies when reading and spelling. Their pervasive phonological difficulties were compounded by their inconsistent and incoordinated speech. These findings challenge the traditional view of Developmental Verbal Dyspraxia as a motor speech disorder. In addition to their articulatory difficulties, the children also had auditory processing and lexical problems. The findings allow further discussion of the role of articulatory and phonological skills in literacy development. A model of reading and spelling strategies is presented and the points where speech and language disordered children are most at risk, are indicated. Finally, the clinical, educational and research implications are outlined.

Background: In the UK about 141,460 people with dementia (PWD) living at home live alone. They have high number of unmet needs (UN) and are at high risk of social isolation. In order to provide person-centred care, needs of PWD must be studied considering their own views. Finally, in order to improve well being it is important to know which factors are associated with UN. Main aim: To identify predictors of UN for PWD living at home. Hypotheses: PWD living alone will have more UN than those living with others, and PWD with a private restricted network will have more UN than those with other networks. PWD will report fewer UN than their carers and researchers. Method: 152 PWD were interviewed about their needs, cognitive status, and quality of life (QoL); and 128 informal carers were interviewed about the PWD’s needs, QoL, social networks, behavioural and psychological symptoms (BPSD), functional status, and services used. Carers were also interviewed about their own symptoms of depression, anxiety, burden, and satisfaction. Non-parametric analyses, multiple regression and path analysis were undertaken. Results: PWD living alone had more UN than those living with others particularly for psychological and social needs. PWD themselves reported fewer UN compared to their carers and researchers. Higher BPSD, low-community involvement social networks, having a younger carer and higher carer anxiety were found to be predictors of higher UN. A model of the relationship among the variables was proposed. Conclusion: The management of PWD living at home should consider: an interdisciplinary and coordinated system which includes environmental, physical, social and psychological areas; targeting people living alone as a vulnerable group; the participation of PWD in their own care management; and interventions aiming to reduce UN including the treatment of BPSD and the involvement of PWD in the community. By doing this, PWD’s quality of life will be ultimately improved.

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Speechreading is the major route through which deaf people access the spoken language of the society in which they live. This thesis investigated speechreading and its correlates in a group of profoundly congenitally deaf British adults, and in a control group of hearing adults. For this purpose, the Test of Adult Speechreading (TAS) was developed. The TAS was designed to be sensitive to the perceptual abilities that underlie speechreading at varying linguistic levels, and to be appropriate, therefore, for use with d/Deaf as well as hearing individuals. The vocabulary and syntax used were selected to be familiar to Deaf adults, and the response mode, using picture choices only, made no demands on written or expressive spoken English. This new test was administered silently to groups of congenitally deaf and hearing adults, with a battery of visual, cognitive and language tasks. The deaf participants differed in their language and educational backgrounds, but all had hearing losses over 90dB. They significantly outperformed the hearing group on the TAS, even when only closely matched pairs of participants were included in the analyses. Adults who are deaf can speechread better than those who are hearing. Multiple factors impact on an individual’s speechreading abilities, and no single factor in isolation results in good speechreading skills. In addition to hearing status, other factors were identified through group comparisons, correlation and regression analyses, cluster analyses and multiple case studies, as being potentially necessary (although not sufficient) for skilled speechreading. These were lexical knowledge, the ability to visually identify sentence focus, and verbal working memory capacity. A range of further factors facilitated skilled speechreading, including hearing aid use, the use of speech at home during childhood, sensitivity to visual motion, personality (risk-taking & impulsiveness), and reading age. It seems there are many ways to become a skilled speechreader.

The health effects of smoking are well known and, despite efforts to reduce smoking in adolescence, prevalence of smoking during the teenage years in the UK has remained stable over recent years. This thesis examines smoking uptake during adolescence and identifies the social, psychological and physical factors associated with this process using data from the longitudinal Health And Behaviour In Teenagers study (HABITS). Between 1999 and 2003 over 5000 students from South London were assessed annually from age 11 to age 16. Self-report questionnaires identified smoking status as well as a range of demographic, social and psychological variables. Objective height, waist and weight data were taken and saliva samples provided for cotinine assay. First, analyses examining smoking prevalence and the sociodemographic factors associated with smoking behaviour were conducted. Gender and ethnicity differences were observed, although the association between smoking and deprivation was less clear. The development of smoking behaviour among an understudied group, 'one time triers' of cigarettes, was tracked, revealing that even brief experimentation with cigarettes leads to a lasting vulnerability for later smoking. Second, social factors associated with smoking were examined and the association between smoking by friends, parents and step-parents and adolescent smoking documented. An independent relationship between early dating and later smoking was also revealed. Third, psychological factors associated with adolescent smoking were identified, and the lack of a prospective relationship between attitudes towards smoking and smoking behaviour was confirmed. Fourth, significantly smaller increases over time in BMI and waist, but not height, were observed among smokers compared with non-smokers. Finally, a population level model of the vulnerability and trigger factors associated with smoking, based on an individual level theory of motivation, was constructed. The findings presented extend current literature on adolescent smoking and have implications for effective prevention strategies.

Spirit-mediums and their activities have been of great interest to anthropologists, dealing, as they do with the nature of being a person in a social world. There have been various orientations towards studying the subject matter, including a psychoanalytical approach, although many anthropologists eschew psychoanalytical accounts as pathologizing the subjects of investigation. I, however, suggest that a Lacanian psychoanalytical approach can offer a significant contribution to the subject matter. It can help one investigate the healing aspect of spirit-medium phenomena and how healing relates to both psychological and social processes. Field research on spirit-mediums [tang-kis] in Singapore was undertaken over a total period of fourteen months. In that time, I was mainly involved in participant observation at two shines. Healing rituals at tang-ki shrines can be considered to be about sexual identity and resistance to a ‘master discourse’ given by governing authorities. I show that tang-ki worship can also be considered to be about being a subject and developing an identity, in a country where there are a multiplicity of identity discourses. In the shrines people develop a discourse that changes them so they are more able to deal with their personal problems and the problems of living in a modern, globalized, capitalist society. While many people who go to tang-ki shrines have problems that could be characterized in terms of psychopathology taken from the psychiatric discourse, I argue that tang-ki worship gives people the means of transcending these problems. I show that tang-ki worship is not insanity in the medical sense, but promotes a way of dealing with the ‘’madness’ within us and the ‘madness’ within society. To this extent, it can be called a transcendent phenomenon.