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Background: Infancy is one of the most critical periods of human development, yet developmental delay during this period is a condition largely undiagnosed and uncared for. In addition, the life course importance of infant development to adult socio-economic position has yet to be examined. Aims and objectives: To perform a life course study of infant developmental delay to: further the understanding of the pre- and perinatal factors which influence it (Objective I), evaluate the potential of utilising available information during the pre- and perinatal period to improve identification of infant developmental delay (Objective 11), and evaluate the links between infant developmental delay and socio-economic position in adulthood (Objective Ill) and social mobility (Objective IV). Methods: The study used data from the 1966 Northern Finland Birth Cohort (NFBC1966) (n=12,231 children). Delay was assessed through measures of infant motor and language development. Findings relevant to Objectives I and 11 were validated in a second, UK- based, birth cohort - the Millennium Cohort Study (MCS). Results: i) 27 pre- and perinatal factors were available, of which 8 were significantly associated with motor or language delay, ii) The identified factors were significant predictors of delay in both cohorts, particularly in high-risk newborns, iii) Infant developmental delay was associated with indicators of socio-economic position in adulthood, iv) Developmentally delayed infants were more likely to be downward socially mobile and less likely to be upward socially mobile throughout the life course than non- delayed infants. Conclusions: Information on a limited number of pre- and perinatal factors may facilitate identification of developmental delay in high-risk newborns. Infant developmental delay is associated with indicators of socio-economic position in adulthood, highlighting the importance of early life development to human capital formation. Part of the socio- economic inequality observed throughout the life course can be traced back to infancy, where delayed development can set individuals on disadvantageous socio-economic trajectories.

Intensive Interaction (11) is an approach to communication which is frequently used in intellectual disability (ID) settings. Given its increasing use it is important to understand the current field of research that exists for the approach. Similarly, as II is a two-way approach it is vital to understand the impact on carers and their experiences as this may influence the way they support people with ID. The systematic review looked at the quantitative and qualitative research into 11. Nineteen studies into the use of II with clinical populations and 7 studies into practitioners' use of II and their perspectives on using the approach were reviewed in relation to their methodological strengths and limitations. Positive social and communication developments were found for people with severe-profound ID. Practitioners identified positive outcomes for themselves in using II and barriers to its implementation. However, the methodology employed by many of the studies was weak and further research utilising more robust designs would be beneficial. The empirical paper employed a qualitative Interpretative Phenomenological Approach methodology exploring the experiences of paid carers' in their relationships with people with profound intellectual and multiple disabilities (PIMD) through using II Three super-ordinate themes captured their experience of the relationship; facing and overcoming personal challenges to pursue a relationship, moving from the invisible to the visible: seeing the person and being with the person. Three super-ordinate themes emerged capturing their experiences of these relationships in the service and professional context; positive impact on job role, difficulties between the relationship and the wider service and coping with difficulties. Further research is required to understand how to train and support carers to cope with the challenges within the relationship and in the wider service.

Bright children who have abnormal difficulty in acquiring age-appropriate motor skills are of increasing concern to parents, teachers and health professionals. Longitudinal studies have found the condition to be associated with educational under-achievement, impaired social development and disturbed mental well-being in adult life. Now officially known as Developmental Coordination Disorder (DC D), the question of whether this condition should really be viewed as a distinct diagnostic entity is the central theme of this thesis. In the opening chapters, the history of terms used to signify 'clumsiness' of movement is reviewed and the different implications of treating such behaviour as a symptom or syndrome is considered. Discussion then moves to the overlap between DCD and other childhood conditions and the question of how these should be conceptualised. Five studies comprising the empirical component of the thesis employed a variety of methodologies. Two questionnaire-based studies showed that in this area, neither consensus on terms nor equitable service provision has yet been achieved. A third, retrospective study, searched for evidence of sub-types within a large sample of DCD children, successfully replicating some of the cluster groups reported by others. In a final, prospective study, a two-stage identification process was followed by 'blind' assessment of boys with DCD, Asperger Syndrome or Joint Hyper-mobility Syndrome. Novel to this area was the inclusion of experimental measures, including dual-task performance, in which motor and cognitive tasks were combined. The results showed that although the group with AS were significantly poorer on ball skills than those with OCD, the general nature of motor difficulties was not systematically constrained by diagnosis. Together, these studies support the thesis that DCD exists as a separable syndrome, but bear less decisively on the existence of subtypes. A series of real-life case studies illustrates the problems associated with differential diagnosis and the implications for appropriate intervention.

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As parent researcher and in light of perceived failings of studies found in the literature this research explores the experiences of parents who have a baby described as having a learning difficulty by employing an alternative broad methodology underpinned by ‘critical hermeneutic phenomenology’. The subsequent ethical trials of adopting such an approach are scrutinised as this bears important relevance to the overall finding that parents’ perspectives are rarely taken into account by those who have little or no experience themselves. Empirical data is generated via recorded and transcribed conversational interviews with four parent participants where the content subsequently informs the critical subject matter discussed throughout the work. The hermeneutic endeavour utilises Interpretative Phenomenological Analysis (IPA) as a guiding channel and although participants’ informed consent for the interpreted construction of experience was gained beforehand, significant limitations with this specific process are highlighted. As such, the methods of work in progress are presented in detail with additional reflexive commentary in the extended appendices to facilitate reader understanding of the development of interpretation as well as to promote confidence in the integrity and ability of the researcher and satisfaction regarding the overall quality of the composition. The findings reveal that parental experience as ‘phenomenon’ can be contemplated as an emotional passage of a ‘self’ that is embroiled in ‘abnormal’ circumstance made most complex via impinging myriad forms of societal organisation. From the data generated, the latter is recognised as being subject to historical legacy at micro as well as macro levels, over time and according to cultural belief. In support of this finding, the socio-historic concept is explored more fully in a dedicated chapter. Further empirical evidence suggests that parents strive to achieve their perceived understandings of normality as brought to consciousness through the associations they make with others and their social environment. Parental activities specifically reveal individual pressures arising as a result of inter-sectional social systems where perceived work and gender roles (for example) also expose anti-social moralistic behaviours. Encouraging further work which promotes a ‘perspectives approach’ to advance the understanding of parents and their experiences, the thesis concludes with realistic expectations for progression towards an improved societal moral condition.