The content of dreams of children aged between three and five years old has been the topic of ongoing debate in past dream research. The bulk of this research was conducted by Foulkes (1982, 1999), who concluded that children of this age group experience impoverished dreams with little emotional content, an absence of active self-participation, and a lack of kinematic imagery (i.e., mental representations of movement, activities and interactions). These conclusions were based on the brief and mundane dream reports provided by children during his 1982 longitudinal laboratory study. However, Foulkes’ research did not test the children’s memory skills and ability to narrate an event, and did not compare these to the dream reports the children produced. The importance of memory skills and narrative ability as potential confounds when studying children’s dreams has been postulated in existing literature. In view of the findings of past studies on young children’s dreams and their cognitive capacity for dreaming, the present study re-examined the quantitative and qualitative features of dream reports of children aged three to five years old. The present study included parameters of testing memory skills and narrative ability to analyse whether these confound the dream report findings, and if so, whether one can draw any firm conclusions about dreams based on a dream report provided by the children.

ASD has an estimated prevalence of 1 in 68, making it one of the most common neurodevelopmental disorders in children. Furthermore, its prevalence is increasing; therefore, there is a rising demand for screening tools to help achieve beneficial early diagnosis and intervention outcomes. However, there is a lack of literature around ASD and ASD screening tool validity in South Africa. This thesis adapted and assessed the use of South African English, Afrikaans and IsiXhosa versions of the 23-item Modified Checklist for Autism in Toddlers (M-CHAT) screening tool, for a Western Cape state hospital. The M-CHAT was completed by parents (N=255) of children between the ages of 1.5 and 4.99 years, at the Red Cross Children's Hospital developmental clinic. The demographic variables of Child's Age or Sex, Income and Mothers Education did not significantly affect the M-CHAT scores. Furthermore, on qualitative inspection, neither Home language nor Ethnicity of the child appeared to affect the screening scores. Final M-CHAT scores and high internal consistencies were similar across the three M-CHAT language versions, likely indicating their equivalence in flagging ASD. Even the extended age range (4.01-4.99 years) included in this study, did not appear to affect the M-CHAT scores. The M-CHAT follow-up interview was important in determining the ASD risk outcome. Overall, 67% failed the M-CHAT initially, thus requiring follow-up questioning, and of those, 40% changed their outcome and subsequently passed. Interestingly, filling out the M-CHAT in a first or second language did not affect the percentage requiring the follow-up nor the proportions changing their outcome after follow-up. The items which were poor or good discriminators between those eventually passing or failing overall were investigated. The good discriminating items were not necessarily the same as the originally suggested critical items. Thus, new critical items and the possible removal of unnecessary items for this context may need further investigation. For phase 2, a small subgroup (n=38) filling in the English M-CHAT took part in formal ASD diagnostic assessments, using the Autism Diagnostic Observation Schedule (ADOS/ADOS-2). Preliminary investigations into the English M-CHAT's predictive abilities are promising. A cut-off of 3/23 items overall indicates high sensitivity (.84) and adequate specificity (.69). The adapted cut-off of 1/6 critical items results in good sensitivity (.76) and high specificity (.92). The promising results warrant further investigations into the predictive validity of all 3 language versions of the M-CHAT. This thesis takes the first steps in validating the use of the M-CHAT in this low SES context and indicates positive prospects for its future use in state clinics in the Western Cape, and ultimately South Africa.

Includes bibliographical references / Autism Spectrum Disorder (ASD) is a highly heritable prevalent pervasive developmental disorder. All cases have deficits in social communication and interaction and in restricted and repetitive behaviours and interests. The mechanisms underlying different clinical presentations remain elusive. Deficits in Theory of Mind (ToM), the ability to understand that others have mental states independent of one's own, have been suggested as a possibly underlying the socia l deficits in ASD. The serotonin transporter promoter length polymorphism (5 - HTTLPR) has been implicated in ASD, and as serotonin is implicated in social functioning more generally, it is possible that 5 - HTTLPR could underlie social functioning in ASD. As such, ToM and 5 - HTTLPR have been implicated in ASD, and specifically as underlying the social deficits typical of this disorder. This protocol assessed core ASD symptoms (i.e. deficits in social communication and interaction, and impairment in restricted and repetitive behaviours and interests) in 69 children with ASD between the ages of 7 and 14 years. The Autism Social Skills Profile, Social Communication Questionnaire, and Repetitive Behavior Scale - Revised assessed these symptoms. 5 - HTTLPR genotypes were established for 55 of these children. ToM was comprehensively assessed in 57 of the children using the University of Cape Town Autism Research Group's Theory of Mind Battery. This protocol is the first is a series of studies assessing the biological bases for social deficits in ASD. One of the main aims was to pilot the use of ASD scales in a local sample. The preliminary analyses assessed the performance of these scales. This data was also used to assess whether the new DSM - 5's merging of social communication and social interaction into a single domain was supported. Study One then assessed for possible relationships between 5 - HTTLPR and cores ASD symptoms, and hypothesised that the 5 - HTTLPR genotype with the most reduced serotonergic transmission woul d relate to increased deficits in social communication and interaction. Study Two explored possible relationships between core ASD symptoms and ToM, and between 5 - HTTLPR and ToM. It was expected that impairment in social communication and interaction would correlation with reduced ToM ability, and that ToM would be most impaired in children with the genotype with the most reduced serotonergic transmission. Preliminary analyses found the scales did not perform well in a local sample. This was likely due to cultural, socio - economic, and educational factors. The bluntness of the scales 13 and broad nature of ASD characteristics likely also contributed. The DSM - 5's diagnostic criteria were supported. Study One and Study Two found no relationships between core ASD symptoms, ToM, and 5 - HTTLPR. Core ASD symptoms were assessed very broadly and it was not possible to establish clear phenotypes for the participants, which likely undermined analyses. At most this protocol showed that broad assessment of core ASD symptoms is not specific enough to reveal relationships to underlying mechanisms, and that ToM and 5 - HTTLPR are not implicated when board measures are used. We emphasise the need for better measures in ASD. We also believe the serotonin system needs to be investigated beyond 5 - HTTLPR in ASD

Methamphetamine use among pregnant women is an increasing problem in South Africa. The aim of this cross-sectional exploratory study was to examine the possible neurotoxic effects of prenatal methamphetamine exposure (PME) on cognition and the developing brain in a sample of affected children in Cape Town, South Africa. Thus, this is a two-part study: the first part examines the effects of PME on neuropsychological outcomes, and the second part examines the effects of PME on intrinsic functional brain connectivity. Children with PME (n = 23) and unexposed controls (n = 22) completed a battery of neurocognitive assessments, and a smaller sub-sample (n = 36; 19 children with PME, 17 unexposed controls) also underwent resting-state functional magnetic resonance imaging (RS-fMRI). Independent samples t-tests revealed that children with PME scored significantly more poorly on measures of IQ, learning and memory, confrontation naming, visual-motor integration, and fine motor co-ordination, when compared to controls. Hierarchical regression analyses confirmed that PME has a significant effect on cognitive performance, and that this effect largely withstands the effects of potentially confounding sociodemographic and anthropometric variables. Independent component analyses revealed significant betweengroup differences in functional brain networks detected in task-free RS-fMRI in children with PME. Specifically, there is evidence for compromised connectivity within and between the basal ganglia network and default mode network in children with PME. Overall, the findings contribute to the small but growing literature on the cognitive effects of PME. The current study is the first to document preliminary evidence indicating aberrant intrinsic functional brain connectivity in children with PME, and suggests that further investigation of potential associations between particular neurocognitive deficits and such aberrant connectivity might be warranted.

Research suggests that people feel more empathy for racial in-group compared to racial outgroup members, and in some circumstances, are more likely to help racial in- than out-group members. Furthermore, there is evidence that cognitive load may also attenuate helping behavior. Research is yet to establish the influence of both racial group membership and cognitive load on empathy and helping, however. In this study, a sample of 104 women (52 Black and 52 White) completed either a Low or a High cognitive load task and then viewed video clips depicting racial in- and out-group members in distress. I measured participants' selfreported empathy, physiological activity, and willingness to help those in distress. The results did not show the expected racial bias in empathic responding, but rather, indicated heightened empathy (seen in both self-reported and physiological responses) for the Black target individual, regardless of participant race. Secondly, although cognitive load did not influence empathic responding, participants in the High Load condition were less likely to offer help than participants in the Low Load condition. Finally, correlation data suggest that racial group membership and cognitive load contributed to the associations between individual differences (i.e., in ethnic identification, motivations to respond without prejudice, and trait empathy), empathic responding, and helping behavior. Overall, the findings contribute to a growing literature on cross-racial empathy, and highlight the complex physiology underlying our empathy for others.

Traumatic brain injury (TBI) is an international public health concern, particularly in lowand middle-income countries. Children who sustain TBIs typically have attentional difficulties, which disrupt the development and functioning of other cognitive, behavioural, and social skills. The aim of this research was to evaluate the efficacy and feasibility of implementing an attention-training program for children who have sustained moderate-tosevere TBI in South Africa, and to compare the efficacy of the program in two clinical samples: children with TBI and children with Attention Deficit Hyperactivity Disorder (ADHD). Fifteen children aged 6 to 8 who sustained TBIs at least a year before were recruited to form three groups: a TBI Intervention Group (n=5), a TBI Art Group (n=5) and a TBI Control Group (n=5). Five children who had been diagnosed with ADHD formed the ADHD Intervention Group. Children in the two Intervention Groups participated in the ‘Pay Attention!’ program (originally designed to assist children with ADHD) for 45 minutes twice a week for 12 weeks. All children underwent neuropsychological testing pre- and postintervention and behavioural data was collected from parents and teachers. Between- and within-group analyses showed that children in the TBI Intervention group did not show overall significant improvements in attention. However, children in the ADHD Intervention Group showed individual attentional improvements on measures of the CPT-II, as well as secondary gains in verbal memory. Nevertheless, implementing a cognitive rehabilitation intervention in South Africa is feasible and necessary, despite limited infrastructure and access to resources. Further research is required to better tailor interventions to the needs of children with TBIs.

Few research studies have investigated the effects of prenatal alcohol exposure (PAE) on reading ability and/or on phonological processing. Most published studies have only included measures of single-word reading. This choice means those studies may lack ecological validity in that they might not have adequately captured the real-life reading difficulties experienced by individuals with PAE. Furthermore, only a handful have considered the possible mediating roles of those higher-order cognitive functions (e.g., working memory (WM)) that are known to be affected by PAE. The current research employed an extensive battery of phonological processing measures, as well as a reading test that featured measures of reading accuracy, reading rate, and comprehension. A sample of 159 children between 9 and 14 years of age, with varying degrees of PAE, including heavily exposed children and non- or minimally-exposed controls, were tested. The design also considered the potential for a mediating role of WM on performances on these tests. Overall, results showed performance deficits in children with either fetal alcohol syndrome or partial fetal alcohol syndrome on reading comprehension and on four measures of phonological processing, after control for potential confounders. Additional analyses showed that performance within all five of these reading-related domains were at least partially mediated by WM performance. I discuss these results in the context of previous findings in this literature, and describe their implications for reading interventions in children and adolescents with PAE.

Certain forms of spatial navigation are centered, neuroanatomically, on the hippocampal formation, a brain structure vulnerable to increased levels of the stress hormone cortisol. Although empirical studies have identified a substantial sex difference, in favor of males, on laboratory-based spatial navigation tasks, little research has investigated whether, and how, these sex differences manifest under conditions of psychological or physiological stress. The current study aimed to resolve some of the inconsistencies in the literature, and to investigate the relations between stress and performance in male and female participants. The current study followed a mixed quasi-experimental pretest-posttest design in which men (n = 23) and women (n = 23) were tested on two separate days (the first day under control conditions and the second under stressful conditions). I utilized a novel stress induction paradigm (the Fear Factor Stress Test) that would produce both hypothalamic-pituitary-adrenal axis and autonomic nervous system activity in men and women, and created a spatial navigation virtual environment task that would allow for cue usage of both landmarks and gradients. Participants also completed the Card Rotations Test as an assessment of their mental rotation abilities. I hypothesized that (a) men would perform better on spatial navigation tasks than women on Day 1 (i.e., the control condition) despite the availability of landmark cues, and (b) stress would affect spatial navigation performance in women more than in men. Results suggested that the stressor used was effective in eliciting appropriate responses in both men and women, however women showed smaller cortisol increases than men, relative to baseline. Regarding the navigation task, under unstressed conditions men showed a steeper learning curve than women in an unchanged environment, and performed better than women only when a proximal landmark cue was removed from the environment. Furthermore, findings suggested that acute psychosocial stress enhanced navigational performance in men, but impaired such performance in women. Regarding the mental rotation task, no sex differences were observed under unstressed conditions; however, under the stressed condition men improved in their performance whereas women were relatively unaffected. It appears then that men's spatial ability might, under particular conditions and on particular tasks, be enhanced following exposure to a stressor. Furthermore, the pattern of results observed in the spatial navigation task suggests that the types of navigation-aiding cues in an environment (as well as location of these cues relative to the target) play a significant role in eliciting sex differences in navigational performance following exposure to a psychosocial stressor.

Although social deficits are a defining feature in Autism Spectrum Disorder (ASD), not enough is known about the origin and impact of these impairments. Current research agrees that deficits in Theory of Mind (ToM) contribute to the social disconnectedness evident in children with ASD. Furthermore, studies in neurotypical populations have found significant links between attachment security and ToM acquisition, and some have posited parenting behaviours as predictors of social development. Less is known about these construct in children with ASD. This study aimed to form a foundational view of the relationships between parenting style, attachment, and Theory of Mind development in a sample of ASD children compared to a sample of neurotypical children. 80 parent-child pairs were included in the study. The sample was comprised of 40 verbal children with an ASD diagnosis and 40 neurotypical children. Children between the ages of 6 and 16 years were included in the study. Parenting style and attachment were measured using scaled response parent-report questionnaires while ToM was assessed using the University of Cape Town Theory of Mind Battery. ASD diagnoses were confirmed using the Autism Diagnostic Observation Schedule, Second Edition (ADOS2). Results showed that while both the ASD group and the neurotypical group reported significantly more Authoritative parenting than the other two styles (Authoritarian and Permissive), there was also more of the less positive parenting styles reported in the ASD group. Furthermore, none of the three parenting styles in question were significant predictors of Theory of Mind. The results further indicated that the ASD group reported less secure attachment, and also more insecure attachment (Ambivalent and Avoidant) than the neurotypical group. Attachment classification, specifically insecure attachment, showed to be a significant predictor of Theory of Mind. Associations between parenting style and attachment showed different patterns in the ASD sample compared to the neurotypical sample. Results, limitations, and futher directions were also discussed.

Peripersonal space (PPS) is the space immediately surrounding the body, encoded by a specific frontoparietal network of multimodal neurons. Stimuli in PPS are represented in a body-part centred manner in terms of possibilities for action, and PPS representations function to facilitate defensive and/or approaching responses to stimuli. The size of PPS differs between individuals and contexts, with physical and psychological factors having a determining role on the size of PPS. For these reasons, PPS has been conceptualised as ‘the space of the bodily self'. In this study we investigated whether the dominance enhancing effects of testosterone may reflect in changes of the representation of PPS. We conducted a double-blind placebo-controlled within-subjects testosterone administration study in women (N=19) where participants performed a multisensory-integration task (a commonly used measure of PPS) while facing an unknown confederate. Results indicated that in comparison to placebo, the administration of testosterone caused a significant enlargement of participants' PPS, suggesting that testosterone caused participants to reflexively appropriate a larger space as their own. This effect was particularly pronounced in participants with higher trait anxiety, converging with other research which has shown that the dominance enhancing effects of testosterone administration can be particularly effective in anxious individuals. Results also indicated a multisensory-facilitation effect around the confederate, which was constant across testosterone and placebo conditions – confirming that the effect of testosterone was self-specific. The PPS boundary gradient was unchanged by testosterone. These findings suggest that an enlarged PPS may provide an embodied index of social dominance. Further, because PPS representations function to support approaching and/or defensive responses to the environment, an enlarged PPS due to raised testosterone may support the enhanced approach behaviour and vigilance to threat known to be conferred by testosterone.