The ability to take another person’s perspective is highly important for social interaction. People with autism have particular difficulty with taking someone else’s point of view. This thesis aimed to examine whether people with autism are impaired at visual perspective taking and the processes which underlie this ability and how this could impact on social interaction. Chapter two examined body representation in children with autism and results showed no significant difference between these and the control groups in regards to performance. Chapter three investigated mental rotation and egocentric spatial transformations in adults with autism compared to typically developing (TD) adults. Results showed that participants with autism were slower but equally accurate in the mental rotation task and slower and less accurate in the egocentric task. Comparisons across tasks suggested that the participants with autism may have general differences in perception compared to typical people. The experiments in Chapter 4 examined level 2 visual perspective taking (VPT2) and the processes which underlie this ability in TD children. The results showed that in typical children VPT2 is driven by the ability to represent bodies from different points of view. Chapter five examined whether children with autism were impaired at VPT2 and whether the same processes predicted this ability in children with and without autism. Results showed that VPT2 in children with autism is predicted by mental rotation ability and not body representation. In the final experiment, level 1 VPT was examined in children with autism. Whilst previous studies have suggested that this ability may be intact in autism, the results of this chapter suggested otherwise. Overall it was found that people with autism have problems in perspective taking which could impact on their social skills.

This research examined relationships and positive growth in families of children who have a developmental disability. Chapter one is a critical review of the literature relating to positive growth in parents of children who have a developmental disability. Past studies have indicated that having a child with a developmental disability can be both stressful for parents and place increased pressures on their time, energy and resources. However, this review of more recent research about the experience of having a child with a developmental disability highlights the range of positive growth experiences parents undergo and some of the possible processes involved. Positive growth experiences reported included changes in parental perceptions of their growth, changes in belief systems, increased sense of coherence and increased hope. Resilience, reframing coping strategies, meaning-making and social support were all implicated in this positive growth process. Clinically, the value of strengths-based services for families emerged. Chapter two is an empirical study, focusing on the maternal experience of a family based Lego Therapy intervention amongst five families who have a child who is on the autism spectrum. Qualitative analysis of interview data resulted in themes of family specific factors (communication, new perspectives, deeper relationships), child-specific factors (impact of the child's ASD, child-specific developments) and intervention-specific factors (ambivalence about the intervention, time). Methodological· and clinical implications are discussed, alongside recommendations for future research. Chapter three is a reflective paper focusing on the individual differences to emerge amongst families and the clinical and methodological implications of this.

Background: The onset of Inflammatory Bowel Disease (IBD) is highest during adolescence. The symptoms may make the essential developmental transitions associated with this stage more challenging and cause difficulties in psychosocial functioning. While previous research has compared adolescents with IBD to healthy controls, it may be more informative to take a developmental approach, examining psychosocial functioning within the early, mid and late stages of adolescence. Aims: The primary aim of this exploratory study was to investigate whether stage of adolescence has an effect on social functioning, body image and self-esteem in adolescents with IBD. The secondary aims were to determine whether stage of adolescence has an effect on mood, and whether demographic and disease factors have an effect on outcome measures. Methods: 63 adolescents aged between 11 and 17 years with IBD were recruited from a gastroenterology outpatient clinic. Each adolescent completed measures of social functioning, body image, self-esteem and mood. Demographic and disease information was also gathered. Outcome measures were compared between the three groups (early, mid and late adolescence) using parametric and non-parametric statistical tests. Results: There were no significant differences in any of the outcomes between the three groups. The only significant finding from regression analysis was that gender significantly predicted self-esteem. Nearly half the sample reported impaired social functioning and a quarter had significant levels of anxiety. Conclusions: Stage of adolescence was not found to have an effect on psychosocial functioning or mood in this population. The small sample size, assigning developmental groups according to age and the mild disease severity of participants limit the conclusions that can be drawn from this study.

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The possibility that seeing aggression on television and in video games might cause aggression in children is a public health concern. A systematic review found insufficient, contradictory and methodologically flawed evidence regarding this association in children with behavioural and emotional difficulties. It indicated the complexity of the subject, along with numerous gaps in knowledge. There are few studies based in clinical settings. This thesis reports a mixed methods pilot study that explored possible associations between aggression seen on television and in video games and reported aggression in children attending specialist outpatient Child and Adolescent Mental Health Services (CAMHS). Forty-seven children aged 7-11 years with behavioural and emotional difficulties, attending CAMHS, and their carers participated in a survey. Twenty children were purposively selected; they and a parent/carer participated in semi-structured interviews, which were analysed using the Framework Analysis Approach. Quantitative findings indicate that children exhibit various types of aggression, of varying frequency and severity. Qualitative findings reveal that children see aggression in multiple real and virtual settings. Children do not think their own behaviour is influenced by seeing aggression. Carers regard aggression as the result of a combination of inner and environmental factors, amongst which seeing aggression in real life has more impact than television/video games. Verbal aggression is often seen in real and virtual settings, frequently exhibited and strongly associated with poor peer relationships and low prosocial behaviour. There is currently no definitive proof of any association between seeing aggression on television and in video games and exhibited aggression in such children. This thesis makes suggestions for the undertaking of and methodology for future research, tackling the challenges of researching this field and hard to reach population. Carers, professional organisations and policy makers should consider the role of aggression, particularly verbal, that children see in both real and virtual environments.

Existing research indicates that typically developing children pass through predictable stages of fear development throughout their childhood. Evidence suggests that in general, children with disabilities experience more fears than typically developing children. Children with disabilities share similar stages of fear development compared to typically developing children, but at a delayed rate, with a more protracted course. Children on the autism spectrum experience higher levels of anxiety, compared to other children. Limited fear research in children on the autism spectrum suggests that they exhibit a unique fear profile compared to their peers, however, little is known about why this may be. Chapter 1 reviews published literature on fear development for typically developing children, children with physical and intellectual disabilities, and children on the autism spectrum. Chapter 2 presents an empirical study that investigates the relationship between sensory processing and fear profiles in children on the autism spectrum. The results support the notion that sensory experiences may account for a proportion of the unique fear pattern experienced by children on the autism spectrum. The thesis concludes with a reflective account that reviews the process of conducting internet-mediated research on children on the autism spectrum.

Attention Deficit Hyperactivity Disorder (ADHD) is a medical diagnosis, applied mainly but not exclusively to children. Diagnosis of ADHD is a controversial issue as the validity of the condition is questioned, and the main form of intervention offered to children in the UK is Methylphenidate, better known as Ritalin, which is a psycho-stimulant. It is also controversial because it rests on the assumption of a particularly westernised cultural conception of what 'normal' childhood behaviour should be, yet dominant discourses of child development and socialisation have influenced this view of children as less competent, immature and in need of moulding to fit societal demands. The orthodox position on ADHD also appears to compound this assumption, as research which includes the experiential accounts of children who have the diagnosis is extremely rare. Children's own views and perceptions of the diagnosis have not been valued. This thesis is based on in-depth qualitative interviews with seven children aged between 6 and 15 and their parents, plus a small-scale parental survey. In addition, observations of health care professionals' practice, carried out at a Child and Adolescent Mental Health Service, will help to demonstrate that only by giving full consideration to the complexity of medical and lay perspectives can an understanding of ADHD as a concept, a condition, a label, and an experience be achieved. In this study 'medicalisation' debates have been used as a means of reflecting on the concept of AD}ID. It is suggested that within the health professional/parent/child triangle dominant discourses position children as passive and dependenwith their health being mediated through their parents. By drawing attention to the embodied nature of the experience and meaning of ADHD it will be shown that the valuable and insightful contributions which children and young people make to the health care division of labour have largely been neglected to date.

Borderline Personality Disorder (BPD) is a severe and chronic mental health disorder, affecting many areas of functioning including: affect regulation, impulse control, interpersonal relationships and self-image. Causal factors are only partly known due to a scarcity of prospective, longitudinal studies which enable one to delineate the time ordering of antecedents, and allow for tentative causal inferences. This thesis explored the developmental precursors of BPD symptoms at 11 years, using a British cohort sample, with assessments pertaining to the study child from pregnancy to 11 years of age. Three studies were conducted. Firstly, the predictive relationship between exposure to maladaptive parenting and subsequent BPD symptoms was explored within a child population, using a clinically relevant assessment of BPD symptoms. This association has been previously shown in a range of retrospective studies. Secondly, the role of peer victimisation in the development of BPD was considered. This study was designed to extend current aetiological models, which focus on parental rather than peer relationships. It was based on the recognition of a strong interpersonal core in the BPD symptom constellation, and the role of trauma experiences in the development of BPD. Finally, the third study was designed to consider how these two experiential factors (maladaptive parenting and peer victimisation) might magnify a predisposition towards dysregulation, eventually culminating in BPD symptoms. Data was obtained from the Avon Longitudinal Study of Parents and Children (ALSPAC), which studied 6,050 children (43.1% of the total sample population), using questionnaire and interview assessments. Results revealed that, firstly, family adversity during pregnancy and suboptimal parenting, during early to middle childhood was predictive of BPD symptoms at 11 years. Secondly, peer victimisation during early to late childhood was predictive of BPD symptoms at 11 years. There was an especially strong dose response effect for severe, combined or chronic victimisation. Finally, those evincing stable dysregulated trait behaviour from 4 to 8 years were more likely to develop BPD symptoms, and this effect was especially strong for high levels of dysregulation. Consistent with the biosocial developmental model of BPD, the association was fully mediated by psychosocial risk factors (peer victimisation). Those with high levels of dysregulation were more likely to be victimised and, in turn, develop BPD symptoms. Further, the indirect associations were significantly stronger for BPD, compared to psychotic or depression outcomes. The strengths and weaknesses, along with practical and theoretical implications, and future directions are discussed in the final chapter.

Objective: Given the well-established association between epilepsy and sleep disturbance and the evidence suggesting the importance of sleep in memory consolidation, there is reason to investigate the relationship between sleep and rate of forgetting in children with epilepsy. This study aimed to investigate the relationship between sleep and forgetting in children with Genetic Generalised Epilepsy (GGE). Methods: Participants were 19 children with GGE (9-15 years old). Actigraphy, sleep diaries and standardised questionnaires were used to measure sleep over a week long period. Rate of forgetting was measured using neuropsychological tests at the beginning and end of the study week. Spearman’s correlation analysis was used to determine if poorer sleep was associated with poorer initial learning and rate of forgetting in verbal memory recall and recognition. Results: No association was found between sleep efficiency or duration and rate of forgetting. Measures of sleep disturbance were mixed, with sleep onset latency found to be associated with rate of forgetting on the Word Lists test. However, increased wake after sleep onset was associated with decreased rate of forgetting. Conclusions: Whilst there was limited evidence of a relationship between some actigraphic sleep parameters and rate of forgetting for verbal information, the results were mixed and likely biased by the small sample size. There is need for further research with a larger sample to establish the nature of the relationship between sleep and rate of forgetting in children with GGE.