Centre for Educational Neuroscience

1. Centre for Educational Neuroscience

2. Some Abbreviations CU = callous-unemotional traits AB = antisocial behaviour CP = conduct problems Primary research focus on antisocial behaviour in children and youth. For the purposes of clarity, want to define some abbreviations up front.Primary research focus on antisocial behaviour in children and youth. For the purposes of clarity, want to define some abbreviations up front.

3. Antisocial behaviour in schools Exposure to risk factors such as poverty, abuse, neglect, and lack of school readiness provides the potential for the development of antisocial behaviour patterns Disruptive behaviour in schools interrupts teaching and learning presents a risk to positive social�emotional and academic development for all children Antisocial behaviours are often thought to be associated with lack of self-regulation (Eisenberg 2002) insufficiently developed social skills required in the structured context of school (Reinke & Herman 2002)

4. What happens to antisocial students? Antisocial students don�t tend to have happy outcomes Problems at 13 associated with school drop-outand multiple criminal activity at 17 (Bergman, Andershed & Andershed, 2009) Excluded students have poorer academic outcomes, more likely to engage in antisocial behaviour and substance abuse Permanent exclusion triggers a complex chain of events which loosen a young person�s affiliation with a non-antisocial way of life (Berridge et al., 2001) This important transition was characterised by: the loss of time structures; a re-casting of identity; a changed relationship with parents and siblings; the erosion of contact with pro-social peers and adults; closer association with similarly situated young people and heightened vulnerability to police surveillance.This important transition was characterised by: the loss of time structures; a re-casting of identity; a changed relationship with parents and siblings; the erosion of contact with pro-social peers and adults; closer association with similarly situated young people and heightened vulnerability to police surveillance.

5. Callous-Unemotional Traits �Another sub-typing solution? CU traits are also known as �early psychopathic traits� CU traits include: Lack of guilt, absence of emotional empathy and shallow affect (poverty of expressive emotions) Frick and White (2008): these traits may have potential for explaining the causes of the most severe and aggressive patterns of antisocial behaviour. Not currently included in the DSM-IV or ICD-10 diagnostic criteria for CD they are being considered for inclusion in DSM-V (Moffitt et al., 2008). The same behaviour can be driven by different vulnerabilities Charting the developmental pathway for different subtypes may offer important clues for interventions DSM-IV divides Conduct Disorder into two sub-categories: Early and Adolescent onset The same behaviour can be driven by different vulnerabilities Charting the developmental pathway for different subtypes may offer important clues for interventions DSM-IV divides Conduct Disorder into two sub-categories: Early and Adolescent onset

6. Cognitive-Affective Profiles of AB/CU+ & AB/CU- Emotion Processing: AB/CU+ have a selective deficit in recognizing fear and sadness (Blair) AB/CU- with a history of physical abuse may �over-recognise� anger (Pollak) Empathy: AB/CU+ may have a deficit in affective empathy, but not cognitive empathy: They know when someone is feeling hurt, but they just don�t care No evidence for empathy deficit in AB/CU-

7. Behaviour in AB/CU+ vs AB/CU-

8. Neuroscience Evidence for CU

9. Brain correlates of fear processing in AB/CU+ Relative to TD, AB/CU+ boys manifested lesser right amygdala activity to fearful faces AB/CU+ not only have problems recognizing fear, they also have a reduced response at the neural level fMRI study of the neural correlates of fear processing in 17 boys with CP/CU+ v. 13 ability matched controls. Other neuroimaging studies on children with high CU traits have suggested frontal lobe differences in response to reversal learning = children with CU traits are poor at learning from punishment and fMRI studies suggest that this may be mediated by differences in vmPFC reactivity. We have taken this information about differences at the level of the brain, in conjunction with evidence from behavioural genetic studies and behavioural and neuropsych investigations to come up with a new internvetion programme that understands the profile of children high in CU traits. This programme is reward focussed � does not fMRI study of the neural correlates of fear processing in 17 boys with CP/CU+ v. 13 ability matched controls. Other neuroimaging studies on children with high CU traits have suggested frontal lobe differences in response to reversal learning = children with CU traits are poor at learning from punishment and fMRI studies suggest that this may be mediated by differences in vmPFC reactivity. We have taken this information about differences at the level of the brain, in conjunction with evidence from behavioural genetic studies and behavioural and neuropsych investigations to come up with a new internvetion programme that understands the profile of children high in CU traits. This programme is reward focussed � does not

10. Motivations of children with CU Children with CU traits have an INTRAPERSONAL DRIVE, i.e. they have: A reduced need for/interest in: Social connectedness don�t think it�s important to play fairly; don�t listen when adults in school talk to them about being unfair or unkind; don�t really try to make their friends feel better; don�t feel guilty if they hurt or upset classmates; don�t feel ashamed when they do something wrong Social approval not really interested in what their teacher and classmates think and say about behaviour; don�t behave better when people say nice things about them; only try hard when can be bothered, rather than as a result of positive feedback An increased need for/interest in: Social control/dominance want to be in charge, will be unkind to people if it helps them to get what they want; think it�s ok to break the rules, e.g. to win a game or to get something; enjoy telling people what to do

11. LET�S GET SMART! Reward focused; play to strengths of pupils with CU+ Key objectives Increase prosocial behaviour Decrease antisocial behaviour Increase motivation to take account of others� feedback and needs, when making behaviour choices Key areas of cognitive-affective functioning targeted Self-awareness, self-concept, self-regulation Social awareness, understanding, problem-solving, skills, interests, dominance Cognitive and behavioural flexibility What do we know already? High proportion of clinical symptoms High proportion of S&L problems Pupils really engage with targets and reward system Teachers report that pupils are doing well with the programme The most troubled pupils in the school are showing massive gainsWhat do we know already? High proportion of clinical symptoms High proportion of S&L problems Pupils really engage with targets and reward system Teachers report that pupils are doing well with the programme The most troubled pupils in the school are showing massive gains

12. Case study 1: Joe 8 years old Beech class � special provision for children with greatest needs and behavioural difficulties Last chance before �out of county� placement Very high CU Average IQ; no specific learning difficulties Works with the programme to plan targets and rewards Is now spending every morning doing maths in regular classroom

13. Anticipated long-term outcomes Pupils will develop more unbiased, flexible cognitions (e.g. beliefs and attributions about their own and other people�s behaviour) Pupils will either increase their capacity to process emotional information and/or learn to manage their behaviour by becoming aware of their difficulties in this area Levels of antisocial and aggressive behaviour will decrease, and levels of pro-social behaviour will increase Mainstream staff and parents will be more confident and skilled in managing behaviour and supporting the young person�s development Pupils will be more engaged in learning We will have a better understanding of the needs of the pupils as a group � this will help to inform future development of provision

14. Thanks to Co-author: Dr Essi Viding (UCL) Researchers & collaborators Professor Norah Frederickson (UCL) Dr Laura Warren (Bucks Ed Psych & UCL) Jane Lang (UCL) Westfield School Buckinghamshire County Council Please contact: a.jones@gold.ac.uk

15. Extra Slides Neuroimaging extras Case Study 2 Anticipated long-term outcomes

16. Same fear � neutral faces task as reported in AJP paper Whole brain analyses to be conservative 78 participants, genotyped for MAO-A and with data collected at nine years of age on SDQ and Family Chaos MAO-A 3 repeats = 35; 4 repeats = 43 78 participants, genotyped for MAO-A and with data collected at nine years of age on SDQ and Family Chaos MAO-A 3 repeats = 35; 4 repeats = 43

17. CU as a moderating factor in intervention effectiveness CU traits moderate the association of parenting and conduct problems

18. Hawes & Dadds (2005) Intervention Programme for young children (mean age = 6 yrs) High CU children showed: Greater conduct problem severity Poorer outcome after intervention Lesser response to �punishment� contingent of intervention Fewer displays of negative affect in response to �time-out� **SOME drop in CU traits after treatment**

19. Case study 2: Sophie 7 years old Beech class low IQ; specific learning difficulties Attention = very poor Behaviour could be very aggressive; swears and lashes out at staff Video work has been KEY She smiles, is friendly and is able to engage with academic work Learning to read

20. Evaluation: The key to successful intervention Single-case studies in EBD can help to identify promising classroom-based intervention (Sutherland et al., 2008) Four strand approach Objective child measures Self-report child measures Teacher report Parent report Evaluation will be on-going for 2 years