The continuities and discontinuities in psychopathology between childhood and adult life
According to Rutter, Kim-Cohen & Maughan (2006), a review of the associations between mental disorders in childhood and adulthood raised a major concern on the causal mechanism and how this determines continuity or discontinuity. Similar issues have been raised for the developmental psychopathology and of developmental perspective (Masten & Cicchetti, 2010; Cicchetti & Curtis, 2007). The need to bring forth mediating processes have been as a result of the availability of the presence of longitudinal studies that cover childhood to adulthood and other contributory factors; new thinking, concepts, and findings on mechanisms with improved technology and virtual revolution on theory and research on the topic. This essay therefore will seek to discuss the nature and life course of neurodevelopmental disorders with specific reference to issues of resilience and risk across a lifespan and the effects on the work of education and developmental psychologists.
Autism spectrum disorders
According to Rutter et al. (2006), in the recent years the tendency has been to group disorders that start early in a person’s life together under neurodevelopmental disorders. These disorders are characterized by eight features; they show a delay or deviance in maturation of psychologically influenced features, the course of the disorder is devoid of the relapses and remissions that characterize many mental disorders of a multifactorial nature, normally the impairment caused by the disorder lessens with age, but tends to persist into adulthood, all such disorders involve a degree of general or specific cognitive impartment, there is a tendency for the various disorders to overlap, individual genetic differences and liabilities are very strong in all cases, environmental conditions play a crucial contributory role, and lastly, there is a marked male predominance in all disorders.
As argued by Obradovic´, Burt & Masten (2010), abnormalities can be detectable by the age of one year but a child with autism may not manifest readily identifiable abnormalities until they are 18 months old. Studies on early follow-up for persons with autism spectrum disorder show that the prognosis of individuals with a non-verbal IQ in their childhood of less than 50 remained uniformly poor and none became independent in adulthood as they continued to show autism handicap problems. The main interest has therefore remained to be on persons with a non-verbal IQ equal to and more than 50.
Cicchetti & Curtis (2006) state that the most systematic data on autism and developmental receptive language disorders is presented in a comparative study that involved 68 individuals with an average of seven years at start of follow-up up to 29 years. The study concludes that, by the end of follow-up, none of the individuals had ceased manifesting autism features but majority of them had made a positive progress compared to when they were first seen. A fifth of the sample had attended and successfully attained a certain form of qualification in an educational institution, with five attending a college or university and two pursuing a post-graduate level course. About a third were under gainful employment and almost a quarter had been described by their guardians has being in a friendship that had shared activities or interests.
In line with earlier studies, the study according to Masten, Burt & Coatsworth (2006) involved the determination of presence of a useful language and IQ level by the age of 5 years to predict outcome. The study also found that even though the best outcomes were in those with an initial IQ of 70 and above as well as among those with a normal initial score, only a sixth managed to achieve very good outcome as to be in gainful employment and had substantial independence (Masten & Cicchetti, 2010). Almost the same number had good outcome but also half had poor to very poor outcome thus they had to live in residential accommodations with very minimal or no independence or with and dependent entirely on family members.
However, it is not clear what the continuing degree of impairment reflects, whether it is services inadequacy in childhood, or severity of the basic handicap of a biological nature, or the services inadequacy in adulthood (Sterling, Lopez-Kidwell, Labianca, & Moon, 2013). Nevertheless, there is some indication to support the last because the appropriate and extensive help for independent and gainfully employed person in adulthood makes a real difference (Cicchetti & Gunnar, 2008). According to Rutter et al. (2006), although IQ in the normal range could predict a somehow better outcome, variations in IQ ranges above 70 were of negligible prognostic importance, and the reason for this is not clear.
The other important finding of the study was the peak age for onset of epilepsy. According to Rutter et al. (2006) this was established to be late adolescence or in early adulthood. This is in line with findings in other independent studies and it is remarkably different from the known onset in the general population on in persons with mental retardness (Masten et al., 2006). The dominant argument for this is that it has some neuropathological significance there is no study findings to back it up. One of the uncertainties for the above findings is that they are concerned with individuals with autism under the traditional diagnosis and very little is known on adults with the milder autism varieties known as the broader phenotype. According to Masten and Cicchetti (2010), available evidence indicates to a higher proportion of those who achieve independence and a functional lifestyle in adulthood, but the proportions remain unknown. Despite these persons achieving independent and substantially functional lifestyles in adulthood, they still continue to manifest important autism features.
Implications for developmental and educational psychologists
As stated by Masten and Cicchetti (2010), there has been keen interest in developmental psychopathology and the possibility that adaptive and maladaptive behaviors and functions may promote or undermine outcome as a result of the profound implications related to case, prevention, and treatment. In autism spectrum disorders, cascading effects may offer an explanation as to why there is widespread difficulties of childhood problems in adulthood. Cicchetti & Gunnar (2008) argue that some indicators of childhood problems of success present consistent forecast on outcome in adulthood in particular through general cognitive competence and socialized conduct against antisocial behavior.
Howlin, Magiati & Charman (2009) present various strategies for educators and psychologists in the management of autism spectrum disorders. Because the effects of the disorders spread overtime, the timeliness and effectiveness of the intervention has a potential to interrupt the negative and/or promote positive cascades. The efforts to this effect may work through countering the negative cascades or by targeting improvements in competencies that promote better outcome and functioning (Cicchetti & Curtis, 2006; Cicchetti & Gunnar, 2008; Obradovic´ et al., 2010). Howlin et al. (2009) suggest a variety of intervention at childhood to counter or reduce the severalty of autism related effects at childhood. This idea is backed by Cicchetti & Curtis (2007) through the argument that, if developmental cascades are common and often start with adaptive behavior during childhood years, it is possible to better behavior and outcome in adulthood.
Masten et al., (2006) argues that there is evidence for a higher return on investment for interventions that are initiated in early childhood. Such investments that have been undertaken for autism spectrum disorders include high quality preschool programs and the intervention design targets to mediate for change and they represent cascade models. According to Sterling et al (2013), such an intervention is founded on the hypothesis that it will later the mediation process that will in turn determine the outcome of the autistic person in major conceptual and behavioral domains. As a result, the intervention adopted by educators and psychologists in managing autism spectrum disorders should be designed to trigger a change in the form of a cascade that traverses from the intervention program, through the mediator, to the outcome.
- Cicchetti, D., & Curtis, W. J. (2006). “The developing brain and neural plasticity: Implications for normality, psychopathology, and resilience”. In D. Cicchetti & D. J. Cohen (Eds.), Developmental psychopathology: Vol. 2. Developmental neuroscience (2nd ed., pp. 1–64). Hoboken, NJ: Wiley.
- Cicchetti, D., & Curtis, W. J. (Eds.). (2007). A multilevel approach to resilience. Development and Psychopathology, 19, 627–955.
- Cicchetti, D., & Gunnar, M. R. (2008). Integrating biological measures into the design and evaluation of preventive intervention. Development and Psychopathology, 20, 737–743.
- Howlin, P., Magiati, I. & Charman, T. (2009). Systematic review of early intensive behavioural interventions for children with autism.American Journal on Mental Retardation 114: 23–41.
- Masten, A. S., Burt, K. B., & Coatsworth, J. D. (2006). Competence and psychopathology in development. In D. Cicchetti & D. J. Cohen (Eds.), Developmental psychopathology (Vol. 3, 2nd ed., pp. 696–738). Hoboken, NJ: Wiley.
- Masten, A.S. and Cicchetti, D. (2010). Developmental cascades. Development and Psychopathology, 22, pp 491495 doi: 10.1017/S0954579410000222
- Obradovic´, J., Burt, K. B., & Masten, A. S. (2010). Testing a dual cascade model linking competence and symptoms over 20 years from childhood to adulthood. Journal of Clinical Child and Adolescent Psychology, 39, 90–102.
- Rutter, M., Kim-Cohen, J., & Maughan, B. (2006). Continuities and discontinuities in psychopathology between childhood and adult life. Journal of Child Psychology and Psychiatry, 47, 276–295.
- Sterling, C., Lopez-Kidwell, V. Labianca, G. & Moon, H. (2013). Managing Sequential Task Portfolios in the Face of Temporal Atypicality and Task Complexity, Human Performance, 26:4, 327-351, DOI: 10.1080/08959285.2013.814658