Kate Woodcock

Introduction

I am a Research Fellow at the Cerebra Centre for Neurodevelopmental Disorders, part of the School of Psychology at the University of Birmingham.  I started my present position as a Research Fellow in December 2008 after completing my PhD, also at the Cerebra centre.  Most of my research to date has focused on people with Prader-Willi syndrome, a rare genetic syndrome associated with intellectual disability and a number of health and behaviour difficulties.  Before starting my PhD I completed an undergraduate degree in Psychology (also at the University of Birmingham) and graduated with a first class honours in July 2004.

Previous Research


Repetitive Behaviour in Prader-Willi syndrome and Fragile X syndrome

Prader-Willi syndrome and Fragile X syndrome are both associated with characteristic profiles of behaviour.  The behavioural profiles shown in both syndromes include high levels of repetitive behaviour.  In 2006 I led an interview study when I interviewed the carers of close to 100 people with one of the two syndromes about any repetitive behaviour that the people with the syndromes showed.

We found that both people with Prader-Willi syndrome and those with Fragile X syndrome show a lot of resistance to changes to their routines or to things that they are expecting to happen.  When things change in routines or in what people are expecting, people with the syndromes often get very upset and ask a lot of questions over and over again.  Changes to routines or expectations are also likely to trigger temper outbursts (also known as ‘tantrums’) in people with Prader-Willi syndrome or displays of anxiety that include repetitive movements and repetitive self-injurious behaviour in people with Fragile X syndrome.

This study showed us that a lot of the characteristic behaviours that are shown by people with Prader-Willi syndrome and Fragile X syndrome that cause particular problems for people with the syndromes can be triggered by unexpected changes to people’s routines or expectations.

[To view ‘Associations between repetitive questioning, resistance to change, temper outbursts and anxiety in Prader-Willi and Fragile-X syndromes’ click here]

Attention Switching and Resistance to Change in Prader-Willi syndrome and Fragile X syndrome

In conjunction with the interview study I led a study investigating executive functioning and repetitive behaviour in people with Prader-Willi syndrome and Fragile X syndrome.  Executive functioning is the term that psychologists use to describe the most complex cognitive processes that allow people to control and regulate their own behaviour.

One of the executive functions that we measured was attention switching. Attention switching is the cognitive process that allows people to change from thinking about and responding to a stimulus according to one set of criteria, to thinking about and responding to the same stimulus according to a different set of criteria.  So, if you are eating a yogurt with a spoon then you are thinking about the spoon as a piece of cutlery and so using it to eat with.  Then, if you decide to make an omelette, you may switch your attention to thinking of the spoon as a hard metal object and use it to crack the eggs.

We found that both people with Prader-Willi syndrome and those with Fragile X syndrome found it particularly difficult to switch their attention (this was particularly pronounced in people with Prader-Willi syndrome).  Importantly, we found that the more difficult people found it to switch their attention, the more resistance to changes to routine and expectations they showed.

This study showed us that difficulties in a very specific cognitive process (attention switching) seem to be related to the high levels of resistance to changes to routines and expectations shown by people with Prader-Willi syndrome and Fragile X syndrome.

[To view  'Task Switching Deficits and Repetitive Behaviour in Genetic Neurodevelopmental Disorders' click here]

[To view an article on this study that was written for a parent newsletter, click here]

Attention Switching, Resistance to Change and Temper Outbursts

In 2007 I led a study that involved detailed assessments with four individuals with Prader-Willi syndrome.  We used a series of carefully controlled games and activities to measure the effects of demands on attention switching capacity or changes to routines and expectations on the individuals’ physiological responses and behaviour.

We found that just by using a computer game that asked people to switch their attention a lot (so all we were doing was placing a demand on people’s cognitive attention switching capacity), we could trigger behaviours that people usually showed during temper outbursts or that people usually showed just before a temper outburst.  When people were asked to switch their attention alot they also showed signs of increased physiological arousal which might be a sign of anxiety.  We also found that when we imposed changes on people’s routines or expectations we could trigger the same temper outburst behaviours or full blown temper outbursts.

This study provided evidence to suggest that at least one route to the frequent temper outbursts shown by people with Prader-Willi syndrome involves a deficit in attention switching.  It seems that changes to routines or expectations place high levels of demand on people’s attention switching capacity.  Because of the difficulties with attention switching that people show, this demand affects people’s physiological system (maybe making them feel anxious), which is difficult for them to cope with.  Eventually, if the level of demand is great enough, people will show a temper outburst.

[To download an example of the individual feedback given to families after this study, click here]

The Neural Networks Underlying Attention Switching in People with Prader-Willi syndrome

In 2008 I led a functional magnetic imaging study (fMRI) using the facilities at Birmingham University Imaging Centre (BUIC).  We investigated the brain networks that were responsible for attention switching in people with Prader-Willi syndrome and in a group of people without the syndrome.

When people without Prader-Willi syndrome were performing an attention switching task (in comparison to a control task) they showed activity in a range of prefrontal and parietal brain areas that have been shown previously to be important in attention switching.  However, when people with Prader-Willi syndrome were switching their attention, they only showed activity in one small prefrontal area in the frontopolar cortex. During switching, this area was actually more active in people with Prader-Willi syndrome than in people without the syndrome.

People with Prader-Willi syndrome do not show the typical pattern of brain activity during attention switching in the brain areas that have been shown to be involved in changing attentional priorities (actually carrying out a switch of attention).  People with the syndrome do show activity in an area at the very front of the brain (the frontopolar cortex) which has been linked to detecting that a change has occured that would require an attention switch.  So the brains of people with Prader-Willi syndrome may allow them to detect that a switch of attention is needed, but then be less equiped to actually carry out that switch.  The additional activity in the frontopolar cortex suggests that people with Prader-Willi syndrome may try to drive attention switching from this area (something that is not done by people without the syndrome).  This might represent some kind of compensatory mechanism.

[To download an example of the individual feedback given to families after this study, click here]