Other Important Cognitive Processes

In addition to the more traditional cognitive abilities mentioned above there are other important cognitive processes including 'theory of mind', moral development, emotional development and development of self-control. These should not be seen as unrelated processes but rather as different interdependent parts of a complex cognitive network.

• Theory of mind. The most likely basic deficits in Autism (and Asperger's Syndrome) appear to be cognitive, in particular involving the ability to appreciate the point of view of others, and that this will differ from one's own (Baron-Cowen, 1989). This has been variously described as a deficit in the 'theory of mind' and these disorders are also known as disorders of social communication. Very few offenders suffer from Autism or Asperger's Syndrome, but for those who do, deficits in their 'theory of mind' capacity may help to explain the lack of empathy for their victims often shown by these offenders.

• Moral development. Much of the research in this area has built on the work of Piaget (1932) and Kolhberg (1974). Generally speaking, it is felt that moral development continues into adulthood. However, between 12 and 14 years most adolescents have achieved Kolhberg's 'Conventional' level of moral development. That is to say, they have developed an understanding of the rules of society in which they live and the consequences for themselves and for others, should they break the law.

• Emotional development. Emotional development is dependent on several factors including cognitive development and one's experience of parenting. Alongside and interwoven with young people's cognitive development is their emotional development. This includes emotional introspection and the ability to consider the consequences of their actions for themselves and others in emotional terms.

• Self-control. Self-control and the ability to resist impulses increases gradually from an early age. The capacity to inhibit irrelevant stimuli comprises the ability to attend selectively to certain stimuli. It involves central attentional processes, which are

Table 2.9.1 Classification of learning disability by IQ

Category

ICD-10

DSM-IV

Educational category

Mild

50-70

50-55 to approx. 70

Moderate learning difficulties

Moderate

35-49

35-40 to 50-55

Severe

20-34

20-25 to 35-40

Severe learning difficulties

Profound

Below 20

Below 20 or 25

developmentally determined, and much of this function is carried out in the frontal lobes of the brain. This part of the central nervous system plays an important role in managing the large amount of information entering consciousness from many sources, in changing behaviour, in using acquired information, in planning actions and in controlling impulsivity. Generally the frontal lobes are felt to mature at approximately 14 years. The ability of self-control will overlap with other abilities. For example, a young person who has developed self-control appropriate to his or her developmental status, will be able to reflect on the consequences of his or her actions in the longer term and will also have the capacity to delay gratification of impulses, if reflection confirms to him or her that these impulses are inappropriate.

Children with learning disabilities deserve additional consideration. Abnormal intellectual development may be due to slowness in development (delay) or to distortions in development (deviation) or a combination of both. One major functional consequence of intellectual impairment is learning disability, a term used in the United Kingdom for the problems experienced by people who previously would have been labelled as having mental handicap or mental retardation. Learning disability may take the form of specific learning disabilities (such as dyslexia) as well as more general learning disabilities (mental retardation).

For a diagnosis of mental retardation or generalised learning disability the developmental impairment should be global and long term. In addition, the child's Intelligence Quotient (IQ) should be less than 70 and the child should be functionally impaired in everyday life skills. ICD-10 (International Classification of Diseases; WHO, 1992) and DSM-IV (Diagnostic and Statistical Manual; APA, 1994) classifications differ to some degree and, as their educational terminology is also different and some older terms persist, it is not surprising that confusion commonly occurs.

The child with general learning disabilities (mental retardation) functions overall at a lower mental age. However, there are difficulties from the psychological perspective in the use of the term 'mental age', even although this can be a useful legal concept. Whatever the cause of the child's disability, its effect is usually to give uneven superimposed selective deficits. The result may be to leave the child with a range of capacities, some of which may be misleadingly competent and may engender false optimism in the interviewer or the child's carer. Any psychological assessment therefore has to cover a wide range of issues, and discrepancies are particularly likely between the following.

• Educational achievement, adaptive skills and social/emotional development. A child's ability often is gauged on the former and given as being equivalent to that of a certain age, for example a 15-year-old child might have the everyday living skills of a 7-year-old. However, while he or she might be unable to cope with money or public transport, he or she may well have had the emotional and social experiences of an older child and the drives of an adolescent. Any figure, whether IQ or age-equivalent, must be recognised as specific to the particular area of development from which it was derived.

• Language reception and expression. The child may sound articulate, perhaps even using legal phrases. But it does not necessarily follow that he or she understands. Even when there is adequate understanding, comprehension will depend on the child's ability to pay attention.

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