My PhD has brought with it many exciting new experiences, but I never expected to find myself standing in Duke University in North Carolina, about to start an academic presentation, and instead having to announce that WHO had just declared us to be in a state of pandemic.
Moments after finishing the same talk, Duke University declared all buildings closed to non-essential staff, meaning (among many other things) that I was extremely lucky to have achieved all my targets for that day. Despite this rather alarming backdrop, I spent a wonderful week meeting researchers, learning about their methods and research interests and exploring the world of US academics. At this point I must thank LuCiD for funding the trip!
I am a final year PhD student studying autism and related communication difficulties, specifically in children with higher cognitive ability (IQ≥70), and with a particular interest in any gender differences that might exist in this domain. My aim throughout has been to contribute towards our understanding of persistent structural language and pragmatic difficulties for this group, with an interest in applying findings into clinical practice. I have also been interested in the female phenotype of autism and how differences in the profile between females and males might support more accurate diagnoses of the former. I am affiliated to LuCiD through the Division of Human Communication, Development and Hearing at the University of Manchester, and supervised by Dr Catherine Adams and Dr Jenny Freed.
My primary aim in visiting Duke University was to meet with Dr Elena Tenenbaum and her team, based at the Centre of Autism and Brain Development. This department, run by Dr Geraldine Dawson, has a number of overlapping interests with ours at the University of Manchester. It is situated in the School of Medicine and is interested in the translation of research findings into health solutions. Although their research encompasses a broad focus on all aspects of autism screening, diagnosis and treatment, Elena’s work specifically addresses language and communication. With a background in language acquisition for typically developing (TD) infants, she now focuses on how TD and autistic children explore the world in early years and how this impacts on cognitive and linguistic development. Bearing in mind the ever present consideration that research into linguistic theory should drive investigations into clinical application, it seemed important to meet with someone who was already bridging that gap. In particular, I was interested in her work on integration of auditory and visual information, and how subtle differences between autistic and TD infants might impact on speech and language processing. Using eye tracking methods, her team found autistic children showed demonstrable deficits in audio-visual synchronicity and differences in attention to facial features relevant to that process. They also demonstrated that this was correlated with poorer scores on standardised measures of language for the autistic group. This trip gave me the opportunity to look around their extensive laboratory and discuss practicalities of this research with Elena and the wider team.
Another aim of the visit was to present my findings to interested researchers and, in fact, I was able to do this twice; firstly, to the team at the Centre of Autism and Brain Development at Duke University and, secondly, at the University of North Carolina (UNC), Department of Allied Health Sciences. Despite being two separate institutions, they are physically close, one based in Durham, and the other 16 miles away in Carrboro. Elena had connections with an early years researcher, Dr Clare Harrop, who had completed her PhD at the University of Manchester, and had subsequently gone to work in the US. Her interests are strongly related to my own, focusing as they do on gender difference, but this time in the domain of social versus object orientation in toddlers. By meeting with her and presenting a talk to her team, I was able to engage with a group who were principally interested in my findings from the point of view of female diagnosis. This, in combination with providing a talk to Elena’s team (where the interest lay mostly in language and pragmatics in autism), was extremely complementary. In both cases I presented for a little over 45 minutes, with additional time for discussion and questions. The teams were extremely receptive to my research outcomes and, in view of my pending PhD viva, the quality and range of questions were especially helpful.
The gradually encroaching effects of the pandemic did not impact on my engagement activities at the start of the week, with the exception that some members of my audience attended via Zoom. At that time I was relatively unfamiliar with video conferencing (although this has rapidly changed over the last few weeks). Having my presentations live streamed and simultaneously recorded for distance attendees was an interesting learning experience. Never let it be said that I do not rise to a challenge! In total I presented to around 20 people and have had follow up emails from several of those: a rewarding outcome in itself.
Clare arranged a number of other activities for me during the week, and in the end I spent about 50% of my time with her and her team members. I was invited to watch her present to a lab meeting hosted by Professor Joe Piven, which provided me with a useful introduction into her research thus far.
I was particularly interested in her work with autistic and TD infants, where she showed a gender difference in their attention to stimuli using eye gaze technology. In one study she demonstrated gender-typical preferences for toys, for example, autistic girls overall preferring dolls and domestic pretend play activities, while autistic boys preferred cars, computer games and Lego. The importance here is that autism diagnosis tools often use examples of interests and behaviours more characteristic of males, which therefore skews assessments to include more males and exclude females. These findings are highly reminiscent of some of my own, with diagnostic test items relating to pragmatic profiles being more representative of the male phenotype and, again, leading to under-identification of autistic females. In another study Clare’s team found that autistic males (as a group) were more detail-focused than autistic females, and the latter were more likely to scan a wider range of visual images, including faces and figures. This was a useful finding that fed into some of my own theories about gender differences in pragmatics, as potentially representative of underpinning deficits in both social and general cognition. The relatively early stage of the research landscape into autistic females meant Clare’s recent findings were a very useful contribution to my own knowledge base.
Although I could go on about the benefits of this excellent transatlantic adventure, I just want to mention my final aim of the trip; specifically, to network widely with researchers in related fields and learn more about work being done in other laboratories. I was able to talk to a number of individuals and learn about post-doctoral opportunities, as well as the research landscape more generally in the US. This has been of value in my current stage of career planning. I had fabulous meetings with many speech and language pathology PhD students (a group which is woefully lacking in the UK). I also met with the wonderful team led by Professor Linda Watson at UNC, who gave extensively of her time and showed a great interest in my work. I was fascinated to hear about her work on sensory and anxiety measures in early years’ autism identification. Remarkably, these measures have shown a great deal of validity in differentiating autistic and TD children, even those with higher cognitive ability. This is a group that is typically diagnosed at a much later age and with much greater detriment to their emotional well-being. Following my visit I have maintained contact with a number of these researchers, and have discussed potential areas of over-lapping work for the future. Although, of course, given the current situation a lot of work has been stalled, and academic efforts on both sides of the Atlantic have been concentrated on supporting existing students with distance learning.
Despite the ever present (and palpably rising) threat of Covid19 during my visit, this was a wonderful trip that I will remember for many reasons. What is known as The Triangle in North Carolina (an urban hub of Rayleigh, Durham and Carrboro) was sophisticated and intelligent. There was a vibrant blues music scene, typified by a wonderful trip to the Blue Note Grill. Local food was hearty and plentiful, giving me my first opportunity to sample fried green tomatoes! But cafe culture and the ever present hipster and hippy communities also prevailed, and provided me with the quality wine and vegetarian options I rely on while travelling. The surrounding countryside reminded me of scenes from “Gone with the Wind”, and made a rustic and relaxing backdrop to the big university campuses. I would recommend a trip there to anyone considering it.
In the last few days it became apparent that it would be wise to cut short my trip, especially after the Presidential announcement of flight restrictions into the US. However, my flight home was uneventful, apart from some untimely ‘gallows’ humour by the airport staff at Raleigh International Airport, who jokingly informed me all flights to the UK had been cancelled that morning!
During this trip I learnt an enormous amount about the wider field of research surrounding my subject area. It gave me the opportunity to discuss my own findings with people who were informed and involved with the client group, and I believe some of those connections will last a lifetime. “Thank you”, again, to LuCiD for funding this wonderful opportunity.