Prof Clare Allely

PhD
Professional Doctorate

Level Professional Doctorate

Student Tania Goddard

Status Current

Part Time No

Years 2023 - 2026

Project Title Fetal Alcohol Spectrum Disorder: Fitness to Participate in the Criminal Justice System in England and Wales

Project Description This research will be formed of four studies. The first study, a systematic scoping review, will explore the current literature and case law regarding FASD and the Criminal Justice System (CJS). The second study will investigate the knowledge of FASD within the legal profession, and identify any current training needs by qualitatively interviewing Solicitors and Barristers with experience in criminal representation. The third study will explore and identify the language and cognitive abilities needed to be fit to plead and the instruments required to test those abilities. Forensic Psychologists and Clinical Psychologists (experts) will be interviewed and asked to consider, with reference to the legal criteria identified by the courts, the abilities they consider a defendant needs to have to be fit to plead, stand trial, and effectively participate. The experts will also be asked to identify the psychometric instruments they would use to test the abilities they have ascertained. The fourth study will use the most prevalent psychometric instruments identified by the experts in the third study to test a group of adults diagnosed with FASD, or known to have prenatal alcohol exposure, and compare the results with a control group. A further Fitness to Plead Assessment Tool, comprised of a twenty minute filmed representation of Crown Court proceedings, and questions assessing court room knowledge and comprehension, will be employed and tested on both sample groups. The Fitness to Plead Assessment Tool has been constructed taking into account the Law Commission’s Draft Bill ‘Unfitness to Plead Volume 2’ (The Law Commission, 2016b) and the key traits to be measured in England and Wales, namely the ability to follow both the evidence and court proceedings.

Awarding Institution The University of Salford

Director of Studies Clare Allely

Second Supervisor Alan Price

Level	Professional Doctorate
Student	Tania Goddard
Status	Current
Part Time	No
Years	2023 - 2026
Project Title	Fetal Alcohol Spectrum Disorder: Fitness to Participate in the Criminal Justice System in England and Wales
Project Description	This research will be formed of four studies. The first study, a systematic scoping review, will explore the current literature and case law regarding FASD and the Criminal Justice System (CJS). The second study will investigate the knowledge of FASD within the legal profession, and identify any current training needs by qualitatively interviewing Solicitors and Barristers with experience in criminal representation. The third study will explore and identify the language and cognitive abilities needed to be fit to plead and the instruments required to test those abilities. Forensic Psychologists and Clinical Psychologists (experts) will be interviewed and asked to consider, with reference to the legal criteria identified by the courts, the abilities they consider a defendant needs to have to be fit to plead, stand trial, and effectively participate. The experts will also be asked to identify the psychometric instruments they would use to test the abilities they have ascertained. The fourth study will use the most prevalent psychometric instruments identified by the experts in the third study to test a group of adults diagnosed with FASD, or known to have prenatal alcohol exposure, and compare the results with a control group. A further Fitness to Plead Assessment Tool, comprised of a twenty minute filmed representation of Crown Court proceedings, and questions assessing court room knowledge and comprehension, will be employed and tested on both sample groups. The Fitness to Plead Assessment Tool has been constructed taking into account the Law Commission’s Draft Bill ‘Unfitness to Plead Volume 2’ (The Law Commission, 2016b) and the key traits to be measured in England and Wales, namely the ability to follow both the evidence and court proceedings.
Awarding Institution	The University of Salford
Director of Studies	Clare Allely
Second Supervisor	Alan Price

PhD in Behavioral Medicine
Doctor of Philosophy

Level Doctor of Philosophy

Student Dr David Tate

Status Complete

Part Time No

Years 2016 - 2020

Project Title The Development and Evaluation of the Cognitive Behavioural Social Competence Therapeutic Intervention for Adults with Autism Spectrum Disorder without an Intellectual Disability (CBSCTI-ASD)

Project Description Many young people with autism spectrum disorder (ASD) can have an average or above average IQ yet still struggle with the social competencies needed to successfully navigate into adulthood. Despite many individuals with ASD experiencing significant challenges during their transition into adulthood, evidence-based social skills interventions to support individuals with ASD during this transition are rather limited. There is growing evidence to suggest that social competencies in adults with ASD without an intellectual disability (ID) can be enhanced through both individual Cognitive Behavioural Therapy (CBT) and group CBT. However, little is known about the benefit of combining these modalities for individuals with ASD transitioning into adulthood. Moreover, there are no studies which have investigated the neural plasticity of a multimodal CBT intervention for adults with ASD without ID. The first stage of this PhD project involved developing and writing the Cognitive Behavioural Social Competence Therapeutic Intervention (CBSCTI-ASD) manual for Adults with ASD without ID. This PhD project includes a total of three studies: Study 1 Evaluation of CBSCTI-ASD; Study 2 Neuroplasticity of the Social Brain Following CBSCTI-ASD and Study 3 Exploring the Experiences of Parents’ with an Adult Child with Autism Spectrum Disorder. For Study 1, CBSCTI-ASD was developed and delivered to five young adults with ASD without ID. The aims of the first study were to evaluate intervention feasibility and efficacy by triangulating data findings. Feasibility was supported and CBSCTI-ASD received high user satisfaction ratings. Adherence to the intervention were high, recorded at ~90% and fidelity to treatment were also high ranging from ~86% to ~100%. Quantitative findings from study 1 indicates that over an eight-week time period the intervention group experienced significant improvements with regard to their social motivation, non-verbal conversation, emotional empathy, assertiveness, interpersonal relationships and self-control.
Qualitative findings provide further anecdotal support towards intervention feasibility and efficacy. After the completion of CBSCTI-ASD, four participants who received CBSCTI-ASD and two of their parents completed semi-structured interviews. Thematic Analysis (TA) revealed four main themes: satisfaction with CBSCTI-ASD, important components of CBSCTI-ASD, challenges and critiques and recommendations. Two qualified cognitive behavioural therapists helped with the delivery of CBSCTI-ASD. Their opinions and experiences of CBSCTI-ASD delivery were explored during a focus group. Findings from TA revealed three themes: training and delivery, successes and challenges, and therapist recommendations. The qualitative findings from study 1 also highlight factors which those involved in delivering and receiving CBSCTI-ASD believed could be effective in guiding the further development of the intervention. Study 2 involved applying functional near infrared spectroscopy (fNIRS) to explore neurological function and changes in neural activity in cortical regions of the Prefrontal Cortex (PFC), an area associated with the social brain. The aim of study 2 was to assess functional regions of the social brain and evaluate the possible neurological effects of CBSCTI-ASD. While applying fNIRS to measure neural functioning, the five participants from the CBSCTI-ASD intervention group from study 1 and a closely matched typically developed control group completed a pre/post-test conversation task. Findings from study 2 show that both the intervention group and the typically developed control group significantly increased neural activity in the Medial PFC (MPFC) during the conversation task, thus confirming a target region of interest for measuring change in neural function. However, no significant differences in brain activity over time between the intervention group and the typically developed control group were identified. Post hoc analysis did shows that the intervention group significantly increased neural activation in the left MPFC from pre-test to post-test. Finally, study 3 aimed to explore the experiences of seven parents with an adult child with ASD without ID. TA was conducted on semi-structured interviews and six main themes emerged: receiving a diagnosis, challenges, parents coping strategies, support and treatment, recommendations for intervention and positive parenting. The findings from study 3 highlight important and complex issues which should be considered when providing support to adults with ASD and their families. The findings from study 1 and 2 indicate that CBSCTI-ASD appears to be a feasible intervention and efficacy is supported at improving social competencies in young adults with ASD without ID. Qualitative findings from study 3 elucidates the intricacies of living with ASD and provides a promising starting point to further the development of CBSCTI-ASD. While these initial findings are promising, additional research is needed to further develop CBSCTI-ASD and provide an assessment of the efficacy of the intervention using larger randomised controlled trials.

Awarding Institution The University of Salford

Director of Studies Clare Allely

Second Supervisor Linda Dubrow-Marshall

Thesis The development and evaluation of the Cognitive Behavioural Social Competence Therapeutic Intervention for Adults with Autism Spectrum Disorder without an Intellectual Disability (CBSCTI-ASD)

Level	Doctor of Philosophy
Student	Dr David Tate
Status	Complete
Part Time	No
Years	2016 - 2020
Project Title	The Development and Evaluation of the Cognitive Behavioural Social Competence Therapeutic Intervention for Adults with Autism Spectrum Disorder without an Intellectual Disability (CBSCTI-ASD)
Project Description	Many young people with autism spectrum disorder (ASD) can have an average or above average IQ yet still struggle with the social competencies needed to successfully navigate into adulthood. Despite many individuals with ASD experiencing significant challenges during their transition into adulthood, evidence-based social skills interventions to support individuals with ASD during this transition are rather limited. There is growing evidence to suggest that social competencies in adults with ASD without an intellectual disability (ID) can be enhanced through both individual Cognitive Behavioural Therapy (CBT) and group CBT. However, little is known about the benefit of combining these modalities for individuals with ASD transitioning into adulthood. Moreover, there are no studies which have investigated the neural plasticity of a multimodal CBT intervention for adults with ASD without ID. The first stage of this PhD project involved developing and writing the Cognitive Behavioural Social Competence Therapeutic Intervention (CBSCTI-ASD) manual for Adults with ASD without ID. This PhD project includes a total of three studies: Study 1 Evaluation of CBSCTI-ASD; Study 2 Neuroplasticity of the Social Brain Following CBSCTI-ASD and Study 3 Exploring the Experiences of Parents’ with an Adult Child with Autism Spectrum Disorder. For Study 1, CBSCTI-ASD was developed and delivered to five young adults with ASD without ID. The aims of the first study were to evaluate intervention feasibility and efficacy by triangulating data findings. Feasibility was supported and CBSCTI-ASD received high user satisfaction ratings. Adherence to the intervention were high, recorded at ~90% and fidelity to treatment were also high ranging from ~86% to ~100%. Quantitative findings from study 1 indicates that over an eight-week time period the intervention group experienced significant improvements with regard to their social motivation, non-verbal conversation, emotional empathy, assertiveness, interpersonal relationships and self-control. Qualitative findings provide further anecdotal support towards intervention feasibility and efficacy. After the completion of CBSCTI-ASD, four participants who received CBSCTI-ASD and two of their parents completed semi-structured interviews. Thematic Analysis (TA) revealed four main themes: satisfaction with CBSCTI-ASD, important components of CBSCTI-ASD, challenges and critiques and recommendations. Two qualified cognitive behavioural therapists helped with the delivery of CBSCTI-ASD. Their opinions and experiences of CBSCTI-ASD delivery were explored during a focus group. Findings from TA revealed three themes: training and delivery, successes and challenges, and therapist recommendations. The qualitative findings from study 1 also highlight factors which those involved in delivering and receiving CBSCTI-ASD believed could be effective in guiding the further development of the intervention. Study 2 involved applying functional near infrared spectroscopy (fNIRS) to explore neurological function and changes in neural activity in cortical regions of the Prefrontal Cortex (PFC), an area associated with the social brain. The aim of study 2 was to assess functional regions of the social brain and evaluate the possible neurological effects of CBSCTI-ASD. While applying fNIRS to measure neural functioning, the five participants from the CBSCTI-ASD intervention group from study 1 and a closely matched typically developed control group completed a pre/post-test conversation task. Findings from study 2 show that both the intervention group and the typically developed control group significantly increased neural activity in the Medial PFC (MPFC) during the conversation task, thus confirming a target region of interest for measuring change in neural function. However, no significant differences in brain activity over time between the intervention group and the typically developed control group were identified. Post hoc analysis did shows that the intervention group significantly increased neural activation in the left MPFC from pre-test to post-test. Finally, study 3 aimed to explore the experiences of seven parents with an adult child with ASD without ID. TA was conducted on semi-structured interviews and six main themes emerged: receiving a diagnosis, challenges, parents coping strategies, support and treatment, recommendations for intervention and positive parenting. The findings from study 3 highlight important and complex issues which should be considered when providing support to adults with ASD and their families. The findings from study 1 and 2 indicate that CBSCTI-ASD appears to be a feasible intervention and efficacy is supported at improving social competencies in young adults with ASD without ID. Qualitative findings from study 3 elucidates the intricacies of living with ASD and provides a promising starting point to further the development of CBSCTI-ASD. While these initial findings are promising, additional research is needed to further develop CBSCTI-ASD and provide an assessment of the efficacy of the intervention using larger randomised controlled trials.
Awarding Institution	The University of Salford
Director of Studies	Clare Allely
Second Supervisor	Linda Dubrow-Marshall
Thesis	The development and evaluation of the Cognitive Behavioural Social Competence Therapeutic Intervention for Adults with Autism Spectrum Disorder without an Intellectual Disability (CBSCTI-ASD)

Public Health and Psychology
Doctor of Philosophy

Level Doctor of Philosophy

Student David Gilbert

Status Complete

Part Time No

Years 2020 - 2023

Project Title Exploring the Vulnerabilities of Individuals with Fetal Alcohol Spectrum Disorders to, and within, Criminal Justice System Encounters.

Project Description Background: Individuals with fetal alcohol spectrum disorders (FASD), a condition caused by alcohol exposure in the womb, are 19 times more likely to be involved with the criminal justice system (CJS). Despite the potential for a high prevalence of Individuals with FASD within the CJS, empirical evidence is sparse.
Aim: I aimed to empirically explore the factors that predispose the FASD population to CJS encounters and the factors that impact outcomes during investigative interviews.

Methods: A ‘fluidly’ sequential exploratory mixed methods design is employed in this thesis. Four studies were conducted: a scoping review, two qualitative studies, and one quantitative study. The scoping review examined the existing literature regarding the performance of individuals with FASD during investigative interviews, and informed the design of the other studies. The qualitative studies with 14 parents/carers of Individuals with FASD and 10 individuals (age range: 11 – 46 years) with FASD explored the experiences/perceptions about predisposing factors to CJS encounters and experiences during investigative interviews. Within the quantitative study, memory, impulsivity, IQ, compliance, and interrogative suggestibility were assessed in 27 young people (aged 11 – 16 years old) with FASD and 25 neurotypical controls of similar age. Results from the qualitative studies were triangulated with those from the quantitative study.

Results: The systematic review revealed that only five empirical studies had been published on the performance of individuals with FASD during CJS encounters. Interviews with parents highlighted vulnerabilities that lead to frequent CJS encounters of their children, emphasised the need for more awareness from professionals (about FASD) while also highlighting that their children had significant strengths and abilities despite their impairments. Individuals with FASD reported that professionals lacked knowledge about FASD; they demonstrated self-awareness of their impulsivity and suggestibility and expressed remorse. They also recognised their strengths and abilities. Quantitative assessments with the FASD group revealed significantly poorer memory recall, lower IQ, higher total suggestibility (immediately and after one week), and higher impulsivity when compared to neurotypical controls of similar age.

Awarding Institution The University of Salford

Director of Studies Penny Cook

Second Supervisor Clare Allely

Supervisions (3)