Conceptualising compensation in neurodevelopmental disorders: Reflections from autism spectrum disorder

NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS

卷:80

Review

Livingston, Lucy Anne¹  Happe, Francesca¹ 

[1] Kings Coll London, Inst Psychiat Psychol & Neurosci, Genet & Dev Psychiat Ctr, MRC Social, Crespigny Pk, London SE5 8AF, England

关键词: Autism Spectrum Disorder;    Neurodevelopmental disorders;    Compensation;    Compensatory mechanisms;    Adaptation;    Camouflaging;    Cognitive phenotype;    Behavioural phenotype;    Remediation;    Theory of mind;    Executive function;    Good outcome;    Under-diagnosis;    Late diagnosis;    Female presentation;    Unaffected siblings;   

DOI  :  10.1016/j.neubiorev.2017.06.005

来源: Elsevier

【 摘 要 】

Within research into neurodevelopmental disorders, little is known about the mechanisms underpinning changes in symptom severity across development. When the behavioural presentation of a condition improves/symptoms lessen, this may be because core underlying atypicalities in cognition/neural function have ameliorated. An alternative possibility is 'compensation; that the behavioural presentation appears improved, despite persisting deficits at cognitive and/or neurobiological levels. There is, however, currently no agreed technical definition of compensation or its behavioural, cognitive and neural characteristics. Furthermore, its workings in neurodevelopmental disorders have not been studied directly. Here, we review current evidence for compensation in neurodevelopmental disorders, using Autism Spectrum Disorder as an example, in order to move towards a better conceptualisation of the construct. We propose a transdiagnostic framework, where compensation represents the processes responsible for an observed mismatch between behaviour and underlying cognition in a neurodevelopmental disorder, at any point in development. Further, we explore potential cognitive and neural mechanisms driving compensation and discuss the broader relevance of the concept within research and clinical settings.

【 授权许可】

Free