Parental and healthcare provider attitudes towards the Healthy Child Programme in England: a qualitative analysis.

BACKGROUND: The Healthy Child Programme (HCP) in England, delivered by Health Visitors (HV) and Nursery Nurses (NN), aims to assess growth and development in pre-school age children. This qualitative analysis aimed to evaluate the perceptions and experiences of HCP providers and parents located in a London borough. METHODS: This qualitative analysis is part of a larger study piloting an automated growth screening algorithm in a London borough. We conducted three focus group discussions; two with parents of pre-school children participating in the pilot study, one in English (n = 6) and one in Sylheti (n = 5), and one with HVs and NNs (n = 11). Sampling was purposeful, and written informed consent was obtained. Groups were facilitated by the same bilingual researcher using semi-structured topic guides. Data were analysed using reflexive thematic analysis and assessed for intercoder reliability. RESULTS: Three broad themes were identified in the data: (1) lack of clarity around the role of the HV and NN; (2) a lack of resources; and (3) a desire for a preventative service. Underlying these themes was a sense of disempowerment shown by HVs/NNs and parents, as well as systemic issues in terms of the accessibility and practicality of the service. Nevertheless, parents and HVs/NNs all stressed the importance of the service in providing information, reassurance and advice. CONCLUSIONS: Various challenges prevent the HCP from providing equitable and effective care to every child. However, the service was recognised as very valuable by users and providers despite systemic difficulties.

Transmitting and decoding facial expressions of emotion during healthy aging: More similarities than differences.

Older adults tend to perform more poorly than younger adults on emotional expression identification tasks. The goal of the present study was to test a processing mechanism that might explain these differences in emotion recognition-specifically, age-related variation in the utilization of specific visual cues. Seventeen younger and 17 older adults completed a reverse-correlation emotion categorization task (Bubbles paradigm), consisting of a large number of trials in each of which only part of the visual information used to convey an emotional facial expression was revealed to participants. The task allowed us to pinpoint the visual features each group used systematically to correctly recognize the emotional expressions shown. To address the possibility that faces of different age groups are differently processed by younger and older adults, we included younger, middle-aged, and older adult face models displaying happy, fearful, angry, disgusted, and sad facial expressions. Our results reveal strong similarity in the utilization of visual information by younger and older adult participants in decoding the emotional expressions from faces across ages-particularly for happy and fear emotions. These findings suggest that age-related differences in strategic information use are unlikely to contribute to the decline of facial expression recognition skills observed in later life.

Face recognition ability is manifest in early dynamic decoding of face-orientation selectivity-Evidence from multi-variate pattern analysis of the neural response.

Although humans are considered to be face experts, there is a well-established reliable variation in the degree to which neurotypical individuals are able to learn and recognise faces. While many behavioural studies have characterised these differences, studies that seek to relate the neuronal response to standardised behavioural measures of ability remain relatively scarce, particularly so for the time-resolved approaches and the early response to face stimuli. In the present study we make use of a relatively recent methodological advance, multi-variate pattern analysis (MVPA), to decode the time course of the neural response to faces compared to other object categories (inverted faces, objects). Importantly, for the first time, we directly relate metrics of this decoding assessed at the individual level to gold-standard measures of behavioural face processing ability assessed in an independent task. Thirty-nine participants completed the behavioural Cambridge Face Memory Test (CFMT), then viewed images of faces and houses (presented upright and inverted) while their neural activity was measured via electroencephalography. Significant decoding of both face orientation and face category were observed in all individual participants. Decoding of face orientation, a marker of more advanced face processing, was earlier and stronger in participants with higher levels of face expertise, while decoding of face category information was earlier but not stronger for individuals with greater face expertise. Taken together these results provide a marker of significant differences in the early neuronal response to faces from around 100 ms post stimulus as a function of behavioural expertise with faces.

Characterizing the neural signature of face processing in Williams syndrome via multivariate pattern analysis and event related potentials.

Face recognition ability is often reported to be a relative strength in Williams syndrome (WS). Yet methodological issues associated with the supporting research, and evidence that atypical face processing mechanisms may drive outcomes 'in the typical range', challenge these simplistic characterisations of this important social ability. Detailed investigations of face processing abilities in WS both at a behavioural and neural level provide critical insights. Here, we behaviourally characterised face recognition ability in 18 individuals with WS comparatively to typically developing children and adult control groups. A subset of 11 participants with WS as well as chronologically age matched typical adults further took part in an EEG task where they were asked to attentively view a series of upright and inverted faces and houses. State-of-the-art multivariate pattern analysis (MVPA) was used alongside standard ERP analysis to obtain a detailed characterisation of the neural profile associated with 1) viewing faces as an overall category (by examining neural activity associated with upright faces and houses), and to 2) the canonical upright configuration of a face, critically associated with expertise in typical development and often linked with holistic processing (upright and inverted faces). Our results show that while face recognition ability is not on average at a chronological age-appropriate level in individuals with WS, it nonetheless appears to be a relative strength within their cognitive profile. Furthermore, all participants with WS revealed a differential pattern of neural activity to faces compared to objects, showing a distinct response to faces as a category, as well as a differential neural pattern for upright vs. inverted faces. Nonetheless, an atypical profile of face orientation classification was found in WS, suggesting that this group differs from typical individuals in their face processing mechanisms. Through this innovative application of MVPA, alongside the high temporal resolution of EEG, we provide important new insights into the neural processing of faces in WS.