A role for attentional bias in cognitive deficits in chronic pain?

<p>This thesis extends current understanding of cognitive deficits in people with chronic pain, specifically those related to attention. Researchers have proposed that attentional capacity is allocated to pain sensation, and away from current tasks and goals, leading to broad cognitive deficits (deficit-view). However, an attentional bias to pain-related information has also been observed in people with chronic pain, suggesting that attention is motivated towards information in the environment that is pain-related, and away from information that is not. Such an attentional bias away from information not related to pain may contribute to the cognitive deficits observed on tasks using neutral stimuli (motivated attention hypothesis). In testing the deficit-view and motivated attention accounts of cognitive deficits in chronic pain, I focused on how people attend to rapidly presented information (temporal attention) and the ability to control attention in the face of distraction. To assess how chronic pain affects temporal attention, I used a phenomenon known as the attentional blink, which is a failure to detect a second target that appears soon after a first. Participants viewed a stream of briefly displayed words in which two target words (indicated by their colour) were embedded, with a manipulation of the time between the first and second target. They were required to report the two targets. In one experiment the first target was either pain-related or neutral (to assess how pain-relatedness affects the induction of the blink), and in other experiments this manipulation was applied to the second target (to assess how pain-relatedness affects how targets overcome the blink). In undergraduate participants, both induction and overcoming of the attentional blink was modulated by pain-relatedness. I then compared the effects of manipulating the second target in people with and without chronic pain. If people with chronic pain have general deficits in temporal attention, a deeper attentional blink (relative to control participants) for both kinds of targets should be observed. If motivated attention describes processing in people with chronic pain, a shallower attentional blink for pain related targets than neutral targets (an attentional bias) should be observed. Critically, this bias should be larger in participants with chronic pain. Contrary to both the deficit and motivated attention views, the attentional blink in participants with chronic pain did not differ from that in controls for either pain-related or neutral targets. Furthermore, neither group showed an attentional bias for pain-related targets, and a follow-up experiment failed to replicate the attentional bias observed in undergraduate students as well. Collectively, these findings suggested that attentional bias, as assessed by modulation of the attentional blink, was not reliable. A stronger test of the deficit-view and motivated attention hypothesis was needed. I shifted focus to another attentional domain, the control of distraction. To assess how chronic pain affects attentional control, I used an emotional distraction task, in which participants identified a target letter in an array that flanked irrelevant distractor images that were either intact or scrambled. Intact images depicted either extreme threat to body-tissue, or benign scenes. Distraction is indicated by slowing on intact relative to scrambled distractor trials. If people with chronic pain have general deficits in attentional control, they should show greater distraction from both kinds of images (relative to controls). If motivated attention describes processing in people with chronic pain, greater distraction from body-threat images than neutral images (relative to controls) should be observed. While all participants were more distracted by images depicting extreme threat to body-tissue, people with chronic pain were not more distracted than control participants for either image type. Findings fail to support either a deficit or motivated attention view of attentional control in chronic pain. Although these experiments do not provide evidence that chronic pain affects attentional processing, across experiments people with chronic pain reported that they experience deficits in attention, and they showed behavioural evidence of psychomotor slowing. These findings suggest that, as is repeatedly reported in the literature, people in chronic pain feel like they have attentional deficits, and that some aspects of cognitive and/or motor processing are impacted. Careful consideration is given to what specific cognitive functions might be impaired in chronic pain. The outcome of this discussion suggests pertinent research directions to further understanding of cognition in chronic pain experience.</p>

A role for attentional bias in cognitive deficits in chronic pain?

<p>This thesis extends current understanding of cognitive deficits in people with chronic pain, specifically those related to attention. Researchers have proposed that attentional capacity is allocated to pain sensation, and away from current tasks and goals, leading to broad cognitive deficits (deficit-view). However, an attentional bias to pain-related information has also been observed in people with chronic pain, suggesting that attention is motivated towards information in the environment that is pain-related, and away from information that is not. Such an attentional bias away from information not related to pain may contribute to the cognitive deficits observed on tasks using neutral stimuli (motivated attention hypothesis). In testing the deficit-view and motivated attention accounts of cognitive deficits in chronic pain, I focused on how people attend to rapidly presented information (temporal attention) and the ability to control attention in the face of distraction. To assess how chronic pain affects temporal attention, I used a phenomenon known as the attentional blink, which is a failure to detect a second target that appears soon after a first. Participants viewed a stream of briefly displayed words in which two target words (indicated by their colour) were embedded, with a manipulation of the time between the first and second target. They were required to report the two targets. In one experiment the first target was either pain-related or neutral (to assess how pain-relatedness affects the induction of the blink), and in other experiments this manipulation was applied to the second target (to assess how pain-relatedness affects how targets overcome the blink). In undergraduate participants, both induction and overcoming of the attentional blink was modulated by pain-relatedness. I then compared the effects of manipulating the second target in people with and without chronic pain. If people with chronic pain have general deficits in temporal attention, a deeper attentional blink (relative to control participants) for both kinds of targets should be observed. If motivated attention describes processing in people with chronic pain, a shallower attentional blink for pain related targets than neutral targets (an attentional bias) should be observed. Critically, this bias should be larger in participants with chronic pain. Contrary to both the deficit and motivated attention views, the attentional blink in participants with chronic pain did not differ from that in controls for either pain-related or neutral targets. Furthermore, neither group showed an attentional bias for pain-related targets, and a follow-up experiment failed to replicate the attentional bias observed in undergraduate students as well. Collectively, these findings suggested that attentional bias, as assessed by modulation of the attentional blink, was not reliable. A stronger test of the deficit-view and motivated attention hypothesis was needed. I shifted focus to another attentional domain, the control of distraction. To assess how chronic pain affects attentional control, I used an emotional distraction task, in which participants identified a target letter in an array that flanked irrelevant distractor images that were either intact or scrambled. Intact images depicted either extreme threat to body-tissue, or benign scenes. Distraction is indicated by slowing on intact relative to scrambled distractor trials. If people with chronic pain have general deficits in attentional control, they should show greater distraction from both kinds of images (relative to controls). If motivated attention describes processing in people with chronic pain, greater distraction from body-threat images than neutral images (relative to controls) should be observed. While all participants were more distracted by images depicting extreme threat to body-tissue, people with chronic pain were not more distracted than control participants for either image type. Findings fail to support either a deficit or motivated attention view of attentional control in chronic pain. Although these experiments do not provide evidence that chronic pain affects attentional processing, across experiments people with chronic pain reported that they experience deficits in attention, and they showed behavioural evidence of psychomotor slowing. These findings suggest that, as is repeatedly reported in the literature, people in chronic pain feel like they have attentional deficits, and that some aspects of cognitive and/or motor processing are impacted. Careful consideration is given to what specific cognitive functions might be impaired in chronic pain. The outcome of this discussion suggests pertinent research directions to further understanding of cognition in chronic pain experience.</p>

Affirming Strength-Based Practices in Disability and Inclusion: A Shared Autoethnographic Study of the Experiences of a Teacher

In this autoethnographic article we focus on the issues of “disability” and “inclusive education” and the challenges of being positive and affirming in this area of research and practice. As a teacher, I (Alina) continue to encounter regularly the dominant deficit view of “disability,” in spite of the extensive body of literature that advocates for the rights of people with disabilities as well as the benefits of inclusive education best built on strength-based thinking. The autoethnographic methodology allowed me to explore my experiences as an educator and reflect on specific events, presented through four vignettes that capture how my beliefs and values as an educator have formed over time. Throughout the article, I work closely with two academic colleagues (Ed and Jane), who become my critical friends, as I travel through this personal and professional journey that includes emotional reaction, reflection and academic analysis. I also engage with the emerging field of strength-based approaches to disability, as well as the importance of dialogue and justice, on an individual and professional level, with the aim of empowerment for students and teachers.

Taking Children’s Human Rights Seriously

Despite the development of the children’s rights movement, human rights scholarship continues to overlook the rights of children. Even those like Ronald Dworkin, who proclaim the need to take rights seriously, are curiously silent, even ambivalent, when it comes to children. This inattention often forces advocates of children’s rights to the margins of human rights scholarship. In the few places where serious philosophical discussion of children’s rights does take place, the analysis intends to diminish the value of rights for children. These critics are not malevolent, and typically want what is best for children, but they do not think it can be accomplished through a children’s rights agenda. This chapter lays out a persuasive argument for a children’s rights agenda, or, for taking children’s rights seriously. Drawing from philosophy, history, literature, popular media, and of course the law, this chapter argues against the conventional deficit view underlying most arguments against the recognition of children’s rights and makes a case for the importance of children’s rights where rights are the currency in use.

Reaching and Teaching Students in Poverty

The second edition of Reaching and Teaching Students in Poverty: Strategies for Erasing the Opportunity Gap aims to move educators from a deficit view of students experiencing poverty to a structural view by examining the structural inequalities in the United States. This book encourages educators to develop equity literacy and provides twelve principles of equity literacy, supported by historical data and current research, to guide readers in this process. The book also offers actionable strategies to implement at the classroom, school, and district level.

From Deficit Remediation to Capacity Building: Learning to Enable Rather Than Disable Students With Dyslexia

Purpose In this article, we explore the deficit view of dyslexia and consider how it may narrow research so as to hamper the progress of scientific discovery and constrain best practices to the detriment of the overall well-being and growth of students with dyslexia. We consider the neurodiversity view of dyslexia as an alternative to the deficit view and explore how strengths-based approaches such as Universal Design for Learning can be used to support the overall well-being and development of students with dyslexia. Practical strategies are provided for applying a strengths-based approach in the speech-language pathologist setting to support students with dyslexia. Method We completed a focused literature review of the history of the deficit view of dyslexia, the alternate neurodiversity view, exceptional abilities related to dyslexia, and strategies for Universal Design for Learning. Results Although the research literature that deals with visual-spatial affordances associated with dyslexia is limited, there is significant evidence that a strengths-based approach to learning experience design can be leveraged by practitioners to improve student self-development, motivation, and academic outcomes. Conclusion We find that further research is needed to explore strengths associated with dyslexia and argue that a shift in mindset from the deficit view toward the neurodiversity view is required to build the capacity of students with dyslexia to thrive in learning and life.

Investigating the lexico-grammatical resources of a non-native user of English: The case of can and could in email requests

Individual users of English as a first or second language are assumed to possess or aspire to a monolithic grammar, an internally consistent set of rules which represents the idealized norms or conventions of native speakers. This position reflects a deficit view of L2 learning and usage, and is at odds with usage-based approaches to language development and research findings on idiolectal variation. This study problematizes the assumption of monolithic ontologies of grammar for TESOL by exploring a fragment of genre-specific lexico-grammatical knowledge (the can you/could you V construction alternation in requests) in a single non-native user of English, post-instruction. A corpus sample of the individual’s output was compared with the input he was exposed to and broader norms for the genre. The analysis confirms findings in usage-based linguistics which demonstrate that an individual’s lexico-grammatical knowledge constitutes an inventory of constructions shaped in large part by distributional patterns in the input. But it also provides evidence for idiosyncratic preferences resulting from exemplar-based inertia in production, suggesting that input is not the sole factor. Results are discussed in the context of a “plurilithic” ontology of grammar and the challenges this represents for pedagogy and teacher development.

The Deficit View and Its Critics

This paper investigates what it is to understand human differences in terms of deficits and examines criticisms of this approach. In the past few decades, across many fields of inquiry and outside the academy there has been a surge of interest in critiquing "the deficit view" of all manner of group differences and deviations from the norm. But what exactly is meant by "deficit view" and related terms when they figure in accounts of human differences? Do critics of the deficit view claim that they are never appropriate or that particular applications of the approach are inappropriate? The aim of this paper is twofold: to identify and articulate some of the conceptual issues at the heart of debates about deficit approaches and to examine how these issues matter. Autism is my focus case. As we will see, many critiques of the deficit view of autism tend to characterize what is problematic about taking a deficit view in terms of the personal and social harm that deficit views can or do effect. One important upshot of my discussion, I argue, is that there is another kind of drawback to deficit thinking that is independent of the deficit view's potential negative personal and social consequences, a drawback that deserves serious consideration and sustained critical attention: in some instances, at least, deficit views impede scientific and philosophical progress in our understanding of the phenomena themselves. Thus, articulating and assessing deficit approaches is of practical and theoretical importance.