Sociability and Social Vulnerability in Williams Syndrome

Abstract

Social vulnerability has been emphasised in relation to Williams syndrome (WS), but there is little evidence on its presentation in adolescence, relevance across neurodevelopmental groups or on the underlying factors. This thesis took a multi-methods approach to address these gaps. The first study (Chapter 3) reports findings of an interview study about adults’ perceptions and experiences of friendships. The results raised important themes around social decision-making, the role of support networks, and negative peer experiences in school. The childhood/adolescent years emerged as important; therefore, the remainder of the thesis prioritised this developmental stage. Chapter 4 examined aspects of social behaviour relevant to social vulnerability and deemed salient in the WS social profile: prolonged eye contact and propensity to approach others. Using cross-syndrome design, it was established that qualities of eye contact and social interaction styles varied within WS and across neurodevelopmental groups (fragile X syndrome, attention deficit hyperactivity disorder and autism). The findings indicate that social phenotypes are best conceptualised as shared across groups and thus raise questions about the design of cross-group studies on social vulnerability. The final Chapters delineated the profile and correlates of social vulnerability in adolescence in WS. In Chapter 5 social vulnerability was evident at elevated levels and this was supported by parent qualitative data. The study also provided first evidence on family impact and highlighted strategies adopted by families to manage social vulnerability, including increased parental supervision. Extending these findings, Chapter 6 investigated several relevant but untested correlates of social vulnerability. Difficulties in executive functioning, adaptive behaviour and particularly social reciprocity (which showed a predictive role) were associated with greater social vulnerability. Parental protection behaviours increased in line with social vulnerability. Together the findings confirm the need to understand the underpinnings of social vulnerability and provide support at the individual and family level, early on in development in WS.