Dr. Hannah Hobson is a senior lecturer in the Department of Psychology at the University of York where she additionally directs the EMERALD (Emotions and Mental health Research in Autism and Language Disorders) lab. Prior to her work at the University of York, Hannah has lectured at the University of Greenwich and was a post-doctoral researcher at King’s College London. She completed her DPhil at the University of Oxford and completed a policy internship at the Academy of Medical Sciences.
Her current research in the EMERALD lab focuses on language and communication difficulties, particularly for children with developmental language disorder (DLD), and their relation to non-linguistic difficulties. She has worked with a variety of populations who have communication difficulties, including those with autism disorder, brain injuries, strokes, etc. She has also worked with mirror neurons and EEG to look at underlying mechanisms of imitation. Hannah is also interested in ensuring the reproducibility of research, within psychology and beyond.
Hannah was in conversation with Grete Feldman, a PhD candidate in the Department of Theoretical and Applied Linguistics.
What has shaped your journey into language science over time? How did you first get into this field?
When I did my undergraduate, I went in like lots of psychology undergraduates thinking I was going to come out eventually a clinical psychologist. But while doing my undergraduate, I really fell in love with modules on developmental psychology and particularly language development and conditions in which language and communication development was atypical. I ended up then doing a PhD with Professor Dorothy Bishop, looking at imitation in children with autism and children with specific language impairment as it was then. During the course of the PhD, I then continued to get really interested and excited about working with autistic young people, but also these individuals with specific language impairment. It's since been renamed developmental language disorder. I feel that working with those populations have kept me working in this field.
I was interested in imitation and cross comparing autism and what is now developmental language disorder (DLD). There's a lot of quite interesting overlap between the two groups of children and it’s quite tricky for practitioners like speech language therapists to make that differential diagnosis sometimes. Early language difficulties are both a red flag for autism, but they can also be developmental language disorder, or sometimes they just resolve. There were some really interesting papers that had recently come out back then about how longitudinal studies of children with DLD, they're sort of early DLD samples. When children were seen around 7 or 8 years old, and when they followed them up in adolescence, quite a few of them had been given an autism diagnosis and there was this big sort of scratching of heads going, well, what happened? We were really sure they didn't have autism when they were little. So, is it possible that the language problems are starting to create sort of social difficulties that are being diagnosed as autism? Understanding the overlap between these two groups really interested me and imitation was kind of a specific skill or a specific kind of cognitive process that I decided to zoom in on. And these days I don't do much with imitation. I did stuff on mirror neurons and was fed up of mirror neurons by the end of my PhD, but still really into autism and DLD. So, I've stuck with those guys. I mean, these days, I think I almost care less about the overlap.
It's still a big problem, clinically trying to differentially diagnose. But now I think we've moved into a sort of phase of neurodevelopmental research where we kind of accept there's a very high degree of overlap between lots of conditions. Needling in on one bit of overlap is almost a bit nitpicky now. We just go, yes, of course they have overlapping profiles. That's the nature of development. Over time, it continued to be a problem in practice, but research has gone, this is the norm. It's normal for these conditions to overlap.
How has the main aim of your research changed? What key questions or issues are you addressing in this moment?
My lab is the Emerald Lab, which is Emotions and Mental Health Research in Autism and Language Disorders, an acronym that attempts to kind of showcase that, what we look at in my group, is the link between language and communication and social emotional processes and mental health. I was describing about how kids with DLD seem to start to have these social problems and maybe that meant they got an autism diagnosis later. In a way, I've kind of continued to be really interested in about how language and communication problems might affect, might be related to things like recognising your own emotions, your access to mental health treatment and what that's like. How people perceive you and how you then experience the world as a stigmatised group and what that might do to your both your language behaviour; but also your social emotional mental health outcomes. What I'm really interested in is the link between language communication differences and social emotional processes and mental health.
How does your current work connect to language and communication across boundaries, the theme of this symposium?
One of the things I've been really recently looking at is camouflaging, which I think is likely what I'll be coming to talk about. This is when a neurodivergent child or young person or adult changes their behaviour in order to minimise the visibility of their neurodivergent characteristics. For a long time, the research on that has been about autism and autistic masking. But my recent work shows that sticking in these diagnostic boundaries is maybe not very helpful and that camouflaging is probably part of the broader neurodivergent experience. We've been looking at camouflaging and developmental language disorder and finding lots of overlaps in terms of the drivers and the outcomes of camouflaging for kids with DLD as we see in autism. I think that's one sort of crossing boundaries, crossing these diagnostic groups, taking a transdiagnostic approach. The other thing is about the kind of disciplines and subdisciplines. Camouflaging, as a phenomenon, is important for speech and language therapists because it's going to affect which children are referred to them. If they're camouflaging very highly, their language problems may not be noticed. They won't be referred for help. It's clinically important. But in order to understand the drivers of camouflaging, I've been delving a lot into social psychology to understand the role of stigma in these young people's experiences and what drives them to camouflage in the first place. Why don't they ask for help? Why don't they say they don't understand? And that sort of drawn me into a different bit of psychology to that which I normally work in.
Working within all these different areas of psychology, what does your day-to-day look like? Are you in the lab? In the library? How does it work?
These days, I'm usually in my lab working with my PhD students or our brilliant master's students who we teach at York. Sometimes I'm going into schools. Sometimes I'm meeting virtually with speech language therapists or talking to mental health practitioners. It’s a lot of virtual meetings, trying to explain what DLD is and how it affects people. A lot of desk research. Occasionally, I get to meet young people with DLD, which is my favourite bit of the job. It's working with lots of different stakeholder groups all the time, which is something I really enjoy.
Where do you hope your research will lead?
In this in the short term, camouflaging is the thing I'm working on mostly at the minute and I'm hoping to kind of unpack how camouflaging and masking affect neurodivergent people and think about what we can and should do about it. I think interventions for masking and camouflaging are probably inappropriate right now because the drivers for these behaviours are high levels of stigma, lack of public and professional awareness. That's where we need to be pulling levers and making things better for these groups of people. So, what I would love, I suppose, is to be able to look back in years and think, oh, my work made a tangible difference, particularly to children and young people with developmental language disorder, which is still really under recognised and really under supported, unfortunately. They're the group that I have in mind that I hope will be able to support better with our work.
How do you see yourself crossing these boundaries in terms of getting this information out to people to develop that public awareness or to make those policy changes?
It's super tricky. I don't know if I haven't cracked that yet, if I'm honest. There are groups of professionals who see the problem and are working super hard, like speech language therapists are very engaged in this problem. But trying to get to other professional groups that are quite overburdened already and trying to highlight to them why this should take up some of their brain space. A colleague of mine was recently sharing that she also works on the relationship between language and mental health, and she'd had feedback on a grant saying that people didn't see the relevance of language to talking therapy, which just blows my mind completely. But I think what it does do is it distils how the people who don't work perhaps in the language field, really take language processes for granted. When language is working well, you barely notice it. And even for people who work in mental health services, we know there's a really high rate of unrecognised communication problems. But even those groups or people reviewing those kinds of grants anyway, don't recognize the important contribution that language makes to be able to ask for help, explain why you're in mental distress, make important relationships. It’s so automatic for people without a language communication problem that I think it just seems niche or like a weird side quest for people who aren't in the know. I think we need to think really creatively.
What aspects of your work are most exciting to you right now? What gives you hope? What gives you joy when you're going into work every day?
It's generally working with neurodivergent people and their families and lots of practitioners who are really engaged in wanting to support children, young people, and adults who have autism or have DLD to thrive and like get the most out of school and enjoy life. Working with all those different groups of people I love. And I do think we're at an interesting cultural moment where the neurodiversity movement has really kind of caught fire. Really, I would say even six years ago, we weren't talking about conditions like autism or DLD or ADHD via this neurodiversity lens. It's really that recent and some people see challenges with that. There are challenges to working with that model and that lens, but I think it offers quite a lot of opportunities to reframe how we think about atypical language communication. And I do think, if harnessed properly, it's a really good opportunity to push DLD up there into public awareness. You've heard of neurodivergence, but have you heard of this form of neurodivergence? It affects 7% of children. It's more common than autism. Why have you not heard of it? It makes it quite an exciting time at the moment. But I know speaking to my colleagues, some of them find the neurodiversity model actually quite challenging for DLD. It’s an interesting time to be working in that area for sure.
We’ve talked about the long-term goals of your research a little bit. Do you have any shorter-term goals at the moment? Where is your research trending?
I'm actually writing a module at the minute, a teaching module on neurodiversity and mental health which I'm excited about because I'm looking forward to drawing together what we know about mental health conditions and how what happens for well-known forms of neurodiversity like ADHD and autism.
For more tangible things in the short term, I'll continue to work on camouflaging and masking. We're just finishing the analysis on a new parent report measure for DLD related camouflaging, which it's a small study, but it's been quite well received, and a lot of clinicians have shown a lot of interest. I think it has hit on something that people are recognising and are interested in and that I hope will allow us to recognise DLD in some kids where we wouldn't otherwise have spotted it. That would be really exciting to me. And I also think camouflaging, just from the data we've collected, it seems to explain a lot of variance in mental health symptoms. I'm expecting that just like in the autism masking literature, we'll see that in other groups, including DLD, that camouflaging is like a steppingstone between being neurodivergent and having mental health problems. Not all neurodivergent people have mental health problems, but it does seem to be a big risk factor, and we need to understand why that's the case.
Any other questions that are outstanding for you or that you'd like to share with the community?
I would also like to extend an open invitation to anyone who is interested in working on anything related to developmental language disorder. I'm always super happy to support work with that group. I think we should be working to support all neurodivergent young people, but DLD does have a special place in my heart because it tends to just get left off the list. And we know from our interviews with young people that when they might disclose DLD, people just go, well, what's that? And then these poor people who've already got a communication difference have the burden of trying to explain to somebody what DLD is. If anybody's ever interested, or wants support working with people with DLD, I'd be very happy to support that work.