The Child Mind BlogBrainstorm
Autism Community Split in Four, Says NIMH Chief
April 11, 2014 Beth Arky
The autism community is conflicted in many ways, most obviously between those seeking a cure versus those who see the autism spectrum as a natural state of neurodiversity. Dr. Tom Insel, director of the National Institute of Mental Health, codified those divisions even further in his Autism Science Foundation 5th Anniversary Celebration talk, "From four kingdoms to one community for autism."
Dr. Insel laid out the four "kingdoms," or schools of thought:
Autism as an illness. Those with this view see autism spectrum disorders as a neurodevelopmental disorder. This group is looking for genetic factors, or biomarkers, with a cure as the goal.
Autism as an injury. This camp sees ASD as a "response to an environmental insult of some sort," making autistic children the "canaries in the coal mine" who might just be warning us of the effects of toxins or even climate change. Here, the goal is prevention.
Autism as an insight. This viewpoint sees autism "as a window into the social brain." Here, the goal is comprehending the fundamentals of how the brain grows and functions.
Autism as an identity. Here, autism is seen as a disability. Adults on the spectrum have become self-advocates who focus on functional outcomes. The goal is inclusion, with advocates seeing themselves as part of a civil rights movement with the motto "Nothing about us without us."
Dr. Insel then raised another way of looking at things: "Maybe there really are at least four different disorders involved—we should be talking about 'the autisms.'" From this perspective, he said, "there are people who may be more in this illness kingdom" versus, say, those for whom identity is a better approach.
Dr. Insel noted that the divisions within the autism world mean it's "not the same type of [unified research] community that works on cystic fibrosis or Type 1 Diabetes." He said the problem is so serious, great scientists are saying they have a lot to offer but this is "a community I don't want to deal with. It's too difficult."
The enormous conflict between these four very different groups needs to be overcome if progress is to be made, he continued. He emphasized the need for finding shared interests to unify the community, such as the demand for greater services for—and understanding and recognition of—adults on the spectrum. And scientific efforts that bring together the far-flung kingdoms are crucial, he concluded. "Science has a way of letting us understand."View Comments | Add Comment
An App for Skinnier Selfies
April 8, 2014 Rachel Ehmke
In what feels like an inevitability, there's now an app to make yourself look skinnier in pictures. For the slim price of just 99 cents in the Apple store, you can get the app, take a selfie, and then choose to shave off 5, 10, or 15 pounds from your face. It's called SkinneePix and it only works on faces, which is bad news for bikini season but good news for those of us who are looking for silver linings in this otherwise depressing story.
Of course we're already used to seeing manipulated photos, even if we don't realize it. Page Six recently reported that Lady Gaga made photographers covering an event "smooth out her jaw line and thin her arm" and "smooth out and thin her legs" before she let them release any photos of her. Besides being a disappointing request—Gaga has previously positioned herself as a role model for girls with body image issues—it illustrates how pervasive photoshopping has become. Even the "candids" of celebs have been passed through the digital wringer.
So it makes sense to market a DIY app for us non-celebs. Selfies are addictive, particularly to young girls who are already spending a lot of time crafting the perfect online identity for themselves. An app that makes you skinnier is going to be a no-brainer for a lot of girls.
Which is too bad because when everyone looks fifteen pounds lighter online—or feels like they should—it's going to make it even harder for girls to feel good about who they really are.
Read more about teens, self-esteem, and the impact of social media here.View Comments | Add Comment
Parenting, Lost at Sea
April 8, 2014 Harry Kimball
It seems everyone has an opinion about the actions of the Kaufman family—Charlotte, Eric, and daughters Lyra, 1, and Cora, 3—who were recently rescued by the Navy after their sailboat Rebel Heart floundered in the Pacific 900 miles off the coast of Mexico. We note that their predicament illustrates, on a grand scale, a choice parents make every day and everywhere: to be risky, or not to be risky?
The Kaufmans were headed from Mexico to New Zealand under sail. Charlotte and Lyra had just recovered from salmonella poisoning before they left, and when they were rescued Lyra had a severe rash and a fever. Were they foolhardy, or were they responsibly trying to introduce their young children to a life rich with adventure?
A family's job is "to be prepared and to have a backup plan," a doctor tells the New York Times. "It sounds like they needed their backup plan and executed it." But others wonder if the Kaufmans lost sight of their kids' needs—and even their basic capacity for adventure. "It's not as if a 1-year-old is going to remember an experience, whether it's positive or negative," a parenting author says. We should stress that developmentally, infants and young children need security and attachment; the benefit of taking risks—and learning to be independent and resilient—comes later.
The Kaufmans are sticking by their decision. For the rest of us it's a lesson in being honest about what we do for ourselves, and what we do for—and to—our children. At some point, kids take risks; but parents shouldn't ever take risks with kids.View Comments | Add Comment
Disney Approach Excites Autism Researchers
April 8, 2014 Beth Arky
Ron Suskind was able to reach his autistic son, Owen, through the boy's fixation on Disney movies. Now scientists want to see if there are larger applications.
Researchers from Yale and Cambridge looking to get inside the mind of an autistic child are taking a page from Suskind's new book, Life, Animated, which tells the story of how the family was able to harness Owen's affinity for animated characters to draw him out into more social engagement and interaction.
Suskind says he invented the term "affinity therapy" to describe how he, wife Cornelia and older son Walt spent countless hours inhabiting characters from movies like "The Jungle Book" and "The Little Mermaid" to connect with Owen, who has gone from a nonverbal 3-year-old to a 23-year-old student with a girlfriend.
Suskind says there are probably about 12 affinities that parents could use to reach their children; they include Thomas the Tank Engine and anime. According to the New York Times, he approached the researchers to put together a clinical trial based on the idea that "some children can develop social and emotional instincts through the characters they love."
The researchers have written a proposal to study the approach, which calls for a 16-week trial involving 68 autistic children, ages 4 to 6. The scientists plan to submit their proposal to the National Institute of Mental Health for funding. We'd love to see those results.View Comments | Add Comment
All 'Big Data' Is Not Created Equal
April 7, 2014 Harry Kimball
Yesterday, the New York Times published an op-ed taking the faddish obsession with "Big Data" to task. Gary Marcus and Ernest Davis rightly point out that not every pattern revealed by supercomputers crunching numbers is significant. They are worried that, because we are historically quick to attach meaning to coincidence, that "the risk of too many correlations" posed by huge data sets already has and will continue to lead us astray.
"A big data analysis might reveal," they write, "that from 2006 to 2011 the United States murder rate was well correlated with the market share of Internet Explorer: Both went down sharply. But it's hard to imagine there is any causal relationship."
Well put. But the authors also understate a crucial distinction and threaten to sour readers on a valuable new approach to scientific observation. They allow that "big data can work well as an adjunct to scientific inquiry but rarely succeeds as a wholesale replacement." Of course it is a tool, and not a magical answer machine. Just as we shouldn't blindly accept computer-generated correlations as truly connected phenomena, we should not confuse what big data analysis is—a new and powerful observational tool—with what it isn't: an end in itself.
If data analysis reveals a correlation that intrigues a researcher, that is when a hypothesis is formed and tested, as always. Big data is a new lens with which to view the world, but we still don't need to believe everything we see.View Comments | Add Comment
The Case for Risky Play
April 1, 2014 Caroline Miller
The Atlantic has a terrific, provocative piece by Hannah Rosin about the negative effects of parenting that tries to take all the risks out of childhood. Rosin takes us on a visit to a British playground that looks more like a junkyard: Kids are busy building structures with old tires and wooden pallets, jumping on dirty mattresses, starting a fire in a tin drum, and sliding down a muddy hill—into a creek if they get going too fast. Grade-school age kids. Without their parents.
It's a startling scene, reminiscent (for those of us of a certain age) of the many unsupervised hours we spent as kids, poking around outdoors, while our parents were inside doing whatever parents did back in the day when they didn't spend most of their free time taking kids places and supervising their activities.
The larger point is that kids who don't get a chance to take risks—what feels like risks to them—don't learn to tolerate and manage fear in a healthy way. Our fear of their being harmed makes them more fearful. And it's backed up with a lot of interesting data that despite our perception of living in more dangerous times, actual risks to children have not increased.
Risky play, Rosen notes, is essentially what psychologists do with anxious children when they use what's called exposure therapy—they face fears in tolerable doses in order to learn to manage those feelings. As Steven Kurtz, a clinical psychologist at the Child Mind Institute, puts it, "helping kids get comfortable with being uncomfortable."View Comments | Add Comment
CDC: Kids With Autism Up 30%
March 27, 2014 Caroline Miller
The Centers for Disease Control released a new survey today finding that one in 68 children in the US has autism, up from one in 88, which the agency reported two years ago. The new prevalence figure, which is based on a sample of 8-year-olds taken in 2010, is a 29 percent increase over the figure for 2008, and a 123 percent increase in the figure for 2002.
• Gender differences: The new figure breaks down into one in 42 boys and one in 198 girls. That ratio has remained constant, though it varies among individual states.
• Ethnic differences: Non-Hispanic white kids were almost 30 percent more likely to be diagnosed than non-Hispanic black children, and 50 percent more likely than Hispanic children.
• Intellectual disability: The number of children diagnosed with autism who do not have intellectual disability has risen to 46 percent, up from 32 percent in 2002.
• Age of diagnosis: The median age of the first diagnosis is 4.5 years, not significantly different from the last survey.
• State breakdown: Prevalence of autism diagnoses varies a great deal among states in the survey—from 5.7 to 21.9 per 1,000 children. The lowest rate is Alabama and the highest is New Jersey.
The survey is based on a sample of kids in 11 sites around the country who have been identified by records from medical providers or school services as having an autism diagnosis. Records are then scrutinized by professionals to check them against accepted diagnostic criteria for autism.
Since it's based on the 2010 survey year, this survey reflects diagnostic criteria for autism-related diagnoses from the DSM-IV-TR, rather than the new criteria in DSM-5 that was released in 2013. Included in the prevalence figures are all children diagnosed with autism, PDD-NOS, and Asperger's Syndrome, which have all been combined more recently into ASD.
The CDC reports that the distribution of children among these subtypes has not changed significantly since 2006.View Comments | Add Comment
Depression, Suicide, and Too Much Sharing
March 25, 2014 Caroline Miller
In an op ed piece in the New York Times today an anthropologist named TM Luhrmann writes about an increase in reported rates of depression and suicide around the world. She notes that the increase reflects changes in how cultures label feelings: "For example, until recently, most Japanese understood intense fatigue as sacrifice for one's work and suicide as an act of reasoned will." Now many Japanese who find themselves drained of energy and beset by suicidal thoughts would call themselves depressed. That's not a bad thing.
But of the factors she mentions, one that's particularly interesting is the change in what she calls "our awareness of other people and where we stand in social space." Studies show that Facebook makes people feel less good about themselves. The constant stream of other people's flattering photos and evidence of fun you're not having, not to speak of accomplishments you haven't achieved, is tough on all of us. But I would suggest that it's probably hardest on teenagers, who are acutely sensitive to, and anxious about, comparisons with their peers.
On a global scale, she's talking about people everywhere knowing, thanks to both television and the internet, how much richer and more powerful others are. On a high school level, it may be addictive to keep up with what everyone is doing and thinking, 24/7, but it's also potentially depressing.View Comments | Add Comment
Autism and Sensory Overload
March 25, 2014 Caroline Miller
In what's called the "intense world theory," a leading neuroscientist is arguing that autism should be seen as a result not of cognitive deficits but of cognitive overload.
Henry Markram's radical rethinking stems from observation of his own son, Kai, who is on the Asperger's end of the spectrum. And his research with rats offers evidence, he argues, for the theory the autistic brain is actually hyper-responsive to stimuli. The rigid and repetitive behaviors associated with autism, not to speak of the meltdowns, are explained as attempt to manage bewildering sensory and emotional overload. And social unresponsiveness is seen as a coping mechanism for a "barrage of chaotic, indecipherable input, a cacophony of raw, unfilterable data."
A story about Markram and his theory on the website Medium is riveting, and it has important implications for treatment. Since children learn social skills in specific windows of development, could it be that "early intervention to reduce or moderate the intensity of an autistic child's environment" might keep kids from shutting down during crucial learning periods and hence protect their development?
Learn about another theory of sensory issues in autism based on brain imaging here, from Dr. Wendy Chung, who reaches a remarkably similar conclusion concerning tailoring learning environments and experiences for young people on the spectrum.View Comments | Add Comment