The Child Mind BlogBrainstorm
Dr. Pasko Rakic on the Map to the Human Brain
Oct. 13, 2014 Harry Kimball
Last week the Child Mind Institute hosted a fascinating group of scientists for our annual On the Shoulders of Giants symposium, and I have to admit it was a little mind-blowing. Dr. Pasko Rakic, our 2014 Distinguished Scientists Award recipient, began the program by reviewing his 50 years of research into the basic development of the cerebral cortex—the center of our higher-level brain function. Unlike other areas of the brain, he said, all of the neurons the cortex will ever have are produced and "migrate" to their assigned locations early in development. Backed up by his innovative experiments, the picture he painted of this process verged on the fantastic: brain cell after brain cell climbing a rope-like filament to a precise location encoded in our DNA. And if they don't find their spot correctly, the result can be a psychiatric or developmental disorder.
That code is the "map" of the brain, Dr. Rakic said, and it has been his life's work to discover its intricacies. At the Roosevelt House at Hunter College, he pointed to a photograph displayed on the wall. "These three people here tried to change the map of the world," he said, referring to the image of FDR, Churchill, and Stalin. "And why did they fail? None of them were neuroscientists."
Dr. Rakic's contributions to our understanding of the human brain have been revolutionary—but he's even more optimistic about the future, represented in the room by this year's Child Mind Institute Rising Scientists, high school students in the New York area with an exceptional dedication to scientific inquiry. "Looking at these young people, I must say I envy you," he told them. "What you are going to be able to discover with the new methods coming your way—you are the giants that are coming."
Dr. Nenad Sestan echoed Dr. Rakic's sentiments in his presentation on the specific genetic signaling involved in the development of a single type of cortical neuron; and Dr. Matthew State spoke about how that genetic knowledge may soon lead to improved understanding and treatment of disorders like autism. Dr. State hoped the Rising Scientists would leave the presentation thinking, "Wow, it is an amazing time to be doing this," and he had this prediction: "Within your lifetimes you are going to be present at a profound transformation of our understanding of mental illness, our ability to treat it, and what it means in society to have a brain disorder."
With the amazing foundation provided by Drs. Rakic, Sestan, and State, there's no reason this cannot be true.View Comments | Add Comment
Kids vs Phones
Oct. 9, 2014 Caroline Miller
Highlights magazine does an annual "State of the Kid" survey of readers, and it gives us a chance to see things from the 6- to 12-year-old point of view. In addition to their favorite TV shows (SpongeBob SquarePants), bands (One Direction), and books (Diary of a Wimpy Kid), we get a snapshot of family life. And what looms large in this snapshot? Parental cell phones.
Some 62% of the kids said they found their parents distracted when they were trying to talk to them, and cell phones were the largest source of distraction—more than siblings or work. "I know my parents are really listening to me when they are sitting down and not on their phones," a 10-year-old wrote.
And to underscore how much emotion is attached to the cell phone, Highlights asked kids what they thought their parents would do if they lost their phones for a day. "I think my mom would go crazy and then have a heart attack. And then faint," one 8-year-old wrote. Said another: "Freak out, but I'd be happy."View Comments | Add Comment
Ask Lena Dunham About OCD
Oct. 6, 2014 Jessica Kashiwabara
Lena Dunham has shared her personal struggles with obsessive-compulsive disorder publicly before (including a recent New Yorker essay entitled "Difficult Girl: Growing Up, With Help"). On her HBO show Girls, she gives a sensitive and realistic portrayal of what it's like for a young person dealing with OCD through her character, Hannah Horvath. Now in a video series called "Ask Lena" Dunham continues to speak out. In our favorite video a young woman with OCD, who admits to self-medicating and a dislike of doctors, writes in to ask Dunham's advice. In her response Dunham speaks like an advocate who really knows what it's like:
There's so much stigma around mental illness in our society, and you probably feel like you're supposed to muscle through this or tough it out. But if you had diabetes, you wouldn't say, "I don't think I should be allowed to have insulin." In order to tame the beast enough that you can analyze it, you need to go and talk to someone who can help you in that department. And you need to be talking to a therapist because it sounds like it's really affecting you on a day-to-day basis, and that there's something within you that feels like you don't deserve help, and you do.
Dunham is using the videos to promote her first book, Not That Kind of Girl: A Young Woman Tells You What She's "Learned." No quibble with that: It's a pragmatic and powerful message from Dunham, who reminds us that we all deserve help and shouldn't feel bad about asking for it. For more resources on OCD, feel free to visit our landing page.View Comments | Add Comment
'Friday Night Lights' Creators Tackle Football Violence
Sept. 30, 2014 Jessica Kashiwabara
Both the author of Friday Night Lights and the director of the film version turned heads recently by criticizing football for its violence and the health consequences its players face. Director Peter Berg wrote that his son is no longer allowed to play football and author Buzz Bissinger said that helmets should have warning labels like cigarettes, suggesting:
WARNING: MEDICAL STUDIES HAVE DETERMINED THAT FOOTBALL CAN RESULT IN EARLY ALZHEIMER'S, DEPRESSION AND DANGEROUS MOOD SWINGS FAR BEYOND THOSE OF THE GENERAL POPULATION.
Both of their pieces were on Time magazine's website, which also ran a cover story about a high school football player who died after sustaining a traumatic brain injury. The headline read "He Died Playing This Game. Is Football Worth It?" They were tough, provocative pieces, that not all parents would endorse, but they expressed the difficulty parents face in responding to the information that's coming out about football and brain injury.
The pieces come on the heels of a court filing made public this month from the NFL stating that retired players do incur brain damage at a higher rate than the general public. According to the documents, nearly one-third of former players will develop at least moderate neurocognitive problems and these impairments surface at a much younger age than the general population. Actuaries found that former players are at higher risk for Alzheimer's, dementia, Parkinson's, and ALS.
With these findings, the NFL has publicly acknowledged a link between football and long-term neurological impairment-a big step after years of denying any connection. But the announcement also leaves us with questions. Chief in parents' minds are the risks of allowing their kids to play football. With people like Bissinger and Berg speaking out, the tide might be starting to turn against one of America's favorite pastimes.
In response to safety concerns, this season the NFL has already made changes including banning hits with the crown of the helmet and placing neurological experts on the sidelines during games. College conferences like the Pac-12 and Ivy League have set weekly caps on full-contact hours for practices. Heads Up Football, a program launched in 2012 by the non-profit USA Football, aims to have all youth league coaches nationwide go through certification courses-teaching proper tackle techniques to reduce helmet contact, among other safety guidelines. Hopefully awareness is going to be a game changer.View Comments | Add Comment
Early Autism Treatment Eases Symptoms by Age 3
Sept. 9, 2014 Harry Kimball
For kids with autism, early intervention is getting even earlier. We're reading today about a small pilot study out of the UC Davis MIND Institute, which suggests a treatment called Infant Start can eliminate autism symptoms if they are identified in the first year or so of life.
In the study, seven children, aged 6 to 15 months, who were "highly symptomatic and at risk of developing ASD," according to ScienceDaily, were treated by their parents, who were trained in how to interact with their kids to encourage social learning, reciprocity, and attention. In effect, the clinicians taught parents how to teach their children to overcome some of the hallmark deficits of autism—very early, and using the parent-child bond. By age 3 or earlier, 6 of the 7 children were developing typically.
"It was the parents—not therapists—who did that," says Sally J. Rogers, PhD, the lead author and developer of a successful intervention for older kids, the Early Start Denver Model. Given the increasing ability of clinicians to identify signs of autism early, an intervention targeting younger kids is welcome to many. "This paper is very important because it's a first effort to have treatment research catch up with the early diagnosis work," Paul Wang, a senior researcher at Autism Speaks, tells the Sacramento Bee.
Right here last month, Beth Arky wrote about another set of studies suggesting some kids can "beat" autism and leave the diagnosis behind after intensive early intervention. Some parents and advocates were sour on the idea that kids could or should "recover" from autism—particularly if "intensive" intervention cost an intensive amount of money. The UC Davis study is saying something different, I think: first, the intervention is "low intensity and could be carried out by the parents in everyday routines," as described in ScienceDaily.
Second, and perhaps more importantly to parents—or to advocates who think of autism as an identity, not an illness—are the words of Dr. Rogers. "I am not trying to change the strengths that people with ASD bring to this world," she says. "People with ASD contribute greatly to our culture. The diversity of human nature is what makes us a powerful and strong species. We are trying to reduce the disability associated with ASD." That seems like a goal that everyone who is invested in the lives of people with autism should be able to agree to.View Comments | Add Comment
Drew Carey Comes to the Aid of Autistic Teen
Sept. 8, 2014 Beth Arky
Drew Carey threw the spotlight on a revolting prank targeting an autistic teen when he pledged a $10,000 reward to help the local police find the high schoolers behind it. What they did was dump a bucket of feces, urine and spit on the special-needs student, who had been told it was part of the viral ALS "Ice Bucket Challenge" fund-raiser.
"WTF? Just saw this. Horrendous," the Price Is Right host Tweeted Friday. "These kids should be arrested and expelled." The incident happened in Bay Village, a suburb of Cleveland, Carey's hometown.
The 14-year-old victim's mother discovered the video of the twisted prank on his cell phone; it had been posted on social media. She said her son was embarrassed and didn't want to tell anyone afterward. Bay Village police chief Mark Spaetzel said the video is one of the most disturbing things he's ever seen.
It's hard to comprehend that high school kids could be this cruelly lacking in empathy. It's all the worse knowing that the victim was apparently targeted because of his "otherness" and vulnerability; it's likely he did nothing to provoke such a mortifying act.
In case the reward isn't needed, Carey added an offer to give unused money to Autism Speaks, drawing praise from the likes of autism mom Holly Robinson Peete. But the comic waded unknowingly into controversial waters; there's a vocal anti-AS camp that opposes the organization's goal of "curing" autism through research, rather than endorsing neurodiversity and helping adults with autism. Their twitter campaign was vehement enough that Carey responded he would donate the money to "some worthwhile organization regardless."
Meanwhile, Jenny McCarthy—who has made the controversial claim that she "cured" her son of autism—tweeted Sunday night that she would match Carey's $10,000 offer.
We'd love to think that the public revulsion over this act will get through to the kids who apparently thought it was funny in the first place to afflict another teenager because he is different.View Comments | Add Comment
What Mo'Ne Davis Means to Girls
Aug. 19, 2014 Rachel Ehmke
Hearing "You throw like a girl" jokes is one of those things nearly all girls put up with at some point. Like mosquitos in the summer, you can pretty much count on them.
That's why Mo'Ne Davis is such a big deal. If you haven't heard of her yet, she's the first girl to ever throw a shutout in the Little League World Series, which is going on right now. Actually she's thrown back-to-back shutouts if you count the 8-0 win against Delaware that qualified her team, the Taney Dragons out of Philadelphia, to head to the World Series. She's one of only two girls playing in the tournament right now, and one of 18 girls in the history of the series. She's 13 years old and throws a 70mph fastball. Also she says that baseball isn't even her favorite sport—that's basketball.
If you have a daughter, she's going to hear that she throws like a girl. Even if she plays on a baseball or softball team, even if she knows exactly how to throw, she's going to hear it. She'll know that it's silly, but it still might rankle. So it's good that now she has Mo'Ne Davis to reassure her that throwing like a girl can be a great thing. And, if necessary, now she can send boys this Vine of Davis striking out a boy.
Read More: 13 Ways to Boost Your Daughter's Self-EsteemView Comments | Add Comment
Robin Williams and Depression
Aug. 12, 2014 Harold S. Koplewicz, MD
When someone like Robin Williams takes his own life, it's a stunning reminder of how powerful emotional anguish can be. It's a reminder that profound emotional pain can occur in the talented, the successful, the admired, the well-loved. And it's a reminder of how difficult it can be to reach someone struggling with depression—especially someone who thinks you don't want to hear about it.
Williams spoke openly about his substance abuse problems; less openly about his emotional struggles. He talked with interviewers about cocaine and alcohol repeatedly, he did comic riffs on his outrageous behavior when he was on a bender. But when Terry Gross asked him, after a stint in rehab, if he had ever been diagnosed with depression or bipolar disorder, he said, "No. I get bummed, like I think a lot of us do at certain times."
In a a podcast interview with comic Marc Maron, who also wrestled with depression, Williams talked about how hard it can be for a comic to decide how far to go with an audience—how dark you can allow yourself to be. Let's say you're feeling insecure, maybe desperately insecure, he said, and you're going with it, and you can tell the audience is with you, they're feeling it. Then you cross some kind of line, you sense them going, "No, no, no. I don't want to go there."
I can't help thinking that this is a good description of the way you feel when you suffer from depression—you sense that you're testing the limit all the time, at risk of crossing the line of what people around you are comfortable hearing. You worry about driving people away by being too negative. There's a very powerful voice telling you not to ruin the image people have of you by admitting how bad it is. That reticence is what we need to combat, by making it clear that we do want to hear, and we do want to help.
"Robin was as sweet a man as he was funny," Jimmy Kimmel tweeted, but it's what he wrote next that hits home: "If you're sad, please tell someone."
Or, as Williams' friend Harvey Fierstein put it more colorfully on Twitter: "Please, people, do not fuck with depression. It's merciless. All it wants is to get you in a room alone and kill you."
We can only guess that Williams was not silent with those close to him about the pain that drove him to take his own life. He was in addiction treatment just last month; his wife and management team acknowledge that he was struggling with depression. His death, after so many years of struggle, and so many years of sobriety, reminds us of Philip Seymour Hoffman, who died of a heroin overdose earlier this year after a similarly long clean streak. His chronic illness appears to have caught up with him.
We worry particularly, in moments like this, about teenagers, who take their lives in truly alarming numbers, and often—especially among young men—without giving a hint to the people who love them that they are miserable. We need to get the message to them that talking about depression won't make us think less of them, and that support and help can make a difference.
I am reminded of this TED talk by Kevin Breel, a young comic who recalls coming very close to taking his life as a teenager. He was living two different lives, he says, one as a popular and successful high school student and stand-up comic, the other as a depressed and suicidal person. The anguish was too powerful to ignore, but too powerful to admit, too. "I was afraid someone would see that beneath my big personality hid an even bigger big pain. "
It was the difficulty of acknowledging his depression that drove him to obsess about ending his problems with a bottle of pills. "What you fear most is not the suffering inside of you," Breel said, "it's the stigma inside of others. It's the shame, the embarrassment, the disapproving look on a friend's face, the whispers in the hall that you're weak, the comments that you're crazy, so you hide it because the stigma around depression is real."
That's what we have to fight—to speak up, as Breel did, about depression, and to offer support to those we know are struggling.
Comedian Paul F. Tompkins brings it back to Robin Williams. "Perhaps the best tribute to him would be if we all reached out to the troubled people in our lives and let them know that we are here for them. Because Robin Williams was there for us."View Comments | Add Comment
Treating Schizophrenia Early, and as a Family Affair
Aug. 8, 2014 Harry Kimball
Thanks to the American Academy of Child and Adolescent Psychiatry newsletter for pointing us towards a story about a radical intervention for schizophrenia: treating it early, comprehensively, and involving everyone in a young person's life, including family and teachers.
The Washington Post reports on a program developed in Maine that identifies pre-psychotic young people and enrolls them in "an intensive two-year course of socialization, family therapy, job and school assistance, and, in some cases, antipsychotic medication." "Pre-psychotic" means they exhibit certain symptoms, like hearing voices or experiencing disorganized thinking, but have not yet had a severe psychotic break. Research suggests that kids in the program are more likely to have jobs or stay in school, and that the program has even dramatically reduced hospitalizations for psychotic breaks in some areas.
There are still big questions about this sort of early intervention for severe mental illness, particularly in regard to pre-diagnosis medication treatment. "That is not a benign intervention," a NIMH scientist tells the Post, in a considerable understatement. And no one claims that schizophrenia can be cured, or even truly prevented. There are many heartening personal stories in the Post article, but it would be foolish to say that the young people profiled aren't still at risk.
Still, the big picture view of mental illness the program espouses—biology, environment, interpersonal relationships—seems like a welcome evolution. As the Post reports: "A large part of the treatment focuses on the family; the Eugene program even helped one mother get a job."View Comments | Add Comment