Advice & Support

 "No one at any major news outlet understands the third variable problem." This is Erin Robinson, a neuroscience researcher turned independent game developer, explaining why news coverage that ties video games to acts of violence by adolescents is chronically flawed. For us non-statisticians, what she's saying is: "Just because two events are correlated, one does not necessarily cause the other."

In her fun and fascinating article, "The Top 10 Weird Children Of Video Games and Neuroscience," Robinson argues that most media sources that link video games to attention problems and/or violent behavior are going for the sensational headline and not the truth of (or at least the latest research on) the matter.

Take the widespread vandalism and looting in the UK last month:  News sources quoted everyone from police constables to pop stars (including former Oasis frontman Noel Gallagher) blaming it, at least in part, on the likes of Grand Theft Auto.

So, too, with coverage of Gevin Prince, a 15-year-old boy from Georgia recently charged with killing his great-grandmother, and injuring his grandmother, with a sword. A typical local newspaper headline read: "Authorities: Video Game Dispute Motive for Great-Grandmother's Death." As it turned out, video games had nothing to do with this horrible event. When the Atlanta Journal-Constitution took a closer look, the paper found out that Gevin has a history of mental illness, and his family had attempted repeatedly to get him the care he—and they—obviously needed, as he gradually spiraled out of control.

I don't consider myself anything like an apologist for video games. Despite the fact that I've been playing them for 30-plus years now (or maybe because of it), I've got my own ambivalences.  But when news sources choose to go the sensational route with these stories, they're doing more than failing to grasp the third variable problem. Ultimately, they're lazily and cynically scapegoating a form of entertainment at the expense of addressing an alarming and urgent reality—the truly tragic state of mental health care for children and adolescents in one of the most developed countries in the world.

In what appears to be a first, a Broadway show is setting aside a performance and tweaking sound levels, special effects, and the theater lobby to accommodate a sold-out crowd of families with children on the autism spectrum. The performance of "The Lion King" on October 2 has been orchestrated by the Theater Development Fund, a New York nonprofit.

Disney and the TDF have made some guesses that they hope will make the show more enjoyable for people with autism, like toning down sound cues and providing bean bag chairs. "But no one has been able to tell us what the effect will be of having around 600 children and adults on the autism spectrum in the theater at the same time," a TDF executive tells the New York Times. Another advocate and watcher was a little more optimistic when speaking with the AP. "Maybe they're not ready for this," she says. "But that doesn't mean we stop trying."

And even if no one knows what will happen when the curtain comes up, there is evidence that quite a bit of thought has been put into this trial run. For instance, as the AP points out, the TDF worked with Autism Speaks to develop a Social Story to post to their website. These are like first-person run-throughs that allow children with autism to get accustomed to new experiences and routines ahead of the actual thing, and have proven tremendously helpful in expanding kids' horizons.

"If I want to clap, I can," reads one section. "I don't have to clap if I don't want to.  If the clapping is too loud, I can cover my ears, wear my headphones, or hold my Mommy or Daddy's hand." 

Click here to read more about autism in all areas of society: in entertainment, at school, at home, and in the news.

Tomorrow is the deadline for New Jersey public schools to comply with the Anti-Bullying Bill of Rights, a new law that "is considered the toughest legislation against bullying in the nation," according to the New York Times. Among other requirements (the list runs to 18 pages) schools must have designated "anti-bullying specialists," employees must promptly investigate and write reports about every instance of suspected bullying at or after school, and every school will report results to the state government.

Reaction has been mixed, to say the least. "Now we have to police the community 24 hours a day," an administrator complains to the Times. "Where are the people and the resources to do this?" What's more, many teachers and other school employees are afraid that failing to live up to the letter of the law could now result in lawsuits. These appear to be legitimate complaints, and we hope educators don't look at the new initiative and think, "I need to cover my back or I'll get sued." Because the real impetus behind this move is kids who are in distress and deserve help.

As many people have commented online, bullying has always been there, but teachers and even other students have too often turned a blind eye. The new law makes it a requirement that teachers become involved, and stresses to students that doing nothing is as bad as being a bully yourself. A science teacher puts the new requirements in admirable perspective. Whether an incident that's investigated turns out to be bullying  or not, when you take a chance to look into it, "you're communicating with the kids," he tells the Philadelphia Inquirer. "If you're wrong and you overreacted, it will still be a positive outcome."

We don't know if the new staffing requirements will work out, or if the statewide reporting system will produce results, or if this will result in a flurry of litigation. But a valuable message has already been sent: Don't turn away.

A disease of the brain, no fault of the person who struggles with it—and yet it sparks fear, ostracization from family, schoolmates, coworkers, groundless and sometimes cruel attempts at treatment when sound, evidence-based medicine is available. This is the story of epilepsy in present-day Sierra Leone as described in the New York Times; but it is also the story of mental illness in much of the developed world over the past 100 years, a story that unfortunately has not reached its conclusion even today.

The trials and tribulations of people in the United States struggling with psychiatric and learning disorders generally pale in comparison to people with epilepsy in Sierra Leone, one of Africa's poorest countries. One woman—who has happily flourished and manages her seizures with the help of phenobarbital—was forced as a teen to inhale steam for hours in the hope that the demons inside her would leave. Later she was made to drink kerosene and almost died.

When it comes to proper treatment, which is becoming available, "the first hurdle is whether or not the family believes that this is an illness that can be treated," Sierra Leone's only neurologist tells the Times. The stakes in the country are high, but we can't help but draw a parallel to the mental health crisis here. (And we can only imagine that the mental health crisis in Sierra Leone is heartbreaking.) We don't lobotomize people anymore, and we don't burn people at the stake, but we do allow kids with autism to die in draconian residential care settings, and we do flood the prison system with people who desperately need professional help, and we do deny treatment, in effect, because we don't "believe" in mental illness.

"I was ashamed," says one Sierra Leonean woman who dropped out of school because of her epilepsy. Sadly, that sounds all to familiar even here.

The fact that Hurricane Irene didn't live up to doomsday expectations provides little solace for those dealing with the worst of the storm's physical aftermath. The same holds true for special-needs parents exhausted after their extreme weekend. While the wind and rain lashed outside, many were on hurricane alert inside their homes, too.

Certainly, millions of parents up and down the Eastern Seaboard had to contend with bored, quarrelsome children and teens cooped up over the seemingly endless weekend. But kids with psychiatric diagnoses including anxiety, ADHD, ODD and autism often have an extremely hard time with a lack of structure and a change in routine—not to mention far less physical activity—making them prone to meltdowns.

During the course of the storm, A Diary of a Mom checked in on Facebook with other parents of kids on the autism spectrum: "I pray that if you're in Irene's path you've managed to stay safe. That storm has wreaked havoc with everyone, but I'll be damned if our kids haven't gotten the worst of it.

"From turbo-charged anxiety to hypersensitivity to changes in pressure, our poor kiddos take a beating when any major weather system moves through—whatever it might be," wrote Mom, whose 8-year-old daughter has autism.  "Add in a lack of power (which is barely explainable at best to kids with difficulty processing abstract concepts) and throw a monkey wrench into our coveted routines and well, it's just hours of fun for everyone ain't it?"

There is anecdotal evidence that changes in barometric pressure worsen the impulsive behavior of children with autism and other diagnoses, including ADHD. And according to the Canadian Journal of Psychiatry there is at least enough data to warrant further investigation. Meanwhile, for more on Mom's weekend, as rearranged by Hurricane Irene, click here.

We just discovered on iVillage an amazing slideshow of 44 celebrities who've battled depression. It's fascinating who's on the list, since (obviously) it belies the stereotype that people with mental illness are underachievers. But it's also compelling to read the details the writers have pulled together of how/when these actors, musicians, writers and world leaders, were felled by it. Some went into profound depression after the death of a parent (Jon Hamm). Several had post-partum depression (Gwyneth Paltrow). Some had an eating disorder (Christina Ricci). Some became drug addicts (Russell Brand). It's stunning, and disturbing, how many said they seriously considered or attempted suicide (JK Rowling, Tim Gunn, Halle Berry, Owen Wilson, among others). It's also interesting to see what they say about what helped alleviate depression: cognitive behavioral therapy, medication, talk therapy, yoga, acting, songwriting—you name it, someone has found it helpful. Of course we think being honest about how you are feeling is the first step, and it's great that so many well-known people have gone public with their struggles.

In a provocative piece in this week's Time magazine, Judith Warner reports on what's called the "assertive-mating theory"—the proposition that the explosion in diagnoses of autism over the last couple of decades could be the result of many more couples who both have some autism spectrum traits, but not a full-blown disorder, getting together and having children. The proponent is Simon Baron-Cohen, Britain's leading autism researcher, an outspoken iconoclast who is something of a pop-science hero and, incidentally, the cousin of Sasha Baron-Cohen.

The theory goes like this: As more women began getting math and science degrees in the 1970s and 1980s, and more people starting meeting their mates at school or work, and the dot-com boom made people who are "high systematizers" more attractive, even if they had limited social skills, it follows that more people with some autistic traits are connecting with others who are "not only like-minded but like-brained."  Ergo their offspring may show a higher incidence of full-blown autism spectrum disorder.

There is, of course, serious skepticism about whether there are enough couples made up of two "strong systematizers" to account for the boom in diagnoses, and there is a risk in blaming parents for "causing" their kids' condition. But Baron-Cohen's theory got a boost, Warner reports, from a Dutch study reported in June that found four times more autism diagnoses in an area known as the Dutch Silicon Alley than another without the concentration of high-tech industries.

Could this kind of social change be a contributing factor to the autism boom? The story is worth looking at—unfortunately, you can read it here only if you have a Time subscription. Otherwise, it's at the newsstand.

I ran across an excellent piece by Jennifer Byde Myers, the mother of a boy with autism, who writes in her blog on Salon about how tempting it can be to abandon science when something you experience—in her case her baby's screams—makes an emotionally compelling case. She tells the story of taking her younger child, her 4-month-old daughter Lucy, to the pediatrician for routine vaccinations. At home, several hours later, she picked Lucy up to nurse her and the baby began to wail inconsolably. 

When holding her tight didn't comfort her, Jenny was sure Lucy was having an adverse reaction to the vaccine, and rushed back to the doctor's office in a panic. "Oh my God," she remembers thinking. "My child had her shots two hours ago, and now she is a different child. This is how it is, one minute the child is there, then they're gone; that's what I've heard. My daughter has autism. Oh my God." Later she sums up: "I broke the baby."

She tells the rest of the story better than I can here, and she makes two important points: First, how terribly painful it is for parents when they feel—and often they are led to feel—that something they did caused a child's psychiatric disorder. And second, how important it is not only to put our trust in science, rather than celebrities, but to speak up for science "when pseudo-, or non-science is being given equal weight."

An African American woman named Ruth White has a terrific piece on the Huffington Post about how she lives with bipolar disorder. Okay, she brags a bit about all the things she's done, including getting two graduate degrees, raising a child, mountain climbing, kayaking the White Nile, winning tenure, starting a maternal and child health project in Africa—you get the idea. But she also talks about how long she hid her disorder and avoided getting help. "I tried running, acupuncture, yoga, Chinese herbs, meditation—anything but "mainstream" medical attention. I did not want to go to a psychiatrist, because 'nothing is wrong with me. I'm not crazy!' "  

Finally she decided that being strong does not exclude getting help. "Superhero status is not required. I cannot save the world, and sometimes I'm the one who needs saving." She acknowledges that she will probably need professional help, and take medication, for the rest of her life.

Her brave and insightful piece is addressed to African Americans, who she thinks are particularly prone to stigmatize mental illness as weakness and refuse to accept that it's a "real" problem. "Instead, to deal with our psychic pain we eat our way into life-threatening obesity, excessively use alcohol and drugs and act out violently through word and deed." She encourages others to "come out" about their disorders, and to support their friends by urging them to get help rather than hide their struggles. We couldn't agree more. 

We haven't read deeply about this, but a new study suggests that an educational approach to adolescent depression called "Surviving the Teens" could have a positive effect. The study, published in the Journal of School Health and summarized by Science Daily, concludes that self-reported suicidal thoughts and behaviors in teens were down up to 65% after the year-long program in school. Of course, we don't know if these structured outreach methods will be shown to consistently produce results or not. One of the coauthors agrees: "We don't claim that Surviving the Teens is the answer to suicidal behavior."

But, he continues, "we are very encouraged by the research so far indicating how helpful the program might be." And there is one area in particular that we are quite excited about. After the program, the participants filled out a survey, and a whopping 72% said they would now talk more with their parents about their problems. 81% said they'd be more open with friends, and 90% said they'd encourage friends to ask for help if they were worried about them. Regardless of the ultimate accuracy of these numbers, teaching teens that it's ok to reach out for help is admirable, and one of the most important things we can do. Because not getting treatment can be tragic—and getting help can change young lives.