Showing posts with label autism-spectrum disorders. Show all posts
Showing posts with label autism-spectrum disorders. Show all posts

Wednesday, October 29, 2014

RSA Replay: Mind Change - Susan Greenfield

http://masszip.com/wp-content/uploads/2014/06/Mind-Change-How-Digital-Technologies-Are-Leaving-Their-Mark-on-Our-Brains.jpg

The video included here is of "Baroness" Susan Greenfield speaking at The RSA about her new book, Mind Change: How Digital Technologies Are Leaving Their Mark on Our Brains (to be released in the U.S. in January, 2015). Her talk was mired in controversy before she ever opened her mouth (see the details in the first companion article below).

Besides the video, I am sharing two articles from The Guardian, both of which are critical of her and her new book, and her refusal to debate other neuroscientists about her "findings."

RSA Replay: Mind Change

Streamed live on Oct 2, 2014


Leading neuroscientist Susan Greenfield considers the vast range of technologies that are creating a new environment around us, and asks: how can we ensure these powerful forces bring out the best in us, and allow us to lead more meaningful, more creative lives?
* * * * *

Despite the fact that Susan Greenfield is a regular contributor to The Guardian, two recent articles take her and her new book out behind the woodshed for a beating. Here are both of them - and the second one is a very detailed take-down of her social commentary parading as science.

Susan Greenfield: why is she reluctant to engage with 'mind change' critics?

The ‘mind change’ activist’s latest attempt to warn us about the dangers of modern technology highlights how arguments from authority should never trump arguments based on evidence


Pete Etchells and Chris Chambers | October 3, 2014



Susan Greenfield: why does she continue to refuse to engage with proper scientific publishing processes? Photograph: Murdo Macleod/Murdo Macleod

Baroness Susan Greenfield has a new book out, which means that she’s back on the media circuit to promote her controversial ideas about how technology affects our brains. In her latest foray on Thursday she gave a lecture at the RSA in London on “Mind Change’, an event mired in controversy before a single word was uttered.

In the lead-up, the author of Bad Science, Ben Goldacre, claimed that he was originally approached to chair the discussion but the Baroness objected to his taking this role, at which point the RSA (rather ironically) changed its mind and retracted its invitation to him.

We contacted Greenfield to verify this claim and she responded through the RSA’s director of external affairs, Nina Bolognesi. Bolognesi stated that “Dr Goldacre was invited by the RSA to chair an event with Professor Greenfield. However, Professor Greenfield’s preference was to have a balanced debate with Dr Goldacre, on a subject where the title was mutually agreed, with Chair holding a neutral view. On Sept 2nd Dr Goldacre declined this offer as he felt he was not an expert on the topic being presented by Professor Greenfield.”

It’s frustrating that the RSA was not more assertive in its original suggestion for the event – it would have been refreshing for the charity to host a more honest, critical debate, and Goldacre would have made an excellent chair.

Aside from this though, the RSA event was disappointing for other reasons. You can watch a recording of it here [posted above], and it’s worth noting that the chair appears to make an effort not to solicit any questions about Greenfield’s position as a controversial public figure. At the outset, Greenfield asks the audience not to use Twitter during her talk – thus attempting to shut down free debate of her ideas, and attempting to impose a didactic, one-way flow of information. If anyone were in any doubt that the Deficit Model is still alive and kicking, then this serves as a reminder that there is much work to be done.

What we’re starting to see in some of the interviews with Greenfield is a gradual amplification of criticisms she has faced over the last few years. The most prominent criticisms were posed by Goldacre in 2011, when he asked why the Baroness refuses to publish her claims within a scientific journal, where they can go through the usual process of scientific scrutiny and peer review. Her response to this has been varied. On the BBC last year, she retorted with “How can I publish just one paper?”. In other interviews, she argues that it shouldn’t matter who publishes on the matter – in her own words “It doesn’t make it more or less valid if I’ve done it or if someone else has.”

No one has ever reasonably asked any scientist to produce a single study to substantiate any one claim. That’s simply not how science works and Greenfield can’t possibly be so naïve as to believe otherwise. But her responses cast an either-or mindset; either you can produce one study, or nothing at all. This is a bizarre standpoint because there is a wealth of studies that could be run – and are being run – to look at all sorts of aspects of technology use, and we’ve discussed some of them here before. Only by running relevant studies can we move beyond the same old surface-level debates about simplistic concepts (like screen time) that don’t have much bearing on the real world.

Most critics of Greenfield don’t take issue with her voicing an opinion. It’s perfectly acceptable to have a view on a subject without having conducted research in that area. However, when you position yourself as such a prominent and persistent advocate of a particular view that has a testable scientific base, you should lead by example – especially when you are a scientist yourself. Develop expertise in that area. Force your arguments to stem from evidence, never from authority. What better way to silence what Greenfield sees as personal criticism than to actually do the research? Greenfield has had more than enough time and funding to lay her cards on the table.


But of course this hasn’t happened. Instead we’re subjected to the same tired arguments and rhetoric. Through what can only be described as a campaign of media manipulation, Greenfield shows that she is afraid of what actual data might reveal. She has adopted the mantle of the pundit who attempts to hoodwink her audience into confusing her personal views with hard facts. But the public isn’t so easily fooled by scaremongering. While the RSA debate offered no insight on “mind change”, it shows one thing clearly. Greenfield has become lost in a sea of her own ideas and is either unwilling or unable to add anything meaningful to the debate about technology.
* * * * *


Mind Change: Susan Greenfield has a big idea, but what is it?

A poorly researched diatribe on the ‘youth of today’, Susan Greenfield’s exploration of Mind Change reads like a Littlejohn column wrapped in the trappings of science


Martin Robbins | October 3, 2014

Bland, logical statements


12 February 2009. In the House of Lords chamber at the Palace of Westminster, Lord Harris of Haringey holds the floor. “My noble friend had some unfortunate experiences when he placed his profile on Facebook a couple of years ago,” he explains, “receiving what the Sunday Times describes as an avalanche of suggestive comments of the ‘Hello, sailor’ variety.”

The Lords have met to hold a debate on the use of social networking sites by children, and the adequacy of safeguards to protect their privacy and interests. As Harris concludes his opening remarks, the Baroness of Ot Moor, Susan Greenfield, rises to her feet to make a statement. There are two different accounts of what happens next.

The first appears in the opening pages of Baroness Greenfield’s new book, Mind Change. One of few scientists to hold a seat in the upper house of Parliament, she tells us that she “decided to present a perspective through the prism of neuroscience,” explaining to the assembled peers, “firstly, the human brain adapts to the environment; secondly, the environment is changing in an unprecedented way; so thirdly, the brain may also be changing in an unprecedented way.”

Greenfield claims to find the controversy that followed inexplicable: “The reaction by the international print and broadcast media to this seemingly bland and logical statement was out of all proportion to its content. Needless to say, I had to endure the inevitable press misrepresentation resulting from a priority of selling copy over actual truth: ‘Baroness says computers rot the brain’ was just one of the more lurid headline-grabbing efforts of one sub-editor.”

The second version comes from Hansard’s official record of what was spoken in the House of Lords that day. “It is hard to see how living this way on a daily basis will not result in brains, or rather minds, different from those of previous generations,” the Baroness explained. Answering her own question, “what might now be in jeopardy?” she listed attention spans, the ability to delay gratification, and empathy. “The mid-21st century mind might almost be infantilised, characterised by short attention spans, sensationalism, inability to empathise and a shaky sense of identity.”

In the five years since that debate, Greenfield has continued to drop her unique brand of “bland, logical statements” on the public with predictable results. Her articles in the press state, in her own words, “one simple fact: the human brain, that most sensitive of organs, is under threat from the modern world.” We are told that our brains are under “widespread attack”; we must wake up to, “the damage that the gadget-filled pharmaceutically-enhanced [world] is doing to our brains”; and sites like YouTube are causing, “the fragmentation of our culture.”

Over the same period, the Baroness has faced growing criticism from leading figures in science and medicine, such as Ben Goldacre and Oxford neuropsychologist Dorothy Bishop. Their request to her is simple: please stop writing op-eds for the Daily Mail, and start presenting your findings in an appropriate peer-reviewed forum.

Mind Change isn’t peer-reviewed, but it’s the closest thing so far to a response. In it, Greenfield lays out her entire argument for the first time; 385 pages of neatly referenced reckonings on the state of our brains and technology’s role in changing them.


Hipster Galileo and the Brain Apocalypse


So what exactly is Greenfield’s idea? In 2012 I wrestled with this question, piecing together fragments from her various articles, and concluding the following. “Greenfield’s hypothesis is that an unknown level of exposure to an unspecified subset of modern technologies may be affecting an indeterminate number of people’s brains in an undefined way, with a number of results.”

I wasn’t far wrong. “The argument underlying Mind Change … goes like this: the human brain will adapt to whatever environment in which it is placed; the cyber world of the twenty-first century is offering a new type of environment; the brain could therefore be changing in parallel, in correspondingly new ways.”

The similarity with “climate change” is deliberate of course. Greenfield compares herself to the plucky pioneers of the green movement in the 1970s and 1980s, fringe groups fighting against the tide whose ideas would soon explode into the mainstream, defining one of the key debates of our generation. She writes as if she sees herself as a sort of lead hipster of the forthcoming brain apocalypse.

The comparison doesn’t work though. Whatever your views on climate change, the phrase represents a clear and testable idea. Human processes are generating carbon dioxide. This accumulates in the atmosphere, at higher levels than would occur naturally. The extra CO2 traps heat that would otherwise have radiated out into space. Storing this extra energy in our skies, land and oceans leads to higher average temperatures and more volatile weather.

Sure, there are complexities and nuances and caveats and exceptions and all the usual baggage that comes with making predictions about a complicated world; but the basic idea can be written down and understood. You can make predictions from it that people can take out into the real world, measure, and test.

Greenfield can’t say the same for her idea, because there just isn’t enough substance to it. Brains adapt to new things, our environment has changed rapidly over the last few hundred years, and presumably this has some effect on us. Nobody really disputes that, but what effects exactly, and through what mechanisms? Where are the “Mind Change” equivalents of higher surface temperatures or CO2 emissions – the things we can measure and study?

So at the end of the third chapter, she attempts an extraordinary gambit. “Mind Change”, she insists, is not a hypothesis but a whole new paradigm. As a consequence, it cannot be tested like a conventional theory; those calling for her to produce evidence are missing the point. Greenfield’s idea is beyond the realms of “proof”.

“Absence of evidence is not evidence of absence,” she observes, “Thus it is impossible to demonstrate definitively that screen-based activities have no effect at all on the brain or behaviour, any more than I or anyone could prove definitively, to use an age-old example,” here it comes, “that there is not a teapot in orbit around Mars.”

So you can’t disprove the existence of Go… sorry, Mind Change, but surely you can provide some sort of evidence that it exists? “It is impossible to demonstrate just as conclusively that screen-based activities are having an unequivocal effect on the brain.” Why? “A flock of swallows rarely make a summer, and few single peer-reviewed papers … are viewed unanimously by all scientists as conclusive.”

This carries on over several pages that wouldn’t look out of place in a creationist pamphlet. She paints a picture of science filled with dogmatic old sods who refuse to accept new ideas. She invokes stories of brave mavericks like Nobel prizewinner Dr Barry Marshall, who gamely swallowed bacteria to prove they caused stomach ulcers, in defiance of conventional medical opinion at the time. Wisely, she steers clear of Galileo.

It’s clear how Greenfield sees herself and her place in science, but her examples are self-defeating. Marshall and his colleague, Dr J Robin Warren, made a clear prediction. They tested it, they presented the evidence, and minds were changed.

Why can’t Greenfield do the same?


How Facebook ruined the 80s


The table of contents provides one clue to the answer, covering a broad but erratic sweep of social networking, video gaming and web search. “One deliberate omission is the field of internet pornography,” Greenfield explains, “where the controversy and debate are obviously not so much about whether it is ‘good’ or ‘bad’ or about how it impacts on types of thinking, but more about legislation and regulation, which are outside the scope of the journey here.”

If that exception sounds a bit odd, what makes it downright astonishing is that in 2012 Greenfield backed a political campaign for default-on internet porn filters, citing the “vulnerability” of the developing brain. “If I had to choose between unfettered internet access, and having children potentially harmed psychologically or worse by porn sites, then for me the decision is an easy one,” she told the Mail.

Why the omission now? For that matter, why leave out the impacts of television, texting, the telephone, or other technologies that have radically altered our lives? What about electricity, the arrival of which completely transformed our sleeping and eating habits?

What’s never really explained is how the technologies that are included in her analysis are different from those that are excluded. Without that clarity, her story twists into irretrievable knots. Short videos on YouTube are presented as new, alien and risky because they erode attention spans; but short cartoons on television in the 1950s were part of a healthy and balanced upbringing because kids didn’t spend too long watching them.

To make matters worse, over time you detect the scope changing, expanding and contracting as needed to suit the arguments or evidence on a given page. “Technology is not necessarily being used in moderation,” the professor tells us at one point. “Entertainment media use in the United States among the young is, on average, more than 53 hours per week.”

Okay, but we’ve switched from video games and the internet to include television and “entertainment” more generally. It sounds pernickety, but it’s a huge problem. Throughout the book Greenfield insists that the change we’re seeing in the internet era is unprecedented, even compared to the emergence of electricity, telephone or, television; but her case studies keep collapsing because they fail to distinguish between the effects of “all of the above”.

For example, she points to a 90% reduction since 1970 in the ‘radius of activity for a child’, the area of the world they wander freely around in. This is a real and well-documented problem, but it’s not clear at all how this relates to video games, the Internet or social media websites, which wouldn’t appear for another 15, 25 or 35 years.

Are fewer children playing outside because of screens, or is it down to other factors: paranoid parenting, television, urban planning, or more parents driving their kids to school? It’s an interesting question, and the honest answer is probably that we don’t entirely know. Greenfield simply bulldozes her way though all that complexity, uninterested in alternatives. It’s just another another side effect of our screen-based lifestyle. Facebook’s clear and obvious impact on the children of the 1980s.

Which brings me back to the table of contents. The twenty chapters include sections of social media, video games, web surfing, and search engines. It’s exact;y what you’d expect from a book by Susan Greenfield, but wait a minute: isn’t this the wrong way round?

Most scientists set out to investigate a phenomenon. This thing is happening – why is that? On that basis you might expect to see chapters on shrinking attention spans, rising rates of depression, generational changes in empathy, and so on. Susan Greenfield’s investigation begins with a pre-conceived list of answers.


More selfish, or more screwed?


If new technologies are having a big impact on our society then it should be visible in certain population trends; the way we can detect the impact of smoking through cancer rates. Sure enough, trends become Greenfield’s favourite weapon in this book. She wields them like an overenthusiastic kid with their first hammer, battering away at the world with reckless abandon.

Take the decline in attention spans of schoolchildren, as Greenfield does. It’s fair to say that a lot of teachers agree with the professor and blame this on new technologies. The assumption is that kids are so over-stimulated by their diet of Grand Theft Auto, Snapchat and instant messaging, that sitting in a classroom with an adult droning at them all day seems slow and dreary in comparison.

That’s plausible, but then it’s also the case that kids aren’t getting as much exercise as they used to, and we know that lack of physical activity can affect performance on tasks requiring concentration. We know that teaching methods and standards will have changed in the same period. We know that IQ has been ticking upwards. There are many alternative explanations here and I’m not singling any out, but Greenfield seems singularly uninterested in exploring them.

Next up is empathy, which, we are told, is in decline. What researchers really mean by that is that kids answer a bunch of questions in a survey differently than their parents did 30 years ago. Data for previous generations doesn’t exist, so we can’t set this against any longer-term benchmark. Does it mean I’m part of a selfish generation? Do these measures have any real correlation to real world actions?

Greenfield quotes studies that show younger people volunteer less, but that’s not surprising when we have to work longer hours to pay higher university costs, and when buying a house is now beyond the reach of most young families. Are we more selfish, or are we just more screwed, facing the pressures of higher debt and lower standards of living than our parents?

Is more empathy even a good thing, as Paul Bloom asks in a fascinating essay? People with greater empathy are more likely to report asymmetrical relationships, and more prone to depression and anxiety. Women tend to score higher in tests of empathy, and this could easily set them at a disadvantage in the workplace.

None of these questions are even brought up, let alone tackled, and we’re left with more “ifs” than a Kipling poem. If the measure of empathy is accurate. If that translates into lack of kindness. If more empathy is always better. If the previous generation weren’t just an outlier. If this could somehow be linked to the rise of the internet rather than perhaps a change in parenting styles as researchers investigating the decline have suggested. If. If. If.

Apparently the kids can’t read either. “Already literacy standards are declining,” Greenfield asserts. “Research has shown that many children are more likely to own a mobile phone than a book. Another study … found that teenagers now prefer easier reads such as the Harry Potter and Twilight Series.”

Let’s set aside the million-plus words of the Harry Potter series for a moment. Greenfield’s statement is both vague and untrue. Literacy levels in England have been rising, not falling. It’s true that we’ve slipped behind other countries (22nd out of 24 countries in the developed world last year) but who leads the index? Japan – a country not entirely unfamiliar with video gaming. That valuable piece of context is conveniently omitted.

Of course as soon as the trends disagree with Greenfield’s assumptions, she finds reasons to ignore them. She notes for example that, “the violent crime rate is going down while the popularity of M-rated video games has increased.” But? “But then decreases in crime rate are most likely to be caused by a host of complex socio-economic factors.”

Oh so now it’s more complicated …


Whatever you want to see


At times, this greedy extrapolation goes beyond exaggeration to complete fiction. Research is present which simply doesn’t say what Greenfield claims it does. Take the following paragraph:


In a survey of US youth aged between 10 and 19, gamers spent 30% less time reading and 34% less time doing homework. Granted, it is hard to separate the chicken from the egg: perhaps children who perform more poorly at school are likely to spend more time playing games, which may give them a sense of mastery that eludes them in the classroom. We need to go beyond correlation to cause: but what we can’t do is just ignore the problem altogether.

Wait a minute, “perform poorly at school”? The study only recorded how long kids spent on various activities. It said absolutely nothing about academic performance and didn’t even attempt to investigate it, a fact the authors make crystal clear in their paper. “An important next step for future research will be to assess the ways in which video game play is related to academic and social outcomes.”

The survey was published in 2007. The following year one of the authors, Elizabeth Vandewater, actually took that next step in a review of research conducted up to that point. “Most studies find a small negative link between the total hours a child spends viewing TV and that child’s academic achievement. But when researchers take into account characteristics of the child, such as IQ or socioeconomic status, this link typically disappears.”

Earlier this year, PLoS One published a vast meta-study looking at data from 192,000 kids in 22 countries. Their conclusion? “Contrary to claims that increased video-gaming can impair academic performance, differences in academic performance were negligible across the relative frequencies of videogame use. Videogame use had little impact on adolescent academic achievement.”

Other studies may disagree, but my point here isn’t whether the conclusion is right or wrong, but that Greenfield is saying things about the research she cites that simply aren’t true. There’s no reason to assume that gamers who do their work faster do it less well – they may just be more motivated, more intelligent, or members of households that are higher on the socioeconomic ladder.

Then we have data taken completely out of context, like the literacy data earlier. “The culture of social networking may predispose users to a narcissistic mindset that in turn enforces low self-esteem,” she declares. “This in turn encourages the development of an exaggerated or completely different identity: the hoped-for, possible self.”

That might seem a bit extreme, but:


It is precisely what might now be happening. Kidscape, a British charity that helps prevent bullying and protects children, conducted a survey in which they assessed young people’s cyber lives through an online questionnaire. Of the 2,300 or so respondents … one in two say they lie about their personal details on the internet. Of those, the one in eight young people who speak to strangers online are the most likely not to tell the truth, with 60% lying about their age and 40% about their personal relationships.

Greenfield goes on to explain how this highlights “the fact that children often create a different persona when they interact with others, especially strangers, in a way that they wouldn’t in the real world.” Taken in isolation, all this sounds terrifyingly dystopian. But before we call the wahmbulance, let’s put this in context.

It turns out – and this may shock you so please, prepare yourself – teenagers lie. Research suggests that up to 98% of teenagers lie to their parents, and the other 2% were probably lying about whether they lie to their parents:


The teens lied about what they spent their allowances on, and whether they’d started dating, and what clothes they put on away from the house. They lied about what movie they went to, and whom they went with. They lied about alcohol and drug use, and they lied about whether they were hanging out with friends their parents disapproved of. They lied about how they spent their afternoons while their parents were at work. They lied about whether chaperones were in attendance at a party or whether they rode in cars driven by drunken teens.

In other words, and contrary to what Greenfield seems to believe, teenagers in the real world lie. They lie about personal details, they lie about their age, they lie about all the things they lie about online and they do it to your faces.

What does this all mean? I wouldn’t like to guess. I don’t know whether these statistics are indicative of some broader problem in society or not. What puzzles me is why Greenfield is so completely uninterested in finding out. Why she fails to ask any meaningful questions about almost any of the research she cites, to spend the 10 minutes it took me to find eg Vandewater’s follow-up today, or to critique and analyse what she covers in any substantial way.

It’s not that she’s necessarily wrong; it’s that she just doesn’t seem to care whether she’s right. All that seems to matter is that it can be twisted into the right shape to fit the preset list of answers she started the book with.

Of course I’m just as biased as Greenfield is, but that’s really my point: without good scholarship, if you cram together all these trends and charts and statistics you end up forming a kind of Rorschach test. You can find in those squiggly lines whatever you want to see.


Raindrops and Autism


In 2011, Greenfield was interviewed for New Scientist about what by now had become her pet subject. “You think that digital technology is having an impact on our brains,” asked the journalist Frank Swain, “So what evidence is there?” Greenfield’s response included the line, “There is an increase in people with autistic spectrum disorders.”

The comment sparked a storm of protest, with two main lines of criticism emerging. The first was scientific. One of Greenfield’s colleagues at Oxford, professor of developmental psychology Dorothy Bishop, took the step of writing an open letter pointing out Greenfield’s failure to grasp even the most basic facts about the topic:


A cause has to precede its effect. This test of causality fails in two regards. First, demographically – the rise in autism diagnoses occurred well before internet use became widespread. Second, in individuals: autism is typically evident by two years of age, long before children become avid users of Twitter or Facebook. You also seem unaware of the large literature discussing possible causes of the increase in autism diagnoses, most of which concludes that most, if not all, of the increase is down to changes in diagnostic criteria.

The second criticism was more visceral:


You may not realise just how much illogical garbage and ill-formed speculation parents of children with these conditions are exposed to. Over the years, they’ve been told that their children’s problems are caused by their cold style of interaction, inoculations, dental amalgams, faulty diets, allergies, drinking in pregnancy – the list is endless. Now we can add to this list internet use.

As Tom Madders of the National Autistic Society told the Guardian:


It’s very unhelpful … to have any suggestion that computers might have a harmful role when so many people with autism, and who are very socially isolated, find they can communicate through email and the internet.

Defending her comments, Greenfield issued a dismissive and bizarrely passive-aggressive remark that went on to spawn a Twitter meme: “I point to the increase in autism and I point to internet use. That’s all.”

In Mind Change she revisits the subject in – marginally – more detail. She back-pedals slightly, replacing “autism” with “autism-like trait”, but her writing suggests that Greenfield – who has no experience or expertise whatsoever in autism research – sees little meaningful difference between the two terms.

The studies that Greenfield puts forward here are utterly bewildering. One shows, according to Greenfield, that excessive internet use “has been associated with a lack of emotional intelligence.” The abstract of the paper describes this as a “weaker effect”, but more problematic is that the paper dates back to 2004 – before Facebook and Twitter even existed, online demographics were rather different to today, and a lot of students were still pretty new to the internet. Does the association suggest internet exposure causes a drop in emotional intelligence, or did the internet in its early days draw people with lower EI in the first place? Who knows. Who cares.

Another study examines the EEGs of people looking at faces, and concludes that “young” excessive internet users might be slightly slower. It’s speculative at best, and tells us pretty much nothing, but Greenfield performs a bait-and-switch, comparing the result to “infants who cannot track their mother’s face often become autistic”.

Then we head into the realms of the truly weird. Greenfield cites a pair of studies by researchers at Cornell exploring the relationship between TV viewing and autism diagnoses, and how in Greenfield’s words there might be “possible associations between technology use and the later development of autism.” The authors compared the amount of rainfall – rainfall – in various counties against cable TV subscriptions and autism rates.

Leaving aside the observation that TV seems to have crept back into the ever-changing scope of Greenfield’s book, there’s a pretty obvious explanation for these results. We already know that autism diagnoses are well correlated to socio-economic status – rich people are more likely to get their kids diagnosed. What else correlates with social demographics? Cable TV subscriptions. As for rainfall, well most of the richer states in the US aren’t in the dust bowl.

It’s hard to understand the kind of arrogance that would lead to a person with no expertise in the field drawing this kind of literature together to make broad statements about autism, and feeling so confident about it that they would be willing to spark stories about it in the national press. For most of the book, Greenfield’s sloppy scholarship is just irritating. On a topic as sensitive as autism, a subject already wracked with controversy in recent years, it crosses the line into something frankly unacceptable.


“Well, Twitter is part of the environment”


What about Greenfield’s own research? The “About the Author” blurb at the front of Mind Change informs us that, “She specialises in applying neuroscience to fundamental issues such as the impact of 21st-century technologies on the mind.” This is a whole book about that subject, so you would expect to see some of that work making an appearance.

This is something the Baroness has been challenged on in the past. Ben Goldacre has publicly questioned her unwillingness to publish on numerous occasions over the last four or five years, with no response:


If a scientist sidesteps their scientific peers, and chooses to take an apparently changeable, frightening, and technical scientific case directly to the public, then that is a deliberate decision, and one that can’t realistically go unnoticed. The lay public might find your case superficially appealing, but they may not be fully able to judge the merits of all your technical evidence.

I think these serious scientific concerns belong, at least once, in a clear scientific paper. I don’t see how this suggestion is inappropriate, or impudent, and in all seriousness, I can’t see an argument against it.

Mark Henderson, author of The Geek Manifesto, tackled Greenfield directly on the subject in a debate on Channel 4 News two years ago. “So far as I’m aware, and please do correct me if I’m wrong,” Mark offered, “you haven’t published anything in the academic literature on this, which is – as you know as a scientist – the proper forum for raising such concerns; and I’m very interested to know why you haven’t done that and whether you intend to?”

Greenfield replied, “If the argument is, as a neuroscientist, have I published on the impact of the environment on the brain” – it wasn’t – “then yes I have.”

“But on Twitter specifically?” Mark badgered.

“Well Twitter is part of the environment,” Greenfield responded, unconvincingly.

I’ve looked for relevant work, on her institution’s website and elsewhere, but I can’t find any. The only thing I can say for sure is that none of this work seems to have made it into her book.


Kids these days


Last year Greenfield had the opportunity to set out her ideas in fiction; a dystopian thriller set in the year 2121, which she called “2121”. The title was intended to draw comparisons with Orwell’s 1984 … and one suspects between Greenfield and Orwell.

Reviewing the novel for Vice magazine I described it, charitably I thought, as “a disease vector for stupidity.” She showed us a world in which generations of digital natives raised on video games and social networks were incapable of wisdom, social contact, and even sex. In fairness to Greenfield, she managed to produce one of the most erotic scenes ever written, which I described as follows:


Fred was already loosening the Helmet strap with the other hand that wasn’t angling my chin,” Sim begins. Asked by Fred to remove her “dress thing”, Sim then explains, “It was still stranger now to step outside of my garment. I only did so in the wash-waste, and never outside.” Then they have sex, at which point Fred realises that Sim may not actually know what sex is, which carries the awkward and tragically unexplored implication that Fred is actually a rapist. “Sim,” asks Fred, “do you know what we’ve just done?” “I think so. I think the Fact-Totum says it’s what people used to do before the reproduction programs made everything so much easier.

Once my erection had subsided, it was hard to get past the realisation that this is how Greenfield sees my generation. Once you peel away the scientific gloss, you end up with a laundry list of the sort of dismissive comments that middle-aged, middle-class curtain-twitchers have been making about “young people” for generations. Lazy, degenerate, selfish, good-for-nothing … the kind of comments that, applied to race, gender or ethnicity, would be considerably harder to defend.

It’s clear that Greenfield sees mind change as a particular threat to the young, but her entire understanding of “young people” is ambiguous and outdated. Just as the set of technologies she talks about changes from chapter-to-chapter; her definition of “young” never quite settles on a specific age group or cohort.

In a live-streamed lecture to the RSA yesterday I heard her suggest that today’s teenagers were the first “digital natives”, but that simply isn’t true. I turned 33 last week, and I was among the first generation of kids to get the internet as a teenager. Kids who were hitting puberty at the turn of the millennium are now pushing 30 and having kids of their own.

The Baroness tells us that: “The digital divide means that parents do not necessarily feel equipped to help their children.” That stereotype might have been true a decade ago, but in 2014 it’s utter nonsense. The latest cohort of parents grew up in the internet era – most of them are digital natives too, and well aware of the perils and pitfalls of cyberspace.

There’s a bigger problem looming for Greenfield here. In the same RSA lecture, she invoked this idea of “teens as the first digital natives” to suggest that mind change was a looming threat for the near future; but if the highly plastic brains of most people under 40-odd are already immersed in this new environment, the radical change should already be upon us. So where is it?

Coupled to that vague notion of “youth” is a proud ignorance of modern technology, and an open contempt for its users. In the same House of Lords debate we began with, she spoke of, “the baffling current preoccupation with posting an almost moment-by-moment, flood-of-consciousness account – I believe it is called Twitter – of your thoughts and activities, however banal.” In an interview with the Independent she said of Facebook: “I don’t have to go bungee-jumping to have an opinion on it.”

That ignorance regularly leaves her unstuck. On the topic of video games, Greenfield’s lack of comprehension and inability to distinguish between different genres of game causes her thesis to fall apart at the seams. Discussion veers between “games”, MMORPGs and “action games”. Considering her interest in social networks, it’s odd that the social and group aspects of multiplayer gaming are basically ignored. “Video games reward players for quickly modifying their behaviour when conflict is experienced,” she claims. It’s a nonsense statement that could only come from someone oblivious to the broad scope of gaming in 2014, when most recent hits rely on planning, cooperation and delayed gratification.

Of course, people like Greenfield don’t play video games. It’s almost impossible to separate Greenfield’s analysis of our society from the champagne-clutching position she holds within it. The “cultured” activities enjoyed by her peer group escape criticism. The TV she grew up with was fine, obviously. But the tweeting gamers who fail to conform to a middle-aged, middle-class ideal of the book-loving, theatre-going, London socialite are weird, wrong, pathological, immature.

“At a formal breakfast I attended recently where the main speaker was the British deputy prime minister, Nick Clegg, the woman sitting next to me was so busy tweeting that she was at a breakfast with Clegg that she wasn’t actually listening to what he was saying.” Well, maybe he wasn’t that interesting … but one suspects that the former director of the Royal Institution struggles with the idea that a man of such status shouldn’t be listened to.

It’s all weirdly counter-productive. The more Greenfield insists that the people she describes – invariably less fortunate than herself – are defective or antisocial, the more she appears so herself.


Do something …


With no central argument to hang it on, the flesh of Mind Change collapses into a sub-Gladwellian mash-up of hand-picked studies, just-so anecdotes and carefully interpreted statistics. There’s no sense of progress toward any conclusion, just a long gallop of facts and figures that leave the reader with the impression that, well, something must be wrong with all these damned screens about.

“It’s up to us to be proactive and to do something.” That’s Greenfield’s challenge, but there’s a catch. “For Mind Change there is no answer as such, because there is no clear question or goal.” Had this sentence been placed at the beginning of the book rather than the end, a lot of people would have been saved a lot of reading.

You can’t argue against Greenfield’s ideas because when you boil away all the conjecture, the unanswered questions, the innuendo, what’s left is … nothing much.

It’s not that the topic isn’t worth talking about. The world is changing, and our brains are adapting to that new world. Good analysis and research looking at the co-evolution of mind and society can only be a good thing. The problem is that Greenfield adds absolutely nothing to this debate. Her manuscript is a 384-page recital of the oft-mocked phrase common in scientific literature: “more research needed.”

Greenfield shows a complete lack of interest in both the research she cites and the technologies she critiques. Conclusions and positions are misrepresented, but often it seems less deliberate than lazy. She cherry-picks literature that appears to support her case but shows little indication of having read much of it, or asked the kinds of questions that leap from the page on even a casual reading. The professor displays one of the biggest character flaws a scientist can have: a lack of curiosity.

Then there’s the attitude, which stinks. Mind Change opens with a passive-aggressive misrepresentation of her own speech to the House of Lords. She insisted to New Scientist, “I didn’t say, and I’ve been misquoted universally, that [technology] rots the brain and it’s bad, I’ve never given value judgements, ever.” This from the person who spoke of “the damage that the gadget-filled pharmaceutically enhanced [world] is doing to our brains.”

She refuses to respond to or engage with critics like Dorothy Bishop or Ben Goldacre in any meaningful way. When the latter was due to participate in an event with her at the RSA yesterday, she demanded they drop him from the role of chair. When some of Goldacre’s criticisms were put to her, she replied (incorrectly): “He’s not a scientist, he’s a journalist.” Good science needs good criticism; but Greenfield has built herself an echo chamber.


But then this isn’t really science at all. Greenfield’s work is bog-standard social commentary disguised as neuroscience. She has witnessed profound changes in our society over the last 65 years, and she doesn’t like them. The kids of today aren’t polite enough, aren’t respectful enough, they’re spoilt brats and infants, they haven’t grown up properly like we did, they’re not as clever as us, they mock me on their weblogs. It was all much better in the fifties.

Once you peel away the scientific veneer, you find a series of statements that wouldn’t look out of place coming from a pub bore or a Richard Littlejohn column. And then you start to detect what makes her columns and speculations so infuriating to deal with. When Greenfield talks so casually about how broken we are, how inferior our minds, how decadent and unworthy our lifestyles and pursuits, it’s hard not to take it personally. I don’t believe that Greenfield represents a better generation of human being.

Nor is it wise for her to preach from such a precarious pulpit. Are we a generation of rude and lazy narcissists, lacking in mental fibre? Do we lack empathy and understanding toward others in our society? Are we sensationalists speaking in crude sound bites? Do we crave fleeting attention at the expense of meaningful achievement?

Physician, heal thyself.

@mjrobbins

Monday, November 18, 2013

Asperger's Syndrome Associated with Hyperconnectivity in the Brain - May Result in TOO Much Empathy

Two new studies in the recent issue of Cell Reports document that in those people with Asperger's Syndrome, a high-functioning form of autism, the brain exhibits hyperconnectivity between neurons and not too little connectivity as once thought.
Hyperconnectivity in Children with Autism



The brains of children with autism show more connections than the brains of typically developing children do. What's more, the brains of individuals with the most severe social symptoms are also the most hyper-connected. The findings reported in two independent studies published in the Cell Press journal Cell Reports on Nov. 7 are challenge the prevailing notion in the field that autistic brains are lacking in neural connections. [Cell Reports, Keown et al]
This is an important confirmation of research I read years ago that suggests Asperger's and some other autism-spectrum disorders (ASD) may result from inadequate neural or synaptic pruning in the post-infant years of life (by age two, we have more neurons than we will have at any other time in our lives, with 50% of those being pruned by the time we reach sexual maturity [although it may continue into our 20s]).

More importantly, this may be an important step in proving the Intense World Theory (IWT, formerly the Intense World Syndrome) of autism-spectrum disorders, which posits that ASDs are not the result of inadequate neural connectivity but, rather, an issue of hyperconnectivity. Some people on this spectrum, particularly those with Asperger's Syndrome and high-functioning autism (HFA), do not lack empathy, but instead may feel too deeply.

The IWT model suggests a genetic aspect to the hyperconnectivity that makes neurons more highly sensitive to stimuli. Here is a basic summary of the IWT developed by Kamila and Henry Markram in their 2010 Frontiers in Human Neuroscience paper, "The Intense World Theory – a unifying theory of the neurobiology of autism."
The experimentally based and common neuropathology proposed in the Intense World Theory is hyper-functioning of elementary brain modules, called local neural microcircuits, which are characterized by hyper-reactivity and hyper-plasticity, both of which seem to be caused by a tendency for excitatory neurons to dominate their neighbors. Such hyper-functional microcircuits are proposed to easily become autonomous, leading to runaway information processing, over-specialization in tasks and a hyper-preference syndrome. The proposed core cognitive consequences are hyper-perception, hyper-attention, hyper-memory, functions mediated by the neocortex, and hyper-emotionality, mediated by the hyper-functionality of the limbic system. These four dimensions could potentially explain the full spectrum of symptoms in autism, depending on the severity of the microcircuit pathology in different brain regions. The degree of hyper-functionality in different brain regions could vary in each child depending on genetic personality traits, on unique epigenetic conditions, and unique sequence of postnatal experiences.
This new research seems to suggest the lack of neural pruning model may be more explanatory. The excessive neural and synaptic connections could possibly result in the

Personal Experience


I test high on various Asperger's scales, but I have always been told that I can't have Asperger's because I do not lack empathy nor theory of mind. Here's a quick definition from Wikipedia:
Theory of mind (often abbreviated "ToM") is the ability to attribute mental states—beliefs, intents, desires, pretending, knowledge, etc.—to oneself and others and to understand that others have beliefs, desires, and intentions that are different from one's own.[1] Deficits occur in people with autism spectrum disorders, schizophrenia, attention deficit hyperactivity disorder,[2] as well as neurotoxicity due to alcohol abuse.[3] Though there are philosophical approaches to issues raised in discussions such as this, the theory of mind as such is distinct from the philosophy of mind.
As a child I had some of the common issues of Asperger's children, including language delays followed by proficiency (could not read until 2nd grade, but I was reading at a high school level in 4th grade), clumsiness (baseball was nearly impossible at first, and I once fell 40 feet out of a tree), social awkwardness (a function of poor social learning - social mores have always been a mystery to me), obsessive immersion in interests (I have been called a walking encyclopedia), and a tendency to miss humor or teasing (I am often hyper-literal).

A lot of these issues were very difficult because most Asperger's children want desperately to fit in and be accepted. I discovered pretty early that chemicals could take the edge off of my social anxiety (resulting from the need to fit and not doing so), particularly alcohol. On the other hand, smoking marijuana made me intensely, overwhelmingly aware of the emotional subtext in communication, to the point of feeling almost paralyzed by that awareness. I could not get stoned with other people and enjoy the experience.

That incredible degree of empathy is something that I had learned to silence in much of my life, or at least to ignore. Frequent marijuana use as a teen and then a five-year or so infatuation with LSD, psilocybin (mushrooms), and mescaline (peyote cactus) took away the ability to turn off the sensitivity to emotions, but it also taught me that I can control my experience.

It has only been the last couple of days that I have become aware of the Intense World Theory of Asperger's and have been integrating that concept into my own experience (of which this post is a part). I have having to change how I think of myself in many ways.

For example, many people with Asperger's exhibit traits that resemble obsessive-compulsive personality disorder (not the Axis I version with rituals - the compulsion part), such as a need for idiosyncratic organization, preferences for specific items (for me it's pens and specific dishes or silverware at home), or a need to categorize things

Anyway, below there is the introduction to Cell Reports on the two Asperger's studies, followed by the abstracts of the studies (both are open access, just follow the title or doi link), and finally, excerpts from and a link to a paper on the Intense World Theory of ASD from 2010.

Convergent Evidence of Brain Overconnectivity in Children with Autism?

Jeffrey David Rudie, Mirella Dapretto

Cell Reports, Volume 5, Issue 3, 565-566, 14 November 2013
doi: 10.1016/j.celrep.2013.10.043

In this issue of Cell Reports, two articles (Keown et al., 2013,Supekar et al., 2013) describe the results of advanced neuroimaging methods used to analyze intrinsic functional brain connectivity in children with autism spectrum disorder (ASD). Although the approaches are quite different, both groups used robust methods to provide a more comprehensive understanding of functional brain organization in ASD. They report that both long- and short-range intrinsic connectivity was increased across multiple brain networks in young children with ASD and that increased connectivity was associated with more severe social deficits. These studies stand in contrast to multiple prior reports of underconnectivity in ASD, suggesting that disrupted brain connectivity in ASD may be dependent on altered age-related trajectories. Critically, the extent to which aberrant patterns of brain connectivity may cause ASD symptomatology instead of resulting from it remains to be determined.

Early studies of brain connectivity in ASD linked widespread underconnectivity to higher-level cognitive deficits observed in autism (e.g., Just et al., 2004). However, these initial reports examined functional connectivity during cognitive tasks. More recent work has used resting-state functional connectivity MRI (rs-fcMRI) to map spontaneous low-frequency fluctuations within cognitive networks that are independent of task performance (and related confounds). These studies have mostly focused on specific networks (i.e., the default mode network) and have generally found reduced long-range connectivity in ASD (see Vissers et al., 2012, for review). Relatively few studies have implemented advanced whole-brain methods for analyzing functional connectivity in ASD (Anderson et al., 2011,Rudie et al., 2013,Di Martino et al., 2013). Importantly, closer methodological scrutiny is now required, given the recent controversy regarding the effects of motion confounds, whereby not appropriately correcting for head motion can lead to both spurious increases in local connectivity and reductions in long-range connectivity (i.e., Power et al., 2012). Thus, it is important to note that both studies previewed here used advanced motion-correction techniques and addressed other major methodological concerns (i.e., global signal regression).

In Keown et al., 2013, the authors focused on local connectivity in adolescents with ASD. Several groups have hypothesized that enhanced local circuit connectivity may provide an explanation for the preservation or enhancement of certain cognitive functions in ASD, such as visual or auditory discrimination (e.g., Geschwind and Levitt, 2007). However, few studies have comprehensively addressed whole-brain local connectivity in ASD. By using methods developed from graph theory, Keown et al., 2013 used rs-fcMRI to compute whole-brain maps of local connectivity. They compared these maps between youths with and without ASD (mean age = 13.8 years) and reported an anterior-posterior gradient of local under- to overconnectivity in ASD. Specifically, occipitotemporal regions showed diffuse overconnectivity in ASD, which was more pronounced in individuals with more severe social deficits, whereas reduced local connectivity was found in frontal regions and was more pronounced in ASD adolescents with less severe social impairments.

In Supekar et al., 2013, the authors used a systematic whole-brain connectivity approach to analyze intrinsic brain connectivity in younger children with ASD (mean age = 10.1 years). By implementing several parcellation schemes and rigorous motion correction techniques, they reported that connectivity was diffusely increased in ASD both within and between different brain networks. This was observed regardless of physical distance, such that both short- and long-range connections were stronger in ASD. Furthermore, they reported that the amount of overconnectivity was associated with increasing levels of social deficits in ASD and replicated both main findings in two additional samples. Interestingly, they also reported that increased connectivity was related to abnormally high amplitudes of low-frequency fluctuations, which they hypothesized to be related to an imbalance of excitation to the inhibition in the brains of children with ASD.

These new findings are not entirely consistent with other recent whole-brain connectivity studies in ASD, although there appears to be more agreement with regards to the findings of Keown et al., 2013. The most relevant data come from a study reporting the establishment of the Autism Brain Imaging Data Exchange (ABIDE), a database which include rs-fcMRI data collected in ASD and neurotypical individuals at 20 different sites (including data from both studies previewed here) (Di Martino et al., 2013). Here, the authors performed several whole-brain connectivity analyses in a sample of over 700 subjects, including analyses of regional homogeneity as a measure of local connectivity. Remarkably, they also found an anterior-posterior gradient of under- to overconnectivity in ASD, similar to what was observed by Keown et al., 2013. Thus, consistent reports of local connectivity alterations in ASD lend support to the hypothesis that increased local connectivity in occipitotemporal regions may be related to islets of superior functioning in sensory systems, whereas reduced local connectivity in frontal regions may relate to disrupted social behavior.

As far as more global connectivity analyses, the findings of Supekar et al., 2013 appear to directly contradict those of Di Martino et al., 2013, who reported widespread reductions in connectivity across multiple systems (except for increased connectivity between primary sensory and subcortical regions). Two other previous studies (Anderson et al., 2011,Rudie et al., 2013) using whole-brain approaches to characterize intrinsic connectivity in ASD also reported widespread reductions in connectivity at both short and long distances. However, a major difference of Supekar et al., 2013 is that the study focused on younger children with ASD (mean age = 10.1) whereas the median age was 14.7 in Di Martino et al., 2013 and the mean ages in Rudie et al., 2013 and Anderson et al., 2011 were 13.5 and 22.7, respectively. This suggests the possibility that early overconnectivity in ASD may give way to underconnectivity across time, particularly at the onset of puberty. However, an rs-fcMRI study of toddlers with ASD found reduced interhemispheric connectivity at this very young age (Dinstein et al., 2011); therefore, connectivity alterations may follow an even more complicated developmental timetable. Additionally, it is important to consider methodological differences (e.g., spiral versus echo planar acquisition and wavelet transformation versus band-pass filter), given that they could have large downstream effects on connectivity data.

Altogether, the new studies by Keown et al., 2013 and Supekar et al., 2013 add considerable weight to the hyperconnectivity side of the current hypo- versus hyperconnectivity debate in ASD while also painting a more complicated story wherein age may play a critical role. It is clear that more studies are needed with younger and longitudinal cohorts in order to obtain a clearer picture of the entire developmental trajectory of altered connectivity in ASD. Lastly, given the heterogeneity of samples and methods used across studies, these new findings highlight the importance of large-scale collaborative efforts such as ABIDE, given that data sharing across multiple sites should help disentangle the impact of several key variables on brain connectivity in typical and atypical development. Continued efforts using advanced analytical approaches, as demonstrated by the studies previewed here, are necessary in order to reach the ultimate goal of using neuroimaging as a clinical biomarker to guide the diagnosis and treatment of complex neuropsychiatric disorders (Fox and Greicius, 2010).

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Full Citation:
Keown, CL, Shih, P, Nair, A, Peterson, N, Mulvey, ME, Müller, RA. (2013, Nov 14). Local Functional Overconnectivity in Posterior Brain Regions Is Associated with Symptom Severity in Autism Spectrum Disorders. Cell Reports; 5(3), 567-572. doi: 10.1016/j.celrep.2013.10.003

Local Functional Overconnectivity in Posterior Brain Regions Is Associated with Symptom Severity in Autism Spectrum Disorders

Christopher Lee Keown [1,2], Patricia Shih [3], Aarti Nair [1,4], Nick Peterson [1,5], Mark Edward Mulvey [1,2], and Ralph-Axel Müller [1,4]
1. Brain Development Imaging Laboratory, Department of Psychology, San Diego State University, San Diego, CA 92120, USA
2. Computational Science Research Center, San Diego State University, San Diego, CA 92182, USA
3. Neuroscience Department, Brown University, Providence, RI 02912, USA
4. Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California, San Diego, San Diego, CA 92182, USA
5. Department of Mathematics and Statistics, San Diego State University, San Diego, CA 92182, USA

This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-No Derivative Works License, which permits non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

SUMMARY
 

Although growing evidence indicates atypical long-distance connectivity in autism spectrum disorder (ASD), much less is known about local connectivity, despite conjectures that local overconnectivity may be causally involved in the disorder. Using functional connectivity MRI and graph theory, we found that local functional connectivity was atypically increased in adolescents with ASD in temporo-occipital regions bilaterally. Posterior overconnectivity was found to be associated with higher ASD symptom severity, whereas an ASD subsample with low severity showed frontal underconnectivity. The findings suggest links between symptomatology and local connectivity, which vary within the autism spectrum.

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Full Citation:
Supekar, K, Uddin, LQ, Khouzam, A, Phillips, J, Gaillard, WD, Kenworthy, LE, Yerys, BE, Vaidya, CJ, and Menon, V. (2013, Nov 14). Brain Hyperconnectivity in Children with Autism and its Links to Social Deficits. Cell Reports, 5(3), 738-747.doi: 10.1016/j.celrep.2013.10.001

Brain Hyperconnectivity in Children with Autism and its Links to Social Deficits

Kaustubh Supekar [1], Lucina Q. Uddin [1], Amirah Khouzam [1], Jennifer Phillips [1], William D. Gaillard [2], Lauren E. Kenworthy [2], Benjamin E. Yerys [2,3], Chandan J. Vaidya [2,4] and Vinod Menon [1,5,6,7]
1. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94304, USA
2. Center for Autism Spectrum Disorders, Children’s National Medical Center, Washington, DC 20010, USA
3. Center for Autism Research, The Children’s Hospital of Philadelphia, Philadelphia, PA 19146, USA
4. Department of Psychology, Georgetown University, Washington, DC 20057, USA
5. Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA 94304, USA
6. Program in Neuroscience, Stanford University School of Medicine, Stanford, CA 94304, USA
7. Stanford Institute for Neuro-Innovation and Translational Neurosciences, Stanford University School of Medicine, Stanford, CA 94304, USA
This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-No Derivative Works License, which permits non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

SUMMARY

Autism spectrum disorder (ASD), a neurodevelopmental disorder affecting nearly 1 in 88 children, is thought to result from aberrant brain connectivity. Remarkably, there have been no systematic attempts to characterize whole-brain connectivity in children with ASD. Here, we use neuroimaging to show that there are more instances of greater functional connectivity in the brains of children with ASD in comparison to those of typically developing children. Hyperconnectivity in ASD was observed at the whole-brain and subsystems levels, across long- and short-range connections, and was associated with higher levels of fluctuations in regional brain signals. Brain hyperconnectivity predicted symptom severity in ASD, such that children with greater functional connectivity exhibited more severe social deficits. We replicated these findings in two additional independent cohorts, demonstrating again that at earlier ages, the brain of children with ASD is largely functionally hyperconnected in ways that contribute to social dysfunction. Our findings provide unique insights into brain mechanisms underlying childhood autism.
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Full Citation:
Markra, K, and Markram, H. (2010, Dec 21). The Intense World Theory – a unifying theory of the neurobiology of autism. Frontiers in Human Neuroscience, 4:224. doi: 10.3389/fnhum.2010.00224

The Intense World Theory of Autism


The challenge for any unified theory of autism is to understand the common cause for the wide spectrum of autistic disorders and the autistic traits that are found in other disorders, if there is one. The Intense World Theory proposes that autistic traits could emerge if a molecular syndrome is activated that sensitizes gene expression pathways to respond excessively to environmental stimulation. Under normal conditions such pathways would enable enriched environments to nurture brain development, but if these pathways are sensitized, then environmental stimulation may cause exaggerated and accelerated development of the brain in general and the glutamatergic system of neural microcircuits in particular. Microcircuit glutamatergic hyper-functionality in the neocortex could cause hyper-perception, hyper-attention, and hyper-memory, which are proposed as the core triad of cognitive traits common to all autistic symptoms. Microcircuit hyper-functionality in the limbic system could cause hyper-emotionality adding a forth dimension that could scale the cognitive impact of the triad pathology. The severity on each of these four axes could perhaps account for autism on any part of the spectrum. The sensitivity to the environment could drive the brain to develop in a premature sequence and in a manner that enhances functionality. At its peak, the environment could become excessively intense and set in motion a systematic regression to where the brain is forced to take refuge in a highly specialized “cocoon” where extremes and surprises are actively avoided and blocked out.

The specific molecular cascade that drives hyper-functionality in brain microcircuits is not thought to be necessarily the same in different parts of the brain since there may be different ways to produce hyper-functionality in different regions and we therefore propose a common syndrome rather than a common specific molecular cascade, for all brain regions. The characteristics of the syndrome could be an exaggerated response to stimulation. In the brain, this common molecular syndrome is proposed to have a dual effect of causing hyper-reactivity and hyper-plasticity of microcircuits to produce hyper-functionality (Figure 5).

FIGURE 5  
http://c431376.r76.cf2.rackcdn.com/2224/fnhum-04-00224-r2/image_m/fnhum-04-00224-g005.jpg

Figure 5. The hyper-functional circuits in autism. As suggested by the Intense World Theory three etiological factors (a genetic predisposition; an epigenetics attack in form of a toxic insult; environmental factors during postnatal development) cause autism by activating a molecular syndrome that may be different across different brain regions, but that leads to hyper-functional microcircuits (expressed as hyper-reactivity and hyper-plasticity) in all brain regions. Two regions known to be affected include the neocortex and amygdala and we hypothesize that other regions may be similarly affected. The consequences on cognitive processing include hyper-sensitivity, -perception, -attention, -memory, -fear, and -emotionality. We propose that this leads to an intense, fragmented, and aversive world syndrome for the autistic child, which could account for a spectrum of behavioral abnormalities.
In the neocortex, the consequences could be severe, because microcircuits lie within functional modules called neocortical columns and if these columns are hyper-functional, the delicate balance between intra- and inter-columnar processing would be upset. The approximately million neocortical columns in humans each need to be precisely excited and inhibited to coordinate higher brain functions and complex behavior. Excessive intra-columnar processing, particularly during development, could enhance the most elementary sensory, motor, and cognitive processes at the expense of being able to orchestrate “symphonies” of higher cognitive functions. With excessive learning and memory processes, sensory regions could consolidate into overspecialized modules and lead to hyper-preference processing. During early development, this may lead to excessive flow of information from sensory areas to the higher integration areas such as the association cortices and prefrontal lobe which may cause prematurely accelerated growth of these higher order brain areas, as indeed observed in autism (Courchesne et al., 2001; Carper et al., 2002), but this is only one out of several possible explanations for this phenomenon. Deficits in higher brain functions such as executive control and holistic processing may also be better explained by overly autonomous elementary modules rather than deficits in these areas or weak long-range connectivity. Indeed, structural MRI indicates higher levels of white matter in the cerebrum and cerebellum in young children with autism (Courchesne et al., 2001; Carper et al., 2002), which – in the light of the Intense World Theory – could be interpreted as a compensatory action to coordinate excessive activity in columns within and between different brain areas.

More specifically, each neocortical column is known to be involved in processing multiple features of stimuli. In the visual cortex for example, such features include the orientation, spatial frequency, contrast or color (Hubel and Wiesel, 1962; Tootell et al., 1981). The emphasis that each column must place on processing the different features is carefully crafted to allow the neocortex to simultaneously specialize in processing many different features locally and generalize in combining features globally. Hyper-reactivity and hyper-plasticity could act synergistically during experiences to enhance sensitivity to features and consolidate memories of features processed. Selective feature sensitivity would more easily allow specific features to trigger column processing, but could make it more difficult to activate other features (and tasks) and to interrupt any processing, once started. Overly strong consolidation of memories of the processing of features in development could also rapidly lead to dominance of the earliest features (“impressions”) and avoidance of processing of other features (manifesting in higher thresholds). Such hyper-autonomous and overly selective columns could make bottom-up control of the activation of columns from the thalamus and top-down control from higher associational areas more difficult leaving the neocortex fragmented into independent modules that are difficult to control and coordinate – an exaggerated and runaway response to stimulation.

Hyper-preference processing in the sensory domain could lead to exaggerated selectivity, sensitivity, and specialization of sensory features and hence hyper-perception, while hyper-preference processing in cognitive processing in general could lead to hyper-attention and in the memory domain, to hyper-memory. Therefore, the degree of hyper-preference processing in neocortical regions, areas and columns and the normal variation of individuals, could contribute a spectrum of autistic traits all manifesting as part of an Intense World Syndrome.

The molecular syndrome, however, also seems to extend beyond the neocortex. While in the neocortex this drives hyper-functionality by hyper-connecting neighboring neurons to produce excessive excitation and by hyper-expressing NMDA receptors to produce excessive plasticity, in the amygdala inhibition is also reduced. The amygdala contains relatively higher numbers of inhibitory interneurons than in the neocortex and reducing inhibition may be more effective in causing hyper-functionality than hyper-connecting through glutamatergic synapses. Hyper-functionality in the amygdala (and related emotion centers) could add a very important hyper-emotional dimension to the triad pathology to render the already intense world progressively more painful and aversive with each experience leading to a progressive lock down and social withdrawal.

While the Intense World Theory is primarily based on experimental data derived from the neocortex and the amygdala, we do not exclude that the same molecular syndrome driving hyper-reactivity and hyper-plasticity could be active in other structures of the forebrain or the mid- and hindbrain as well. For example, it is well established that the cerebellum is strongly affected in autism with decreased numbers of the inhibitory Purkinje cells (Ritvo et al., 1986; Bailey et al., 1998; Bauman and Kemper, 2005), which would predict hyper-reactivity. It is also known that there are increased white matter volumes (Courchesne et al., 2001) which would increase activation of brain regions from other regions. Indeed, others already postulated a disinhibition of the cerebellum that would lead to increased reactivity and could alter connectivity not only within the cerebellum, but also across the cerebello-thalamo-corticial circuits (Carper and Courchesne, 2000; Belmonte et al., 2004b; Boso et al., 2010).

In summary, autonomously acting hyper-functional microcircuits in the neocortex may cause exaggerated perception to fragments of a sensory world that must normally be holistically processed, and may cause hyper-focusing on fragments of the sensory world with exaggerated and persistent attention. This hyper-attention could become difficult to shift to new stimuli due to the difficulty for bottom-up and top-down mechanisms to coordinate the overly autonomous low-level neocortical columns. The hyper-plasticity component may also drive exaggerated memories to further amplify hyper-attention toward the same stimulus and drive over-generalization of attention to all related forms of the stimulus. The positive consequences are exceptional capabilities for elementary and specific tasks while the negative consequences are impairment of holistic processing, a rapid lock to a limited repertoire of behavioral routines, which are then repeated obsessively.

As a consequence the autistic person would remain with a fragmented and amplified perception of bits and pieces of the world. The intense world that the autistic person faces could also easily become aversive if the amygdala and related emotional areas are significantly affected with local hyper-functionality. The lack of social interaction in autism may therefore not be because of deficits in the ability to process social and emotional cues, but because a sub-set of cues are overly intense, compulsively attended to, excessively processed and remembered with frightening clarity and intensity. Typical autistic symptoms, such as averted eye gaze, social withdrawal, and lack of communication, may be explained by an initial over-awareness of sensory and social fragments of the environment, which may be so intense, that avoidance is the only refuge. This active avoidance strategy could be triggered at a very early stage in a child’s development and could progress rapidly with each experience manifesting as a regression, which is striking in some cases. With such early over-specialization, many other important elementary certain skills may never be properly developed to enable normal navigation in a socially rich world with an appropriate understanding of social cues and communication. As already stated by other authors (for example Frith, 2003) “autism affects development, and in turn development affects autism” (p. 2). Compiling higher order functions such as abstract thought and language when the elementary alphabet of features is so overly attended to may become difficult if not impossible in severe cases.
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Predictions of the Intense World Theory


The Intense World Theory is not only consistent with a large number of previous studies, and has the explanatory power to reconcile a large number of apparently contradictory data and interpretations, but also has significant predictive power because it is grounded at the molecular, cellular and circuit levels. The set of some testable predictions derived from the Intense World Theory are listed below.

Perception


• Circuit level:

○ Some level of hyper-reactive and hyper-plastic circuits in all brain regions. This can be tested by progressively increasing the intensity of multi-site stimulation of a brain region. The molecular, synaptic, and cellular causes may differ in different regions.
○ The loss of inhibition and hence hyper-reactivity also in sub-cortical regions where inhibitory neurons are more prominent such as in the cerebellum.
• System level:
The variance, as opposed to the mean, of the pixel intensities in fMRI measures should be higher in autistic subjects with the upper and lower intensities being greater than in neurotypical subjects. Higher upper pixel intensities may even be present in under-activated brain regions. These predictions would best be tested using fMRI at the highest spatial resolution.
Enhanced low-level feature processing in primary sensory brain regions. This could manifest in greater peaks in some tuning curves for different features as well as lower detection thresholds.
• Cognitive and emotional levels:
○ Highly idiosyncratic stimulus preference to activate brain areas, which should become more idiosyncratic with progression of the disorder.
○ Vulnerability to sensory overflow. Consequential behavior would be panic, aggression, and withdrawal as already suggested by anecdotal reports.
• Associated Pathologies:
○ A lower threshold for stimulus-induced epilepsy (such as stroboscopically induced epilepsy).
○ Neglect syndrome.
○ Learning impairments correlated to the degree and variance of associations required.
○ Panic attacks and phobias triggered by uniquely personal situations (as originally noted by Leo Kanner).
○ Post-traumatic stress disorder.

Attention


• Circuit level:

○ Abnormally high levels of persistent reverberant activity within circuits that is difficult to interrupt.
• Systems level:
○ Amplified neocortical response during thalamic stimulation.
○ Abnormally high degree of synchronization between the mPFC with some brain regions and abnormally low synchronization, with other regions.
○ Abnormally high tendency for phase locking with smaller phase lags indicating a higher degree of oscillations and coherence across those brain areas engaged.
• Cognitive level:
○ Enhanced sustained attention to material of interest (as anecdotally reported).
○ Once attention is captured, impaired shifting of attention to different features or tasks, because of internal hyper-processing (as also suggested by the difficulty to engage the attention of an autistic child).
○ Attention to arbitrary fragments related strongly to early life experiences.
○ Strongly enhanced focused on internal processes.
• Associated Pathologies:
○ Attention deficit disorder (ADD) or Attention deficit hyperactivity disorder (ADHD).
○ Learning impairments in some cases and super-learning in others.
○ May seem distracted and disengaged, but are actually hyper-focused on internal processes.

Memory


• Molecular:

○ Enhanced NMDA receptor subunit expression in the neocortex. Alterations in the adult, after critical periods, may be absent and increases may still be observable following stimulation.
○ Other markers associated with synaptic plasticity may follow a similar pattern as some NMDA receptor subunits.
• Cellular:
○ NMDA mediated Ca2+ toxicity in adult and aged autistics. This will have consequences for the enhanced learning and memory postulate of the Intense World Theory, which may be less pronounced in aged autistics.
• Cognitive level:
○ Strong imprint of early life experiences and learning material, which is highly resistant to extinction and dominates over new learning challenges. E.g., this could potentially show in high interference in learning semantic material.
○ Enhanced simple associative learning (conditioning), which is resistant to extinction. This should be particularly well observable early in life. Later in life strong early life memory traces will over-shadow further learning attempts.
○ Learning impairments are predicted for all negatively associated stimuli and resistance to rehabilitation is predicted because of fear of previous negative associations. The Intense World Theory predicts that all children with autism will display greater than average memory performance for the tasks that the autistic has chosen as non-threatening.
○ Enhanced learning and memory should be most observable in very young autistic children and less so in progressively older autistics. In elderly autistics – due to the neurotoxicity effects of enhanced NMDA signaling throughout in particular the early lifespan – learning and memory impairments may become more evident.
• Related Pathologies:
○ Idiosyncratic, albeit exceptional memory capabilities.
○ Repetitive tendencies.
○ Obsession compulsive disorder.
○ Stronger and more persistent memories following conditioning.
○ Behavioral inflexibility.
 

Emotions


• Cellular:

○ Cell toxicity in brain areas that are easily excitable such as the amygdala and hippocampus due to over-excitation.
• Circuit:
○ Hyper-reactive and hyper-plastic amygdala and other limbic structures.
• Systems:
○ Enhanced amygdala activation when autistics are instructed by teachers or parents.
○ Enhanced amygdala activation when autistics view eyes, faces or social scenes.
○ Enhanced sympathetic responses to social content such as eyes, faces, social situations etc. This could be tested with measures of the autonomic system, such as skin conductance, heart measures or stress and anxiety hormone levels.
○ Enhanced sympathetic responses to novel and sensory rich situations.
○ Enhanced sympathetic responses to negatively associated stimuli.
• Cognitive level:
○ Enhanced fear conditioning in autistics – most pronounced in young children.
○ Enhanced generalization of fear responses to similar content.
○ Resistance to fear extinction.
○ Enhanced active avoidance of fear-associated material.
○ Enhanced active avoidance of high-emotion content such as eyes, emotional faces, social encounters.
○ Enhanced active avoidance of novel environments is predicted due to fear of surprises that arise from over-generalization of previous negative associations.
○ At the behavioral level unpredictable, exaggerated, extreme, and inappropriate reactions to surprising situations.
• Associated Pathologies:
○ Anxiety.
○ Panic attacks and phobias.
○ Post-traumatic stress disorder.
○ Paranoia.
○ Depression.
○ Hyper-emotionality.
○ Behavioral inflexibility.
○ Repetitive tendencies.
 

Psychological Scores


• The Intense World Theory predicts higher variance in any set of scores from a large psychophysical test battery as compared to controls with the highest and lowest scores. In particular, since columns are hyper-reactive, but highly selective, the reaction times to a battery of tests should display a higher variance with the longest and shortest reaction times. The theory predicts that the key parameter to measure is the variance of performance on different scores rather than focusing on any one task, on absolute values, or on the average performance of many tasks. The theory predicts the same high variance characteristic for cognitive profiling.

• High measures of variance on cognitive battery tests should be independent of intelligence, but due to the proposed highly idiosyncratic feature over-selectivity of neural columns.