Stoopid Kids!

-By Jake T. Snake

So I open up the local newspaper last week and I see this gannett article that has suddenly popped up virtually everywhere. These kind of articles in the mainstream media always make me a little nervous, so I track down the abstract(the article hasn't actually been published yet). I include this below for your edification.

Socioeconomic Disparities Affect Prefrontal Function in Children

 By Kishiyama MM, Boyce WT, Jimenez AM, Perry LM, Knight RT. 

Social inequalities have profound effects on the physical and mental health of children.     Children from low socioeconomic (SES) backgrounds perform below children from higher SES backgrounds on tests of intelligence and academic achievement, and recent findings indicate that low SES (LSES) children are impaired on behavioral measures of prefrontal function. However, the influence of socioeconomic disparity on direct measures of neural activity is unknown. Here, we provide electrophysiological evidence indicating that prefrontal function is altered in LSES children. We found that prefrontal-dependent electrophysiological measures of attention were reduced in LSES compared to high SES (HSES) children in a pattern similar to that observed in patients with lateral prefrontal cortex (PFC) damage. These findings provide neurophysiological evidence that social inequalities are associated with alterations in PFC function in LSES children. There are a number of factors associated with LSES rearing conditions that may have contributed to these results such as greater levels of stress and lack of access to cognitively stimulating materials and experiences. Targeting specific prefrontal processes affected by socioeconomic disparity could be helpful in developing intervention programs for LSES children.

The research is also discussed here, here and here.

I could write for days about this article, but I won't do that to any of you, because I like you. These type of discoveries always lead to the inevitable nature versus nurture debate which is a false bifurcation of the world. The right will use this research to prove that poor kids are just born that way and that trying to intervene to ameliorate these effects is useless anyway. Those of a more progressive stripe will argue for more intervention and programs to undo the damage done by environmental factors. I fall squarely in the second camp. Let me explain why.

What would you say if I told you that we have proof that the functioning, the neural pathways, the chemical responses and even the structure of the brain can be altered by experience, both positively and negatively? If I told you that mental illness can be a result of environmental factors, rather than biologically predetermined at the moment of conception? We have this proof. All we need to do is look at the veterans returning from combat who are experiencing post traumatic stress disorder. The experience of war has changed them mentally and physically and altered the way their minds and bodies work. We know that people with PTSD exhibit structural changes in their brains and changes in brain functioning, that they have elevated pulse rates, blood pressure and other changes in physical functioning. Interestingly, one of the hypotheses brought forward for the differences in poor kids brain function is stress and exposure to the resulting stress hormones in daily life, akin in some ways to our combat veterans.

The brain has almost limitless plasticity and ability to evolve and adapt to the context it is in to survive. Even PTSD is an appropriate adaptation if it helps you to survive in a particular context. The brain prioritizes and spends its resources on those functions most vital to survival. If that happens to be old brain stuff, rather than executive functions well as far as our brains are concerned it is better to survive, even if you haven't successfully memorized thos vocabulary words for this week's class.

I have worked with these children and the situation is even more dire, because when they are found to have problems with impulse control (an executive function) for example, a diagnosis of attention deficit problems is made and we begin medicating them adding more chemicals (usually stimulants) to a brain already awash in stress hormones.  One of the other characteristics of those suffering from post traumatic stress disorder is high levels of anxiety best exemplified in what is known as an elevated startle response. These are the folks who end up on the ceiling after you tap them on the shoulder to say hello. Let us consider for a moment what we would be creating if a child was dealing with PTSD symptoms, was already wound very tightly and our solution was to give them an amphetamine.

The truth is that we all receive a genetic inheritance that presents a spectrum of possibilities. Biology is not destiny. We can provide a rich environment that maximizes the possibilities that children have or we can continue to sacrifice the next generation, because we have a significant investment in punishing their parents for having the audacity to be poor. Much like with health insurance, there are workable models out there that demonstrate how to provide for the greater good rather than remaining social darwinists. I fear that we lack the will and resolve to help our fellow human beings, even when they are children.

Comments

[Interrobang]

Let us consider for a moment what we would be creating if a child was dealing with PTSD symptoms, was already wound very tightly and our solution was to give them an amphetamine.

You do know, right, that the canonical medical test for ADD/ADHD is a paradoxical reaction to amphetamines (or I should say stimulants in general)? What you get, if you really do have someone who's non-NT in that kind of way, aned you give them amphetamines, is someone who can actually sit still for a while, and/or, if you dose them heavily enough, someone who behaves like they're sedated.

That's basically why so many adults who later find out they're ADD/ADHD spend years self-medicating by drinking vast amounts of coffee every day and saying that caffeine helps them focus. They say that because it does.

Now, if we want to talk about class indicators and the likelihood of wrong diagnoses (even though that one ought to be a snap), overmedicalisation, and/or undertreatment, that's a whole other issue.

[dAVE]

There's also the Flynn effect. Wherein IQ in a population goes up 3 points a decade, or roughly 10 pts a generation. A 100 score on an IQ test today isn't the same as a 100 from one from your parents' generation.

Presumably this is because of advances in nutrition, prenatal care, general increase in literacy and knowledge, etc.

So, even if poor populations continue to lag behind, it's not immutable or inevitable.

From what I've seen personally, there's just a lot of families out there that simply don't have any books in the house. None. And kids who never see mom and dad reading are at a severe disadvantage by the time kindergarten rolls around.

Baby college at the Harlem Children's Zone Project is working to fix this.

And, for all the conservatives out there, it's a lot cheaper than just letting things go the way they have been.

[Thers]

I dig that sign in the picture. If God's going to be judging me, I wanna hang out with the sex addicts, though, as opposed to the Mormons.

[DrDick]

I see that the "scientific" social conservatives have gone back to their roots. For most of the 20th century they have focused on race (the Wretched Bell Curve), anyone?). Now they are returning to the source of this pseudoscience. Can't remember his name right now, but the original research which provides the model was done in the 1930s and was intended to show that the British working classes were inherently inferior to the upper classes so that programs to benefit them were doomed from the outset.

This kind of research ignores a huge body of research on brain development and funtion over the past 50 years. We know that the brain, particularly when it is developing during childhood, responds in relatively consistant ways to a variety of environmental factors such as diet, activity levels, physical and emotional stress, mental stimulation, nurturance and touching, heavy metals and other environmental pollutants, violence, and the like and that these changes are enduring. We also know that these generally correlate with social class in ways that disadvantage the lower classes.

[Jake T. Snake]

Interrobang,

Sadly, I am aware of the diagnosis by medication practice. Please remind me what the difference between psychiatry and voodoo is again?

Stimulants help virtually everyone concentrate, thus the rampant abuse of stimulants by college students, so there goes that diagnostic theory. This is one of the basic problems in psychiatry, there are few objective diagnostic measures for mental illness. PTSD is one of the exceptions which is why I find it an interesting place to begin these discussions. We can prove PTSD via physical testing. ADHD we cannot, although they are doing some interesting work with brainscans. There is a whole lot of "I know it when I see it" going on with diagnoses. If you ever need a good laugh, go read the diagnosis manual. It is subjectivity writ large based on the supposition that you can disregard context.

As to diagnoses and class, yes, you are most likely to be labeled schizophrenic if you are poor and African-American. Pathology = divergence from the median. ADHD is qualified as a deficit in executive or frontal lobe functions, so maybe it is a class issue if poverty creates it as this research suggests.

During my 8 years working in mental health I watched a lot of kids who clearly had PTSD (significant histories of sexual abuse and the like) given stimulants when it was the worst thing for them. It often fed into a cycle of sleeplessness at which point they were often diagnosed as bipolar and given more meds. (Big sigh) You get the idea.

[Jemand von Niemand]

So, let me make sure I understand these people: Poor = Stress; Bad Environment = Teh Stoopid.

Why don't they just fall back to the default position of landed European aristocracy -- men are like horses (women don't count); breeding and blood always tells; Jews are evil christ-killers and Catholics are (shudder) Italians; Darker Peoples have only recently climbed down out of the Jungly-Bungly Tree, etc. etc., and stop wasting our time with self-congratulatory cartoon science?

[DrDick]

Jemand -

All of the forces impacting on poor children have social, not genetic, causes and therefore have social solutions. While some changes are permanent, others are reversible (and we do not really know fully which is which). Further, there is a tendency to pathologize the behavior of the poor and ethnic or racial minorities, even when these are "normal". You correct these problems by insuring that all children have adequate diets, removing environmental hazards, imposing effective policing in poor as well as affluent neighborhoods, providing intellectually stimulating environments for all children (Head Start and related programs), and the like.

[Davis]

Dr. Dick already said it for me, but I want to add that the effect of nutrition on early brain development was hardly addressed in the debates over The Bell Curve (of course, not addressed at all in the book itself).

[UUgal]

We found that prefrontal-dependent electrophysiological measures of attention were reduced in LSES compared to high SES (HSES) children in a pattern similar to that observed in patients with lateral prefrontal cortex (PFC) damage.
---

imo, Patterns of thought processing in human beings are like the structures of a spider web. Some people tend toward thinking along lines like "spokes;" some tend toward connecting across the spokes like "spirals" (usually possessing some combination of both). Take away either type of structure and the web loses its strength.

It strikes me as significant that the types of measurement employed in these studies are more likely to look for, see, tap into and affirm the functioning of spokes, rather than spirals - while being almost completely inapt to look for, detect, tap into and assess the existence of (muchless the value of) the spirals.

hmm.

I also venture a guess that there is a recursive relationship between PTSD and "ADD" as our current cultural institutions are predominantly geared for the "spokes" and are more likely to present barriers, negative feedback, punishment and hostility to "spirals."

Think Renaissance times and compare it with the compartmentalized structures of "modern" society. Spirals are integral to the process of looking across categories, synthesizing information and innovating, often adding unique solutions and perspectives. My attention deficit (to what you're paying attention to) is my attention asset (to what you're ignoring/unaware of).

The spirals shine via Renaissance.
The trick is to create (more) avenues that maximize opportunities for both style tendencies.

Maybe?

Other than the evidence produced by unique works (flashes of insight, symphonies, innovative technologies, etc.), I'm not sure there will ever be a test to measure the kind of information processing to which I'm referring.

But I sure hope so.

[Jake T. Snake]

UUgal,

Agreed. This is why the strength-based approaches work well with people diagnosed or categorized as somehow different. Instead of focusing on the parts of people that are deficient, you look at what they do well and in most cases there is more than enough material there to cover any deficiencies. I often told people I was working with that I din't care what there diagnosis was. All Ineeded to know is what they did well and how we could help them do more of it. It sounds simplistic, but it works. We do a poor job of recognizing different types of intelligence. Most of the people who were my clients were amazingly bright and well adapted to the realities of their lives. They had numerous talents and skills that I did and still do not possess. I continue to be amazed and humbled by what they teach me.

[Jake T. Snake]

Dear god I need a copy editor!

The boy in that picture has empty thought bubbles.

Just sayin'

[Jemand von Niemand]

Dr Dick,

I agree. Where I have an issue is with those who assert that past a certain point, effects of environment and diet are irreversible.

[flawedplan]

Thanks for this, the tone of it made me tear up. It's opening a door, I'm going to write a post and link back and things. There is hope here, long overdue. Thank you for helping me come to terms with my bitterness.

[Steven Morgan]

Thank you for this article. Alongside the idea of the brain's malleability, you may be interested in an article I wrote about neuroplasticity and psychiatric recovery:

http://www.mindfreedom.org/kb/diagnostics/rethinking-the-brain