Thursday, September 30, 2010

A Reader's Reflections: Early Years

Francis Bacon wrote, Some books are to be tasted, others to be swallowed, and some few are to be chewed and digested. The process by which one acquires the appetite for books to be chewed and digested, reveals something about the pathway of a person’s intellectual growth. During my early childhood, I grew up in a home without books, with the exception of a decade old tan-covered dog-eared Webster’s dictionary, the kind with finger notches along the fore edge of the book.  My parents were both very bright, but during the Great Depression, had no opportunity to attend school beyond 8th grade, which I suppose accounted for their lack of exposure to reading led them away from books.  Nonetheless, each evening after supper, my father read the Minneapolis Star Journal newspaper from cover to cover, aside from the stock market pages, but he didn’t read books until after he retired. Though often exhausted from a long day’s hard work as a greenhouse foreman, he often expressed his passionate views about politics to me as he read one or another piece in the Star.

My mother seldom read books either.  Gary, my older brother, gave me three Lone Ranger novellas for Christmas when I was in 4th or 5th grade, which piqued my enthusiasm for reading. To that point I had been a plodding reader.  In my sixth grade year, my parents decided our family needed an encyclopedia, so they shelled out more than they could afford for an Encyclopedia Americana. I spent many hours poring over color images of planets in the Encyclopedia, reading about Mars’s moons, Deimos and Phobos, and studying the dark grey craters on the moon.  I was a sporadic reader throughout high school, gravitating toward science and science fiction, such as Percival Lowell’s The Solar System, Heinlein’s Stranger in a Strange Land, HG Wells’ War of the Worlds and Kurt Vonnegut’s The Sirens of Titan.

I think of that as my “Rocket Boys” period, after the book about six boys in a West Virginia coal-mining town who decided to build a rocket and send it up into the firmament. The original memoir, October Sky, by Homer Hickam Jr. struck a chord with me.  About the same age, I built a jury-rigged pipe rocket powered by home-made gun powder which blasted a hundred feet or so into the air over our back yard in Brooklyn Center, Minnesota. I slipped a smaller bore pipe inside a slightly larger diameter pipe, screwed a cap onto the smaller pipe. I packed gun powder inside the open end of the smaller pipe, which I had propped up the makeshift device among piles of sand and cinderblock, and lit the fuse. Next thing I knew my mother was standing on our home’s back steps, shouting, “What in the world do you think you’re doing?  Are you trying to blow us all up?”  I was lucky I wasn’t seriously injured in the process, because the fuse didn’t light properly at first.  I switched to a less risky alternative.  I built 6-inch reflecting telescope and spent countless hours peering at the surface of the moon and the rings of Jupiter on cold winter nights while stomping my feet to kept my toes from freezing. My reading kindled my naively optimistic attempts to understand the world around me.

Unsure of the direction my studies would take me, as a freshman at the University of Minnesota, I was smitten by Henry James’s Isabel Archer in Portrait of a Lady. I found Henry James’s portrayal of Isabel’s inner monologues absolutely captivating.  James’s mastery of complex, often very convoluted Victorian language was a marvel to me.   Alan Ginsberg’s Howl and Jack Kerouac’s On The Road’s Beat spontaneity overcharged my restrained Midwestern emotions. Kerouac produced the manuscript of On the Road on a continuous scroll by taping pages of semi-translucent paper together to feed the old manual typewriter and write without interruption. The text was single-spaced, without paragraphs, and edited in pencil by Kerouac.  Kerouac’s thumbing his nose at established publishing practices was appealing to a young budding non-conformist making his way in what seemed to be a rule-bound world.

A year or two later I discovered Kafka’s The Trial, Metamorphasis and Penal Colony.  Kafka’s anti-bureaucratic absurdism appealed to my youthful rebellious mentality, which as with most young people was preoccupied with social and political injustice. I had grown up in a vegetable farming area north of Minneapolis in which no one attended college.  Higher education was perceived as being for effete snobs who were trying to better than everyone else.  I suppose it was no surprise that there were times that I especially identified with Kafka’s character, Gregor Samsa’s who had been converted into a disgusting giant insect, scurrying about his apartment with an apple stuck in his carapace, thrown by the land lady who had attempted to shoo him away.

For a interlude in graduate school I was taken with Lawrence Durrell’s Cefal├╝ later published as the The Dark Labyrinth, which tells the story of a group of travelers who become lost in an underground labyrinth on Crete, a labyrinth which may or may not still be inhabited by the minotaur. The story unfolds with a blend of allegory and symbolism, which was highly appealing to a budding psychology doctoral student. The Alexandrea Quartet, certainly captured my imagination, a four volume account of an overlapping contemporaneous series of events, unfolding from various narrators’ perspectives. Around the same time, I came upon Herman Hesse’s Siddhartha, Steppenwolf and Narcisuss and Goldmund dedicated to a search for authenticity, self-knowledge and spirituality.  I found his struggle to understand the relation between physical reality, perception and emotional expression were in sync with some of my own intellectual machinations at that time. 

That reading era concluded with Nikos Kazantzakis’ Zorba the Greek. The narrator, a young Greek intellectual, with whom I identified, resolved to set aside his books for a few months and sets off for Crete in order to re-open an abandoned mine and immerse himself in the world of peasants and working-class people. The narrator is fascinated by Zorba's lascivious opinions and expressive manner and decides to employ him as a foreman. Zorba resembled some of the men who surrounded me as I was growing up, though a bit more out of the ordinary.  Zorba's soliloquies set the tone for a large part of the book. The narrator, who has socialist ideals, attempts to get to know the workers, but Zorba warns him to keep his distance: "Man is a brute.... If you're cruel to him, he respects and fears you. If you're kind to him, he plucks your eyes out." The narrator absorbs a new zest for life from his experiences with Zorba and the other people around him, but reversal and tragedy mark his stay on Crete, and, alienated by their harshness and amorality, he eventually returns to the mainland once his and Zorba's ventures are completely financially spent. [Based in part on].  That was the year I learned to savor gyros with tzatziki sauce, zucchini fritters, fresh sauted green beans with onions, tomato and dill and stuffed grape leaves with kalamata olives, pretty exotic fare for a young man raised on meatloaf, corn on the cob and mashed potatoes with gravy.

In my elementary and high school years, books served as friends who honored my intellectual proclivities, because my peers seldom did so.  For years I had a Gary Larson cartoon posted above my desk that shows cows in a pasture standing on their hind legs chatting, until a car appears along the road next to the pasture. At that point the cows all stand on all fours munching grass.  As soon as the car passes, they resume standing on their hind legs and resume their conversation.  I certainly knew the drill as a child, but things changed dramatically once I was in college. 

Thursday, September 23, 2010

Unemployment: Getting Blood from a Turnip

American unemployment was 4-7% (average about 5%) from 1994 to the end of 2007, then sharply rose to the current 9.6% level in the final year of the Bush administration.  This national average unemployment rate of 9.6% is very misleading.  In ten states unemployment continues within that pre-2008 typical range (below 7%), while in seven states it has risen staggeringly high (Nevada’s is 14.4%).   Most of the remaining 33 states are experiencing a 1-3% increase in unemployment over the pre-2008 levels, which isn’t great, but it is not the wide-spread disaster portrayed daily on television evening news.  There are nonetheless pockets of high umemployment within states and regions that are otherwise doing well economically, especially where construction and manufacturing had been major employers.

During economic recessions minority workers and those with disabilities are often among the first to be laid off.  The Autism Job Hunt website reports that the unemployment rate for people with autism is 75% – 97%. Because of limited social and communication skills, intolerance for changes in routines and other autism related issues, people with autism tend to get places at the tail end of the job line. [see]   Economists call these structural causes of unemployment, i.e. people’s skills don’t match with available jobs.  Job training and providing supported employment help up to a point, but long term solutions involve improving the overall economic outlook since all ships rise with a rising tide.

Why has it been so difficult to reduce unemployment in the US more generally?  An article by Jen Mystowski in the Seattle Post Intelligence described one of the key factors in our employment woes, outsourcing.  Not surprisingly, 80% of Americans think outsourcing is hurting our economy, and it is.  There is no question outsourcing leads to US job losses. Outsourcing has horribly detrimental effects on individuals who face job loss, and often subsequent long term employment insecurity.  Proponents of outsourcing, including most economists who think in macroeconomic (not individual) terms, argue that shipping American jobs to countries with lower wages brings down prices for products sold in the US, so therefore benefits American consumers.  It also creates pressure for lower wages in the US as a by-product.  So next time you stroll down the aisle at Wall Mart or Target (or Niemann Marcus!), try to take comfort from the fact that the somewhat lower prices for the stuff they are selling you means that you and your neighbors may be out of work, possibly for a very long time. Not too comforting is it?

In the European Union regulations provide protection against such massive job losses due to outsourcing. Labor laws in the US are not as protective as those in the European Union, to our great disadvantage.  Even major business leaders are finally acknowledging outsourcing has to be reigned in. Jeff Immelt, CEO of General Electric called for the US to increase its manufacturing base of employment by 20% because the US has outsourced too much and can no longer rely on consumer spending to drive demand. Would you rather have a job and pay more for stuff, or be chronically unemployed, and maybe be a bit more frugal with your money?

The second reason for persisting unemployment and underemployment is that businesses are using the recession as an excuse to lay people off and to pressure existing workers to work harder, often for less, which means employers don’t need to hire.  Many employers  had wanted all along to cut costs by getting rid of workers, and the economy provided their excuse.  Lay offs have exceeded recession-related reduced demand. Employers tell workers who complain about excess job demands and often at lower wages, if they whine, they will be replaced by one of the many people looking for work.  It’s like squeezing blood form a turnip. The average hours of work per week per full time worker in nearly all sectors of the economy exceeds 40, which taking into consideration many people are forced to work reduced hours. means that lots of other people are working overtime. If forty people work an hour of overtime, that replaces one full time employee.  Remember, no whining if you want to keep your job.  That's what happens when there is no collective bargaining. 

Then there’s the problem of part time workers.  According to the Bureau of Labor Statistics, the number of persons employed part time for economic reasons (sometimes referred to as involuntary part-time workers) increased by 331,000 over the previous month to 8.9 million. These individuals were working part time because their hours had been cut back or because they were unable to find a full-time job. By hiring one or two part time workers at lower wages with no benefits, businesses can make more money without hiring you or your neighbor full time. The losers are the people who could be working full time and the employer who has an unstable and less productive workforce.

The third reason for persistent unemployment is fear. People are terrified of being unable to pay their bills or buy their medicine. Some of the fear is irrational, leading them to hold onto their money for dear life.  They don’t spend money on anything unless they absolutely need to have something right now. That leads to lower consumer spending, which starves the economy.  Fear is being stoked by the 24/7 television network reports that oversimplify the economic news, like a 9.6% unemployment rate, which sounds terrible.  Most Americans are not at grave financial risk, but you would never know that from watching the evening television news or listening to the radio. This morning I heard a Minnesota Public Radio report about the one or two counties in Minnesota that are suffering serious unemployment, but reporters neglect to say the rest of the state is actually doing pretty well. Reporters almost never highlight the good news among workers in industries that are growing more rapidly.  The mantra of television news producers, in particular, is “keep it simple.”   The newsies don’t like telling viewers there are only seven of fifty states that have very high unemployment rates, while most of the rest of the country is experiencing some pain, but no more than the 1980 or 1991 recessions.  The television news people hate telling good news that muddies the water, like that the number of long-term unemployed (those jobless for 27 weeks and over) declined by 323,000 over last month to 6.2 million. Employment has actually risen in several sectors of the economy, news that has been difficult to find in daily doom and gloom reports that stoke further fear. Better to keep the populace hanging by their fingernails from the economic precipice, and hiding their dollars under the mattress.

The final reason for unemployment is the lack of replacement manufacturing and construction jobs in the green infrastructure economy to replace lost jobs. Finland, Sweden, and Japan aren’t waiting to develop alternative sources of energy to drive their economies.  We shouldn’t either, but the US ranks 23rd among “green” economies, right behind Latvia.  Many displaced manufacturing and construction workers could be productively employed by private manufacturing and construction businesses if a commitment were made by the US government to move forward expeditiously in developing alternative green energy, including the necessary infrastructure, such as a new electricity grid designed to accommodate wind and solar power.  We need strong leadership in the White House and Congress on a green infrastructure initiative.  It’s at the heart of creating long-term increases in employment.

In the meantime, employers could stop trying to squeeze blood from their employee turnips.  Just because they don’t scream ouch, doesn’t mean they aren’t hurting.

Thursday, September 16, 2010

Child Rearing, Versedness and Consilient Science

One cannot understand what it means to rear a child, whether a youngster with autism or otherwise, by watching the child through binoculars from a comfortable distance, as though one were engaged in bird watching.  Child rearing is an inherently messy business, requiring rolled-up sleeves, a tender heart, and at times, nerves of steel.  A child with autism is like a poorly translated sonnet whose meter has been muddled and whose closing couplet doesn’t quite rhyme.  How shall we repair the meter without the original as our guide?  In her poem Versed, Rae Armantrout writes, “Metaphor forms/ a crust/ beneath which/ the crevasse/ of each experience/. Traversed by robotic conveyers.”  Let us begin there.
We turn to the tools of science to divine an answer to our versed puzzle.  Our frustration is palpable; definitive answers are so bloody elusive and take so interminably long to achieve. Just when I’m prepared to hear an answer to my question, there is no one to ask, or so it seems. That is because science doesn’t work that way. Scientists do not wait around wearing an intelligent expression, waiting for someone to ask them a question.  It is important to remember that science is seldom based on a particular fact or study that yields earth-shattering results, though that’s always a pleasant surprise when it happens. Effective science is about whether one persistently pursues the trajectory that defines a wisely productive strategy.  Focus on the discovery arc, not the specific finding.
Scientific research is like fishing.  You have to be a good observer of nature so you’ll know which bait to use.  Next, you need to know where to cast your lure, and finally you have to be patient, and be prepared to try again and again until your data leaps out at you like a fish taking a lure.   We cast our bait hoping to reel in a big scientific lunker.  Our skills are improving as we learn how to recognize what we are looking for instead of concluding the task is too daunting or the fish caught so far are too small.  William Whewell, the 19th century historian of science recommended we look at the interface of fields of study for the most fruitful clues.  He called the process of “jumping together” of ideas, concepts and data from sister disciplines, Consilience.  The distinguished biologist, E. O. Wilson wrote a wonderful book by that title in 1998 about the interface of fields of science.   
Educational and behavioral neuroscience is a consilient undertaking.  It is the application of brain science knowledge and methods in tandem with principles of behavior analysis and its methods, to lead to new understanding that permits us promote acquisition of children’s intellectual, social and emotional skills that will elevate their quality of life.   One of the most promising entry points in this effort has involved developing highly effective methods of turning on or off genes that lead to new brain connections, called experience-dependent neuroplasticity. Those experiences are arranged by behaviorally trained teachers and therapists through a process we call Early Intensive Behavioral Intervention.  While experience-dependent brain plasticity may not be the holy-grail many of us suspect, it is a window of opportunity too good to pass up, and may just help us refashion our sonnet.   When we compose our next couplet it will rhyme effortlessly as though things had always been done that way and we will wonder what all of the fuss is about, for it will seem plain as the nose on your face.

Thursday, September 9, 2010

Snakes and People: Coiling or Recoiling?

There has apparently been considerable controversy about the direction in which snakes coil, clockwise or counterclockwise. Dr. Eric Roth (Department of Zoology, University of Oklahoma) has tested these reptiles for the direction they prefer to coil.  Dr. Roth studied the coiling behavior of 30 cottonmouth snakes over a six-month period.   Adult snakes (16 of 20 snakes) preferred to coil in the clockwise direction. Many female snakes (15 of 20 snakes), but few male snakes (only 4 of 10 snakes), also tended to coil in a clockwise pattern.  Roth’s article seemed to come to the conclusion that on average they preferred turning clockwise to the right (Roth, E.D., 'Handedness' in snakes? Lateralization of coiling behaviour in a cottonmouth, Agkistrodon piscivorus leucostoma, population. Animal Behaviour, 66:337-341, 2003.)

A more recent study by Harold Heatwole, Peter King and Samuel G. Levine arrived at a different conclusion. They studied the direction of for two species of viperid snakes—copperheads (Agkistrodon contortrix) and cottonmouths (Agkistrodon piscivorus). Overall, neither species showed a significant preference for coiling in a particular direction. Only 1 of 22 snakes exhibited an individual preference, a result displayed random direction of coiling. Roth’s previously published claim for laterality in coiling direction by cottonmouths actually presented similar results but came to the opposite conclusion. The data from the combined studies suggest that if laterality in coiling direction does occur, it is extremely weak and inconsistent. Oddly, the only snake which exhibited a distinct preference for turning right responded with apparent interest when the name “Glenn” was called. (“Laterality in coiling behaviour of snakes: Another interpretation”  Laterality: Asymmetries of Body, Brain and Cognition, Volume 12, Issue 6 November 2007).
This brings me to the upcoming mid-term elections.  Many people, including some respected pollsters have come to the conclusion the electorate is turning distinctively in a clockwise direction, i.e. to the right.  On the other hand the Pew Poll of only committed registered voters arrived at the same conclusion as Heatwole’s second Copperhead snake study, namely that people, like their viper counterparts, seem to be undecided about which direction they should turn.  They turn equally to the left and right.    
According to the latest Pew Poll, it will be easier to encourage younger folks to turn to the left this November, with the promise an improved economy and other benefits, than to the right (57% to 32%) than their 50+ year old elders who are turning to the right by 11 percentage points.  The problem is, how to get younger people to actually vote.
Facts help.  This year, the Obama Administration's Health Care Plan began preventing insurance companies from denying children coverage due to pre-exisiting conditions, like autism.  In another three years it will protect everyone else. If you are college age, beginning this year, young people who are not covered through their employer will be able to stay on their parents' health plan until their 26th birthday, which is a boon to young people looking for jobs.  The Republicans have promised to reverse these gains if they achieve a majority in the House and/or Senate in November.  Rachel Maddow's (MSNBC) famous "bikini graph" showing consistent reversal of job losses sustained under the Bush administration and gradual job growth, provides further encouragement that we're moving in the right direction.
Here's another idea. Maybe a YouTube video featuring House Minority Leader Rep. John Boehner lip synching to Taio Cruz’s “Break Your Heart" would help generate some interest among young voters.  Remember Boehner’s “Hell No!” podium pounding tantrum during the health care debate? Clips of those outbursts would look great interspersed with verses from Break Your Heart…. “and I know karma’s gonna get me back for being so cold/ like a big bad wolf, I’m born to be bad and bad to the bone…”  Someone out there with a laptop and digital editing software could put together a YouTube video in a Sunday afternoon, which with a little luck could go viral. 
One last thing about snakes’ coiling. When snakes are scared, they find a hiding place and coil up together. Some snakes rattle their tales, like people shouting and holding up signs claiming Obama is like Hitler or Stalin and that he doesn’t have a birth certificate. Tail rattling. If disturbed, snakes strike, pretty much like people who are disturbed by what they don't want to hear. 
Just goes to show there’s much to be learned from studying the snakes' and people's behavior when they’re scared.

Friday, September 3, 2010

Meniere's Disease and Regressive Autism

In early January 2007 I packed my suitcase for a grant review meeting held annually at a hotel on Key Biscayne, Florida. I didn’t really spend much time on the beach at those meetings, since nearly all of our time was in a hotel conference room, discussing research proposal.  Nonetheless, it was always nice to escape from Minnesota’s minus 20 degree temperatures for a couple of balmy days in Florida.  I had written drafts all of my reviews and settled in to get a good night’s sleep before heading to the airport the next morning.  Around 4am I awakened.  When I sat up in bed the room was violently spinning.  I felt a sense of panic, wondering what in the world was happening to me.  I tried to stand but immediately fell, fortunately backward into bed. Within minutes vomiting began, which lasted all morning into the afternoon.  My wife called the Sonesta hotel and left the message for the Committee Chair that I was ill and couldn’t attend the meeting.   So much for warm gulf breezes and seafood salad with iced tea under palm trees.

After recovering from the acute episode, I saw my physician who initially said it was probably caused by a virus that affected my inner ear, but he acknowledged it could also be an uncommon type of vertigo caused by a problem with crystals falling into the canal of my inner ear.  That seemed far-fetched at the time.  Six months later the second episode occurred, this time I had been seated at my computer working on a chapter I was writing.  I suddenly turned my head in response to a noise, and the room began spinning and didn’t stop.  By holding onto the wall, I managed to make my way from my study to bed without falling.  Vomiting lasted the rest of the day. 

I was referred for a test in which a fiber optic camera covered my eyes like goggles and transferred what the camera saw to a computer monitor. The physical therapist asked me to lie down with my head tilting over the edge of the table.  She rapidly moved my head first to the right for 30 seconds, then the left and then she asked me to roll over on my left side and finally to sit up straight, all the while wearing the eye movement camera.  After three repetitions of this sequence, she showed me the images of my nystagmus, rapid jerky movement of my eyes in the direction opposite the head position.  It looked like a series of frantic appearing “beats.” By the third repetition, the nystagmus stopped. That was how I learned I had Benign Paroxysmal Positional Vertigo (BPPV), a real mouth full.  The therapist explained that small crystals, called otoconia, are shed by tissue inside the inner ear which float downward by gravity into the inner ear canal where they eventually settle in sufficient numbers to block the flow of fluid needed to detect the direction of head movements, hence the vertigo when you move your head. 

That wasn't great news, but it turned out there was something I could do about it.  The therapist gave me exercises I could do at home, and I eventually purchased a DVD from Dr. Timothy Hain, an otolaryngologist in Chicago, demonstrating the Epley Maneuver Exercises that would clear the crystals from my inner ear canals.  The exercises seemed to have been working well, until in Mid-May of this year.  I had gone for a routine eye clinic appointment to fit new eyeglass prescription.  As I was pulling into the parking lot the spinning began followed within a minute or two by retching.  I managed to call for help using my IPhone and was hospitalized overnight until the spinning and vomiting stopped with the aid of IV medication. 

 The most recent episode was on July 6th when I was scheduled to teach a class on autism at the University of Minnesota, and I had another episode of violent spinning sensation and vomiting that lasted twelve hours.  I have had more frequent episodes, but now they have been preceded by a feeling of fullness in my right ear, tinnitus, first high pitched ringing and then an almost roaring sound in my right ear. Voices are muffled and unintelligible when I cover my left, “good” ear so am only using my right ear to hear.  After the last episode’s immediate crisis had passed, I saw an ear nose and throat specialist and his colleague, a physican’s assistant who specializes in such conditions.  An audiologist test for loss of hearing at various frequencies was conducted. The audiogram indicated and I had lost much of my hearing at low frequencies in my right ear.  I could tell from the expression of her face that the news was not good.  She said, “With your history of recurring vertigo and vomiting episodes, feeling of fullness in the ear, roaring tinnitus, and now loss of low frequency audition, that is the profile of Meniere’s Disease."  She didn’t break all of the bad news to me at once.  As a professional working with families of kids with autism I do the same, so I knew the drill.  I suppose she was sparing me the information that I would very likely eventually lose my hearing entirely in the affected ear.  She prescribed an anti-inflamatory medication that she said might help over short term with relief from symptoms.  I keep a packet of chewable meclizine in my pocket at all times and on my bedside table at night in case the spinning sensation begins.  If I sit or lie extremely still after taking meclizine the most violent episodes are usually prevented.

Meniere’s disease is a progressive, chronic relapsing neurological condition that destroys the labyrinth of the ear’s cochlea and inner ear that enables one to hear and maintain balance.  In many cases between 5 and 8 years after onset, the condition “burns out,” with cessation of spinning and vomiting episodes but entire hearing loss in the affected ear.  The cause of Meniere’s disease is unknown and there are no treatments demonstrated to be effective. Theories abound but data are scant.  Vestibular Rehabilitation Therapy may enable me to maintain better balance and to use visual and other kinestheic cues that are still working in the other ear to compensate for lack of balance sensation from the affected ear. 

Now I know a little of what parents feel like when they are told their child has regressive autism, for which there is no known specific cause or treatment to halt the progressive loss of skills and worsening of autism symptoms.  My paroxysms of vertigo and vomiting are awful and temporarily debilitating, but nothing compared with the daily crises experienced by children with autism and their families. Long-term intensive early behavioral intervention overcomes most of the symptoms over 2-4 years for half of the children, and the remainder experience improvements but not as dramatic.  If I’m lucky, Vestibular Rehabilitation Therapy will enable me to function more like kids who receive Autism Early Intensive Behavior Intervention with “best outcome,” copacetic if not entirely wonderful.  With my political proclivities, it’s fortunate that my left ear is my “good” ear and eventually won’t be able to hear at all with my right ear (take that, Glenn Beck).

I will likely be a more empathetic listener the next time I have to discuss regressive autism with parents whose child has that condition.