In his Comments, Daniel has asked a lot of questions, and I thought that I’d take a minute to answer two of them. First, after I reviewed a book (Elyn Saks, The Center Cannot Hold, Hyperion:New York, 2007) in which a schizophrenic individual provided her personal descriptions of her life with this illness, he asked how I (a scientist) could know that a first-person account like hers was truthful.
The short answer is that I (a scientist) cannot know. Subjective evidence provided by any individual introspective reporter has a limited value in science. On the other hand, I (scientists) know a LOT about the disease processes that alter behavioral function in schizophrenia, and scientists have conducted thousands of studies variously measuring the performance abilities of populations of schizophrenic patients, using experimental strategies that are designed to eliminate the possibilities of false reporting or deception. Scientists appropriately subject this accumulated information to statistical analyses that informs us about measures of certainty/uncertainty, and on the basis of this wider knowledge, and having read a number of other consistent first-person accounts, Gwyn Saks personal accounts ring true. I applaud the bravery and the effort that this apparently-strong, intelligent woman has made, to provide us with a highly informative and apparently unvarnished account of her life with this devastating illness. However, as a scientist, her individual reporting necessarily falls into a non-fact (subjective) category.
In the same questioning vein, Daniel asks how you can know that students who show powerful advances from using a brain plasticity-based training program (see May 9th blog) aren’t improving just because they perceive these new activities as being exciting, and rewarding. Daniel, the reason that randomly-assigned intent-to-treat controlled trials with psychologically-balanced “control” therapies are the Gold Standard of outcomes assessment is to eliminate just this kind of uncertainty. These training programs have long since passed that test: if you match the hoopla for the “control” class, Fast ForWord training still accounted for much larger gains than were recorded in an equally exciting/fun/intense/serious control limb of the trial. Moreover, the magnitude of those gains were directly correlated with the gains in performance recorded in specific FFW exercises. That argues strongly that those exercise gains translate to kid-performance gains. Or put another way, they can ONLY come from the specific training provided by FFW. Finally, other studies have shown that this training remodels the brains of trained children (they’re “higher-performing” = “more normal” after than before training). It’s hard to fool Mother Nature in such studies, Daniel!
If you look across the landscape of claims for the thousands of things that have been created and sold to make children or adults smarter or more capable, Daniel, you WOULD discover that the vast majority of claims come from non-controlled trials. Exactly the kinds of misgivings that you raise may apply for them. NOT SO, for the FFW kid-training programs, or the Posit Science Brain Fitness or Insight training programs. Controlled outcomes trials are costly, and complicated to organize and conduct. Alas, there is just no substitute for them, if the goal is to determine whether or not your programs really work.
Thanks for the explanations, especially about the FFW etc programs.
One clarification. Regarding Elyn Saks schizophrenia symptom-descriptions, I believe her accounts are truthful. My point is they are very ambiguous, poetic, incomplete, lacking in explanation and elaboration, etc. I’ve also noticed this among autistic/aspergers people who provide their accounts, including those that have their accounts published in books (there are several autistic/aspergers authors, from verbal high functioning, to non-verbal lower functioning).
I’ve also noticed that many with schizophrenia and autism who write their accounts publically (books etc) frequently use stereotyped http://en.wikipedia.org/wiki/Stereotype symptom-descriptions, which they then pass off as their own with slight turns of phrases, such as, among autistics, “fragmented vision” (and “I see a mosaic, not the whole picture”, “I see parts not the whole”), “sensory disintegration” (and “my senses don’t work together”…”When I hear I can’t see, when I see I can’t hear”), “sound is painful”, “light is painful”, “the world closes in around me”, “poor depth perception”, “touch is painful, like sandpaper on my skin”, etc etc.
I asked Donna Williams (autistic author) what she meant by ‘fragmented vision’ and she said “think of a mosaic”, and I then asked her when in her life she realized she has fragmented vision, and to what she is comparing it, that is, did she have a period of non-fragmented vision that served as the basis for her awareness of this symptom, or, does she only at times have this vision and at other times not. She replied (I’m paraphrasing) “Scientists informed me of my fragmented vision.” I believe she was the first person, starting in her books in the early 1990′s, to use this term ‘fragmented vision’, and it, along with a more recent term “sensory disintegration” (“my senses don’t work together”) have become stereotypically used by an immense number of those with autism/aspergers, as well as stereotypically used by many scientists and physicians and parents.
My point is that I think these symptom-descriptions are one or more of the following: not their own, extremely vague, not provided with minimally adequate explanation, and not accurate (I’d argue there is no fragmented vision in autism/aspergers, nor the phenomena of sensory disintegration).
Also, it’s saddening to see the stereotyped terms and phrases appear from new autistic/aspergers authors and others, and even scientists, doctors, and parents. The terms and phrases are accepted in an uncritical way, and used readily as if they are true, and often used as their own. I’ve asked many scientists to explain how they know that many or all autistic people have tunnel vision, fragmented vision, and to explain what they (the scientists etc) mean by these. I’ve been surprised at the extremely poor and incomplete explanations. I mean extremely poor. Embarrassingly so.
An example. The website http://www.wrongplanet.net http://www.wrongplanet.net/forums.html appears to be the largest online community of autistic/aspergers people, and topics of or related to “eye contact” arise very frequently (you can search ‘eye contact’ at http://www.wrongplanet.net/forums-search-results.html in the Keywords box, and find dozens of threads and multi-hundred replies).
In reading many threads over the last few months, I’ve found that (1) the discussion consists only of the psychological and personal experience of difficulty with eye contact, and things related such as self-help and support discussion, such as, dealing with the difficulty of eye contact (psychologically and behaviorally how to cope with it) etc, and (2) the discussion does not consist of attempts to address, at a fundamental level, why eye contact is difficult, that is, what occurs such that eye contact is difficult. Yes there are hundreds of explanations like:
“I don’t like to look at people’s faces or eyes” “It freaks me out” “I don’t know which eye to look at or for how long” “There is nothing interesting of the eyes and face” “I get incredibly anxious upon looking at someones eyes and face” “I can’t think when I look at someone” “Eyes are overwhelming” “Eye contact is unimportant and only a neurotypical (normal person) stupid phenomena”.
These and similar explanations only describe the personal and psychological experience, and do not describe what, if anything, occurs with one’s visual-perception and/or visual-attention such that they are limited in their ability to have eye-contact as a useful part of their interaction with others.
I believe this is so because they are not able to observe what occurs, because they have known nothing different. In contrast, there is a severely affected adult with aspergers who had a brief period (about 1 week) of nearly full remission from devastating aspergers sensory symptoms, caused by a serious brain event that had it’s own specific physical symptoms. This person has observed what occurs during normal eye contact, and this person has observed what occurs during impoverished eye contact. This person is able to contrast what occurs during both, and observes what occurs with visual-perception itself, that is, fundamentally.
“Tito seems to lack a sense of his own body, the kind of internal map, Dr. Merzenich said, that normal children develop in their first few years. The maps involve brain regions that specialize in the sense of touch and movement and are widely connected to other areas, and they are highly dynamic throughout life, changing in response to everyday experience.”
Rather, Tito, likely, as he looks around, and as he moves around, lacks the ability to see the entirety space he is located in, and the space around him. And, this, involves a lack of “sense” of (1) the entirety of his body, and (2) where his entire body is located.
He clearly has SOME sense of his own body (and not a lack of ANY sense of his own body). What sense he has stems from the extent of his ability to see the space he is located in.
Also, all of this occurs whether his eyes are open or not: What occurs in his internal imagery, and his internal picturing of the world around him as he thinks, feels, and moves around, is the same in nature to when his eyes are open.
The issue is not, I’d argue, the lack of an “internal map” caused by problems with “the sense of touch and movement” and the construction of this internal map.
This is not hypothesis. This is observation of perception itself.
In a previous article of yours about other medical conditions, you talked a lot about expanding the visual field, but it was so in terms of pure vision. Tito’s vision is 100% normal. His visual-attention is not. Yes it’s possible that visual exercises and/or brain exercises will expand his visual field, but this will be irrelevant to his visual-attention.
Would you be interested to discuss this, and contrast this with your view and others views?