New Therapies Take Early Aim at Autism

04/16/14 | by Training Games | Categories: Play

Scientific American Mind
Dec 19, 2013 | By Luciana Gravotta

Autism, a complex disorder of brain development, is now estimated to affect one in 88 kids.

Delivering therapy to kids with symptoms of autism at age one or two is likely to result in greater improvements in IQ, language and social skills than does starting therapy later.

Researchers have developed screening tools that can identify at-risk infants and toddlers, along with a treatment designed for children as young as a year old.

Soon after Noah turned a year old, his parents, Leslie and Paul, noticed something was not quite right with their son. At 10 months Noah had learned to say “Mama” and “Dada,” but at 14 months he no longer uttered any discernible words. Music had a powerful and strange effect on Noah: when he heard it, he would stop what he was doing and “zone out,” according to Leslie.

Four months later Noah's parents brought up their concerns about their son with his pediatrician. The doctor recommended they wait until his second birthday to see if he would catch up with his peers. The advice did little to allay Leslie and Paul's worries.

Absence of language, heightened sensitivity to sound or other sensory stimuli, and difficulty shifting focus from such stimuli, including music, raise the specter of autism in very young children. Autism, a complex disorder of brain development, is now estimated to affect one in 88 kids. It is characterized by communication deficits, impaired social interaction, repetitive motor behaviors, and, sometimes, intellectual disability or physical health problems. Because autism is defined by complex behaviors, obvious signs do not emerge until children start stringing words together and engaging in play with their parents, at about two years old. Children with autism may, for example, continue to play alone far longer than is normal.

The concept that autism is treatable is controversial and new. Newer still is the idea that if children receive therapy very early in life, they are more likely to overcome their deficits. Now, however, many experts believe that delivering therapy to children as young as age one or two—instead of four, as is more typical—can garner greater improvements in IQ, language and social skills. Officials at the American Academy of Pediatrics and the Centers for Disease Control and Prevention, among others, now recommend early detection. To identify autism (or autism risk) in younger children, researchers have had to develop novel screening tools. In addition, one new intervention designed for children as young as a year old has been shown to significantly improve social communication skills.

Noah was not pointing, was not responding consistently to his name and was not bringing his parents objects that he wanted to show them. Noah now scored “at risk.” Leslie and Paul brought him to a neuropsychologist, who watched him play and tested him for behaviors that are considered red flags. His parents completed additional rating scales. These assessments indicated that Noah indeed had autism. His was a moderate case; his cognitive abilities outpaced his social skills.

Paul scoured the Internet for other interventions and found the Early Start Denver Model (ESDM), a therapy for infants as young as a year old developed by Sally J. Rogers of the University of California, Davis, MIND Institute and Geraldine Dawson, now at Duke University Medical Center. Because no ESDM therapists lived near them—only 50 or so individuals are certified to perform it in the U.S.—Leslie and Paul used the manual as their guide. But eventually they realized they needed professional help and contacted Dawson. They began driving three hours each way to get Dawson's advice, as well as therapy for Noah.

The ESDM emphasizes interaction as the basis for learning, and instead of doling out explicit rewards, the therapist aims to make the activities themselves rewarding to the child. An adult first searches for something that engages the child—tickling, say, or driving toy cars. Then the parent or therapist coaxes social behaviors in that context. If a child likes a specific book, for example, the adult might encourage the child to point to the book as a way of requesting it. In Noah's home, toys are now in bins and on high shelves so that he has to point to get what he wants.

Collaborative play involving eye contact and sharing is taught next. For example, Noah's parents try to surprise their son by changing the tone or speed of their voice while reading, so that Noah will look up at them and make eye contact—which they reward with a huge smile. Social skills are also taught as part of everyday activities, such as during bath time or lunch. If Leslie wants Noah to choose between two types of drinks at a meal, she holds both beside her face so that he naturally looks up at her before asking for one of them. In Noah's case, early therapy seems to have produced remarkable results. Within one month of first seeing Dawson, at 28 months old, Noah started pointing spontaneously. About three months later he looked at his parents to request something. One month after that, in April 2013, Noah gestured as a way of sharing information with others: he pointed something out to his younger sister, Elina.

Tags: autism

Our Brains Have a Map for Numbers

04/08/14 | by Training Games | Categories: Play

Jan 14, 2014 |By Emilie Reas

“Come on. Get out of the express checkout lane! That’s way more than twelve items, lady.”

Without having to count, you can make a good guess at how many purchases the shopper in front of you is making. She may think she’s pulling a fast one, but thanks to the brain’s refined sense for quantity, she’s not fooling anyone. This ability to perceive numerosity - or number of items - does more than help prevent express lane fraud; it also builds the foundation for our arithmetic skills, the economic system and our concept of value.

Until recently, it’s remained a puzzle how the brain allows us to so quickly and accurately judge quantity. Neuroscientists believe that neural representations of most high-level cognitive concepts - for example, those involved in memory, language or decision-making - are distributed, in a relatively disorganized manner, throughout the brain. In contrast, highly organized, specialized brain regions have been identified that represent most lower-level sensory information, such as sights, sounds, or physical touch. Such areas resemble maps, in that sensory information is arranged in a logical, systematic spatial layout. Notably, this type of neural topography has only previously been observed for the basic senses, but never for a high-level cognitive function.

Researchers from the Netherlands may have discovered an exception to this rule, as reported in their recently published Science paper: a small brain area which represents numerosity along a continuous “map.” Just as we organize numbers along a mental “number line,” with one at the left, increasing in magnitude to the right, so is quantity mapped onto space in the brain. One side of this brain region responds to small numbers, the adjacent region to larger numbers, and so on, with numeric representations increasing to the far end.

To examine how the brain responds when perceiving quantities, the researchers conducted functional magnetic resonance imaging of the brain while participants viewed different numbers of dots on a screen. They included multiple versions of the task, keeping key features — like dot size, circumference and density — constant, to be certain that any effects were indeed attributable to dot quantity, rather than dot shape or size. The participants weren’t asked to judge the number of dots, to ensure that brain activity related to perceiving quantity, rather than counting. The researchers then looked for brain activity that systematically varied with the number of dots the participants viewed.

The scientists identified a region, a few centimeters wide, in the right superior parietal lobe (in the upper back part of the brain) that mapped numerosity. One edge of this patch (closer to the middle of the brain) responded maximally to small quantities, and the opposite edge (closer to the outside of the brain) responded to the largest quantities. The location and layout of this map was remarkably consistent across all eight individuals’ brains. Earlier studies reported that this same brain area in humans, and single neurons in an analogous part of the monkey brain, responded to numerosity. However, these studies had not detected this systematically organized map.

The researchers more closely examined how activity in this neural map related to the numbers and types of dots the participants viewed. They found that the parietal cortex map represented relative, not absolute, quantities. For instance, a given region might respond to two dots in one task condition, but to three in another; but across tasks, it always responded to small numbers of dots. Furthermore, the amount of cortex devoted to a given quantity varied, such that disproportionately more area represented small quantities, and less area represented large quantities. The map was more selective for smaller than larger numerosities. This system makes intuitive sense, as it corresponds with our subjective experience. It’s much easier to distinguish between one or two cookies left in the jar, than between eleven and twelve cookies. In light of these findings, this finer discrimination for smaller quantities might arise from their overrepresentation in the brain.

This isn’t the first time neuroscientists have observed maps in the brain. In fact, it’s well established that sensory and motor information, including representations of our visual surroundings, bodily space or sound frequency, is also topographically organized to subserve vision, touch, taste, smell and movement. For example, a homunculus, or “little man,” is mapped onto the brain’s motor and somatosensory cortices, such that different regions of this cortical map support movement and sensation in different body parts. The brain areas devoted to feeling the face and lips are adjacent, and the area responsible for toe movement lies next to that involved in ankle movement. This new study reveals that such maps aren’t limited to sensory and motor functions, but also exist for an abstract feature - numerosity.

Information overload acts ‘to dim the lights’ on what we see

04/08/14 | by Training Games | Categories: Play

17 March 2014 UCL News

Too much visual information causes a phenomenon known as 'load induced blindness', with an effect akin to dimming the lights, reports a new UCL study.

The new findings could be used to identify high-risk situations in all walks of life and look at ways to mitigate times of highest risk. These techniques could be used to understand everyday problems such as why you might bump into a lamppost on a busy street or even to assess the demanding information loads faced by pilots and surgeons.

More than half of all air crashes are down to pilot error, as the overwhelming amount of information faced by pilots makes them more likely to miss things. The research shows that when people have to deal with lots of visual data, their ability to spot critical information is lessened as if light levels of the image they need to detect were significantly lowered.

In the experiment, volunteers completed a sensory memory task that either involved encoding the color of a single square, 'low load', or both the colors and positions of six different colored squares, 'high load' over many computerized displays that were rapidly flashed up. In addition, while they encoded the colored squares, a stripped black and white image appeared in the surrounding area. The striped patches had lines in different orientations, representing the building blocks of shapes. Participants were asked to detect whether the orientation of the lines was rotated clockwise or anticlockwise.

Participants correctly spotted rotations with 95% accuracy during the low load task but only 64% accuracy during the high load task. The contrast of each image was varied throughout the trials, representing a change in the level of light illuminating each image. The results showed that participants required the equivalent of 50% more light contrast on average to spot orientation rotations under high load conditions.

“Spotting the appearance of any critical image in the environment depends on its level of contrast as our neurons are more responsive to stronger contrasts” explains UCL Professor Nilli Lavie, who led the research. “In high load situations people needed significantly more light contrast to spot rotations with a threshold of 27% contrast, compared with 18% contrast for low load conditions. In other words the neuron responses required more contrast and the image appeared dimmer in the high load. For a pilot, this could make the crucial difference between whether or not they spot that the hand of a dial has moved or a warning light has come on, or see something through the window that was not detected by instruments.”

The study involved 14 healthy volunteers with normal vision, each of whom completed 384 trials in total. The effects were consistent across the group, and the images used in the trial were specifically designed to investigate the effects of light contrast.

“What’s fascinating is that the relationship between image contrast and people’s ability to spot things is shifted in high-load scenarios in a pattern that is the very same as if the image’s level of light contrast was turned down,” says Professor Lavie. “The neurons’ response to light contrast has a very particular function, with highest response at the crucial mid-range zone, and the effect of load followed the same function. This suggests load caused the same effect on the neurons’ response as dimming the actual image light contrast.”

Further investigating the ‘load blindness’ induced by information overload could offer future strategies to minimize human error in demanding jobs.

“We need to identify and understand the most attention-demanding situations that people face so that we can look at ways to address the risks,” explains Professor Lavie. “Surgeons are another group who must deal with high levels of information, so it would be useful to evaluate the stages of surgical procedures that are the most vulnerable to information overload. You could then look at installing appropriate preventative measures to mitigate these risks, whether that’s changing training, equipment or staff roles.”

What Causes the Brain to Have Slow Processing Speed, and How Can the Rate Be Improved?

03/24/14 | by Training Games | Categories: Play

Scientific American Mind Volume 25, Issue 2

Mar 1, 2014 |By Heather Walker

Geoffrey A. Kerchner, assistant professor of neurology and neurological sciences at the Stanford University School of Medicine, responds:

To a brain scientist, processing speed means just that: the rate at which a human can take in a bit of new information, reach some judgment on it and then formulate a response. Studies suggest that the speed of information processing changes with age along an inverted U-shaped curve, such that our thinking speeds up from childhood to adolescence, maintains a period of relative stability leading up to middle age, and finally, in late middle age and onward, declines slowly but steadily.

That processing speed slows with age is intuitive to most people. Many elderly individuals have noticed that it takes them longer to solve problems or make decisions than it did when they were young. Yet the reasons for this age-related deceleration in information processing are not completely understood and may vary from person to person. Some compelling evidence suggests that such a decline reflects wear and tear of the white matter in the brain, which is made up of all the wires, or axons, that connect one part of the brain to another. Slowed information transfer along axons may impede processing speed. But what causes this axonal communication to slow down in the first place?

In some people, diabetes, smoking, high blood pressure or other so-called vascular risk factors can wear away at the blood vessels feeding the brain's white matter, starving axons of much needed oxygen and glucose. Some people may have a genetic predisposition to age-related white matter decay, a poorly understood but actively studied hypothesis. In other individuals, slowed processing speed could be the first sign of a neurodegenerative illness, such as Alzheimer's disease. Head trauma, including concussions, may play a role. These are a few of the many ideas out there—other factors surely remain to be discovered.

More important, slowed information processing affects almost every aging adult to some degree, and the line between normal and abnormal is fuzzy. A person may sustain or even improve information processing speed by paying close attention to vascular risk factors, engaging in regular aerobic exercise, eating well and continuing to challenge oneself intellectually.

Toward a More Collaborative PowerPoint: Q&A with Michael Schrage

03/24/14 | by Training Games | Categories: Play

By Cliff Atkinson

Michael Schrage writes and consults about the design and diffusion of digital innovation and their effects on business relationships. One innovation called PowerPoint has had a big effect on business, and according to Michael, a core problem with it is the fact that it is a presentation tool in the first place, instead of a collaboration tool. Michael is a contributing editor to WIRED, Marketing Computer and ID magazines, and has written for Harvard Business Review, the Wall Street Journal, Red Herring, Institutional Investor, Science, the Los Angeles Times and the Washington Post. Michael is an MIT Media Lab Fellow and author of No More Teams and Serious Play.

Cliff Atkinson: Michael, is PowerPoint having a big impact on communications, or is it simply reflecting trends that have been going on all along?

Michael Schrage: The most vicious criticisms of PowerPoint are absolutely true. But the people who believe that PowerPoint has done a fabulous job of clarifying are also right. Most adults know within 90 seconds whether a PowerPoint sucks or is useful. When it works, it’s fabulous and it reinforces the talk. In the hands of people who know how to use it, it reinforces their credibility. In the hands of people who take the path of least resistance, it undermines it. I’ve seen literally the abstract of three Ph.D. theses on a single slide - what’s the point of that? I’m not the only person in the room wondering that. The fact that incompetence in PowerPoint is so easy to identify, really makes it so much easier for the audience to assess the intelligence of the speaker.

CA: What is an effective PowerPoint design approach?

MS: Once you’re talking about designing the “presentation,” you’re defining the presentation to the exclusion of meaningful interaction. Instead, you should ask how much time you spend focused on how the audience is going to interact with you.

CA: Why do we use PowerPoint to "present" instead of "interact"?

MS: I think the technology biases that, and the way most meetings are run reinforces it. I hate to say it, but it’s a path of least resistance. The question is not “What am I trying to say?”, but “What kind of reaction do I want from the audience?” It’s not about optimizing the presentation; it’s about optimizing interaction. There is a difference between somebody teaching and somebody learning. The idea that I appear to be a great teacher, but my class doesn’t learn, means I’m really not a great teacher.

CA: So media should and could facilitate interaction?

MS: Clearly, interaction does matter. It depends on a variety of issues: the nature of the presentation, the size of the group, message to be delivered. It does not appear that our technical infrastructure - especially if we’re building it around things like PowerPoint - is robust enough, flexible enough, or capable enough to embrace in any meaningful way facilitating interaction, as opposed to facilitating presentation. That’s a bad thing. That should change.

CA: Do the ways people use PowerPoint stem from a general fear of public speaking?

MS: Often times what you are witnessing in a public speaker is a performance. There’s nothing wrong with performance art. But please, let’s not delude ourselves into believing that good performance art translates into increased business or interpersonal productivity. When we’re talking about how we want to communicate with an audience, we are kidding ourselves if we do not think as much about the nature of interaction as we do about the nature of presentation. And the idea that we shouldn’t try to get a sense of who the audience is, and the kind of impact we think matters to them, is delusional. Or even worse, unprofessional.

CA: Can journalistic writing skills help people prioritize information in PowerPoint?

MS: The classic question I ask myself as a journalist is, “Who do I want to pick up the phone and call whom after reading this piece?” If I have a decent answer to that, after I’ve covered the basics, that’s a fabulous way of prioritizing. A good journalist will get a sense of “What’s the story? What’s important in the story? Where’s the conflict driving the story? And where’s the consensus?”, and you move within those parameters. You have a finite amount of time and a finite amount of space - in journalism, it’s due today. The constraints force you to prioritize. The issue is not banning PowerPoint - it’s about putting constraints on it. For example, limit a PowerPoint to no more than 10 slides, no more than 20 words, and 2 of those slides have to have pictures or charts. Just as in the strict rhyming structure of sonnets or haiku, art is defined by constraints. A problem with PowerPoint is that you can just create another slide. In the first and final analysis, do we use technologies to engage our audience, or to better articulate what we want to say? There are a lot of arrogant people who believe that better articulating what we want to say is synonymous with engaging the audience. That’s not acceptable.

CA: It sounds like it boils down to self-centeredness.

MS: Does PowerPoint enable narcissism? Yes. That’s why PowerPoint is very often not about building community consensus, but about imposing an individual’s view.

CA: It’s interesting that when people talk about “interactive” technologies like email, chat and websites, they never mention PowerPoint, even though it is the only one of those technologies that actually brings people into the physical presence of one another to “interact”. Why is PowerPoint not part of the “interactive” conversation?

MS: I’ve done facilitated meetings where people take notes and project them on a screen, or take spreadsheets and project them. You do have meetings that take advantage of projection capabilities, and you work around the spreadsheet, or you work around the document. You actually do collaborative design that way. But there’s no place to do that in PowerPoint. PowerPoint has never been treated as an interactive medium. Microsoft should build voting capability into PowerPoint. The voting technologies make a huge difference for two reasons: the audience pays attention because they get to participate, and you get a sense of what the audience considers its priorities are. There are times when I intentionally try to show the audience how divided it is - I’m trying to use wedge issues with the audience to create a fight, to create tension. There are other times I try to promote consensus. Those are useful techniques for any presenter and facilitator.

CA: Having that sort of instant audience feedback sounds like it would break the ice and make everyone more comfortable.

MS: You at least begin with where they are. Beginning where you are is totally obnoxious and arrogant. I think it’s a mistake.

CA: How do you approach your own PowerPoint?

MS: I look at each slide as a market test - I’m always looking to see how the audience reacts to a slide. If they’re not smiling, or there’s not a perceptible change in the body language, then there’s something wrong. You want iteration and feedback. PowerPoint should not be a finished presentation, but an invitation to respond and interact.

Cliff Atkinson is an acclaimed writer, popular keynote speaker, and a consultant to leading attorneys and Fortune 500 companies. He designed the presentations that helped persuade a jury to award a $253 million verdict to the plaintiff in the nation's first Vioxx trial in 2005, which Fortune magazine called "frighteningly powerful." Cliff’s book Beyond Bullet Points (Microsoft Press, 2005) is an bestseller that expands on a communications approach he has taught at many of the country's top corporations, advertising agencies, law firms, government agencies and business schools.

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