The Speed of Dark

For parents,  a child’s “pathology”  or diagnosis may sometimes seem to encompass the whole world.   You’re in the trenches, dealing with it every day–the child’s behaviors, the child’s struggles, the reaction of those around you to the child and the child’s struggles, and your struggles, the therapy appointments, the judgments so many people make about you as a parent and your child as a child.   Anyone in any of life’s “trenches” (whether it’s a health or economic or social trench)  begins to feel that the sides of the trench and the shells raining down from above define reality.

But that’s not the case.

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It’s understandable that parents of children with autism, like parents of children with any developmental problem, want to know what caused  it–and often want to know who’s to blame.    Unfortunately, in the case of autism and childhood immunizations, a combination of greed, bad logic, and outright lying by some unscrupulous  “investigators” has created a situation in which innocent parents have come to believe that evil vaccines caused their children’s autism.

It’s not true.   Yet, like many errors, it’s become ingrained in some peoples’ minds–largely because of three factors.  First, it gives parents someone to blame and gets them off the hook with relatives.   If it’s caused by vaccines, they don’t  have to consider the known causes, including genetics.  Second, it makes a huge profit for those who promote the vaccine hypothesis and offer goods and services to ameliorate the supposed damage done by the vaccine.  And third, there’s the profit motive: if autism were caused by vaccines, then suing vaccine manufacturers (and now, the government because it’s taken over the liability) could make a lot of money for lawyers and parents alike.

To understand why the vaccine hypothesis is wrong requires some history as well as good science.

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When our son was little, he was considered “low-functioning” because he was nonverbal and tested severely delayed on just about all developmental measures.

A friend’s son was considered “high-functioning” because he was highly verbal and had a high IQ.

The story of how verbal ability became a marker for “high-functioning” in autism is grist for another post, but the implications, for both verbal (Asperger’s) and nonverbal (classic autism) varieties of spectrum disorders is today’s topic. There’s a long history in our educational system of assuming that IQ measures “global” intelligence and thus determines what can be expected of a given child in every aspect of their lives (other than, maybe, sport.) The kid with a high IQ is expected to make A in everything; the kid with a low IQ is expected to struggle in everything.

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A recent Commentary in the international science journal NATURE (11 December 2008, vol 456, p.702)  discussed the science and ethics of the use of cognitive-enhancing drugs by the healthy.   As the article pointed out, substances believed to help people control attention, remain alert when working at night or extra house, and learn faster/better are now in widespread off-label use–used by those who do not have the diagnoses for which these substances were developed.

Coercion–pressure to use these substances even if the individual doesn’t want to–is already being applied (for instance, by the Armed Forces for the use of certain stimulants, and by teachers who  believe a child will be less trouble in the classroom if put on Ritalin) and employers began to looking at the possibility of enhancing work performance with drugs some years ago.   Since coercion by an employer is one of the plot drivers in The Speed of Dark it seemed like a good topic for this blog.

What is “cognitive enhancement” and what kinds of issues should be considered when anyone (disabled or not) faces a decision about the use of pharmacological or any other method of “enhancement?

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