Wednesday, February 10, 2010

New from the TMS lab and autism research


Last night I attended Brain Health / Body Wealth at Harvard Medical School. Dr. Alvaro Pascual Leone told a rapt audience about new discoveries in brain plasticity and what it may mean to us, especially as we age. Then Dr. Dan Press talked about practical neurology, and what’s on the immediate horizon for conditions like Alzheimer’s.

After they spoke Paul Levy came to the podium. He’s the head of the Beth Israel hospital, and he spoke of the need for more funding to support the cutting edge research that doctors like Alvaro and Dan are pursuing. To my surprise, the event finished with this video of me:

www.youtube.com/johnelderrobison

I knew they were going to show it, but I’d never seen the thing projected on a big screen and I almost felt embarrassed being up there like that. But I believe in all I said, and I believe most of all in the promise of the work Alvaro and his team is doing at Beth Israel neuroscience.

There’s a lot of talk about genetics in the autism world. And genetic research may lead to discoveries that help my grandchildren. However, genetics study is not likely to help you, me, or our kids, friends and family. Research like Alvaro’s – using TMS to remediate disability in people like me – has tremendous promise for all of us, in the very near future.

Looking at that video, I was really struck by how far I’ve come in the past two years. If you watched that earlier video of me, watch this one now, from two summers past. Look at the differences in me. In this earlier video, I am robotic and mechanical. My voice is different. I am stiff and rigid. It’s almost a different person.

http://www.youtube.com/watch?v=BIZsYGxXHis

Compare the animation in my face, my hands, the range and prosody of my voice . . .

TMS has played a big role in the transformation you see between those two films. If we could do what’s been done for me for anyone else who asked for help on the spectrum . . . it would be a parent or clinician’s dream come true. And I believe we will. But not quite today. We are so close, yet also so far . . .

People write me and ask, “How can I sign my child up for this?” I am always sorry to say that clinical trials are still some years in the future, even though you can join our scientific studies now. If you’d like to talk about joining a study you can write Lindsay Oberman, Phd at loberman@bidmc.harvard.edu

Do join us; but keep in mind that we are engaged in scientific discovery. It’s too early to promise or even expect any specific result. We’re still experimenting – stimulating different area of the brain to see which ones are involved in what I call emotional intelligence. There’s no way to find that out, other than by doing experiments with autistic people like me. Or you – if you join me.

If you join us, the experiments may change you, or they may not. The scientists can’t make any promises. Not yet. We certainly can’t set false expectations, yet what I have seen gives me great hope. I know what’s in there now. Whatever happens, we are advancing science and we are on the fast track to solving this particular set of problems.

As I say in the video, some of my TMS experiences have been totally life changing. Turning on the ability to see into other people overnight is, as I describe in the video, one of the most powerful emotional experiences of my life and the effects of that are still reverberating today.

But other TMS experiences did nothing. A few may have even made me a bit worse. That’s what science is all about. You try different things, pick the winners, and sharpen your focus for the next round of research.

I talk in the video about how one stimulation turned on the ability to see into others. We all agree that’s a wonderful, incredible result. But it was also unexpected. The scientists were prepared to measure a subtle temporary change in me. Instead, we got a major permanent shift.

While that’s great, it also gives us pause for thought. How will we measure such changes in others? And if that stimulation produces a permanent change, we have to be very careful, because other stimulations could produce permanent changes we don’t want.

That’s why we have to move slowly, despite everyone wish for speed!!!! The last thing we want to do is damage someone in the quest for insight.

So I’ve talked of the caution and worry and where we are . . . what about the promise?

TMS has shown me a world of emotional response that I never knew existed. I have always had deep feelings, both for myself and for others, but I lacked the immediate connection. When the TMS turned on “seeing,” I was able to look at another person’s smile and immediately smile back. I look at people and I just sense what they are feeling. To someone like me, it’s almost magical. If you're not autistic, you might say, so what? If you're like me, it's hard to even imagine such a power of perception.

TMS has shown me what I’ve missed all these years, and I want to make up for all that lost time. But it’s also turned my life upside down, as the balance of wants and needs changed for me overnight, and I see many of the people in my life in a different light.

I wish this work were as easy as it seems when we hit it right. We stimulate an area, and get a powerful result like I describe. But then we stimulate it again, and nothing much happens. Why? We don’t know. We stimulate an area in me with great effect, and it does nothing for someone else in the study. We get a result on someone else, and it does something opposite for me. How? Right now, it’s an extremely complex puzzle, probably the most complex puzzle I’ve ever known in my life.

I believe Alvaro and the scientists will unravel it, and I will be proud to make whatever contribution I can. Alvaro and his team at Harvard Medical School and Beth Israel Deaconess Medical Center are truly the best in the world, and they are defining the cutting edge of autism research.

We are going to find the answer to this puzzle. I feel very confident that we will learn how to “turn on” emotional intelligence in other people like me. In doing so, we can take away a huge component of disability from high functioning autism.

And it does not stop there. What if the mechanism that holds down emotional insight also holds down speech? What else may be affected? The possibilities for that are staggering for the more seriously impaired population.

I’m proud to be part of it, that’s for sure. And I welcome any of you, if you want to join me on this journey.



Here are some of my other TMS autism stories:

Look Me In The Eye: Brain Plasticity and TMS
Look Me In The Eye: A return to the TMS lab
Look Me In The Eye: Brain Plasticity and how it affects us
Look Me In The Eye: A summary of my TMS posts

Tuesday, February 2, 2010

Join me Feb 9 for an evening at Harvard Medical School



If you have followed my work with the TMS lab at Beth Israel Deaconess Medical Center you may find this evening fascinating . . .

Brain Health—Body Wealth

SPONSORED BY THE BOARD OF OVERSEERS

Tuesday, February 9, 2010

5:00 p.m. to 7:30 p.m.

The Joseph B. Martin Conference Center

at Harvard Medical School

77 Avenue Louis Pasteur, Boston, MA

Complimentary Parking

Business Attire

Additional Guests Welcome

Kindly reply by February 1, 2010 to Kirsten Doyle at (617) 667-7331 or email kdoyle@bidmc.harvard.edu.




5:00 p.m. cocktail reception and Brain Fitness Assessments

Measure Up

Assess your BMI, blood pressure, and other health measures that matter

Master Memory

Check your memory and learn strategies to improve it

Margaret O’Connor, PhDBonnie Wong, PhD

Connections Count

Assess your mood and learn strategies to nourish relationships

Antonio Bullon, MDLissa Kapust, LICSW



MindMatters

Learn techniques to reduce stress

Rebecca Wells, MD

Keep Moving

Fit exercise into your daily routine

Jennifer Divine, MD

Eat Right

Learn how to make good food choices

George Blackburn, MDKristina Spellman, LD



6:00 p.m. dinner and speaker presentations

Featuring...

Your Brain Keeps Changing

Harnessing brain plasticity to prevent cognitive decline

Alvaro Pascual-Leone, MD, PhD

Director, Berenson-Allen Center for Noninvasive Brain Stimulation

Beth Israel Deaconess Medical Center

Groundbreaking research at The Center for Brain Health (CBH) at Beth Israel Deaconess Medical Center is transforming the way we grow older by recognizing the centrality of a healthy brain in the aging process. The focus of the Center is the development of technologies and interventions aimed at the earliest detection of brain disorders; the prevention of neurocognitive decline and the preservation of brain fitness across the age-span; and the repair and rehabilitation of impaired brain function to forestall chronic deterioration and its effect on general health. By accomplishing these goals, CBH will extend the overall health, societal productivity, and quality of life for elders.

www.bidmc.org/CentersandDepartments/Departments/Neurology/CognitiveNeurology.aspx

5:

Monday, February 1, 2010

Gravity Pulls You In




Last summer, my friends Kyra Anderson and Vicki Forman asked me to write a foreword for the anthology of autism stories they's been working on for the past few years. I'm proud to tell you that they completed the project, and the book goes on sale next week. You can order a copy here:

Order Gravity on Amazon



And now I'll share the foreword, to give you an idea what's coming in the book. I hope you enjoy it.


Have you ever wondered what it would be like to raise a kid with special needs? I have. You’d think I’d know, since I was a kid with special needs myself. I have Asperger’s syndrome, a form of autism. The autism spectrum encompasses a wide range of conditions from total disability to mild eccentricity. I’m fortunate to be at the less-impaired end of the spectrum.
The one thing all of us have in common is some degree of social impairment. We may also have speech, coordination, learning, and health issues. Most of the kids who populate Gravity Pulls You In have some kind of autism.

I recognize myself in many of their stories. They bumble and struggle and fail, and I remember experiencing those very same things long ago. Then I read of their triumphs, and I remember my own small victories. Exceptional clarity of memory is fairly common among people on the spectrum.

With all the names I was called growing up, it’s no surprise I saw myself as a misfit child. With that self image, I naturally thought anyone like me must be a misfit, too. However, I know different now. Today I realize that the autistic condition is really the human condition. Our hopes, dreams, and feelings are exactly the same as anyone else’s. We just don’t show our feelings in the conventional way, and we don’t respond to other people’s signals as expected.

Yet inside, we are all the same.

It’s very frustrating how much of the world is oblivious to that simple truth. In fact, my own distress over that bit of ignorance is one of the things that drives me to be a writer, speaker, and advocate today.

I thought I could contribute a story from the special needs child’s perspective, but as I read what others had written I saw my own experience was fundamentally different. I am indeed a person with Asperger’s, and I have been this way all my life, but there is a very important distinction. When I was a child, I didn’t know I was autistic, and neither did anyone else. I was a just a regular kid with a lot of problems and very few friends. I was also a kid who did strange things. And I was a kid who got into a lot of trouble.

You might also think I’d understand the special needs perspective because I raised a kid with special needs thirty-some years later. My son, who is now 19, also has Asperger’s. However, I didn’t know he was Aspergian until he was seventeen, and by then, the kid-raising was mostly done.

My special needs parent experience was limited to watching Cubby get tested, listening to inconclusive results, and arguing with an uncooperative school system. Eventually, I gave up. “He’s just not applying himself,” they said. That was the same line they fed me, thirty-some years earlier, and I gave up then too. At one level I knew they were wrong, but I did not know exactly how to counter them. Naively, I believed they had my son’s best interests at heart. I don’t know why I would have thought that, because I knew they were not on my side as a kid, but there you have it. Maybe it’s the eternal optimist in me. Anyway, I now know better. If I get a third chance, with an Aspergian grandson, I will not send him to that school system. I will make better choices.

Faced with failure and an endless hassle, I dropped out of high school, and so did Cubby. He’s in college now, but he’s had a harder time that he might have, had the school be a little smarter or a little more cooperative, or if I’d pushed them a lot harder. But it’s not my nature to whine about such things. Cubby is in school and working two jobs, and he’s making his way. That’s all any of us can hope for, short of rigging a lottery machine and getting away with it.

I guess my experiences show that it was possible to raise a special needs kid in ignorance in the sixties, and it’s still possible to do it today. But can parents do a better job with the benefit of additional knowledge? My sense is, they can. That’s why books like this exist. I wish I’d read some myself, long ago.

I also wish someone had told me about Asperger’s when I was a teenager. I knew I had problems, and in the absence of an explanation like autism, I assumed I was just defective. The corrosive aftereffects of that childhood assumption followed me right into middle age, when I finally received a proper diagnosis. Much suffering could have been avoided if I’d known at fifteen.

That’s one good side to early diagnosis. Another is the benefit of early intervention. Countless medical studies have shown that kids who receive early diagnosis followed by aggressive therapy do better than kids like me, who grew up in a free-range state.

So those are two great reasons to raise kids in a state of awareness and focus. Every parent in this book does that. If I could go back in time and raise myself again, or start over with my son, I’d do the same. What parent wouldn’t?

So what’s the downside? I can sum it up in two words: Reduced expectations. There is a real risk that a diagnosis will place limits on a kid’s development because people will forevermore say or thing, He has autism, so he can’t do that . . . When I grew up, no one had any knowledge of Asperger’s syndrome. That meant I was held to the same standards as every other child on the street. I had to learn to get along, attend classes, and get passing grades just like everyone else. At least, that was the idea. I followed that path till tenth grade, and then I dropped out and went my own way.

There was absolutely nothing to hold me back except myself. In fact, I often had more incentive to make my own way because I was always on the edge of starvation and ruin. In my early adult years I lived as an outlaw, working with traveling music groups, riding with bikers, and even living in the woods. I did those things because I failed in my efforts to follow the conventional path. I dropped out of school because I could not learn in the manner the teachers taught. I could not attend college because I lacked a high school diploma. And I couldn’t get a good job because I wasn’t a college graduate.

But I didn’t let that stop me. I made my own path and found some measure of success. However, the fact that I was an outlaw and an outsider always weighed heavily on me. I was always gazing in the windows of legitimate life, wondering what it might be like inside. As successful as I became, that remained the hard truth.

That’s where things stood when I finally got The Diagnosis.

By time Asperger’s officially entered my life, I was forty years old. I had married and fathered a child. I had designed video games at Milton Bradley, directed research at Simplex, and then left the corporate life to found J E Robison Service Co, a specialty automobile business. Chicopee Savings Bank had named me to their board, and I was involved in my community. By most standards, I had a full life. If you asked me who I was, I’d have defined myself by those achievements.

If you asked for more, I might have fallen back on the basics. I was a white male, six foot three, two hundred twenty five pounds. Born in Athens, Georgia. If you pressed me some more, I’d volunteer that I was middle class, and generally conservative. That was how I’d describe myself.

Suddenly, with the receipt of The Diagnosis, none of that mattered. The whole concept of “people like me,” took on a whole new meaning. All those former adjectives were out the window; rendered meaningless. From D-Day forward, I was a guy with Asperger’s. Everything else was rendered secondary to that new facet of me.

The doctors are quick to tell you autism isn’t lethal. Yet it’s still one of the big scary words in medicine, like AIDS or cancer or Alzheimer’s. As such, it’s no surprise it came to dominate my thinking. I thought of what I’d previously known – or thought I’d known about autism. I thought of Tommy, the kid on the St. Elsewhere television show. I thought of Rain Man. I thought of all the silent lost people on the grounds of the Belchertown State School. Were they autistic, too?

Alzheimer’s doesn’t kill you, but it gradually takes away your mind. Would autism do that to me? Luckily, my reading abilities were still good. Nothing had started failing. Yet. I set out to learn as much as I could, while I could still read and speak.

I was in a state of extreme anxiety at first. My new diagnosis left me feeling as if I had just caught a new and deadly disease. I soon learned that wasn’t the case. My midlife diagnosis was attributable to new medical knowledge, not my own deterioration. I was relieved to learn that I am actually getting slowly and steadily “better” through a lifelong process of learned adaptation and acquired wisdom.

So many things suddenly made sense. For the first time, I understood how I could be smart and yet get straight Fs in school. I saw how Asperger’s had made school hard for me, and I’d done some pretty unusual stuff after dropping out. New insight brought those memories into focus, and I saw how the differences in my brain had shaped the course of my life in countless subtle ways. Yet I also realized the success I enjoyed as an adult was real, and it wasn’t going away. In fact, as I moved forward with new knowledge and confidence, I saw my life was getting better every day.

Asperger’s is not a disease. It’s a way of being that comes from non-standard wiring in the brain. The latest science suggests we’re born different, or else we become Aspergian early in infancy. That means Aspergian life is the only life we’ve ever known; we don’t get sick and get Asperger’s as teenagers. We will always be aliens when we gaze at people who don’t have Asperger’s, and they will always struggle to understand our thinking.

How does that affect the parents? I never really considered that question until quite recently. This book contains many stories that describe the joy, pain, confusion, frustration, and triumph of raising a kid like me. I had no idea. It also contains stories of resolve and determination that surprise even me. Some of these people are what you might call High Performance Parents.

One thing strikes me in almost every story. Autism has taken over the lives of these people, perhaps to a greater degree than it took over my own life. I talk about life as an autistic outsider, gazing in at the world of normal people. Autism has made these parents outsiders, gazing into the unreadable minds of their own children. What a strange reversal.

When you’re a kid on the spectrum, autism is all you know; all you ever knew. There’s frustration at things we can’t do, and even rage. But there’s no sense of loss, because we never possessed what autism is said to have “taken away” from us. We start with a certain set of abilities, and we build on them. Sure, we may have less ability in some areas than other kids, and it can hurt to realize that, but we make the most of what we have. What else can we do?

The situation for aware parents is very different. They see and imagine all manner of things their disabled kids (us) are lacking, and they suffer terribly for us. At least, that’s the impression I get from talking to parents today. Was my own mother that way? I really don’t know. Oblivion to others is, after all, an Asperger trait. I know I wasn’t that way raising Cubby. In that sense, ignorance is indeed bliss.

But does this awareness, focus, and worry produce a better kid? Or does it just produce a more stressed parent? I really don’t know. That is one of the great mysteries of kid-raising. Any of us – if aware – would do all the things parents in this book do. And the evidence in favor of early and aggressive intervention is strong. But it’s a hard road, not matter how you do it.

You can find Kyra online at www.thismom.com Vicki is at http://www.vickiforman.com/