Tag Archives: mental health

Parenting science: 12 top stories of 2012

It’s that time of year when we’re flooded with ‘best of’ lists, so allow me to jump on the bandwagon. 2012 has been a great year for science – the discovery of the Higgs Boson, the landing of Curiosity rover on Mars, and the ‘encyclopaedia of DNA’ that has given us the deepest insights into the human genome.

Here, I’ve picked out some of the stories that might interest parents, covering areas such as child learning and development, reproductive technologies, embryology, genetics, and even a bit of public policy thrown in. I’m sure I’ve missed some interesting ones too, so please add yours in the comments!

Mouse eggs created from stem cells for the first time (New Scientist)

Once a fully functional body cell develops from a ‘parent’ stem cell, it’s thought there is no going back to the previous state. A team of scientists in Japan, however, used a cocktail of signalling molecules to reprogram skin cells to become immature egg cells in mice (they had already done this to create sperm cells). What’s more, these cells could be fertilised and, in some cases, led to healthy mouse pups. This was a stunning feat of biological engineering that will help in the study of mammalian development and also hold promise in treatment of infertility. In a related story, controversy over whether biology textbooks need to be re-written took a turn when more convincing evidence was published that the number of eggs in a female isn’t fixed for her lifetime but can instead by replenished from a stem cell stock.

‘Chimera’ monkeys created in lab by combining several embryos into one (The Guardian)

The headline is pretty self-explanatory and the article itself is a fascinating read, so I won’t re-invent Ian Sample’s superbly crafted wheel. So if you want to know more about the controversial technique of creating normal, healthy monkeys with cells from more than one embryo and why it might benefit stem cell therapies, go read it! This may not be as bizarre and ‘unnatural’ as it first sounds, though, as we may all be walking chimeras and carry cells from siblings, aunts and uncles.

Genome Sequencing for Foetuses (Wired Science)

Being able to test foetuses for genetic faults that increase the risk of a serious disease, such as Down’s syndrome and blood or nervous system disorders, is hugely important. This is currently done mostly by invasive techniques such as taking samples of the placental tissue or amniotic fluid. This study, however, showed that it’s possible to work out the foetus’ genetic make-up by piecing together tiny fragments of DNA floating around in the mother’s blood. The ease of such a test would, of course, raise ethical issues about what is appropriate to screen for and what counselling parents would need, as well as requiring a firm and clear communication of risk.

DNA-swap technology almost ready for fertility clinic (Nature News)

Mitochondria are little energy powerhouses within most of our cells and they contain a small amount of their own DNA that is inherited wholly from the mother. A range of devastating diseases, that can affect the brain, liver, muscle and many other organs, are caused by defects in this mitochondrial DNA. A group of US researchers showed it was able to swap the mitochondria in a mother’s egg with one from a healthy donor to produce a normal looking embryo free from the mitochondrial genetic faults (restrictions on this technology would not allow a live birth). You can read about how the scientists actually did this in David Cyranoski’s article. And I would add that, contrary to some scare stories, these would not be ‘3 parent babies’ – mitochondrial DNA contains only 37 genes (involved in protein synthesis and biochemical reactions that make up respiration) compared with the many thousands of genes coded for by the DNA in the nuclei of our cells.

Babies are born dirty, with a gutful of bacteria (New Scientist)

Earlier this year I blogged about the “The microworld that lives inside you” and how the microorganisms that outnumber our own cells 10:1 are first transmitted from mum as a baby is born. A study by Spanish scientists, suggested that this isn’t the whole story. By studying the “meconium” – the baby’s first poo that is made up of materials ingested during the time in the womb – they detected two types of well developed bacteria. We don’t know for sure, but these were probably passed from the mother through the placenta. Our so-called “microbiome” is really important, because it influences our digestion, immune system, risk of disease, and maybe even our personalities.

Childhood stimulation key to brain development, study finds (The Guardian)

A US study provided more evidence that a sensitive period of learning and development exists early in childhood. They surveyed children from when they were four years old, recording details such as the number of books and the types of toys they had, to measure the amount of mental stimulation to which they were exposed. They also scanned the brains of the same children when they were between 17 and 19. As Alok Jha explains: “…the more mental stimulation a child gets around the age of four, the more developed the parts of their brains dedicated to language and cognition will be in the decades ahead.” Of course, this was an observational study and so limits the strength of the conclusions about whether the types of toys really caused brain developments, but the way the researchers tracked the same children over many years and the factors they took into account (parental nurturance had little effect, for example), was particularly impressive. Another cautionary note: the results were presented at a scientific conference and, as far as I know, have not appeared in a scientific journal, which means it won’t have yet been properly quality assessed by experts.

Golden ratio discovered in uterus (The Guardian)

At the risk of straying into mysticism, this was a nevertheless alluring report of a Belgian gynaecologist’s claim that the uterus represents an aesthetically pleasing “golden ratio”. This ratio is derived from something called the “Fibonacci sequence”, which is a sequence of numbers starting 0,1,… where every subsequent number is the sum of the previous two (so: 0, 1, 1, 2 , 3, 5, 8, 13, 21,…). The ratio between pairs of number in the sequence (divide one by the other) ends up being 1.618, which is the “golden ratio”. As Alex Bellos explains, its devotees believe it expresses aesthetic perfection and is found wherever there is beauty. According to Dr Verguts, when women are between the ages of 16 and 20 and at their most fertile, the ratio of uterine length to width is 1.6, spookily close to the “golden ratio”.

What happens to women denied abortions? This is the first scientific study to find out (io9)

Another set of results presented at a scientific conference, rather than in a scientific journal, but that is worth noting nonetheless. Annalee Newitz cites a Facebook post written by the lead researchers of a study that followed up women who had sought abortions at different abortion clinics in the US: “We have found that there are no mental health consequences of abortion compared to carrying an unwanted pregnancy to term. There are other interesting findings: even later abortion is safer than childbirth and women who carried an unwanted pregnancy to term are three times more likely than women who receive an abortion to be below the poverty level two years later.” Newitz further emphasises the preliminary results: “When a woman is denied the abortion she wants, she is statistically more likely to wind up unemployed, on public assistance, and below the poverty line.” If these findings turn out to be valid when further quality checks are carried out, they could help shape the debate on abortion policies and the state support a women seeking an abortion receives.

Boys and girls may be entering puberty younger (New York Times and The Guardian)

A study on the timing of puberty in boys by the American Academy of Pediatrics complements an earlier study on girls, which both hinted that puberty is, on average, starting gradually earlier in both sexes. Current estimates, at least for US children, are that the average age of puberty onset is around 9 years in black boys and girls and around 10 years in white boys and girls (although full sexual maturity may happen later than this). No one, as yet, knows why, but speculations include diet, changes in physical activity, improvements in healthcare, and chemicals present in the environment that affect our hormones.

Fathers bequeath more mutations as they age (Nature News)

A Swedish study concluded that a father passes on more genetic mistakes to their children than do mothers, and the older the man, the more mutations he is likely to pass on. This is most probably explained by the fact that sperm are generated from dividing ‘precursor’ cells throughout a man’s life and this cell division becomes less precise with age. Most inherited mutations won’t lead to any problems for the child, but the occasional one may increase the risk of a genetic disease like autism or schizophrenia. Taken together with rising average age of fatherhood, does this help explain, at least in some part, why autism rates are rising? (It could, but awareness and diagnostic changes are also likely to be at play). It’s not definitive and it shouldn’t scare older would-be fathers, but it may help in better informed decision-making.

An HPV Vaccine Myth Debunked (New York Times)

One of the arguments opposing vaccinating children against the Human Papilloma Virus (HPV), which can cause warts and cancer, is that in the minds of the young girls it frees them up to be sexually more promiscuous. Studying long-term medical data from girls in Atlanta, USA, however, showed no difference between vaccinated and non-vaccinated girls in pregnancies, sexually transmitted diseases, testing for sexually transmitted diseases, or contraceptive counselling. The article finishes by saying: “As one expert said, parents should think of the vaccine as they would a bicycle helmet; it is protection, not an invitation to risky behavior.”

Hungry mothers give birth to more daughters (Nature News)

Another eye-catching story was the report that during the Chinese Great Leap Forward famine, the proportion of boys being born dropped (from 109 boys for every 100 girls to 104 boys for every 100 girls). This sets up the tantalising possibility that sex ratios are adjusted in response to environmental conditions such as nourishment, a situation already known in deer where undernourished males tend to have fewer offspring than undernourished females (although in humans other factors like psychological and physical stress could be at play).

A final story that caught my eye was the latest results from the Avon Longitudinal Study of Parents and Children (ALSPAC), also known as the Children of the 90s, which probably warrants a blog post in itself. Nature News covered it and The Guardian’s sublime Science Weekly podcast featured it too (after 26:10). My favourite bit was how they collected the children’s milk teeth: “We had to negotiate for those. They are worth money to children, after all. In the end, we only got the milk teeth when we presented each boy and girl with an official Alspac form, signed by the tooth fairy.”

How sweet!

Advertisements

Telly addicts: alarm over kids’ TV viewing habits

There was a flutter of activity across Twitter and blogs the other day, in response to some reports that suggested kids’ increasing TV viewing was having a detrimental effect on mental health. According to the reports, TV viewing should be limited for children even into their teens and banned altogether for under-threes. The issues highlighted here will be familiar to detractors of Bad Science and Bad Reporting, but I wanted to record some thoughts for posterity.

I first saw the story in The Guardian and it was also picked up by BBC News, The Independent, The Telegraph, Daily Mail, Metro and many other outlets. Whilst it’s an interesting and worthwhile area of study, the paper published in the journal Archives Of Disease In Childhood and the subsequent press statements, had a few problems that undermine the stark headlines.

The paper was not an original research paper, but an opinion piece that looked back at some previous research. The chief agitator in this is Aric Sigman, a psychologist whose method of ‘cherry-picking’ evidence Ben Goldacre has had much to say about in the past. ‘Cherry-picking’ is essentially picking the bits of evidence that support a particular claim, whilst ignoring other evidence that doesn’t. As Goldacre points out, a better way to analyse previous research is to perform a ‘systematic review‘. These reviews say exactly how the literature was searched and compiled, which means it is more free from bias and allows others to reproduce it.

As for this specific case, Pete Etchells at SciLogs does a good job at highlighting the problems with the selective nature of the analysis and why it’s important to understand the cause of something before issuing guidance on fixes. I worry that many developmental outcomes – such as empathy, attention, educational performance – are lumped in under the banner of ‘mental health’, but that is probably for someone more qualified to comment on. Professor Dorothy Bishop‘s remarks in the Guardian article are salient too – if Sigman’s concerns are to do with kids just sitting for long periods, you shouldn’t advocate reading books for too long.

My first thought on reading the reports was that the conclusions seem to be based entirely on correlative studies, so it’s hard to determine cause-and-effect. What if children who watch more TV are also more likely to have inattentive parents? You may still see an association between more TV watching and developmental problems if these are both caused in some way by inattentive parenting, but enforcing a reduction in TV time wouldn’t do anything – getting parents to interact more at other times would have the most effect. (For the record, this is just an example of ‘correlation does not imply causation’ and I’m not suggesting this is supported by the evidence!)

On a more general but related point, there is a real problem with defining ‘screen time’, because you’re essentially describing a medium and not an activity. The Mind Hacks blog (written by KCL psychologist Vaughan Bell and Sheffield University psychology lecturer Tom Stafford) has written about this in relation to internet use. Bell has also written about how there have been worries throughout modern history over new technology. Even ‘education’ was once considered a risk to mental health.

As for TV, there are clearly different types of programmes kids can watch – some are aimed at learning and education, some are musical and participatory, some are interactive, and so on. And there are also different contexts in which to watch TV – alone, with parents talking things through, in the background whilst doing other things, etc. Understanding whether different types of TV interaction have different effects or whether other factors in the child’s environment tend to lead to a particular sort of behaviour, are critical in getting to the root of the issue.

The evidence just isn’t strong or reliable enough to make the sort of alarmist claims Sigman has made. And this is why it is again so disappointing to see the same blanket coverage across much of the press, with little in the way of a proper critique (Prof Bishop’s comments aside). It was once again left to bloggers and commentators on social media to provide a more discerning look at the issues.

I want to emphasise that I’m not dismissing these issues, and there may well be problems caused by excessive use – however that’s defined – of certain types of ‘screen time’ (as Etchells notes too). But it’s important to know what you’re measuring and understand the nuances. It is also crucial to have proper evidence before issuing supposed evidence-based guidance.

Spuriouser and spuriouser: the Greenfield effect

Baroness Susan Greenfield, Professor of Pharmacology at University of Oxford, has been in the news a bit recently. She’s being getting a lot of coverage due to her views on the (possible) effects of computer-based activities on children’s mental development. The most striking claims are that the use of social media tools, such as Facebook and Twitter, can lead to autism and/or shortened attention span, and more recently that playing computer games can cause dementia and alter risk-taking behaviours.

These claims have attracted a lot of criticism from bloggers and fellow scientists alike for, amongst other things, being totally unsupported by any peer reviewed research and contradictory to known biological effects. Baroness Greenfield has responded at various points by accusing her detractors of stifling open debate and likening them to those who denied a link between smoking and lung cancer. She also asserts that she’s ‘just asking questions’, which prompted an inventive stream of similarly spurious links on Twitter (#greenfieldism). The serious point behind the humour being that, without any evidence behind, it is just as valid to juxtapose internet use and autism as it is to link Rebecca Black and the Greek sovereign debt (courtesy of @alsothings).

A similar thing happened when Glenn Beck started ‘just asking questions‘, which lead to counter questions about Glenn Beck’s personal history. Although this was an overly extreme question with which to respond, it does highlight the danger of suggesting causal links without any empirical support whatsoever.

Putting unsupported claims in the spotlight to push personal viewpoints about computer games and social media, especially when they’re packaged as scientifically validated ideas, is a dangerous path to lay. The effect of technology use on brain development is clearly an important topic to consider, but any guidance must have some scientific proof behind it. Even a single study that has been through the peer review process and published in an academic journal is not enough to make the sort of bold claims Susan Greenfield has made . Only once hypotheses have been discussed, repeated, followed-up, tested on different groups by other scientists do theories start to become accepted (or rejected) by the scientific community. Baroness Greenfield hasn’t even got as far as the first step.

Tentative evidence can be found to suggest we need to seriously consider the effect of increased computer activity, such as whether violent computer games can alter brain activity and wiring. These types of studies, however, are fraught with potential confounding factors – do violent computer games change the brain activity of gamers or are gamers with particular types of brain activity more drawn to violent computer games? This is why a body of evidence is needed to eliminate these confounding factors and tease out the true causal link.

Parents have a hard enough time in drawing out the best advice, many of which appears to be based on personal opinion and gut-feeling, and so a scientist making raising serious doubts without going through the proper scientific process first can only add to anxiety and confusion. These effects are often long-lasting too. While Andrew Wakefield’s dodgy claims about the link between the MMR vaccine and autism has been thoroughly refuted by the scientific community, culminating in the original research paper being retracted and Dr Wakefield being struck off the General Medical Council register (see this for a brief history), doubts linger in parents’ minds and huge efforts are still being made to bring the vaccination rate up to the required level (e.g.).

Technology now available to children provides unparalleled access to information resources, creative tools and network sharing, and my inclination is that this is A Good Thing for broadening and challenging the mind (see Carmen Gets Around for a similar conclusion). Of course, I await the evidence to support this, but one thing is clear, computer technology has changed the way our kids behave forever. Just watch this YouTube clip…

On the social environment

I was brought to thinking about child development and the influence of early parental nurturing after watching a lively exchange on BBC’s Newsnight between the clinical psychologist, Oliver James, and Dr Ellie Lee, a lecturer in social policy at the University of Kent.*

From what I could see, the intense antagonism (aside from James’ unwavering dogmatism) was partly the result of a difference between a purely clinical look at child development, by which controlled scientific studies are held up to encourage the need for early intervention, and the sociological implementation of these ideas, which can introduce many variables to successful intervention.

For instance, showing that supportive parenting behaviours can lead to improved mental and language abilities in infants is one thing (as James would point out), but how you successfully communicate that to parents and change behaviour, is another (as Lee might counter). To lay down a hard-and-fast prescription for parents to follow, without layering burden upon burden, is not always straightforward. A more nuanced approach is required, as appreciated in the Early Intervention report featured in the Newsnight item.

Oliver James, in particular, seems very disposed to attach blame to a parent for any perceived character flaw in their child, and guilt-tripping parents in this way seems an overly blunt approach. And this is the point that Dr Lee may have wished to explain more explicitly.

It seems to me, albeit speculatively, that the parent’s well-being is an important consideration when encouraging them to follow particular regimens. The current consensus of the scientific community may be that a child should be doing X, Y and Z, but it may also be the case that to achieve this, one or both of the parents would end up dangerously sleep deprived, mentally exhausted and with a strain on their relationship. This would be differentially affected by a person’s physiology, underlying immunity, predisposition to mental illness, and so on. It would also depend fairly heavily on a person’s life – their age, whether they’re a single parent, in proximity to close family, in a high pressured job, etc. All of these considerations temper any absolute assertion of an intervention based on clinical data.

The field of psychosocial research, which seeks to understand the interplay between one’s psychology and their social environment, is an important factor to consider when establishing any health initiative. It would be great to see whether there is any direct evidence related to this in the context of early intervention programmes for parents. A recent special issue in the journal Science, lays out some of the issues facing educational intervention initiatives, including the obstacles faced when moving from scientific research to public policy. The need for a holistic approach is summarised in the introduction:

Early childhood education remains peppered with both opportunities and debate. Continued progress will require new research that bridges traditional disciplines of neuroscience, psychology, sociology, economics, public policy, health, and education.

So whilst the clinical research may show that a particular intervention leads to the absolute best outcomes, it may be that a parent ends up finding a middle ground that still provides a beneficial environment for their child, but also a satisfactory outcome for themselves (a sort of cost-benefit assessment, if you like). It would be no good hectoring parents into following a specific course of action, with no amount of flexibility, if it leads to a significant worsening of their own physical or mental health, especially if the knock-on effect is a deterioration in family relationships. It seems highly unlikely that this would allow people to be good parents nor provide a decent environment for the child (a brief look at the scientific literature suggests this assumption isn’t entirely unreasonable, e.g. this, this and this).

I should emphasise that I do not wish to appear as though I am justifying or accepting of ‘bad behaviour’ of parents. There are clearly things we should all strive to do, things that are a struggle, and this will involve a series of adaptations, compromises and sacrifices.

Why, say, do one in five British adults smoke when we know categorically that is causes lung cancer, heart disease and increased risk of stroke? Worse, why do so many adults still smoke in the presence of children or during pregnancy, when passive smoking can cause the same health problems in children (and more) and parental smoking increases the chances that a child will smoke as an adult? A look at how mothers from disadvantaged backgrounds respond to tobacco control initiatives gives some clues – in short, increasing stigmatisation can be counter-productive.

I would like to think, though, that most, if not all, parents are happy to put their very best efforts in and would never be wilfully neglectful. But the point which seems to emerge is that the results of clinical research should be considered against a backdrop of social and population variances. In the case of early intervention, labelling a child as ‘at risk’ or categorically predicting their development, could be helpful in targeting the right guidance and support to the right people, but should not lead to undue and counter-productive stigmatisation.

So, appreciating that each baby, each parent, each family’s circumstance is different, is very valuable. It is critical, as always, to be guided by the scientific evidence available and make this the basis of any initiative to improve child development, but it may not be possible to then arrive at a ‘one-size-fits-all’ formula, a point similar to that made by Dr Luisa Dillner regarding sleep routine.

In short, it’s complicated. Plus ça change…

————————————————————————————————————————————-

* Better quality video embedded (05/10/2011) – thanks to Denys Andrianjafy.