From & To Sathish #7 - Page 38

https://yalereview.org/article/audrey-wollen-theory-of-handbag

A Unified Theory of the Handbag.Was an accessory the secret to evolution?

https://www.yahoo.com/news/why-more-300-people-us-090201801.html

Why are more than 300 people in the US still dying from COVID every week?

https://nautil.us/what-birdsong-says-about-motivation-1213111/?utm_campaign=website&utm_medium=email&utm_source=nautilus-newsletter

What Birdsong Says About Motivation

In self-driven learning, performance is its own reward

https://nautil.us/your-memories-are-like-paintings-774424/?utm_campaign=website&utm_medium=email&utm_source=nautilus-newsletter

Your Memories Are Like Paintings

Understanding that memories are interpretations can transform you.

By Kevin Berger

I listened to a favorite album from 1983 the other day that gave me the profoundest joy. I danced around my kitchen singing along to every word. My whole body felt happy.

The album is Field Day by the rock singer and songwriter Marshall Crenshaw. Everything I love in rock is there—melodies that ingratiate, beats that elevate, and a voice ingrained with regret for love gone astray. “Do you remember the promise I gave you? The one I swore I would hold to?” he sings in the song “Our Town.” “Well, you’re there, I’m here, and everything I said was wrong.” The whole album is just perfect.

I hadn’t listened to Field Day in 25 years. And what I was feeling wasn’t nostalgia—longing for better days gone by. That’s because of Crenshaw’s natural elan as a songwriter. Field Day transcends the pop culture of the ’80s. Every note sounded as fresh as if it was written today.

It’s also because better days are a myth. Our brains never see the past clearly. They are like painters who are never satisfied. They constantly retouch the past with the colors of the present, putting a fresh version of ourselves on display for us to ponder.

Turns out memory is a castle made of sand. That’s unsettling, no?

That’s one of the captivating insights in 2023’s Why We Remember by Charan Ranganath, a professor of psychology and neuroscience at the University of California, Davis. Memories are not a true or false picture of the past; they are a Monet lily pond.

“Most paintings typically include some mixture of details that are faithful to the subject, details that are distorted or embellished, and inferences and interpretations that are neither absolutely true nor entirely false, but rather a reflection of the artist’s perspective,” Ranganath writes. “The same is true of memory.”

I came away from Why We Remember with a beautiful picture of how memories make up the canvas of our mental lives. It’s an unnerving picture, too. Memories are as sensitive as teenagers. The slightest change in mood or environment will cause them to unravel or change appearances.

“Our memories are dynamic, malleable, and sometimes inaccurate because our brains were designed to navigate a world that is constantly changing,” Ranganath writes. “Human memory needed to be flexible and to adapt to context more than it needed to be static and photographically accurate.”

That’s a pretty great insight. It’s also pretty great how Ranganath scores his neurobiology with a rock-and-roll flourish.

In his time away from directing the Memory and Plasticity Program at UC Davis, Ranganath plays guitar and sings in a rock band (made up of fellow neuroscientists) called Pavlov’s Dogz. Their repertoire is mostly songs from the ’70s and ’80s by David Bowie, the Ramones, Joy Division, the Pixies, and Gang of Four.

Ranganath names chapters in Why We Remember after songs (“Just My Imagination,” “More Than a Feeling”) and opens them with quotes from Iggy Pop, the Flaming Lips, and this scientifically accurate slice of sageness by Nick Cave: “Memory is imagined; it is not real. Don’t be ashamed of its need to create.”

When Ranganath and I spoke over video recently, he was in his home office in Davis, sitting in front of a wall of guitars. I told him his book gave me an existential shiver. Our self, built on our memories, is our psychological anchor in a turbulent world. Turns out it’s a castle made of sand. That’s unsettling, no?

“Yes, it definitely can be,” Ranganath said. “Although, it’s not as if people who have amnesia have no sense of self. You can have a significant memory disorder and still have a sense of self. But it’s incredibly impoverished. What you find in people who suffer memory loss from a stroke or electroconvulsive therapy is that their sense of self gets stuck at the time of the event. They have an idea of who they were but can’t update it into a sense of who they are now. It can be true for all of us. As I get older, it can be scary to look in the mirror. I think, ‘I should be looking differently than I do!’ So, in some sense, we don’t optimally update our memories to catch up to our current selves.”

Evolution is to blame for our shaky memories and selves. If we evolved to remember everything, we couldn’t function due to the overload of sensory information. We’d be mentally paralyzed on the savanna. While we stood there recording every sensation—the whoosh of the wind, the metallic gleam of the dragonfly, the musty smell of the air—we’d become an easy lunch for a predator. So much for human survival.

Instead, the clever brain uses its energy wisely to store only the sensory inputs that matter—the ones that seem new, surprising, have an edge. “Our brains are designed to give us the most information with the least amount of resources,” Ranganath told me. “That allows us to be cognitively nimble and flexible, with very little energy consumption. There’s no free lunch in a biological system like memory.”

Enter another clever invention of evolution: emotions. Fear, lust, despair, love, a whole suite of sensations, stir up biochemicals like noradrenaline and dopamine that flood the brain to stabilize or modulate the assemblies. The more intense the emotion, the more likely we are to remember the experience that caused it. Our ancestors quickly learned not to sleep near the leopard den again.

How the brain creates “episodic memories” is a focus of Ranganath’s research. Neuroscientists have identified two basic types of memory. Semantic memory refers to remembering facts like the capital of New Jersey. Episodic memory refers to the act of recall that time-travels into the past to revive the experience of first hearing Bruce Springsteen’s “Thunder Road.”

Ranganath and his collaborators have done experiments that highlight how the brain stores information in schemas, or diagrams. “The way the human brain uses schemas to construct new memories is not unlike how an architect uses a blueprint to design houses,” Ranganath writes. “An architectural blueprint functions as a kind of map of the barebones information about the structure (walls, doors, stairs, windows, and so forth) that shows how everything is connected. The abstract nature of a blueprint means it can be reused over and over.”

The default mode network, an area in the neocortex, stores the schemas in cellular pieces that can be used to assemble new memories. The hippocampus, the seahorse-shaped area in the middle of the brain, is the builder.

Our brains are not designed to give us the entirety of reality.

In the brain, the hippocampus has great connections. “It gets inputs from virtually every kind of motivational chemical in the brain you can imagine,” Ranganath explained. During the act of remembering, the hippocampus uses its connections to the default mode network to “put the pieces together to store a specific episodic memory.”

Ranganath, fond of metaphors, writes that his and his collaborators’ research reveals forming an episodic memory is like building with LEGOs. “With LEGOs, you can use an instruction sheet to rebuild [a] medieval scene or use a different set of instructions that show how the same bricks can be combined to re-enact a scene from Star Wars. Likewise, when it comes to memory, the [default mode network] has pieces that can be reused across many different events.”

In the brain, though, the pieces don’t hold together snugly. “The very act of recalling a memory can lead it to become fragile and changeable,” Ranganath told me. “It can lead to distortions and misinformation, to the point where the memory becomes corrupted.”

The problem is other neurochemical players are always anxious to add their own pieces to a memory. These spoilsports are the cell assemblies that animate our present states of mind and moods. The act of remembering, Ranganath said, is “dominated by the beliefs and perspective we have in the moment.”

Our present perspectives often choose the movie to play in our minds. When the world looks ugly, it’s often nostalgia, “that bittersweet feeling of joy and sadness,” Ranganath said, that comes to our emotional rescue. We imagine carefree days of smart leaders and safe communities, friendly neighbors and better music. It’s perfectly natural.

“People tend to have a positive memory bias, and tend to recall positive events more often than negative ones,” Ranganath said. “And they tend to recall them more positively than they actually were. Then there’s the flipside, which is when you’re in a negative mood, you tend to remember events more negatively than they actually were. Every demagogue you can think of has cashed in on nostalgia, used it to create a toxic worldview of society falling apart, saying ‘I’m the one to take us back to the way things were.’”

Given the chameleon nature of our memories, changing their colors to suit different environments, do we ever see anything for what it is, remember it for what it was? To borrow one of Ranganath’s own rock lyric references, Is this the real life? Is this just fantasy?

“Our senses, our brains, are not designed to give us the entirety of reality,” he said. “They’re a window into reality. That’s good because reality is so infinitely dimensional. As we were discussing, you couldn’t function if you sensed everything. My dog can sense all sorts of frequencies that I can’t. So, we’re only getting a narrow band of the world, anyway.”

Yet we must have some clear recollections of events that happened to us? “We do,” Ranganath said. “Our memories clearly have elements of reality. In our lab conditions, we find some people are extraordinarily precise in their memories. They can remember all sorts of details. But the thing is, we infuse those details with meaning, with perspective, and build these stories, and that is uniquely human.”

Remembering is dominated by the perspective we have in the moment.

Memory, in fact, is an act of imagination. Mounds of research, based on brain scans, show the same mental processes and areas of the brain that we use to fantasize about sipping exotic cocktails in a hammock on a tropical beach, are the same processes we draw upon when recollecting the time we were, well, sipping exotic cocktails on a tropical beach.

“There’s a deep link between memory and imagination on so many levels,” Ranganath said to me, excitedly. “One of the cool levels to think about today is the products of human imagination are truly innovative, as opposed to something that I might get out of ChatGPT from some clever prompt. That’s because we have such weird experiences that are totally unique. We are predisposed to being in different places to experience different things, talking to different kinds of people, to feeling the full range of human emotions. We can put together things that would never come through some large language model trained on the internet.”

Interestingly, Ranganath compared the process of memory to being a scientist. His main gig, he said, was to collect data from experiments. He followed best practices to ensure his data was as accurate and unbiased as possible. But the theories hatched from science always came down to interpretation. “Interpretations are meaning generated from data,” he said. “The key is we don’t often bother to look at the difference between our interpretations and the data.”

The same is true for memory. We often don’t look at the difference between our experiences and our brain’s interpretation of them. But understanding that memories are a mix-and-match process, designed to be nimble and flexible to adapt to changing circumstances, can transform us. We can reflect on ourselves in ways that expand and animate our perspectives today.

This may not be a revelation to turn-of-the-20th-century French writer Marcel Proust, whose reflections on his memories constitute one of the greatest works of art in history, his series of novels, In Search of Lost Time. For the rest of us, to understand that your memories are not photographs but paintings that your brain, being the imaginative artist that it is, is constantly retouching, is a beautiful thing.

Listening to Field Day recently didn’t transform my brain into a movie of my life in 1983. But it certainly did stir neurochemicals to create traces of myself and feelings that year.

A vivid scene in my mind was my tiny living room in my San Francisco cottage, where I had my stereo, and often played Field Day—the vinyl LP, of course—as a release from the stress of finishing my master’s thesis in English literature. I wrote about how Southern author Walker Percy put the existentialist thinkers to work in his comic and ironic fiction about alienation.

Actually, my most detailed recollection of that time was carrying my pale blue electric Smith Corona to the typewriter shop on Market Street to get the eraser shavings cleaned out of it and one of the keys unstuck. “It’s time to replace this thing,” the owner said to me.

Those are wonderful recollections because I loved writing my thesis and was happy and proud with how it turned out. But playing Field Day in 2024 was more meaningful than it was in 1983. My listening mind had gained 41 years of experiences and memories. I thought about the deep and important place of music in my life, carrying me through amazing and wrenching times. My past was present, and I felt totally alive.

After his decades of research, I asked Ranganath what memory taught him most about being human.

“I was really impacted by Daniel Kahneman’s observation that we have an ‘experiencing self’ and a ‘remembering self,’” he said. “Your experiences of things are continuous in real time and associated with all sorts of feelings and thoughts and sensations. And then in the cold light of reason you have this remembering self in a completely different context, trying to make sense of yourself, a person with a very narrow window of experience. I tried to embrace that and very consciously ask myself, especially after I turned 50, ‘What are the memories I’m going to carry with me from this point on?’ I want to make choices to get the best memories I can.”

https://www.yahoo.com/lifestyle/not-8-glasses-day-anymore-090000749.html

It’s not 8 glasses a day anymore. Here’s how much water you should drink each day

https://nautil.us/where-did-the-brain-come-from-380114/?utm_campaign=website&utm_medium=email&utm_source=nautilus-newsletter

Evolution

Where Did the Brain Come From?

600 million years ago, the sea sponge had a dream.

By Kenneth S. Kosik

Before our evolutionary ancestors had a brain—before they had any organs—18 different cell types got together to make a sea sponge. Remarkably, some of these cells had many of the genes needed to make a brain, even though the sponge has neither neurons nor a brain.

In my neuroscience lab at the University of California, Santa Barbara, my colleagues and collaborators discovered this large repository of brain genes in the sponge. Ever since, we have asked ourselves why this ancient, porous blob of cells would contain a set of neural genes in the absence of a nervous system? What was evolution up to?

The sea sponge first shows up in the fossil record about 600 million years ago. They live at the bottom of the ocean and are immobile, passive feeders. In fact, early biologists thought they were plants. Often encased by a hard exterior, a row of cells borders a watery center. Each cell has a tiny cilium that gently circulates a rich flow of microorganisms on which they feed.

This seemingly simple organization belies a giant step in evolution. For the previous 3 billion years, single-celled creatures inhabited the planet. In one of evolution’s most creative acts, independent cells joined together, first into a colony and later into a truly inseparable multicellular organism.

Why did this porous blob of cells contain neural genes? What was evolution up to?

Colonies of single cells offered the first inkling that not every cell in the colony had to be identical. Cells in the interior might differ subtly from those on the periphery that are subject to the whims of the environment. Colonies offered the advantages of cooperation among many nearly identical cells.

The next evolutionary innovation, multicellularity, broke radically from the past. With multicellularity, cells became highly specialized; they relinquished their individual identities and independence for the greater good of the organism. This innovation was one of the greatest acts of altruism in the history of life.

Although these cells were now no longer able to survive on their own, the organism gained by the collective functioning of different cell types. As organisms added specialized cells, integrated modules called organs conferred novel functions and abilities.

Nowhere have specialized cells within an organ become more diversified than in the nervous system. The evolution of the nervous system in animals was critical to the wildly successful kingdom of life. But it did not happen all at once. As ancient creatures crossed the long-vanished boundary from single-celled organisms to animals, a complex nervous system emerged.

The early evolution of animals is full of puzzles, and the origin of the nervous system lies at the core of the maze. From a common ancestor of all animals, for which no trace exists today, sprang two lineages called sister groups. The more recent sister is the sponge. The older sister is the comb jelly, which is just a few millimeters in size or as large as five feet, consisting of a jelly-like body with a layer of cells above and below that creates a cavity.

To encode a nervous system requires thousands of genes, each of them with many thousands of nucleotides, the letters of the DNA code. Acquiring this massive genetic storehouse of instructions while sustaining viability each step of the way was a daunting task. After 3 billion years of single-cell organisms that adapted to the changing climate of the early Earth, the first animals began to flicker in the dark roil of the ocean bottom, hardly recognizable as an innovation against the highly competitive world into which they were born.

From the sponge evolved the entire animal kingdom, including us. The comb jelly, although it still survives today, was an evolutionary dead end devoid of the potential from which a novel species could evolve. Curiously, the comb jelly has a nervous system, but the sponge, as noted, does not, even though it has many of the genes needed to make one.

Many questions surface from this history. Did the common ancestor of both the sponge and comb jelly already have a nervous system that was lost in the sponge? Or did the nervous system get invented twice, once in the comb jelly and then again in the evolutionary descendants of the sponge?

A deep look at the synapse offers some clues. The synapse is among the most salient features of a nervous system. This complex structure is used for communication between two neurons, or a neuron and another target cell like a muscle. It has two parts, one that sends the message, and the other that receives the message. The message sent to the receiving cell is integrated within an intricate network, designed to make a single decision—either fire or not. The instructions are packaged in chemicals released by the sending cell and read by the receiving cell.

From an engineering perspective, this design makes no sense. If you want to wire one thing to another, you wire them together directly. Neurons, with their synaptic way stations, bring an electrical signal traveling along an axon to an abrupt halt, convert it to a signal that releases chemicals across the synapse, and initiate an electrical signal on the other side of the synapse. This slows down the entire process and introduces some error when the signal is transmitted, because synapses are not 100 percent reliable. What makes the synapse so remarkable is its ability to change with experience. It can become more or less efficient in transmitting a signal depending on the input it receives. It is a built-in mini-learning device, spread through the nervous system, like the tiny knots of cornrows.

With my students, we burrowed deep into the synapse, to the very genes that encode its proteins. The two sides of the synapse must be precisely aligned for efficient transmission of the message. This precise alignment is mediated by a protein scaffold that locks the two sides in place. Some of the hundreds of proteins that together function as a synapse, particularly the scaffold proteins, had already begun their evolutionary journey in single-celled organisms. Scaffolds suspend what is attached to them. The sponge utilized the ancient scaffold, but wiped it clean and suspended new proteins from it to build the synapse. Evolution drew upon ancient genes, as a parts list, to construct the nervous system.

The sea sponge reveals what a partial nervous system looks like along the way toward a full-fledged one. To feed, the sponge’s watery interior is lined with flagella, hairlike appendages, that maintain a coordinated beat to circulate microorganisms for ingestion. The coordination beat of the flagella suggested something akin to an inchoate neural system.

The ancient, unassuming sea sponge made possible the vast variety of future lifeforms.

Two years ago, a remarkable set of experiments came from the lab of Detlev Arendt at the European Molecular Biology Laboratory in Heidelberg. Arendt and colleagues discovered that two different cell types in this digestive chamber can make contact, and these two cells express the specific proteins that lie on one or the other side of the synapse. These first experiments at cell-cell communication are not synapses; they lack the machinery to convert the contact to an electrical signal in a neuron. Nevertheless, nature had begun to explore neural-like communication.

History is written by the victors, so evolution only tells us about the winners—those who survived, either as modern living progeny of an ancient ancestor or encrusted in the fossil record of a once successful existence on the planet. From such rudimentary beginnings, nervous systems with synapses capable of buzzing their chatter all around the body became winners in the animal kingdom.

The nervous system evolved and radiated throughout the animal kingdom. It led to survival tactics such as mating, the color changes of octopuses, hibernation, the waggle dance of bees, and dream states while sleeping. Brains could grow as big as a VW engine in the blue whale or shrink to a speck of tissue the width of a human hair in the ragworm.

The nervous system and the enhanced fitness it offered was one likely basis for the great divide between the plant and animal kingdoms that set each on separate evolutionary paths. It provided animals with motility, while plants bypassed the entire undertaking. And animals have adapted motility in a legion of styles: the swimming of fishes, the flying of birds and bats, the crawling of insects, the slithering of snakes, the swinging arms of gibbons, and the preposterous sideways scampering of crabs.

It’s easy to underestimate the complexity of motility. An animal must predict where within the obstacles of its surrounding space it will be with each motion, and the speed at which it will move. It must feel the motivation to move, whether that be the detection of danger, the sensation of hunger, the pursuit of a mate, or the restless urge to wander. You can almost see the brain in action when you approach a squirrel in the road—it hesitates for a split-second while deciding to dart toward its intended destination, with some uncertainty about what might lie there, or back to the familiar safety from where it came. With motility comes choice, whether free or not is another matter.

How astounding that within a 600-million-year-old sea sponge, a gene set lay the framework for a future that could not have been anything more than an abstract space, an intangible dream, as elusive as the space of consciousness.

This abstract space is the property of “evolvability,” built deeply within the structure of biology, to create variation among species that is heritable and increases the organism’s fitness for its environment. Evolvability does not reside in any gene sequence but is a collective property through which genes are connected to the environment.

The sea sponge, with its unrealized nervous system, was oblivious to the eons that stretched out in front of it, as it silently worked out its future. That future lay in its genes, a set of instructions that can faithfully reproduce over generations and change form as they evolve. Evolution conferred the unassuming sea sponge with a genetic program that made possible the vast variety of future lifeforms. Together life intricately and beautifully melds constancy over generations and change over evolutionary time in a beautiful dance.

Kenneth S. Kosik is a neuroscientist whose research has appeared in The New York Times, BBC, CNN, PBS and 60 Minutes. His University of California Santa Barbara Arts and Humanities commencement address is archived here.

https://nautil.us/debunking-dangerous-views-of-autism-1214137/?utm_campaign=website&utm_medium=email&utm_source=nautilus-newsletter

Debunking Dangerous Views of Autism

This psychologist has worked with autistic people for 50 years. Here’s what she wants you to know.

By Lina Zeldovich

When Catherine Lord was a psychology student a half century ago, she took part in a pioneering effort to move kids with autism from psychiatric institutions into the community. Lord was inspired by positive changes in the kids and devoted her life to developing therapies for people with autism and understanding the biology of the condition.

Today, Lord is a professor of psychiatry at the University of California, Los Angeles, and renowned worldwide for developing tools to diagnose autism, which have become clinical standards, and for her efforts to improve the lives of people with autism and their families. Along with her research, Lord maintains a clinical practice where she works with people with autism, from toddlers to adults.

So I couldn’t think of a better scientist to address the views of autism espoused by Robert F. Kennedy, Jr. Since being appointed as the United States Secretary of Health and Human Services, Kennedy has continued to spread misinformation about the condition, a pattern that began two decades ago when he claimed childhood vaccines cause autism, a charge long ago proven to be false.

Earlier this year, Kennedy announced the National Institutes of Health would launch a new study to investigate the causes of autism. To conduct its study, he said, the NIH would gather medical records of Americans with autism from federal and commercial databases.

In conversation, Lord spoke with authority and concern as she pointed out the mendacity and danger of Kennedy’s comments, and clarified the state of autism research and science.

He has made a variety of statements about autism that suggests he doesn’t really know what he’s talking about.

Before we discuss RFK Jr., would you describe autism for us?

Autism spectrum disorder, or autism, is a neurodevelopmental disorder. People with the disorder may have deficits in social communication and interaction and restricted and repetitive patterns of behavior, interests, or activities. Autism is really a construct, an idea that there is something different about people who have very basic deficits or difficulties in social communication, starting very young, and also certain repetitive or sensory differences compared to neurotypical people.

Autism is probably present before birth, and it affects development. Even if someone doesn’t get a diagnosis very early, it means that you process information from the world differently, and you will be affected differently by your experiences.

Some people with autism are better at certain things than neurotypical people, but they might also be worse than neurotypical people at other things. Finally, autism is different in a 2-year-old than in a 40-year-old, even though the basic condition is still the same.

What do you think of RFK Jr.’s views of autism?

It’s not clear whether he understands what autism actually is. It is a confusing condition because it is very heterogeneous. It’s very different across people, in part because it’s developmental, and in part because it’s often accompanied by other conditions or diagnoses that affect how someone functions. I don’t think that he understands that. He has made a variety of different statements about autism that suggests that he doesn’t really know what he’s talking about. And then the statements change as someone presumably is trying to help him understand it better—but the accuracy of those statements hasn’t improved.

RFK Jr. continues to promote the discredited theory that vaccines can cause autism. And yet the theory lingers. Why do you think that is?

Many people with autism when they are babies really don’t look very different from any other baby. The clearest symptoms of autism usually become apparent toward the end of the second year of a child’s life. There is a phenomenon in autism where kids, for example, learn to say a few words or do a few things and then either don’t progress past that or actually lose those skills as they become less interested in people. The phenomenon of sort of “becoming autistic” often happens between 18 and 24 months, and many of the vaccines that kids receive occur in that time or just before that time.

Watching children miss their developmental milestones is a very difficult thing for a family. It’s also a very difficult thing for people to report, because they’re not expecting this. I think just as human beings, we want an explanation of why on Earth this is happening. And so the family is making judgments about what happened three months ago or four months ago or six months ago, and it’s easy to blame it on vaccines. It’s a simple explanation and a timely one.

However, there is no evidence whatsoever that kids who have been vaccinated are more likely to have autism. There’s nothing that suggests that what’s in vaccines might cause autism. There’s just none! On the contrary, there is data that shows that autism is present long before this age time window—in terms of differences in the brain and the brain function. The chances are very likely that what is going to produce autism is present before babies are even born, but we don’t see it.

What do you think of RFK Jr.’s investigation into the causes of autism?

I think it’s going to be a waste of money. And I also really worry—particularly if RFK Jr. does not do this in a very careful, thoughtful way—that someone will find something which we will then be forced to spend the next 10 years showing not to be true. So I do worry that this will cause harm, because there will be kids who are infected with diseases they did not need to get because their parents were afraid to vaccinate them. For RFK Jr. to say, “Oh, I think in five months I can do this,” when people have been trying to do that for 30 years—it just makes no sense.

Autism rates have risen in recent decades. Why do you think that’s happened?

There are several reasons why autism diagnosis is rising. When I started in this field 50 years ago, people did not know what autism was. Today, clinicians are much more aware of autism than they were even 30 years ago. It’s in the press, it’s on social media, it’s everywhere.

The second reason is that we think of autism as a much broader issue now. You can have autism and have intellectual disability or ADHD or depression. You can be an adult who didn’t get a diagnosis early on, but who—when we listen to your history—clearly always had these problems. So you can be diagnosed as an adult instead of when you were a child 20-30 years ago, which contributes to rates rising.

The third thing is that in some places, such as the U.S. and Western Europe, you can get better support if you have autism than if you have some other unnamed problem—and families realize that. Fifty years ago, autism was absolutely a last resort diagnosis that no one wanted to hear. No one came to a clinic hoping to get this diagnosis. Today that has changed. Now we see people who would like a diagnosis of autism because they can get better support. I think this accounts for most of the increase.

Many people with autism when they are babies really don’t look very different from any other baby.

What are the current hypotheses about the causes of autism?

We have spent 30 years looking for the causes of autism. The emphasis in the NIH for the last 30 years has been on genetics, but we haven’t found anything of practical use. Some of the genetic work has been done with the idea that if we knew what genes were associated with autism, it could be like Down Syndrome, where you would get a test—and fix those genes using gene therapy. There was a huge hope among geneticists that they would come up with such treatments, but at this point, it has not happened. And even when it does happen, it’s going to happen for a very tiny group of children because the genetic patterns exist in less than 1 percent of autism cases.

But even that approach has been received by the autistic community as very inappropriate—“wait a minute, what are you trying to fix in me?” And what do we really want to know about babies before they’re born? So I don’t think we’re moving toward prevention for a long time and before we know a lot more about genetics. As a clinician, I’m not trying to fix autism. I’m trying to help people figure out how they can live in this world. It’s not about fixing autism. It’s about supporting them and giving people strategies for doing well.

As a practicing clinician, how do you think people in the autism community view what’s happening in Washington?

I think almost everyone is concerned. People are worried that RFK Jr. does not understand autism, that he’s using it for some purpose that is not clear. I think they’re worried that they are not being represented when he’s talking about them, because he’s not talking about the breadth of autism. And they’re worried that they could be the cause of something really terrible, if we have decreases, for example, in uptake of vaccines.

I think the one vestige of positive reaction is from parents of kids who are very handicapped, saying, well, at least he’s acknowledged they exist, that there are some autistic children and adults who have very severe impairments where they need 24-hour care and cannot speak for themselves. But then, RFK Jr. said something about profound autism being defined by toilet training, which is just completely not true. So the same families were upset.

His latest statement about using health records to create a registry, made people worry about their privacy. I’ve had a bunch of people write to me and say, “Can he have access to my records or my child’s records, and how can we stop this?” Patients are concerned about DOGE and other people who are looking through health records, not knowing what they’re seeing, but making decisions. For example, if I am evaluating someone for autism, I have to put the autism evaluation code on the medical bill, but the person may not ultimately have autism. So the hope is that they will realize it’s much more difficult than RFK Jr. thinks it is.

Lina Zeldovich is an award-winning science journalist and author. Her prior book, The Other Dark Matter, has been optioned for a TV series. Her new book, The Living Medicine: How a Lifesaving Cure Was Nearly Lost—and Why It Will Rescue Us When Antibiotics Fail was published in October, 2024. Follow her on Bluesky, Instagram, X, and LinkedIn.