Monday, December 10, 2012

Uncovering the Neurocognitive Systems for 'Help This Child'

In their article, “Socioeconomic status and the brain: mechanistic insights from human and animal research,” Daniel A. Hackman, Martha J. Farah, and Michael J. Meaney explore how low socioeconomic status (SES) affects underlying cognitive and affective neural systems. They identify and focus on two sets of factors that determine the relationship between SES and cognitive development: (1) the environmental factors or ‘mechanisms’ that demonstrably mediate SES and brain development; and (2) those neurocognitive systems that are most strongly affected by low SES, including language processing and executive function.  They argue that “these findings provide a unique opportunity for understanding how environmental factors can lead to individual differences in brain development, and for improving the programmes and policies that are designed to alleviate SES-related disparities in mental health and academic achievement” [1].

Neuroscience can tell us how SES may affect her brain.
Can it move us to do something about it?

Theoretically, I have no doubt that neuroscience can make a powerful contribution to early childhood development by determining whether and which neurocognitive systems appear to be more extensively affected by low socioeconomic status.
This is, as the authors themselves point out, important work, because understanding which systems are affected can help educators and policy-makers develop programs to target them more directly and successfully. For example, the work of D’Anguilli et. al. demonstrates that low-SES children pay more attention to unattended  stimuli, and are thereby more susceptible to becoming distracted and having a harder time focusing on a given task. [2] A corresponding, corrective strategy would consist in introducing games, lessons and computer-based strategies which explicitly target executive functions – and indeed, just such a set of measures is being used by the Tools of the Mind curriculum, which as of this year is being implemented in 18,000 pre-kindergarten and kindergarten classrooms, in Head Start programs, public schools, and childcare centers across the nation.

Fig. 1: The yellow 'brain development' box represents those neurocognitive systems that are most affected by low SES, and could include 'language processing' and 'executive function'
So far, so good. So what am I worried about?

What do you think? 

I’m not ‘worried’ so much as left wondering about one issue in Hackman et. al.’s review that I would now like to explore, and that I would welcome further discussion about.

My concern relates to the broader relationship between scientific knowledge and our individual and collective moral motivation to do something about an ongoing injustice. Allow me illustrate what I mean using two diagrams adapted from the Hackman et. al. article. The first represents the state of our knowledge regarding the relationship between SES and development, without any concrete neuroscientific understanding of the neurocognitive systems that mediate between them:
Fig. 2: We know that SES affects developmental outcomes,
even if we don't understand the neurocognitive systems that mediate the relationship

The second represents the state of our knowledge regarding the relationship between SES and development, now including our emerging neuroscientific understanding of the neurocognitive systems that mediate between them, outlined in the paper:
Fig. 3: Neuroscience is beginning to elucidate which neurocognitive systems are
most strongly affected by SES, and thereby influence children's developmental outcomes

My question is this: if sociologists and psychologists have already firmly established the relationship between SES, specific environmental mediators, and resulting developmental outcomes, as in Figure 1, (and they have, as the evidence cited by Hackman’s et. al. attests to), then can the addition of a scientific understanding of the intermediary mechanisms in any way enhance or strengthen our practical commitment to improving children’s SES and the corresponding environmental mediators that affect their development?  In other words, if I already know that SES, and specifically prenatal influences, directly affect elements of children’s cognitive and emotional development, do I need to know anything before doing something about it? And will knowing more about it, including understanding the causal sequence mediating the relationship, prompt me to do anything more about it than I was doing before?

Again, as mentioned, I fully recognize and appreciate the potential of neuroscientists and their collaborators to “design of more specific and powerful interventions to prevent and remediate the effects of low childhood SES.” [1] A second, equally essential neuroscientific question to explore is whether certain brain propensities increase the likelihood of individuals' living in low-SES circumstances. Could we say that certain brain propensities correspond to developmental diseases, or to a kind of physical handicap - one that traps people in poverty and decreases their likelihood of attaining a better quality of life?  If so, would this oblige us to take action? These are fundamental questions that need to be explored further. For my part, I'm not sure I agree with the statement that neuroscience can “highlight the importance of policies that shape the broader environments to which families are exposed” with any more clarity or motivational force than our existing knowledge already does. [1]

I am a neurophile, but…

Here’s why I’m slightly skeptical.  To borrow an example from the philosopher Peter Singer, imagine that you’re driving down the street and see a person bleeding profusely from his leg. [3] You could rush in and help this man, but you’re wearing your brand new, $375 J.Crew Ludlow suit jacket, so you think to yourself, ‘Ok, do I leave him there? I mean, it’s terrible, but I guess so, because I don’t want to get blood all over my beautiful jacket.’ If you responded to the situation in this way, we would probably call you a moral monster.

One of these is not like the other. Or...?

Now consider a different case. Imagine that you’re watching your favorite episode of the Walking Dead when a commercial from Care comes on and reminds you that for $375, you could pay for and facilitate 8 healthy births, and thereby help save the lives of several mothers and their babies. Now you think to yourself "Well, I guess it would be good to save those people, but I really just want that jacket." In this case, our general consensus would be that while you're no Mother Theresa, we probably wouldn't want to condemn for being a moral monster. (After all, that jacket is made from 'world class wool'!) So what gives? As Singer pointed out in a series of influential articles, our rational obligation towards the mothers and their newborns should be the same as towards the bleeding man. [3] So how and why do our intuitions differ?

In his article, “From neural ‘is’ to moral ‘ought’: what are the moral implications of neuroscientific moral psychology?,” the philosopher Joshua Greene suggests that an evolutionary perspective may help explain the differences in our responses. He proposes, “consider that our ancestors did not evolve in an environment in which total strangers on opposite sides of the world could save each others’ lives by making relatively modest material sacrifices. Consider also that our ancestors did evolve in an environment in which individuals standing face-to-face could save each others’ lives, sometimes only through considerable personal sacrifice. Given all of this, it makes sense that we would have evolved altruistic instincts that direct us to help others in dire need, but mostly when the ones in need are presented in an ‘up-close-and-personal’ way.” [4] According to Greene, this makes a sense of why human beings can be extraordinarily altruistic in their immediate, interpersonal interactions, but still gobsmackingly selfish in their transnational relations.

Unfortunately, our relationship to children in lower-SES environments is closer to the distant pregnant mothers in Singer's analogy than it is to the bleeding stranger right in front us. Few of us interact with low-SES children on a daily basis, and so many of us worry about how they get on in more abstract, theoretical terms. But if this is right, then more information, or even more scientific understanding, will not be enough to move us toward addressing their developmental issues. Rather, we will need to use other kinds of knowledge, such as our emerging understanding of biased moral motivation, to reflectively increase the probability of translating our moral principles into actions. That is, examples like Singer's bleeding stranger tell us something about how our moral motivation works, and we need to use this type of knowledge to try and make low-SES children seem more like the man with the leg wound in our moral imaginations. This would increase the likelihood of our doing something to improve low-SES children's circumstances. One way of achieving this would be to ensure that we interact with low-SES parents and their children on a more regular basis, e.g., by doing something as simple as taking public transportation. This would make us more likely to put our hard-won neuroscience research to use.

____

[1] Hackman, D. A., Farah, M.J., Meaney, M. J., 2010, 'Socioeconomic status and the brain: mechanistic insights from human and animal research,' in Nature 11, Available at https://mail-attachment.googleusercontent.com/attachment/u/0/?ui=2&ik=bb31177d51&view=att&th=13ad223ce6979971&attid=0.4&disp=inline&safe=1&zw&saduie=AG9B_P9-g3MEKF3MHUpOaKNL2td1&sadet=1355272405884&sads=-iGOQ0R2Qyb4_aHrUapR1YuvG1g

[2] D’Angiulli A, Herdman A, Stapells D, Hertzman C. 2002, 'Children’s event-related potentials of auditory selective attention vary with their socioeconomic status.' Neuropsychology 22:293–300.

[3] Singer, P., 1972. 'Famine, affluence, and morality.' Philosophy and Public Affairs 1, 229–243.

[4] Greene, J. 2003. ''From neural 'is' to moral 'ought': what are the moral implications of neuroscientific moral psychology?' Nature. Available at: http://www.overcominghateportal.org/uploads/5/4/1/5/5415260/from_neural_is_to_moral_ought.pdf



Want to cite this post? 
Haas, J. Uncovering the Neurocognitive Systems for 'Help This Child'. The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2012/12/uncovering-neurocognitive-systems-for.html

4 comments:

Kristina Gupta said...

Thanks Julia - this is a fantastic post! I too am very skeptical about the claim that greater neuroscientific knowledge about the relationship between low SES and poor educational outcomes will lead to political action on this issue. I say this because when I worked on “family economic security issues” at a non-profit in DC five years ago (the National Women’s Law Center), I attended a number of events where advocates attempted to use neuroscientific data to justify more funding for early childhood education. But, according to the Washington Post, “in 2010, per-child state spending for pre-kindergarten programs was almost $700 below its 2001-2002 level.” So, I’m not sure the neuroscience argument has been all that persuasive (http://articles.washingtonpost.com/2011-04-26/local/35230001_1_state-cuts-federal-stimulus-funds-education-secretary-arne-duncan).

Daniel S. Goldberg said...

Nice post.

Since I work on the SDOH as well as neuroethics, this is right at the center of what I think about on a daily basis.

I share your skepticism -- am even more skeptical, perhaps:

http://inequalitiesblog.wordpress.com/2011/05/17/this-is-your-brain-on-poverty/

Julia Haas said...

Thanks, Kristina!

Unfortunately, that's exactly the kind of statistic I had in mind. But hopefully we can 'outsmart' our less rational human tendencies. If we combine our understanding of human motivation with our understanding of neuroscience, we may increase the chances of really following through and helping those children from low-SES backgrounds.

Julia Haas said...

Thanks, Dr. Goldberg.

I did recently come across one intriguing article about the Family Recovery Programme in the UK:

http://www.economist.com/news/britain/21564842-what-experiment-state-sponsored-parenting-says-about-british-politics

The program sends social workers to spend one-on-one time with families that are on the verge of being broken up by the local authorities. It is definitely a controversial approach, especially when it comes to determining the role of the state in the family. But the results are pretty interesting... And I wonder what would happen if Jackie Baptiste, the social worker featured in the article, could bring a laptop with her every day, and have the kids play the kinds of development-oriented games that Hackman et. al. describe. Would those be the kinds of targeted interventions they had in mind?