Cognitive Enhancement and Education: Perspectives from a Low-and Middle-Income Context
By Jayashree Dasgupta and Georgia Lockwood Estrin
This piece is part of a series of featured posts from the 2020 International Neuroethics Society Meeting. It is based on an abstract titled “How Do Parents View Cognitive Enhancers for their Children? Evidence from India” that won the award for the “Best Oral Presentation.”
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Image courtesy of Wim Klerkx |
Traditionally, pro-cognitive drugs, such as methylphenidate, have been used for treatment purposes in neurodevelopmental disorders, like Attention Deficit Hyperactivity Disorder (ADHD). From a clinical deficit perspective, there is a clear understanding that children fall below the norm due to an underlying condition, and therefore the use of cognitive enhancement to help a child achieve their full potential is largely acceptable to parents and society. However, the concept of “normal” cognitive development is complex, and research has demonstrated poverty and adversity to be among the several factors which influence brain development (Lipina & Evers, 2017). Would children from disadvantaged backgrounds who fail to reach their true cognitive potential be considered to fall below the norm and be a potential target for cognitive enhancement? Whilst there has not been much research in this area, a series of studies conducted by Farah and colleagues has shown strong associations between poverty and adverse development of children’s cognitive abilities (e.g. Farah et al., 2006). For some, this suggests that children from disadvantaged backgrounds, who are at high-risk of not achieving their full cognitive potential, should be offered cognitive enhancers as a way to potentially equalise the playing field and optimize brain development for those most in need. However, the use of cognitive enhancement raises many neuroethical concerns, including those related to opportunity, medical safety, coercion, and fairness (Schelle et al, 2014).
These questions may be particularly pertinent in Low and Middle Income Countries (LMICs), where there are over 200 million children at risk of sub-optimal development, a majority of whom live in India (Lu, Black, & Richter, 2016). Theoretically, cognitive enhancers like pro-cognitive drugs, nutritional supplements, and stimulants could be widely distributed to help such children overcome the limitations of living in adverse circumstances. An advantage of such cognitive enhancers, compared to e.g. providing more broad-based social changes, is its potential to be scaled up at comparatively low cost, thereby benefitting more children (Butcher, 2003). This debate argues that cognitive enhancement could help disadvantaged children attain their true cognitive potential, and benefit from advantages like improvements in academic performance, thereby opening avenues for upward social mobility. This has been a focus of academic deliberations, and neuroethicists have questioned whether it is our moral and social responsibility to provide children growing up in sub-optimal environments cognitive enhancement. However, cognitive enhancement research in children has almost exclusively been carried out in High Income Countries (HICs), and we know little about how this idea is viewed in LMIC contexts where parents and children could be potential end users and beneficiaries.
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Image courtesy of Anders Sandberg on Flickr |
So what about other types of “cognitive enhancing” tools?
Unfortunately, the most significant event of 2020 was the COVID pandemic, which has impacted education systems globally. Schools across the world have been struggling with disruptions to the academic year and India has been one of the countries to institute nation-wide school closures in an attempt to reduce the spread of COVID. It is estimated that this has impacted 320 million learners across the country. To help children continue with their schooling, there has been a sudden and unprecedented shift to online education. The government has launched several e-platforms to assist students and teachers until schools reopen, and at an institutional level, schools have developed and are delivering curriculum online.
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Image courtesy of Pixabay |
Despite these questions, our research in India has so far suggested that parents across socioeconomic strata appear to be reticent for quick fix solutions involving pharmacological approaches and supplements for cognitive enhancement that come with concerns about safety and potential side effects. Our research instead points towards the need to invest in traditional and acceptable approaches, such as improving access to quality education in LMIC contexts. Ironically, the current pandemic may be providing us with a unique impetus to improve the quality and universal access to online education - an opportunity that should not be missed.
References
- Butcher, J. (2003). Cognitive enhancement raises ethical concerns. Academics urge pre-emptive debate on neurotechnologies. Lancet, 362(9378), 132-3.
- Farah, M. J., Shera, D. M., Savage, J. H., Betancourt, L., Giannetta, J. M., Brodsky, N. L., Malmud, E. K., and Hurt, H. (2006). Childhood poverty: Specific associations with neurocognitive development. Brain Research, 1110(1), 166-174.
- Keshavan, M. S., Vinogradov, S., Rumsey, J., Sherrill, J., & Wagner, A. (2014). Cognitive training in mental disorders: Update and future directions. American Journal of Psychiatry, 171(5), 510–522. https://doi.org/10.1176/appi.ajp.2013.13081075
- Lipina, S. J., & Evers, K. (2017). Neuroscience of childhood poverty: Evidence of impacts and mechanisms as vehicles of dialog with ethics. Frontiers in Psychology, 8(JAN), 1–13. https://doi.org/10.3389/fpsyg.2017.00061
- Lu, C., Black, M. M., & Richter, L. M. (2016). Risk of poor development in young children in low-income and middle-income countries: an estimation and analysis at the global, regional, and country level. The Lancet Global Health, 4(12), e916–e922. https://doi.org/10.1016/S2214-109X(16)30266-2
- Schelle, K.J., Faulmüller, N., Caviola, L. and Hewstone, M., 2014. Attitudes toward pharmacological cognitive enhancement—a review. Frontiers in Systems Neuroscience, 8, 53.
- Verhoeven, M., Poorthuis, A. M. G., & Volman, M. (2019). The Role of School in Adolescents’ Identity Development. A Literature Review. Educational Psychology Review, 31(1), 35–63. https://doi.org/10.1007/s10648-018-9457-3
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Georgia Lockwood Estrin is the co-lead of this project. Her work focuses on ethical issues surrounding neurodevelopmental research in low-resource settings, and she is currently a Sir Henry Wellcome Post-doctoral Research Fellow at Birkbeck, University of London.
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Dasgupta, J. & Lockwood Estrin, G. (2021). Cognitive Enhancement and Education: Perspectives from a Low-and Middle-Income Context. The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2021/03/cognitive-enhancement-and-education.html