Book club: Attention, genes, and developmental disorders

Coming up for air after election day, I decided to actually tackle something that didn’t involve people screaming at each other about Medicaid, health insurance exchanges, and the rest. By chance, I ran across a fascinating, albeit challenging book, Attention, genes, and developmental disorders, published two years ago by Oxford University Press. It’s by Kim Cornish and John Wilding, two scholars who research the neuropsychology of genetic disorders. I don’t know if I have the chops to seriously engage this volume. I’m finding out by blogging about it.

Chapter 1 begins with a bravura example, unpacking the complexity of an apparently routine task. Imagine that you go to your local supermarket searching for your favorite yogurt. In your mind’s eye, you know what the container looks like. From experience, you know roughly where it can be found on the store shelves, though the store might have moved the yogurt display since your last visit. Along the way, you may be distracted by a toddler screaming, by running into a friend, by a text buzzing through on your smartphone. You might encounter an especially attractive or frightening person. Once you find that general area, you need to carefully sift through various similar-looking brands to find the correct item. More serious distractions might arise, too. A fire alarm might ring. A fellow shopper might get sick.

In short, a lot is going on here:

Searching for an object in the supermarket is not just an exercise in simple problem-solving; it is full of demands on attention in various different senses of that much-used term. Indeed we may say that all successful behavior that is not instinctively preprogrammed or well learned requires selection and organization of a correct sequence of actions from among competing alternatives and hence involves selective attention, maintenance of attention (sometimes called sustained attention) and control of attention.

As Cornish and Wilding unpack these processes, it becomes immediately obvious that one must clarify what the catch-all phrase attention actually means, and where this multi-faceted process might seriously go awry. This particular book club won’t appeal to everyone. It gives me a nice opportunity to learn-through-explanation about some of the important facets of ADHD, autism, fragile X syndrome, and Down syndrome, as well as two less-familiar ones known as Williams syndrome and 22q11 deletion. This is also useful groundwork for my embryonic book on developmental disability policy.

This seems unusually narrow for a TIE topic. I believe it still fits our ecosystem. If one wishes to write about health policy in matters of cognitive or behavioral disorders, it’s valuable to know at least a little something about the actual conditions people confront: their etiology, how these are measured, conventional wisdom about the possibility and limitations of treatment interventions.

Anyway, we’ll see how this goes. If you are an expert in these matters, I especially hope that you will participate and comment.

@haroldpollack

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