A sad day for neuroscientists everywhere. Rest In Peace Oliver Sacks! Read the New York Times article summarizing Dr. Sacks impressive life here![tweet https://twitter.com/OliverSacks/status/638090548520349697] [tweet https://twitter.com/OliverSacks/status/638090607085395968]
And now, weak, short of breath, my once-firm muscles melted away by cancer, I find my thoughts, increasingly, not on the supernatural or spiritual, but on what is meant by living a good and worthwhile life — achieving a sense of peace within oneself. I find my thoughts drifting to the Sabbath, the day of rest, the seventh day of the week, and perhaps the seventh day of one’s life as well, when one can feel that one’s work is done, and one may, in good conscience, rest.
Science denial has real, societal consequences. Denial of the link between HIV and AIDS led to more than 330,000 premature deaths in South Africa. Denial of the link between smoking and cancer has caused millions of premature deaths. Thanks to vaccination denial, preventable diseases are making a comeback.
Denial is not something we can ignore or, well, deny. So what does scientific research say is the most effective response? Common wisdom says that communicating more science should be the solution. But a growing body of evidence indicates that this approach can actually backfire, reinforcing people’s prior beliefs.
When you present evidence that threatens a person’s worldview, it can actually strengthen their beliefs. This is called the “worldview backfire effect”. One of the first scientific experiments that observed this effect dates back to 1975.
A psychologist from the University of Kansas presented evidence to teenage Christians that Jesus Christ did not come back from the dead. Now, the evidence wasn’t genuine; it was created for the experiment to see how the participants would react.
What happened was their faith actually strengthened in response to evidence challenging their faith. This type of reaction happens across a range of issues. When US Republicans are given evidence of no weapons of mass destruction in Iraq, they believe more strongly that there were weapons of mass destruction in Iraq. When you debunk the myth linking vaccination to autism, anti-vaxxers respond by opposing vaccination more strongly.
In my own research, when I’ve informed strong political conservatives that there’s a scientific consensus that humans are causing global warming, they become less accepting that humans are causing climate change.
Ironically, the practice of throwing more science at science denial ignores the social science research into denial. You can’t adequately address this issue without considering the root cause: personal beliefs and ideology driving the rejection of scientific evidence. Attempts at science communication that ignore the potent influence effect of worldview can be futile or even counterproductive.
How then should scientists respond to science denial? The answer lies in a branch of psychology dating back to the 1960s known as “inoculation theory”. Inoculation is an idea that changed history: stop a virus from spreading by exposing people to a weak form of the virus. This simple concept has saved millions of lives.
In the psychological domain, inoculation theory applies the concept of inoculation to knowledge. When we teach science, we typically restrict ourselves to just explaining the science. This is like giving people vitamins. We’re providing the information required for a healthier understanding. But vitamins don’t necessarily grant immunity against a virus.
There is a similar dynamic with misinformation. You might have a healthy understanding of the science. But if you encounter a myth that distorts the science, you’re confronted with a conflict between the science and the myth. If you don’t understand the technique used to distort the science, you have no way to resolve that conflict.
Half a century of research into inoculation theory has found that the way to neutralise misinformation is to expose people to a weak form of the misinformation. The way to achieve this is to explain the fallacy employed by the myth. Once people understand the techniques used to distort the science, they can reconcile the myth with the fact.
There is perhaps no more apt way to demonstrate inoculation theory than to address a myth about vaccination. A persistent myth about vaccination is that it causes autism.
This myth originated from a Lancet study which was subsequently shown to be fraudulent and was retracted by the journal. Nevertheless, the myth persists simply due to the persuasive fact that some children have developed autism around the same time they were vaccinated.
This myth uses the logical fallacy of post hoc, ergo propter hoc, Latin for “after this, therefore because of this”. This is a fallacy because correlation does not imply causation. Just because one event happens around the same time as another event doesn’t imply that one causes the other.
The only way to demonstrate causation is through statistically rigorous scientific research. Many studies have investigated this issue and shown conclusively that there is no link between vaccination and autism.
The response to science denial is not just more science. We stop science denial by exposing people to a weak form of science denial. We need to inoculate minds against misinformation.
The practical application of inoculation theory is already happening in classrooms, with educators adopting the teaching approach of misconception-based learning (also known as agnotology-based learning or refutational teaching).
This involves teaching science by debunking misconceptions about the science. This approach results in significantly higher learning gains than customary lectures that simply teach the science.
While this is currently happening in a few classrooms, Massive Open Online Courses (or MOOCs) offer the opportunity to scale up this teaching approach to reach potentially hundreds of thousands of students. At the University of Queensland, we’re launching a MOOC that makes sense of climate science denial.
Our approach draws upon inoculation theory, educational research into misconception-based learning and the cognitive psychology of debunking. We explain the psychological research into why and how people deny climate science.
Having laid the framework, we examine the fallacies behind the most common climate myths. Our goal is for students to learn how to identify the techniques used to distort climate science and feel confident responding to misinformation.
A typical response of scientists to science denial is to teach more science. But that only provides half of what’s needed. Scientific research has offered us a solution: build resistance to science denial by exposing people to a weak form of science denial.
Do you know a psychopath?
According to a 2014 National Consumers League poll, 29% of American adults believe that childhood vaccinations can trigger autism. To many, these views are difficult to comprehend. After all, multiple controlled studies conducted on huge international samples have debunked any statistical association between vaccines and autism. Moreover, when the Danish government removed thimerosal – a mercury-bearing preservative that most anti-vaccine advocates regard as the suspect ingredient – from its vaccines in the late 1990s, the rates of autism went up rather than down. Why, then, does the belief persist?
Well, it’s not that surprising. The false link between autism and vaccines is merely the tip of a massive iceberg of fads and misconceptions. In a 2008 review, psychologist Tristram Smith of the University of Rochester Medical Center identified more than 50 disproven or unsupported therapies for autism that were still in use, and the number has only mushroomed since then. These therapies run the gamut from gluten-free and casein-free diets, anti-fungal treatments, Pepcid, testosterone and secretin to dolphin-assisted therapy, magnetic shoe inserts, hypnosis, hyperbaric oxygen chambers, sheep stem cell injections, trampoline therapy…and on and on.
Despite the prevalence of these fad therapies, relatively few scientists who study autism have raised their voices to rebuke these methods. Perhaps that is because most do not regard public outreach as part of their job description.
In a recent article in the journal Evidence-Based Communication Assessment and Intervention, my co-authors Julia Marshall, Howard Shane, James Todd and I examined the persistence of facilitated communication, a scientifically discredited autism therapy. The premise of facilitated communication is that autism is primarily a movement disorder, not a mental disorder. As a consequence of supposed motor deficits, individuals with autism cannot articulate words properly, which presumably explains why many are incapable of speech. With the aid of a facilitator who offers gentle support to their arms, previously uncommunicative individuals with autism can supposedly type eloquent sentences and paragraphs.
If it all sounds too good to be true, that’s because it is.
Scores of controlled studies performed soon after the widespread introduction of facilitated communication to the United States in the early 1990s demonstrated that its seeming effectiveness is a mirage. Facilitators are unintentionally directing autistic individuals’ fingers to the desired letters, much as Ouija board players unknowingly direct the planchette to specific letters and numbers.
We found that facilitated communication, despite being debunked by the late 1990s, remains alive and well in much of the autism community. The method continues to be widely practiced in the US and parts of Europe. It’s still publicized in numerous trade and academic books, seminars, workshops and high-profile documentaries.
This revelation has taken many of our academic colleagues by surprise. One told me that earlier this year, he had invoked facilitated communication in a psychology course as a prime example of a fad that had long been consigned to the dustbin of pseudoscientific history. This is a critical point – for scientists these matters are settled. But that doesn’t mean the information in studies disproving claims from fad therapies has hit the mainstream.
Why is autism such a magnet for fads? And why have discredited ideas endured in the face of contrary evidence? Several likely culprits conspire to create a “perfect storm” making those desperate for a cure or an effective treatment receptive to misinformation.
In the case of the autism-vaccine link, the soaring increase in autism diagnoses over the past two decades is certainly a contributor. But there is growing evidence that much of this spike reflects two factors: increasingly lax criteria for autism diagnosis across successive editions of the official psychiatric diagnostic manual (DSM), and heightened incentives for school districts to report autism and other developmental disabilities.
There is therefore ample reason to doubt that the “autism epidemic” actually reflects a genuine increase in the frequency of the condition. But the dramatic rise in diagnoses has led many people to believe in shadowy causal agents, such as childhood vaccinations.
The fact that the symptoms of autism typically become evident at about age two, soon after routine vaccinations begin, lends this belief further surface plausibility. The link in timing is coincidental, but some people connect the dots into a tidy causal narrative.
And many fad treatments for autism are surely born of desperation. There are no known cures for the condition. It’s not surprising that most parents of children with autism simultaneously seek out four to six different treatments for their children. Nor it is surprising that this field has been remarkably fertile ground for ostensible quick fixes, such as facilitated communication.
And some probably fall victim to a diabolical illusion. A number of the behavioral problems associated with autism, such as inattention and anger, often wax and wane over brief periods of time. If a natural – and unrelated – downtick in symptoms happens during or after therapy is delivered, parents and teachers may then conclude that the treatment brought the improvement, even though the decline in symptoms would probably have occurred anyway.
Appearance shapes how we view autism. Children with autism do not have the distinctive facial markers of, say, children with Down Syndrome or fetal alcohol syndrome. That fact might lead some to assume that individuals with autism are cognitively and emotionally normal individuals trapped inside a malfunctioning body. If that is so, all that is presumably required is an intervention, such as facilitated communication, to unlock their unrealized mental potential.
The popularity of autism fads imparts two sobering lessons. First, we can all be misled by the raw data of our sensory impressions. Virtually all autism misconceptions stem largely from what psychologists call naïve realism, the error of placing uncritical trust in our unfiltered observations. Second, scientists need to play a more active role in combating false information about autism and other mental disorders.
When researchers conduct studies that dispel the alleged dangers of vaccines or the alleged effectiveness of pseudoscientific treatments, they may assume that their job is done. That’s not the case. The legacy of autism fads suggests that their real work may have only just begun.
Tristram Smith’s study “Empirically supported and unsupported treatments for autism spectrum disorders” appeared in the Scientific Review of Mental Health Practice. 2008; 6:3–21.