>> as eric is implying, between the psychology and the genetics is the brain. and the hope is that although there may be three or 400 genetic risk factors, they will converge on common pathways. so this is a diagram of a neuron, all these genes are in that little sphere tucked the nucleus and all that genetic information is read and it main tand the shape of the neurocell and function of the neurocell. and one key function we have all been talking about is the connection that nerve cell makes with the next cell in line called the synapse which literally means to clasp. and some synapses are stimulating the next cell in line and o some inhibit it. and the general theory which i ascribe to is that there is an imbalance between this

exciteation and inhibition, almost, the world is too much with us, and the autistic child can't process information because of imbalances in those synapses, in key areas of the brain. perhaps those areas in the temp oral lobe, the superior temp oral gyhus that were pointed out in your diagrams. but there are many, many, many proteins that influence not just the function of the synapse, but the stability of the the synapse and the ability of that synapse to change with the experience so i think all of our hopes is the genetics will show us the way the key targets in the synapse which may be knew therapeutic targets and which we can use as biomarkers for whether we are going in the rye direction, whether it is behavioral therapy or pharmacologic intervention.

well, it is, but i think everything we know about the brain is a sense of theory. this to me is one of the more compelling, obvious areas of further investigation. and it will be the key for understanding neuropsychiatric disorders. >> i think it's fair to say that although our understanding of the psychiatric, of the genetics of any psychiatric disorder is extremely primitive. in the case of autism it is probably somewhat more so fist cased that than it is in the other areas that is correct is number one. and number two t isn't complete oly a theory. we have the finding that these areas don't communicate as well from thea's work and we have the findings from your work and other people's work that some of the genes involved like-- are actual oly o involved in synaptic function. so certainly this is one of the contributing factors. >> i also think that the

genetics work is really leading us towards more personalized treatment. and as we're discovering a different genetic underpinnings or the underlying biology in each individual person we're better able to target treatment, particularly pharmaceutical treatment so where in the past when i would taken my daughter to see the psychiatrist we say well, you could try a little prozac or you could try a little clonadinin and i would say explain to me the mechanism in which that will help her and there was no explanation. you can try this, maybe it will work. maybe not. but now that we are understanding the genetics and proteins associated with those genes, the treatments that we're looking at in animal models are really targeted and have a very defined mechanism of action. and that's really hopeful for a lot of families. >> i think you make an absolute oly beautiful point. there is true in all of medicine. i mean o our new insights into breast cancer and to colon cancer come from seeing a disease that we

used to think was unitarree having men subdivisions based on genetic subdivision. and the reason we can treat some of these things bet certificate because drugs that were quite effective, but we didn't appreciate them, were being used against inappropriate targets. once we know this particular gene is involved, and this kind of colon cancer, we can direct the drug specifically for that. and the outcome in some cases is really quite extraordinary. >> yeah. one thing that has been remarkable is the influx of talent into this field that people are coming to the field of autism both from cognitive science, from genetics, from molecular, cellular, biology to shed new light on it i think it's been remarkable in the last five years the influx of talent. matters, a psychiatrists interests and other disorders. some of it your own work has uncovered key synaptic protein genes. and we're finding that more and more. and it's going to need a

commute of scholars to really take these different hints and get so the next level. >> i think it's completely understandable. if you appreciate the brain is hot. we really want to understand how we work. and the brain is a way to get there. so there is a a tremendous influx, per se but the thing that is unique about the human brain is social interaction. this is a disease of the most uniquely human characteristic, a child interacting with its mother. what is more fundamental to human existence. and so this is o obviously an area that draws a lot of interest. >> yeah. >> are you optimistic, alison. >> i'm more optimistic now than si have been over the last ten years. i think that the investment that we've made at the federal level and from individual advocacy organizations in autism is really starting to show dividends. i think you heard about some of the research that has come to light in just the

last few years and ou how critical that has been to changing our view on how we can treat autism and personalize treatment. i also think that there's been a large increase in awareness of autism and that that has led to a more compassionate community, one where our families don't have to feel so afraid to take their children or their adults with autism out in the community. it really reduces its social o isolation that a lot of our families have desribed for a long time. >> as we learn new things are we discarding old ideas about autism. >> i think one important idea that has been discarded. >> refrigerator mother. >> exactly, is that it was the result of bad parenting and that parents of children with autism were too cold, to properly bond with their child and that that is what caused the child to retreat into their own world. my brother was diagnosed in the 1960s.

my mother was told that she was a refrigerator mother, too cold to bond with my brother. and that his autism was her fault. and that she should try harder with the next child. >> the guilt that that spread. >> the suffering on the part of o mother. >> unbelievable. >> still evident today. and people wonder. >> we have to continue, actually, to make it plain that this has nothing to do with. >> yes, many people feel they are guilty for passing on genes, even if it is in the sperm or the eggs that it is their fault somehow. and it's a major societal issue. >> are you as excited about its genetic developments as matthew is? >> i find it very interesting. but i would like to have that bridge built from the gene to the synapse to the whole nervous system to the brain, networks, and to the behavior. we do need to go from one to the other. and there are many, many steps to build in between.

we can't just go along one thing and say we've built this whole question. >> i think the opportunities to do that now are just fantastic. >> and it's thrilling. >> because we know more about the genetics. >> because we have the rules. >> because of uta's work we know about the cognitive col. she and the husband have been very interested and received major wards o for their work on social cognition. i should point out since i really like uta a great deal, shes with the one that brought the attention of the scientific community in the united states and england to asperger. he was working in vienna. no one was reading the german literature. she comes from germany. she translated his paper. this was written in 1943. 1991 she translated it. and that is the first time that english speaking scientific community became aware of his work.

so she brought this together and made one real oize it's a much more heat lo-- hetero again cruise disease because he emphasized the intellectually capable kids. >> i would like to add one other thing that is really important in this story. that it is helped us so much more to understand the neurotypical social brain as well. >> yes,. >> things that we would never have thought of. who would have thought that there is this innate ca passit ot attribute mental states it is crazy. but if you can have this window through the pathology to look at what is actually happening. >> also so many other interesting things came out that the fact that there are some kids with autism who are quite creative. >> tremendous. >> interesting that we don't have here a kind of des ability that is general. the interesting thing is that it tells you that certain things can be such great strengths, great independence of thought.

coexisting together with some real weaknesses in some other kinds. >> it is actually so interesting because there is a real discussion. you may have some insuitors into this to what degree is the theory of mind in any other species besides our os. there is discussion, obviously there is cap ability for social interactions by many groups. but whether or not this involves being able to mentalize in this way is not at all clear. >> uta i think you said something which is very avant-garde and very important. just using the words the social brain is a controversial concept. i think we must not forget the cost to society and to families of they were dictment. and i think the cost of not just the individual but to families and close relatives is enormous. and it it is unrelenting. i know children may very well improve with age but this is a lifelong commitment to the child, and for each family member.

i think allison -- >> i mean autism affects not only the person who is diagnosed but their entire extended family. the fact that my daughter o only sleeps three or four hours a night and everyone in my household is awake certainly affects the way my younger daughter performs in school the next day. one of us always has to be awake with her at night because we worry that she will leave the house, wandary way and we know children with autism sometimes wander and are hit by cars or drown or meet way terrible fate. but i think every parent wants to know, wants to get ino side their child's head, o even if just for two minutes, and say why, what is the meaning of your behaviour what are you trying to tell me. how can i better help you. what is it that you want me to know. i mean just to have that one minute window of understanding, i any, is every parent's greatest wish. >> yeah so there is an urgency to this that is

really ought to be made clear. >> my daughter is severely affected. she is not really-- she has severe cognitive disabilities. she has very minimal functional language. she's not really aware of the needs of other people. and frankly sometimes i think of that as a blessing. i think many of the kids who are higher functioning become so aware of the fact that they are different from their priors that that adds another layer of psychological issue to their autism. but my daughter is, the thing that concerns me most is that as she gets older, her world is getting smaller and smaller. with most teenagers and address inds as they get older their world expands am they have new experiences. they have experiences without their parents that they go and they enter the world. the world for pie daughter is getting smaller and smaller. she still watches the same "sesame street" videos as a 14-year-old that she watched

when she was two years old. her interests are not broadening, they are narrowing. so we are constantly trying to think of ways to introduce her to new experiences but in a way that is comfortable for her. and that really requires going to a place ten times before she can even feel comfortable there that environment. and this requires patience and vigilance that i think a lot of the families describe. but it's something to aspire to. i think one of the things about families of children with autism is that they never give up hope. they're constantly trying to help their children improve. they're extremely resilient and hopeful. and i think will continue to raise money and raise awareness and support research until we knows what's causing autism and until we have treatments that are effective for all of our children. >> rose: i think we just heard here what makes this whole understanding, this whole quest to understand the brain so exciting for

those of us who put together this program. and also for people with just a general curiosity to understand who we are and why we are the way we are. and how central the brain is to that so that's part of what makes this series and the previous series so exciting for us. we've been talking here about the cognitive mind. next time we're going to speak about moods. you said, eric, next time we talk about moods. so we're going to talk about depression. when currentlin began to focus on psychotic disorders he knew there were skoo classes, kits friendia, and moods, depression and manic sigh coseis-- psychosis, depression is the most common psychiatric illses. about 20 million americans suffer from it every year and between the ages of about 15 to 40 it is the major cause of disable. so not only a fascinating o

problem but an he o enormous public health issue. >> rose: can't wait, thank you, thank you. thank you. and thank you this extraordinary journey we take to understand the brain to understand the diseased brain, to understand the functioning brain, to understand all that it is, as i said earlier, without who define who we are and why we are the way we are. see you next time captioning sponsored by rose communications captioned by media access group at wgbh access.wgbh.org