What's most important? Intelligence or emotional health?

By Louise Kinross

What factors in childhood predict later satisfaction and happiness in life?

Two articles crossed my desk about studies that come to vastly different conclusions.

The first article is about a study published in 2014 in the Economic Journal by London School of Economics (LSE) researchers. This study finds emotional health in childhood and later is the most important predictor of adult life satisfaction. 

Researchers used data from about 9,000 people born over a three-week period in 1970 and tracked by the British Cohort Survey, which has participants fill out a questionnaire about their lives every five to seven years. 

Emotional health, the LSE researchers found, is more important than education or income to future happiness. Least important, they say, is intellectual performance as a child. 

The second article is a piece I read on Saturday by Globe and Mail columnist Margaret Wente: The explosive science of genetics,

It suggests the exact opposite.

In it, Wente refers to a 2015 study in Molecular Psychiatry from Nature.

"Intelligence (as Dr. Plomin and others wrote in an influential piece in Nature) is 'one of the best predictors of important life outcomes such as education, occupation, mental and physical health and illness and mortality.' 

"Intelligence, one of the most heritable behavioural traits, is also an important factor in class differences," Wente writes. "Intelligent people are healthier, happier and stay married longer. They are also likely to marry each other and produce intelligent children. The implications for inequality and social mobility are significant."

The findings obviously have implications for parents raising children with intellectual disabilities. But I think they also relate in some ways to people living with physical disability. In both instances, people with disabilities tend to rate their quality of life much higher than their families or doctors and researchers do.  

The common view is that disability, of any kind, is a negative.

In NeuroTribes, Steve Silberman's groundbreaking new book on the history and nature of autism, he presents a different view.

He notes that Hans Asperger, one of autism's research pioneers, saw a child's gifts as "inextricable from their impairments." According to Asperger, the "positive and negative qualities" of a child with autism, or any disability, "are two natural, necessary, interconnected aspects of one well-knit, harmonious personality."

This reminded me of a piece by parent and author Rob Rummel-Hudson. 

In it, Rob argues that his daughter's differences are generative. "It changes everything about how she thinks and how she processes the world around her," he writes. "Those different paths are hard for her teachers and friends and even her family to understand, and impossible for us to travel. But they are her paths, and they are beautiful." 

I wrote about it here: Disability doesn't just take, it gives.

I wondered how the 'emotional health' researchers written about above would square their findings with the 'intelligence' scientists, and vice versa. 

So I sent an e-mail to each of the lead researchers.

I'll let you know what I hear.

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What does IQ have to do with happiness?

By Louise Kinross 

I’m a little stumped.

I read this piece called Genetic screening to enhance IQ should be embraced in The Conversation. In it, an ethicist argues we should test embryos for gene changes associated with low intelligence (70-85) and discard them because of “the bad things” low IQ portends: poor job opportunities, low income, increased risk of poverty and welfare dependency, greater likelihood to drop out of school and increased chance of incarceration and being murdered (quite a mouthful).

This 2013 Psychological Medicine study seems to support the association between low intelligence and less happiness. Of almost 7,000 people, those in the lowest IQ range (70-99) reported the lowest levels of happiness compared with those in the highest IQ group (120-129). When asked to rate their level of happiness, 12 per cent in the lowest group said “not too happy” (that doesn’t strike me as a huge number. I don’t have the full study to look at what portion of the high IQ group said they were “not too happy.”)

However, the study authors suggest that it's not the degree of intelligence per se that leads to happiness, but the fact that people with higher IQs have better incomes and health and less mental illness.

But isn't stigma one of the main reasons that marginalized groups make less money, have poorer health and experience more anxiety and depression (I'm thinking historically of women, minorities and people with a range of disabilities)? What role does discrimination have to play in these outcomes?

Remember the 2012 French study that showed that even adults who outwardly say they accept kids with disabilities carry a negative bias against children with Down syndrome at an automatic, unconscious level (deduced through implicit-association testing)? In other words, they react to people with Down syndrome based on a negative stereotype they may not even know they have. “These implicit associations are the result of social values...carried by our culture,” says the lead researcher Claire Enea-Drapeau, a school psychologist in Marseille, France. “They are likely deeply embedded and difficult to break.”

However, in spite of the pervasiveness of automatic bias against kids with Down syndrome, this 2011 American Journal of Medical Genetics study found that nearly 99 per cent of 300 people aged 12 and over with Down syndrome say they are happy with their lives; 97 per cent like who they are; and 96 per cent like how they look. 

How does this finding fit with the Psychological Medicine research above?

Further, would we ever expect people in the general population to say they were almost 100 per cent happy and okay with themselves? The AJMG study seems to fly in the face of this statement from our ethicist above: “It is pretty clear that low-normal levels of cognitive function tend to reduce well-being.”

Then I googled IQ and depression and found this article about how the rate of suicide in undergrads at Harvard over a recent five-year period was two times the national average for college students. Wouldn't Harvard students be among some of the brightest? And, according to the earlier research, happiest?

I remembered this BLOOM interview we did with Holland Bloorview neurologist and autism expert Evdokia Anagnostou about how high IQ doesn’t predict happiness in people with autism. In fact, there's a high rate of anxiety and depression in youth and young adults with higher-functioning autism.

I felt like I was being buffeted back and forth between arguments suggesting that happiness was dependent on high intelligence and those suggesting it was independent of it.

And I started to think about how perhaps we were looking at this in a simplistic way. I was reminded of Harvard psychologist Daniel Gilbert’s Stumbling on Happiness—a book that looked at common blind spots in how we imagine the future. These include a lack of empathy that allows us to imagine an experience different than our own and a tendency to overestimate the negative impact of an event and underestimate our resilience.

Gilbert said this helps explain a study that showed sighted people will pay more to avoid going blind than blind people will pay to regain their sight. It also explains why most people assume they couldn’t be paralyzed and happy, even though surveys of people with quadriplegia show the opposite (in fact, sometimes they rate their quality of life as better post injury).
I wondered how much resilience on the part of children with low intelligence and their families might ameliorate some of the supposed negative impacts.

During this time I read A Healing Family, a memoir by Japanese Nobel Prize winner Kenzaburo Oe, about raising a son who was born with brain damage. In it, Oe keeps coming back to the fact that despite the challenges, having a son with intellectual disability came to define his worldview and enabled his family to adapt in ways that readied them for other challenges.

“Twenty-five years ago, my first son [Hikari] was born with brain damage. This was a blow, to say the least; and yet, as a writer, I must acknowledge the fact that the central theme of my work, throughout much of my career, has been the way my family has managed to live with this handicapped child. Indeed, I would have to admit that the very ideas that I hold about this society and the world at large—my thoughts, even, about whatever there might be that transcends our limited reality—are based on and learned through living with him.”

And further on: “On a more personal level, I can imagine a very concrete example of what happens to a society that shuts out its disabled by asking myself how we ourselves—[the Oe family]—would have turned out if we hadn’t made Hikari an indispensable part of our family. I imagine a cheerless house where cold drafts blow through the gaps left by his absence; and, after his exclusion, a family whose bonds grow weaker and weaker. In our case, I know it was only by virtue of having included Hikari in the family that we actually managed to weather our various crises, such as my mother-in-law’s gradual mental decline.”

I guess I'm not sure what I think anymore.

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In autism, we confuse IQ with happiness

Does being smarter make you happier? Not necessarily, says Dr. Evdokia Anagnostou, a child neurologist and clinician scientist in the Autism Research Centre at Holland Bloorview.
 
In the general population intelligence predicts school success, which correlates with “getting a university degree and money, our two obsessions,” Dr. Anagnostou says. “But IQ doesn’t predict how good life is, the quality of your life, or life satisfaction.”

And this is particularly true among people with autism, she says. “Parents are really focused when their child is diagnosed on figuring out the child’s IQ, because of the assumption that kids with autism and high IQs are doing better. And while they do have the potential to integrate better or easier or with less intervention, it’s a potential. In practice, there are many issues that make that original assumption wrong."

One is the high rate of anxiety and depression in children with high-functioning autism.  "If you look at the old category of Asperger's, up to 80 per cent of those children will have a significant anxiety disorder by the time they reach adulthood," Dr. Anagnostou says. "Up to 70 per cent will have one major depression as young adults, and 50 per cent will have more than one depressive episode. One in five will have obsessive compulsive disorder. There is significant mental-health co-morbidity for higher-functioning kids, so the term ‘functioning’ becomes tricky."

Dr. Anagnostou says there may be a genetic predisposition to mental-health problems in this group, "but some of it has to do with people realizing and being very aware of their difference and their inability to fit in and their limitations."

This often plays out in the workplace. Dr. Anagnostou notes that many adults with autism who are university grads are unemployed. "If you think about what makes you successful in a job interview, it's not necessarily your IQ, it's your ability to interpret social clues, to be socially savvy. A lot of very high-IQ people with autism fail at those things and so their technical intellectual ability is not translated into functional skill. We don’t have workplaces that will tolerate and accommodate and capitalize on the strengths of people with autism. There are also huge problems with anxiety and depression interfering with someone's ability to maintain a job."

Mental-health issues tend to spike after puberty and worsen after age 18, when supports for students with autism wane, she says. "We make sure our kids who have the ability to do well get supported in high school and we accommodate them. But then we take that away when they get to college. Very few universities have programs for people with autism."

On the other hand, youth with autism and mild intellectual disability often “do very well,” Dr. Anagnostou says. “With supports they can finish school, learn vocational skills, get a job, and they tend to have less mental-health issues than the high-IQ group. They’re often happier. If you have a university degree and end up in a life-long volunteer position, which is what happens to a lot of young adults with autism and high IQs, the kid who had the lower IQ who has the job and can support himself has a better outcome.”

Dr. Anagnostou says a problem in the world of autism treatment—and the larger culture—is an overfocus on academic performance. "I think we need to revisit our outcome measures for early intervention programs. Right now we're reporting on IQ points gained, but IQ doesn't always predict function or quality of life. We need to know childhood predictors of quality of life in adulthood and those should be the targets of our intervention programs. If IQ is one of them, great, but so far IQ hasn't been predictive of quality of life in the autism population."

More attention in the early years should be placed on nurturing emotional regulation, social engagement, shared smiling, and social motivation, Dr. Anagnostou says.

Early detection and treatment of mental-health issues is important. Cognitive behavioural therapy has been shown to significantly reduce anxiety in children with autism. “There are a lot of efforts now to adapt programs,” Dr. Anagnostou says. “For example, the Facing Your Fears program at Holland Bloorview includes more visual information, more practice, less time spent on thinking things and more on doing things. Children spend a lot of time learning how to identify emotions, which is often hard for kids with autism; rating their emotions; and using plans to manage them.”

Another intervention area that gets overlooked is the wellbeing of parents and siblings. "There are high rates of depression and anxiety in parents of children with autism and we know that parental mental-health predicts childhood outcomes, whether you have autism or not,” Dr. Anagnostou says. “The amount of resilience parents have predicts the amount of meaningful support they can give. So some of our intervention needs to go toward maintaining family health—in parents and siblings, and of the family unit."

She also says better systems of support are needed for adults with autism. "You can't have quality of life in adulthood if you don't have systems to support people, if they lose them at age 18."

More study into factors that lead to happiness and life satisfaction in adults with autism are needed, Dr. Anagnostou says. “Smartness is not the only thing that matters in terms of how happy these kids grow up to be, or how meaningful their life is. There are many other things that predict how good a life is. In autism, IQ predicts zip.”

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Does being smart make you a 'better' person?

When I was at university (yes, decades ago!) I think I felt that I was somehow "responsible" for my intelligence. That I'd made a choice to be "smart" while others make choices to be athletes or runway models or contractors.

I think I was even a bit smug about it. 

I remember a conversation with a friend that went something like this: "If you could be smart OR beautiful—but not both—what would you choose?"

I was flabbergasted when my friend (who happened to be brilliant and was once a child model) chose beauty. She felt it was more important to be beautiful than smart, she said. She felt it could get her further in the world. 

This seemed shallow to me. I thought of beauty as something that a person had little control over. You're either born with looks that fit Western standards of beauty—or you're not. And looks can't tell you anything about who a person is inside, I thought. Looks can't make you a "good" person.

It's taken me all these years, and the birth of my son with intellectual disability, to realize that I didn't in any way "earn" my intelligence, or "work hard for it," and it certainly wasn't a "choice."

It was an aptitude bestowed on me at birth. It was luck.

For some reason, I'd grown up believing that smart people got where they were because of some combination of moral superiority and hard work. That they'd chosen to be smart. And that there was some kind of higher good associated with intellect that didn't exist with other human attributes.

I was reminded of this mindset when I saw intelligence described as "the highest virtue" in this article by Columbia University professor Rachel Adams, who has a son with Down syndrome.

Her piece begins: "Last week, a doctor told us our 4-year-old son's IQ is 67."

Adams recounts the process of having her son tested and, how, even though she knows the weaknesses of standardized testing, the results were devastating.

"Much as I recognized the flaws in the test, I found it impossible not to care about the results," she writes. "I know how much they matter. Between us, my husband and I have nearly 25 years of higher education, three master's degrees, two Ph.Ds and a J.D. We've gone far in life by being extremely good test takers. I teach at an Ivy League university where intelligence is held to be the highest virtue. It was cause for celebration when the SAT scores of our first year entering class outranked those of Yale's. I see the opportunities made available to students who, because of talent or training, know how to succeed at standardized tests."

It was Adams pairing of intelligence with "virtue" that made me balk.

I've always considered virtues to be various kinds of human goodness. In this online Oxford dictionary reference virtue is described as:

"Behaviour showing high moral standards: A quality considered morally good or desirable in a person."

Virtue is also described as a "useful" quality of a thing (e.g. "these are his greatest virtues") and in the archaic sense of chastity.

By describing intelligence as "the highest virtue" at Columbia, Adams seems to give it a moral quality (though perhaps she meant simply to say it is the most "useful" human attribute).

Intelligence—which is largely dicated by our parents' genes—has nothing inherently to do with goodness. It can be used for good, and it can be used for bad.

Because Adams ranks intellect 'numero uno" among virtues, the reader is nudged to consider the traditional theological virtues of faith, hope and charity (love). Is Adams suggesting that intellect has surpassed these as a moral good?

I don't think she is—because she goes on to say that the best rejoinder to her son's low IQ score was to be found at home, in "the warm reality of my complicated child," a boy she sees as "clever and funny and full of potential."

I do, however, think Adams is underscoring how quick our culture is to define intellect as the most precious of human qualities, and to assign a moral characteristic to it: Smart people are good people. 

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IQ Schmy-Q or 'IQ is overrated'

It bothers me that services for adults with developmental disabilities in Ontario hinge on intelligence quotients (IQ) alone.

When we tried to get service at an agency that serves children and adults with intellectual disabilities, we were told that Ben's psych assessment from last year wasn't adequate because it didn't state IQ. Eligibility is restricted to those who score in the 2nd percentile or under in cognitive functioning.

Ben's assessment is a detailed, 10-page report documenting testing over multiple visits. It provides a very clear picture of Ben's strengths and needs. In fact, I showed it to a developmental pediatrician who said that a simple IQ score was meaningless in comparison to the depth and breadth of knowledge contained in the psych report.

But all the agency cared about was the percentile ranking. In fact, they said Ben would have to be tested AGAIN in order to get this quotient, before qualifying for service.

Ben's psych assessment last year took place at Holland Bloorview over four mornings. Instead of using the information contained in this document -- which our developmental pediatrician says is rich -- the agency wants my son to undergo more testing -- at the public's expense -- so they can pin him with an IQ.

Something is wrong when that kind of weight is placed on one test and one number -- particularly for a boy who can't speak -- and a detailed, timely report by an exceptional, well-respected psychologist is ignored.

This morning Susan Senator, author of Making Peace with Autism, posted a link on her blog to Autism and IQ, an interesting piece at theAutcast.com. Check it out!

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Perfection

My stomach tightened when I saw the 'sell' for this story about genetic engineering in last weekend's Globe and Mail.

Invitro-fertilization and genetic testing are increasingly used by couples... capable of conceiving naturally to screen out not just catastrophic diseases but other 'undesirable' conditions.

What are those undesirable conditions? One company that screens genes is considering adding the skin condition psoriasis to the list, the article says. The 'undesirables' also include not health conditions, but physical features like short height that don't fit with our North American concept of beauty. We hear about a fertility clinic in Mexico where Canadian and other couples go for IVF -- not because they can't conceive, but because they want to select whether it's a boy or a girl (a 'no-no' in their home country). We hear that on the horizon are DNA microchips that analyze genes that influence height, intelligence, hair, skin and eye colour and athletic ability.

The piece refers to a 2009 survey of 999 people that found that most supported prenatal screening that would result in the abortion of fetuses with serious diseases, along with mental retardation (75 per cent) and blindness (56 per cent). At least 10 per cent of respondents to this New York University School of Medicine survey also favoured improving height and 13 per cent considered it acceptable to screen for intelligence.

The piece begins with this sentence: Humanity has long dreamed of perfection, striving to be faster, stronger and brighter.

Is that your definition of perfection?

To me it sounds a bit like a robot.

What about striving to be deeper, gentler, less judgmental, more kind?

The article notes that "We now have the potential to banish the genes that kill us..."

Isn't that a bit of an overstatement? Isn't the human condition still a fatal one?

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Education: Is it 'earned' or a right?

On Monday I heard a fascinating CBC interview with Chris Mburu (left), a lawyer with the United Nations Human Rights Agency.

Chris is the focus of a documentary film -- A Small Act -- about how a $15-a-month sponsorship from Swedish teacher Hilde Back enabled him -- a young Kenyan living in a mud house -- to go to school and eventually Harvard. Chris decides to find the stranger who changed his life and creates a scholarship program in her name: The Hilde Back Education Fund. The fund provides scholarships to the brightest students from poor communities in Kenya. A Small Act follows top students in Mukubu Primary School competing for a scholarship.

It's a story about how one small act of generosity can have a ripple effect, changing lives. In the CBC interview, Chris talks about how he calls on scholarship recipients to go back to their communities and 'lift them up' with their own charitable projects.

But as I was listening to this fascinating story, I couldn't help wondering why only the brightest students in poor communities were candidates for scholarships.

The fund says it promotes access to education as a fundamental human right. But apparently that right hinges on intellect -- which many would argue is something a person is born with.

If the fund aims to focus on those who are disadvantaged, why does it only recognize and reward the most exceptional, the students who are most advantaged academically to begin with?

Such a thought would never have entered my mind before I had a son with an intellectual disability. The brightest students 'deserve' to be rewarded with scholarships, I would have thought. But now I wonder how much of being smart is genetic and 'gifted' to someone at birth? Is it true that the most brilliant students are the ones who work the hardest, and have somehow 'earned' their intelligence?

I wonder about the Kenyan students who struggle to learn, despite best efforts?

What about those who have intellectual disabilities? I haven't seen the movie, but I imagine they aren't educated in the same classes as the ones vying for scholarships.

When the scholarship students return to their communities to "lift them up" -- will it just be elite students who benefit? At what point will access to good education be for every Kenyan and every Canadian -- regardless of IQ?

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