Does sleep boost memory, affect autism, Alzheimer's?

Learn more about your incredible brain.

Why do we feel great after a solid night's rest and crummy without one?

Are we "brainwashed" during sleep?
Cerebrospinal fluid washes in and out of brain during sleep

Date:

October 31, 2019

Source:

Boston University

Summary:

A new study illustrates that the brain's cerebrospinal fluid pulses during sleep, and that these motions are closely tied with brain wave activity and blood flow. It may confirm the hypothesis that CSF flow and slow-wave activity both help flush toxic, memory-impairing proteins from the brain.

FULL STORY

New research from Boston University suggests that tonight while you sleep, something amazing will happen within your brain. Your neurons will go quiet. A few seconds later, blood will flow out of your head. Then, a watery liquid called cerebrospinal fluid (CSF) will flow in, washing through your brain in rhythmic, pulsing waves.

New research from Boston University suggests that tonight while you sleep, something amazing will happen within your brain. Your neurons will go quiet. A few seconds later, blood will flow out of your head. Then, a watery liquid called cerebrospinal fluid (CSF) will flow in, washing through your brain in rhythmic, pulsing waves.

Learn more about your incredible brain.

"We've known for a while that there are these electrical waves of activity in the neurons," says study coauthor Laura Lewis, a BU College of Engineering assistant professor of biomedical engineering and a Center for Systems Neuroscience faculty member. "But before now, we didn't realize that there are actually waves in the CSF, too."

This research may also be the first-ever study to take images of CSF during sleep. And Lewis hopes that it will one day lead to insights about a variety of neurological and psychological disorders that are frequently associated with disrupted sleep patterns, including autism and Alzheimer's disease.

The coupling of brain waves with the flow of blood and CSF could provide insights about normal age-related impairments as well. Earlier studies have suggested that CSF flow and slow-wave activity both help flush toxic, memory-impairing proteins from the brain. As people age, their brains often generate fewer slow waves. In turn, this could affect the blood flow in the brain and reduce the pulsing of CSF during sleep, leading to a buildup of toxic proteins and a decline in memory abilities. Although researchers have tended to evaluate these processes separately, it now appears that they are very closely linked.

This research may also be the first-ever study to take images of CSF during sleep. And Lewis hopes that it will one day lead to insights about a variety of neurological and psychological disorders that are frequently associated with disrupted sleep patterns, including autism and Alzheimer's disease.

The coupling of brain waves with the flow of blood and CSF could provide insights about normal age-related impairments as well. Earlier studies have suggested that CSF flow and slow-wave activity both help flush toxic, memory-impairing proteins from the brain. As people age, their brains often generate fewer slow waves. In turn, this could affect the blood flow in the brain and reduce the pulsing of CSF during sleep, leading to a buildup of toxic proteins and a decline in memory abilities. Although researchers have tended to evaluate these processes separately, it now appears that they are very closely linked.

Learn more about your incredible brain.

Autism and homelessness

The first peer-reviewed study into autism and homelessness has been published, in the journal Autism.

The researchers* found evidence suggesting that autistic adults are over-represented among the homeless population. They have called for more research to understand the links between autism and homelessness, to help prevent autistic people becoming homeless and to improve support for those who are already homeless.

Existing research & method

Anecdotal reports from autism clinicians and keyworkers, as well as two small studies from a few years ago, have suggested that there may be high numbers of autistic people in the homeless population. But this is the first academic research looking at this issue properly.

The researchers attempted to fill this gap by gathering initial evidence about the prevalence of autistic traits in homeless people. They worked with one homeless outreach team is the UK and screened 106 people they support to see if they could be autistic.

Results & discussion

12.3% of homeless people had a range of autistic 'traits' in line with diagnostic criteria. This is substantially higher than the general population autism prevalence of 1%. It is not clear that this 12% were actually autistic, but the screening suggested that they could be.

Writing in the journal, Autism, the researchers said: "If autistic difficulties are common among homeless populations, then this has important implications. Many people are homeless in the United Kingdom; the most recent estimate is that there are almost 5000 rough sleepers at any one point (Ministry of Housing, Communities and Local Government, 2017), and there is a much larger group of people with no stable accommodation who are termed the 'hidden homeless' (Crisis, 2017). There may therefore be a considerable number of homeless autistic adults who are not having their needs met and who are in an extremely vulnerable position."

Learn about the brain in clear language.

Alasdair Churchard has a doctorate in Clinical Psychology from University College London and worked on this study alongside Morag Ryder, William Mandy and Andrew Greenhill. He said: "Our research shows that autistic people may be at higher risk of becoming homeless than the general population.

"It is well-known that life for homeless people is extremely mentally and physically hard, and those who are autistic are likely to have additional vulnerabilities which would only make their lives more difficult.

"Further research is required in this area, and we have been working with professionals in the homelessness field to raise awareness about the potential links between autism and homelessness."

Sarah Lambert, Head of Policy at the National Autistic Society, said: "This is an important and robust study, which suggests that there could be a significant number of autistic adults who are homeless - and potentially living without an understanding of their needs or appropriate support.

"It's well established that many autistic people struggle to get the support they need and face huge difficulties throughout their lives, including high rates of mental health problems, underemployment and social isolation. We've heard anecdotal reports of autistic adults falling through gaps in support and into homelessness but there's very little research into this or awareness of this as an issue.

"This is the first peer-reviewed study to provide initial evidence of a link between autism and homelessness and provides an important platform to get to grips with this issue. We now need further research to investigate this link, and to develop the right support for homeless autistic people and to prevent those at risk from falling into homelessness in the first place."

"Homeless autistic people have gone unrecognised and unsupported for far too long."

Case study

Dr. Andrew Greenhill, a clinical psychologist also involved in the research, said: "One person that stands out for me is an older man who had lived on the street for 45 years, in an inner city.

"He ran away from his family home because his relationship with his father was so poor and physically abusive. He then survived by following a regular routine and sleeping in the same place every night, relying on the food made available at day-centres and drop ins. He refused all professional help or contact, and existed in a 'bubble' whereby he refused all attempts to engage. It was clear that he found social engagement of any kind very distressing and was highly motivated to avoid this.

"Eventually he was admitted to hospital after it appeared he'd had a stroke, and was unable to care for himself. He eventually accepted a room in a low intensity 'cottage hotel' hostel, where there were few, if any expectations about things like form filling, attending meetings or assessments. He has since managed to maintain his preference for privacy and solitude whilst having his basic needs met, with support workers around to keep an eye on him and to help out if any difficulties arise."

###

Read an article about the research on the Conversation website and access the full research paper in the Autism Journal.

*The research was carried out by Alasdair Churchard, alongside Morag Ryder and William Mandy from University College London and Andrew Greenhill from Kensington & Chelsea Learning Disability Service.

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

April Is Autism Awareness Month: Part II: Causes

Causes and Risk Factors

While scientists don’t know the exact causes of ASD, research suggests that genes can act together with influences from the environment to affect development in ways that lead to ASD. Although scientists are still trying to understand why some people develop ASD and others don’t, some risk factors include:

• Having a sibling with ASD
• Having older parents
• Having certain genetic conditions—people with conditions such as Down syndrome, fragile X syndrome, and Rett syndrome are more likely than others to have ASD
• Very low birth weight

Diagnosing ASD

Doctors diagnose ASD by looking at a person’s behavior and development. ASD can usually be reliably diagnosed by the age of two. It is important for those with concerns to seek out assessment as soon as possible so that a diagnosis can be made, and treatment can begin.

Diagnosis in Young Children

Diagnosis in young children is often a two-stage process.

Stage 1: General Developmental Screening During Well-Child Checkups

Every child should receive well-child check-ups with a pediatrician or an early childhood health care provider. The American Academy of Pediatrics recommends that all children be screened for developmental delays at their 9-, 18-, and 24- or 30-month well-child visits and specifically for autism at their 18- and 24-month well-child visits. Additional screening might be needed if a child is at high risk for ASD or developmental problems. Those at high risk include children who have a family member with ASD, have some ASD behaviors, have older parents, have certain genetic conditions, or who were born at a very low birth weight.

Get the basics of the brain, in easy-to-read language.

Parents’ experiences and concerns are very important in the screening process for young children. Sometimes the doctor will ask parents questions about the child’s behaviors and combine those answers with information from ASD screening tools, and with his or her observations of the child. Read more about screening instruments on the Centers for Disease Control and Prevention (CDC) website.

Children who show developmental problems during this screening process will be referred for a second stage of evaluation.

Stage 2: Additional Evaluation

This second evaluation is with a team of doctors and other health professionals who are experienced in diagnosing ASD.

This team may include:

• A developmental pediatrician—a doctor who has special training in child development
• A child psychologist and/or child psychiatrist—a doctor who has specialized training in brain development and behavior
• A neuropsychologist—a doctor who focuses on evaluating, diagnosing, and treating neurological, medical, and neurodevelopmental disorders
• A speech-language pathologist—a health professional who has special training in communication difficulties

The evaluation may assess:

• Cognitive level or thinking skills
• Language abilities
• Age-appropriate skills needed to complete daily activities independently, such as eating, dressing, and toileting

Because ASD is a complex disorder that sometimes occurs along with other illnesses or learning disorders, the comprehensive evaluation may include:

• Blood tests
• Hearing test

The outcome of the evaluation will result in a formal diagnosis and recommendations for treatment.

Source: NIH

April Is Autism Awareness Month. Understanding the basics, Pt.1.

Skip to conteOverview

Autism spectrum disorder (ASD) is a developmental disorder that affects communication and behavior. Although autism can be diagnosed at any age, it is said to be a “developmental disorder” because symptoms generally appear in the first two years of life.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a guide created by the American Psychiatric Association used to diagnose mental disorders, people with ASD have:

• Difficulty with communication and interaction with other people
• Restricted interests and repetitive behaviors
• Symptoms that hurt the person’s ability to function properly in school, work, and other areas of life

Autism is known as a “spectrum” disorder because there is wide variation in the type and severity of symptoms people experience. ASD occurs in all ethnic, racial, and economic groups. Although ASD can be a lifelong disorder, treatments and services can improve a person’s symptoms and ability to function. The American Academy of Pediatrics recommends that all children be screened for autism. All caregivers should talk to their doctor about ASD screening or evaluation.

Signs and Symptoms of ASD

People with ASD have difficulty with social communication and interaction, restricted interests, and repetitive behaviors. The list below gives some examples of the types of behaviors that are seen in people diagnosed with ASD. Not all people with ASD will show all behaviors, but most will show several.

Learn about the developing brain, in easy-to-read language. 

Social communication / interaction behaviors may include:

• Making little or inconsistent eye contact
• 
  
• Tending not to look at or listen to people
• 
  
• Rarely sharing enjoyment of objects or activities by pointing or showing things to others
• 
  
• Failing to, or being slow to, respond to someone calling their name or to other verbal attempts to gain attention
• 
  
• Having difficulties with the back and forth of conversation
• 
  
• Often talking at length about a favorite subject without noticing that others are not interested or without giving others a chance to respond
• 
  
• Having facial expressions, movements, and gestures that do not match what is being said
• 
  
• Having an unusual tone of voice that may sound sing-song or flat and robot-like
• Having trouble understanding another person’s point of view or being unable to predict or understand other people’s actions

Restrictive / repetitive behaviors may include:

• Repeating certain behaviors or having unusual behaviors. For example, repeating words or phrases, a behavior called echolalia
• 
  
• Having a lasting intense interest in certain topics, such as numbers, details, or facts
• 
  
• Having overly focused interests, such as with moving objects or parts of objects
• 
  
• Getting upset by slight changes in a routine
• 
  
• Being more or less sensitive than other people to sensory input, such as light, noise, clothing, or temperature

People with ASD may also experience sleep problems and irritability. Although people with ASD experience many challenges, they may also have many strengths, including:

• Being able to learn things in detail and remember information for long periods of time
• 
  
• Being strong visual and auditory learners
• 
  
• Excelling in math, science, music, or art

Causes and Risk Factors

While scientists don’t know the exact causes of ASD, research suggests that genes can act together with influences from the environment to affect development in ways that lead to ASD. Although scientists are still trying to understand why some people develop ASD and others don’t, some risk factors include:

• Having a sibling with ASD
• Having older parents
• Having certain genetic conditions—people with conditions such as Down syndrome, fragile X syndrome, and Rett syndrome are more likely than others to have ASD
• Very low birth weight

Diagnosing ASD

Doctors diagnose ASD by looking at a person’s behavior and development. ASD can usually be reliably diagnosed by the age of two. It is important for those with concerns to seek out assessment as soon as possible so that a diagnosis can be made, and treatment can begin.

Diagnosis in Young Children

Diagnosis in young children is often a two-stage process.

Stage 1: General Developmental Screening During Well-Child Checkups

Every child should receive well-child check-ups with a pediatrician or an early childhood health care provider. The American Academy of Pediatrics recommends that all children be screened for developmental delays at their 9-, 18-, and 24- or 30-month well-child visits and specifically for autism at their 18- and 24-month well-child visits. Additional screening might be needed if a child is at high risk for ASD or developmental problems. Those at high risk include children who have a family member with ASD, have some ASD behaviors, have older parents, have certain genetic conditions, or who were born at a very low birth weight.

Parents’ experiences and concerns are very important in the screening process for young children. Sometimes the doctor will ask parents questions about the child’s behaviors and combine those answers with information from ASD screening tools, and with his or her observations of the child. Read more about screening instruments on the Centers for Disease Control and Prevention (CDC) website.

Children who show developmental problems during this screening process will be referred for a second stage of evaluation.

Stage 2: Additional Evaluation

This second evaluation is with a team of doctors and other health professionals who are experienced in diagnosing ASD.

This team may include:

• A developmental pediatrician—a doctor who has special training in child development
• A child psychologist and/or child psychiatrist—a doctor who has specialized training in brain development and behavior
• A neuropsychologist—a doctor who focuses on evaluating, diagnosing, and treating neurological, medical, and neurodevelopmental disorders
• A speech-language pathologist—a health professional who has special training in communication difficulties

The evaluation may assess:

• Cognitive level or thinking skills
• Language abilities
• Age-appropriate skills needed to complete daily activities independently, such as eating, dressing, and toileting

Because ASD is a complex disorder that sometimes occurs along with other illnesses or learning disorders, the comprehensive evaluation may include:

• Blood tests
• Hearing test

The outcome of the evaluation will result in a formal diagnosis and recommendations for treatment.

Source: NIH

Autism's Puzzles

Learn brain basics in easy-to-read language.

What is autism spectrum disorder?

Autism spectrum disorder (ASD) refers to a group of complex neurodevelopment disorders characterized by repetitive and characteristic patterns of behavior and difficulties with social communication and interaction. The symptoms are present from early childhood and affect daily functioning.

The term “spectrum” refers to the wide range of symptoms, skills, and levels of disability in functioning that can occur in people with ASD. Some children and adults with ASD are fully able to perform all activities of daily living while others require substantial support to perform basic activities. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5, published in 2013) includes Asperger syndrome, childhood disintegrative disorder, and pervasive developmental disorders not otherwise specified (PDD-NOS) as part of ASD rather than as separate disorders. A diagnosis of ASD includes an assessment of intellectual disability and language impairment.

ASD occurs in every racial and ethnic group, and across all socioeconomic levels. However, boys are significantly more likely to develop ASD than girls. The latest analysis from the Centers for Disease Control and Prevention estimates that 1 in 68 children has ASD.

What are some common signs of ASD?

Even as infants, children with ASD may seem different, especially when compared to other children their own age. They may become overly focused on certain objects, rarely make eye contact, and fail to engage in typical babbling with their parents. In other cases, children may develop normally until the second or even third year of life, but then start to withdraw and become indifferent to social engagement.

The severity of ASD can vary greatly and is based on the degree to which social communication, insistence of sameness of activities and surroundings, and repetitive patterns of behavior affect the daily functioning of the individual.

Social impairment and communication difficulties
Many people with ASD find social interactions difficult. The mutual give-and-take nature of typical communication and interaction is often particularly challenging. Children with ASD may fail to respond to their names, avoid eye contact with other people, and only interact with others to achieve specific goals. Often children with ASD do not understand how to play or engage with other children and may prefer to be alone. People with ASD may find it difficult to understand other people’s feelings or talk about their own feelings.

People with ASD may have very different verbal abilities ranging from no speech at all to speech that is fluent, but awkward and inappropriate. Some children with ASD may have delayed speech and language skills, may repeat phrases, and give unrelated answers to questions. In addition, people with ASD can have a hard time using and understanding non-verbal cues such as gestures, body language, or tone of voice. For example, young children with ASD might not understand what it means to wave goodbye. People with ASD may also speak in flat, robot-like or a sing-song voice about a narrow range of favorite topics, with little regard for the interests of the person to whom they are speaking.

Repetitive and characteristic behaviors
Many children with ASD engage in repetitive movements or unusual behaviors such as flapping their arms, rocking from side to side, or twirling. They may become preoccupied with parts of objects like the wheels on a toy truck. Children may also become obsessively interested in a particular topic such as airplanes or memorizing train schedules. Many people with ASD seem to thrive so much on routine that changes to the daily patterns of life — like an unexpected stop on the way home from school — can be very challenging. Some children may even get angry or have emotional outbursts, especially when placed in a new or overly stimulating environment.

What disorders are related to ASD?

Certain known genetic disorders are associated with an increased risk for autism, including Fragile X syndrome (which causes intellectual disability) and tuberous sclerosis (which causes benign tumors to grow in the brain and other vital organs) — each of which results from a mutation in a single, but different, gene. Recently, researchers have discovered other genetic mutations in children diagnosed with autism, including some that have not yet been designated as named syndromes. While each of these disorders is rare, in aggregate, they may account for 20 percent or more of all autism cases.

People with ASD also have a higher than average risk of having epilepsy. Children whose language skills regress early in life — before age 3 — appear to have a risk of developing epilepsy or seizure-like brain activity. About 20 to 30 percent of children with ASD develop epilepsy by the time they reach adulthood. Additionally, people with both ASD and intellectual disability have the greatest risk of developing seizure disorder.

How is ASD diagnosed?

ASD symptoms can vary greatly from person to person depending on the severity of the disorder. Symptoms may even go unrecognized for young children who have mild ASD or less debilitating handicaps. Very early indicators that require evaluation by an expert include:

• no babbling or pointing by age 1
• no single words by age 16 months or two-word phrases by age 2
• no response to name
• loss of language or social skills previously acquired
• poor eye contact
• excessive lining up of toys or objects
• no smiling or social responsiveness

Later indicators include:

• impaired ability to make friends with peers
• impaired ability to initiate or sustain a conversation with others
• absence or impairment of imaginative and social play
• repetitive or unusual use of language
• abnormally intense or focused interest
• preoccupation with certain objects or subjects
• inflexible adherence to specific routines or rituals

Health care providers will often use a questionnaire or other screening instrument to gather information about a child’s development and behavior. Some screening instruments rely solely on parent observations, while others rely on a combination of parent and doctor observations. If screening instruments indicate the possibility of ASD, a more comprehensive evaluation is usually indicated.

A comprehensive evaluation requires a multidisciplinary team, including a psychologist, neurologist, psychiatrist, speech therapist, and other professionals who diagnose and treat children with ASD. The team members will conduct a thorough neurological assessment and in-depth cognitive and language testing. Because hearing problems can cause behaviors that could be mistaken for ASD, children with delayed speech development should also have their hearing tested.

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What causes ASD?

Scientists believe that both genetics and environment likely play a role in ASD. There is great concern that rates of autism have been increasing in recent decades without full explanation as to why. Researchers have identified a number of genes associated with the disorder. Imaging studies of people with ASD have found differences in the development of several regions of the brain. Studies suggest that ASD could be a result of disruptions in normal brain growth very early in development. These disruptions may be the result of defects in genes that control brain development and regulate how brain cells communicate with each other. Autism is more common in children born prematurely. Environmental factors may also play a role in gene function and development, but no specific environmental causes have yet been identified. The theory that parental practices are responsible for ASD has long been disproved. Multiple studies have shown that vaccination to prevent childhood infectious diseases does not increase the risk of autism in the population.

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What role do genes play?

Twin and family studies strongly suggest that some people have a genetic predisposition to autism. Identical twin studies show that if one twin is affected, then the other will be affected between 36 to 95 percent of the time. There are a number of studies in progress to determine the specific genetic factors associated with the development of ASD. In families with one child with ASD, the risk of having a second child with the disorder also increases. Many of the genes found to be associated with autism are involved in the function of the chemical connections between brain neurons (synapses). Researchers are looking for clues about which genes contribute to increased susceptibility. In some cases, parents and other relatives of a child with ASD show mild impairments in social communication skills or engage in repetitive behaviors. Evidence also suggests that emotional disorders such as bipolar disorder and schizophrenia occur more frequently than average in the families of people with ASD.

In addition to genetic variations that are inherited and are present in nearly all of a person’s cells, recent research has also shown that de novo, or spontaneous, gene mutations can influence the risk of developing autism spectrum disorder. De novo mutations are changes in sequences of deoxyribonucleic acid or DNA, the hereditary material in humans, which can occur spontaneously in a parent’s sperm or egg cell or during fertilization. The mutation then occurs in each cell as the fertilized egg divides. These mutations may affect single genes or they may be changes called copy number variations, in which stretches of DNA containing multiple genes are deleted or duplicated.  Recent studies have shown that people with ASD tend to have more copy number de novo gene mutations than those without the disorder, suggesting that for some the risk of developing ASD is not the result of mutations in individual genes but rather spontaneous coding mutations across many genes.  De novo mutations may explain genetic disorders in which an affected child has the mutation in each cell but the parents do not and there is no family pattern to the disorder. Autism risk also increases in children born to older parents. There is still much research to be done to determine the potential role of environmental factors on spontaneous mutations and how that influences ASD risk.

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Do symptoms of autism change over time?

For many children, symptoms improve with age and behavioral treatment. During adolescence, some children with ASD may become depressed or experience behavioral problems, and their treatment may need some modification as they transition to adulthood. People with ASD usually continue to need services and supports as they get older, but depending on severity of the disorder, people with ASD may be able to work successfully and live independently or within a supportive environment.

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How is autism treated?

There is no cure for ASD. Therapies and behavioral interventions are designed to remedy specific symptoms and can substantially improve those symptoms. The ideal treatment plan coordinates therapies and interventions that meet the specific needs of the individual. Most health care professionals agree that the earlier the intervention, the better.

Educational/behavioral interventions: Early behavioral/educational interventions have been very successful in many children with ASD. In these interventions therapists use highly structured and intensive skill-oriented training sessions to help children develop social and language skills, such as applied behavioral analysis, which encourages positive behaviors and discourages negative ones. In addition, family counseling for the parents and siblings of children with ASD often helps families cope with the particular challenges of living with a child with ASD.

Medications: While medication can’t cure ASD or even treat its main symptoms, there are some that can help with related symptoms such as anxiety, depression, and obsessive-compulsive disorder. Antipsychotic medications are used to treat severe behavioral problems. Seizures can be treated with one or more anticonvulsant drugs. Medication used to treat people with attention deficit disorder can be used effectively to help decrease impulsivity and hyperactivity in people with ASD. Parents, caregivers, and people with autism should use caution before adopting any unproven treatments.

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What research is being done?

The mission of the National Institute of Neurological Disorders and Stroke (NINDS) is to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. The NINDS is a component of the National Institutes of Health (NIH), the leading supporter of biomedical research in the world.  NINDS and several other NIH Institutes and Centers support research on autism spectrum disorder. 

Where can I get more information?

For more information on neurological disorders or research programs funded by the National Institute of Neurological Disorders and Stroke, contact the Institute's Brain Resources and Information Network (BRAIN) at:

BRAIN
P.O. Box 5801
Bethesda, MD 20824
800-352-9424
http://ninds.nih.gov

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Limited offer: free e-books on the brain and health

These books, part of the Healing the Brain Series from A Thousand Moms cover topics important to teachers, students, parents, counselors...anybody concened with their family, their friends, theirselves. Please take a look, download these flipbooks, and share. 

About the author: David Balog is chief information officer for A Thousand Moms: Building Community Support for Lesbian, Gay, Bisexual and Transgender Youth in Foster/Adoptive Care. He was a science/medical writer at the Dana Foundation in New York City, where he created, wrote and edited the Dana Sourcebook of Brain Science through four editions. More than 50,000 copies of this widely acclaimed book was distributed to teachers, students, and professionals in all 50 states and numerous other countries.

Amazon.com reviews: Author David Balog has done an excellent job of creating a book for educators (or anyone working with youth) that explains the complicated workings of the brain in an easy to understand manner. Balog goes on to discuss various types of trauma and how the adolescent brain responds to trauma such as depression, stress, addiction, risk taking, PTSD, etc. 

[A] cohesive narrative about a subject that has been put in the dark by society. I was informed about things I thought I knew plenty about. I was inspired by the read and heavily recommend that anyone reading this reviews invests themselves into this book and the cause it strives for. 

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