Okay,
I
want
to
start
with
a
piece
of
toast.
A
piece
of
toast?
One
specific
piece
of
toast.
A
parent
told
me
their
kid
eats
toast
every
single
morning,
but
only
if
it's
cut
into
triangles.
Squares?
Refused.
Rectangles?
Refused.
Same
bread,
same
butter,
same
plate,
triangles
are
nothing.
And
I
bet
the
first
reaction
that
parent
got
from
other
people
was,
oh,
kids
are
picky,
mine
was
too.
Every
time.
And
this
parent
said
the
hardest
part
wasn't
the
toast.
It
was
feeling
like
they
were
the
only
family
on
earth
or
breakfast
was
a
negotiation.
Which
is
exactly
the
thing.
Because
when
you
actually
look
at
what's
going
on
in
that
moment,
the
shape
of
the
toast,
the
texture,
the
predictability,
the
anxiety
on
both
sides
of
the
table,
it's
not
a
quirk.
It's
a
window
into
how
that
child's
whole
system
is
processing
the
world.
And
that's
really
what
today
is
about.
Not
fixing
the
toast,
understanding
the
toast.
Understanding
the
toast.
That's
the
episode.
So
this
is
edition
five
of
the
Lumos
newsletter,
and
the
whole
edition
is
built
around
feeding
challenges
in
autism.
Selective
eating,
food
refusal,
and
something
called
avoidant
restrictive
food
intake
disorder,
which
people
shorten
to
ARFID.
And
the
editorial
team
made
a
point
I
want
to
echo
before
we
get
into
any
science.
A
lot
of
families
feel
isolated
by
this.
Mealtimes
are
supposed
to
be
connection
and
nourishment,
and
instead
they
become
a
daily
battle.
If
that's
your
house,
you
are
genuinely
not
alone.
This
is
one
of
the
most
common
struggles
in
the
autism
community.
Three
articles
today.
One
is
about
gut
bacteria
and
the
brain
in
mice.
One
is
about
tracking
where
a
child's
eyes
go
and
what
that
might
tell
us
about
why
certain
foods
get
refused.
And
the
third
is
a
little
bit
of
a
left
turn
about
plastic
in
our
food
supply.
Which
sounds
unrelated
until
you
sit
with
it
for
a
minute.
Okay,
let's
start
in
the
gut,
literally.
So
this
first
study
is
in
molecular
psychiatry,
and
the
headline
idea
is
the
gut
microbiome,
which,
quick
translation,
is
the
community
of
trillions
of
bacteria
and
other
microbes
living
in
your
digestive
tract.
Everyone
has
one.
It's
shaped
by
what
you
eat,
where
you
live,
your
genetics,
even
how
you
were
born.
And
people
have
been
talking
about
We've
been
talking
about
the
gut-brain
connection
for
a
while
now.
Right.
There's
this
growing
body
of
work
suggesting
that
the
gut
and
the
brain
are
in
constant
conversation.
Through
nerves,
through
immune
signals,
through
chemicals
those
bacteria
produce.
What
this
study
did
is
look
at
that
conversation
in
a
very
specific
group
of
mice.
Mice.
So
let's
flag
that
right
up
top.
Yes.
This
is
mouse
research.
And
we'll
come
back
to
why
that
matters.
But
here's
The
setup.
The
researchers
used
mice
carrying
a
genetic
change
that's
linked
to
both
autism
and
a
condition
called
neurofibromatosis
tipo
1.
That's
a
genetic
disorder
where
people
are
prone
to
growths
along
the
nerves
and
it
has
a
known
overlap
with
autism
traits.
So
the
mice
have
a
genetic
change
that
connects
to
autism
in
humans.
What
did
they
find?
The
mice
with
that
genetic
change
had
a
different
gut
bacterial
makeup
compared
to
typical
mice.
Not
just
a
little
different,
different
enough
to
measure.
And
then,
the
interesting
part,
those
gut
differences
lined
up
with
changes
in
the
brain
and
with
behaviors
that
resemble
autism
traits
in
mice,
things
like
difficulties
with
facial
interaction.
Wait,
how
do
you
measure
social
difficulty
in
a
mouse?
Great
question.
Researchers
typically
give
a
mouse
the
choice
between
spending
time
near
another
mouse
or
near
an
object.
Typical
mice
usually
prefer
the
other
mouse.
Scientific
host,
Jami.
Let's
study
why
that
is.
But
it
does
echo
a
pattern
that
shows
up
in
human
autism
research,
and
it
suggests
biological
sex
might
shape
how
the
gut
and
brain
interact.
So
let
me
try
to
summarize.
Genetic
change,
different
gut
bacteria,
and
those
bacteria
differences
track
with
brain
and
behavior
changes,
more
so
in
males.
That's
it.
And
the
reason
the
newsletter
put
this
in
a
feeding
edition
is
the
question
it
raises.
If
the
gut
is
influencing
behavior
and
development,
then
what
a
child
eats
and
what
their
gut
is
doing
with
it
might
be
part
of
the
feeding
picture.
Not
just
an
outcome
of
picky
eating,
but
potentially
something
upstream
of
it.
Okay,
so
wait.
That
flips
the
usual
story.
Usually
it's,
the
kid
eats
five
foods,
therefore
their
gut
is
a
mess.
Right,
and
that
direction
is
certainly
real.
A
very
narrow
diet
will
shape
your
microbiome.
But
this
study
hints
the
arrow
might
also
point
the
other
way.
The
gut
might
be
nudging
behavior,
and
behavior
includes
how
a
child
approaches
food.
Now,
give
me
the
honest
limitation.
Several.
First,
mice
are
not
children.
Mouse
social
behavior
is
a
rough
stand-in
for
human
social
behavior
at
best.
Second,
this
was
one
specific
genetic
change.
Autism
in
humans
is
incredibly
diverse,
with
hundreds
of
genes
involved,
and
many
cases
with
no
single
identifiable
cause.
So
this
is
one
path,
not
the
path.
And
third,
finding
that
The
fact
that
gut
differences
line
up
with
brain
differences
doesn't
prove
the
gut
is
causing
the
brain
changes.
They
could
share
a
common
cause.
So
no
one
should
hear
this
and
go
buy
a
probiotic?
Please
don't
hear
it
that
way.
There
is
no
evidence
from
this
study
that
any
supplement
or
diet
changes
autism
traits
in
children.
What
it
does
is
make
the
gut
a
legitimate
thing
to
pay
attention
to,
rather
than
an
afterthought.
So
what
does
a
family
actually
do
with
this?
I'd
start
with
observation.
A
lot
of
autistic
children
have
digestive
issues
that
go
unmentioned
because
the
child
can't
describe
them,
or
because
everyone's
focused
on
the
behavior.
Constipation,
stomach
pain,
reflux,
those
are
worth
noticing
and
writing
down.
And
the
question
to
bring
to
the
doctor
is?
Something
like,
could
my
child's
digestive
health
be
part
of
what's
going
on
at
mealtimes?
Is
there
anything
we
should
check?
That's
a
reasonable,
grounded
question,
not
should
we
overhaul
their
diet
based
on
a
mouse
study.
Right,
because
if
a
child's
stomach
hurts
after
eating,
refusing
food
is
a
pretty
logical
response.
It's
the
most
logical
response.
And
the
newsletter's
framing
was
good
here.
Gut
health
as
a
complementary
piece
of
the
puzzle,
always
with
professional
guidance,
Scientific
research
about
autism
subtypes,
genetics,
autism
subtypes,
robot
therapy.
And
this
has
been
used
in
autism
research
for
a
while.
For
a
long
time,
yes.
The
classic
findings
which
this
review
builds
on
are
that
autistic
children
often
show
different
visual
attention
patterns.
On
average,
they
tend
to
look
less
at
faces
and
at
social
interactions
and
more
at
objects
or
specific
details
in
their
surroundings.
A
corner
of
the
room,
the
pattern
on
a
shirt,
the
wheels
on
a
toy.
I've
heard
parents
describe
exactly
that.
My
kid
walked
into
the
room
and
noticed
the
ceiling
fan
before
they
noticed
grandma.
That's
the
pattern.
And
eye
tracking
lets
you
measure
it
precisely,
in
fractions
of
a
second,
instead
of
relying
on
someone's
impression.
So
what's
new
in
this
article?
The
new
piece
is
combining
eye
tracking
data
with
computational
models,
basically
mathematical
and
machine
learning
tools
that
look
for
patterns
in
all
that
gaze
data.
The
argument
is
that
by
pairing
the
two,
researchers
can
pinpoint
individual
differences
in
attention
far
more
accurately
than
eye
tracking
alone.
Individual
differences.
Say
more
about
why
that
word
matters.
Because
autism
isn't
one
pattern.
Two
autistic
children
can
have
completely
different
visual
styles.
The
goal
here
is
to
move
away
from
a
single
average
profile
and
toward
understanding
this
child's
attention.
The
review
frames
eye
tracking
as
a
tool
for
understanding
individual
variation
across
psychiatric
conditions,
with
autism
And
where
does
food
come
in?
So
this
is
the
connection
the
newsletter
draws.
If
a
child's
visual
attention
is
pulled
towards
specific
details
and
away
from
the
bigger
picture,
think
about
what
a
plate
of
food
looks
like
to
them.
A
speck
on
the
pasta?
Two
foods
touching?
A
brown
spot
on
a
banana?
Those
details
might
be
enormous
to
a
child
whose
attention
naturally
locks
onto
them.
The
toast
triangles.
The
toast
triangles.
The
shape
might
be
the
thing
their
eyes
land
on
first.
And
a
change
to
that
shape
is
a
change
to
everything.
So
the
idea
is
that
food
refusal
might
be
partly
a
visual
thing,
not
just
a
taste
or
texture
thing?
That's
the
hypothesis.
Appearance,
texture,
how
the
food
is
visually
presented.
The
newsletter
suggests
eye
tracking
could
help
us
understand
the
sensory
and
behavioral
reasons
behind
picky
eating
by
literally
showing
us
what
the
child
is
looking
at.
That's
a
lovely
idea.
What's
the
catch?
The
catch
is
that
this
is
largely
about
potential.
The
article
is
about
the
method
and
where
it
could
go,
not
a
finished
tool
you
can
use.
Eye
tracking
isn't
a
diagnostic
test
for
autism
today,
and
there's
no
eye
tracking
test
for
feeding
problems.
The
hope
is
that
one
day
this
leads
to
earlier
diagnostic
tools
and
more
personalized
interventions.
Hope
is
the
operative
word.
And
I'd
imagine
measuring
gaze
and
knowing
what
it
means
are
two
different
things.
Very
different.
A
child
looking
at
an
object
instead
of
a
face
could
mean
many
things.
Interest,
avoidance,
sensory
overwhelm,
or
just
that
the
object
was
more
interesting.
The
models
find
patterns.
Humans
still
have
to
interpret
them.
And
there's
a
lot
of
room
for
error
there.
So
in
the
kitchen
right
now,
what's
useful
here?
I
think
the
useful
thing
is
a
shift
in
how
you
observe.
Instead
of
asking,
what's
wrong
with
my
child
that
they
won't
eat
this?
Try
asking,
what
are
they
seeing
when
they
look
at
this
plate?
Like
actually
watch
where
their
eyes
go.
Exactly.
You
can
do
a
version
of
eye
tracking
with
your
own
eyes.
Watch
where
your
child
looks
when
a
new
food
arrives.
Do
they
look
at
it
at
all?
Do
they
Alex
and
Jamie.
And
the
question
for
the
clinician?
If
you're
working
with
an
occupational
therapist
or
a
feeding
specialist,
you
could
ask
whether
visual
sensitivity
might
be
part
of
your
child's
picture
and
whether
there
are
presentation
strategies
worth
trying.
If
you're
not
working
with
anyone
yet
and
mealtimes
are
really
hard,
that's
worth
raising
with
your
pediatrician.
Okay.
The
third
article,
plastic.
Plastic.
And
I'll
be
upfront,
this
one
is
not
about
autism.
The
newsletter
says
so
and
will
say
so.
So
why
is
it
here?
Because
it's
about
what's
in
our
food,
and
for
a
lot
of
autism
families,
food
quality
is
already
a
top
concern.
So
let
me
describe
what
the
study
is.
It's
called
the
PERTH
trial,
published
in
Nature
Medicine,
and
it
asks
a
really
specific
question.
If
you
reduce
plastic
contact
with
food,
do
the
levels
of
plastic-associated
chemicals
in
a
person's
body
go
down?
What
chemicals
are
we
talking
about?
Two
main
families.
Phthalates,
which
are
chemicals
that
make
plastic
soft
and
flexible,
and
bisphenols,
which
are
used
in
hard
plastics
and
in
the
linings
of
cans.
Both
show
up
in
people's
urine,
and
researchers
have
been
studying
their
potential
health
effects
for
years.
And
how
did
they
get
the
plastic
out
of
the
food?
Because
I'm
imagining
a
farm
and
there's
plastic
everywhere
on
a
farm.
That's
what
makes
this
study
ambitious.
The
researchers
worked
with
farmers
and
food
producers
to
remove
every
plastic
source
they
could
modify,
from
farm
to
plate.
They
even
changed
how
a
meal
delivery
service
operated
so
that
the
food
reaching
participants
had
as
little
plastic
contact
as
possible.
So
this
wasn't
just
don't
microwave
your
leftovers
in
a
plastic
container.
No,
this
went
way
upstream.
And
the
participants
on
the
low
plastic
diet
ate
only
the
food
provided
to
them.
No
outside
food,
no
alcohol,
no
supplements.
The
whole
point
was
to
control
exposure
tightly
enough
to
see
whether
the
chemical
levels
in
their
urine
actually
changed.
And
did
they?
So
here's
where
I
have
to
be
careful.
The
newsletter
describes
the
design
and
the
goal
of
the
trial,
but
it
doesn't
report
specific
numbers
for
the
results.
I
don't
want
to
invent
a
figure.
What
I
can
say
is
that
the
trial
was
designed
to
measure
exactly
that,
whether
a
low
plastic
diet
lowers
exposure
to
these
chemicals.
And
the
full
results
are
in
the
Nature
Medicine
paper
linked
in
the
newsletter.
I
appreciate
that.
So
what's
the
honest
limitation?
A
few.
This
is
a
tightly
controlled
experiment.
Normal
families
can't
partner
with
farmers
and
redesign
their
food
supply.
So
even
if
the
diet
lowers
chemical
levels
in
a
study,
the
real
world
version
is
going
to
be
much
more
modest.
And
again,
this
study
did
not
look
at
autism,
at
behavior,
at
anything
about
development.
It
measured
chemical
exposure.
That's
it.
So
I
don't
want
anyone
hearing
this
and
thinking
plastic
causes
autism.
No.
There
is
nothing
in
this
study
that
says
that.
And
we're
not
suggesting
it.
The
study
tells
us
something
about
one
route
of
chemical
exposure.
What
it
means
for
health
is
a
separate,
much
longer
question.
So
why
include
it
for
autism
families?
I
think
the
newsletter's
reasoning
is
this.
Many
autistic
children
have
sensitivities,
or
digestive
or
health
issues
that
haven't
been
fully
explained.
And
they
often
eat
a
narrow
range
of
foods,
which
means
heavy
exposure
to
whatever
is
in
those
foods
and
their
packaging.
If
one
of
your
child's
five
foods
comes
in
plastic,
they're
getting
a
lot
of
that
one
thing.
That's
a
point
I
hadn't
considered.
A
narrow
diet
concentrates
whatever's
in
it.
Right.
Fifteen
different
foods
spreads
your
exposure
around.
Three
foods
every
day
concentrates
it.
So
what
does
a
family
do
with
this
one?
Low
stakes,
reasonable
things.
Glass
or
stainless
steel
for
storing
and
heating
food
when
you
can.
Avoiding
heating
food
in
plastic.
We're
here
to
talk
about
the
Alex
suggests
talking
to
a
nutritionist
or
a
doctor
about
implementing
a
cleaner
diet.
I'd
frame
it
as,
are
there
simple
changes
to
how
we
store
and
prepare
food
that
makes
sense
for
our
family?
And
then
let
the
professional
size
it
to
your
actual
situation.
Okay,
so
let's
pull
these
three
together.
Gut
bacteria
in
mice,
eye
movements
in
children,
plastic
in
the
food
supply.
On
the
surface,
three
totally
different
things.
But
I
think
they
share
one
idea,
And
it's
the
idea
we
started
with,
the
toast.
Go
on.
When
a
child
refuses
food,
the
easy
story
is
picky
eating,
a
behavior
to
be
managed.
All
three
of
these
articles
push
against
that.
The
gut
study
says
there
might
be
biology
underneath.
The
eye
tracking
work
says
there
might
be
a
sensory
reason
we
can't
see
from
the
outside.
And
the
plastic
trial
reminds
us
that
food
itself
is
more
complicated
than
it
looks.
So
the
takeaway
is
get
curious
before
you
get
frustrated.
That's
exactly
it.
The
child
refusing
the
square
toast
isn't
being
difficult.
They're
responding
to
something.
Our
job
is
to
figure
out
what.
And
none
of
these
studies
gives
us
the
answer
today.
None
of
them
do.
And
I'd
be
suspicious
of
anyone
who
says
they
do.
But
they
each
give
us
a
better
question.
And
better
questions
are
what
you
bring
to
your
child's
doctor,
your
feeding
therapists,
your
dinner
table.
Everything
we
talked
about,
including
the
links
to
molecular
psychiatry,
nature
machine
intelligence,
and
nature
medicine,
is
in
edition
five
of
the
Lumos
newsletter.
Go
read
the
actual
papers
if
you
want
the
details
we
couldn't
fit
here.
And
if
tonight's
dinner
is
triangles
again,
that's
fine.
That's
a
child
who
knows
what
works
for
them.
Start
there.
Start
there.
Thanks
for
spending
this
time
with
us.
Take
care
of
yourselves,
and
we'll
talk
soon.