Why debunked autism treatment fads persist

The emotional appeal of facilitated communication is "very powerful and understandable," says psychologist Scott Lilienfeld. "The problem is, it doesn't work."

By Carol Clark

The communication struggles of children with autism spectrum disorder can drive parents and educators to try anything to understand their thoughts, needs and wants. Unfortunately, specialists in psychology and communication disorders do not always communicate the latest science so well.

These factors make the autism community especially vulnerable to interventions and “therapies” that have been thoroughly discredited, says Scott Lilienfeld, a psychologist at Emory University.

“Hope is a great thing, I’m a strong believer in it,” Lilienfeld says. “But the false hope buoyed by discredited therapies can be cruel, and it may prevent people from trying an intervention that actually could deliver benefits.”

Lilienfeld is lead author of a commentary, “The persistence of fad interventions in the face of negative scientific evidence: Facilitated communication for autism as a case example,” recently published by the journal Evidence-Based Communication Assessment and Intervention. Co-authors of the commentary are Julia Marshall (also from Emory) and psychologists James Todd (from Eastern Michigan University), and Howard Shane (director of the Autism Language Program at Boston Children’s Hospital).

The authors describe a litany of treatments for autism that have been attempted with little or no success over the years, including gluten- and casein-free diets, antifungal interventions, chelation therapy, magnetic shoe inserts, hyperbaric oxygen sessions, weighted vests, bleach enemas, sheep-stem-cell injections and many more.

As a case study, however, the article focuses on one intervention in particular: Facilitated Communication, or FC.

FC purports to allow previously nonverbal individuals with autism and related disorders to type by using a keyboard or letter pad. A facilitator offers support to the individual’s arms, allowing him or her to type words and complete sentences.

Soon after its introduction into the United States in the early 1990s, however, FC was convincingly debunked. Studies overwhelmingly demonstrated that facilitators were unconsciously guiding the hands of individuals with autism toward the desired letters, much as individuals using a Ouija board unknowingly guide the planchette to certain numbers and letters.

“The emotional appeal of FC is very powerful and understandable,” Lilienfeld says. “And no doubt the overwhelming majority of people who use FC are sincere and well-meaning. The problem is, it doesn’t work.”

In some cases, the authors note, FC has resurfaced with minor variations in the technique and a new name, such as “rapid prompting,” or “supported typing.”

By reviewing published surveys of practitioner use and canvassing the popular and academic literatures, Lilienfeld and his co-authors show that FC continues to be widely used and widely disseminated in much of the autism community despite its scientific refutation. They examine a number of potential reasons for the surprising persistence of FC and other autism fads. They note that the inherent difficulties in treating autism may give rise to an understandable desire for quick fixes of many kinds.

Lilienfeld and his colleagues underscore the pressing need for experts in the autism field to better educate the public about not only what works for the condition, but what does not.

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Poison power: From Cleopatra to Cyclops

Why did Cleopatra choose to be bitten by a poisonous snake when she had access to any number of plant poisons to commit suicide?

In the video above, Emory ethnobotanist Cassandra Quave explains how the Egyptian queen experimented before picking her poison. She also describes how the myth of Cyclops may have originated from the effects of a medicinal herb.

Poison has shaped history, myth and medicine in myriad ways. Over time, people have discovered ingenious ways to transform and make use of plant poisons for use in agriculture, fishing, hunting and medicine. Learn more about how poison plants are used in medicine in the video below.

Quave, an expert in the interactions of people and plants, and an assistant professor of dermatology in Emory’s School of Medicine, is among a lineup of guest lecturers at the Fernbank Museum, in conjunction with the special exhibition "The Power of Poison," continuing through May 1.


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Fossil tracks mark student's passage into New World of discovery

“Wherever you go, you should always pay close attention to your environment because you never know when you could come across something really cool," says Emory graduate Meredith Whitten, shown basking in the winter sun of the Bahamas.

By Carol Clark

Nobody knew better than Christopher Columbus that knowledge and experience, guided by luck and the right conditions, are key to making a discovery – even an accidental one. On October 12, 1492, he found what he thought was a shore of the Indies, but was actually an island in the Bahamas that he christened San Salvador.

During the winter break of 2013, Emory senior Meredith Whitten was on San Salvador for a study abroad trip, part of an environmental sciences class called “Modern and Ancient Tropical Environments.” Whitten had already visited the island when she took the course as a sophomore, and she was returning as a teaching assistant.

“It’s a great course because you get to go back into the past by looking at the rocks,” Whitten says. “It’s cool to see how the Earth has changed and also stayed the same.”

“She brought a lot of knowledge and experience to the group,” adds Anthony Martin, the professor who developed and teaches the course. Martin is a paleontologist who specializes in trace fossils: Tracks, burrows and other signs of ancient life.

“We go around the entire island in a big, open-bed truck,” Martin says of the field portion of the class. “We stop at known fossil sites, and at interesting modern environments to imagine what they might have looked like in prehistoric times. I call it ‘The Magical Mystery Tour.’”

Whitten stands by the fossil track site, the pale patch of rock next to her feet.

On December 30 of 2013, that tour stopped at a shoreline site where Martin noticed an outcrop of red rock. “I wanted to explain to the students about palesols,” Martin says. That paleosol, or fossilized soil, originated as dust from the Sahara desert. Not unlike Columbus, that dust was carried across the Atlantic by trade winds and deposited on San Salvador. “Some of that dust had iron minerals that got oxidized and, like the red socks in your wash, colored the sediment,” Martin says.

While he was explaining all this to the students, Whitten was looking at a patch of white rock being lapped by the ocean. “I could tell that the rock was recently exposed because it was so white and hadn’t been weathered,” Whitten says. “There must have been some storm surge that had recently broken off the top layer.”

A wave had just splashed the rock, darkening its features. And it was late afternoon, so the light slanted at just the right angle to make details in the rock’s surface pop out. Still, only someone who knew what to look for could have noticed the faint impressions.

“I saw the shapes and called Dr. Martin to come over, I thought I’d found fossilized bird tracks,” Whitten recalls. “I was sort of surprised when he looked at them and agreed. It was very cool and exciting for both of us.”

It took knowledge, experience and a careful eye to spot the faint impression of a partial bird track.

The field class turned into a real-life lesson in how to document a fossil find.

Whitten and Martin are co-authors of a paper on the two partial bird tracks, to be published in March by the journal Geologica Acta. The avian footprints are the first known vertebrate trace fossils on San Salvador, and only the second example from the Bahamas. They date back about 120,000 years, to the Pleistocene Epoch, and match the size and form of tracks made by modern-day gulls.

“Fossilized tracks like these give us a better idea of what previous environments were like,” Whitten explains. She notes that it’s likely shorebirds were walking around the upper part of a beach, near the dunes, when the tracks got cemented in carbonate sand, buried and preserved. “Understanding past coastal environments, and how sea levels have changed, could give us insights into what may be occurring as we look ahead at climate change.”

After graduating from Emory last May, Whitten decided to take time off as a dive instructor in the Bahamas before entering graduate school with the aim of a career in managing fishery policy.

“It was so fun to have a day in the field turn into so much more,” Whitten says of her experience in the Emory class. “Wherever you go, you should always pay close attention to your environment because you never know when you could come across something really cool.”

Columbus couldn’t have said it better.


Photos courtesy Meredith Whitten

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Using space satellites to track disease risks

Satellite data can map waterways harboring snails that spread disease, and pinpoint where these snails are likely to intersect with people.

BBC Science Correspondent Jonathan Amos wrote about a session of the recent annual meeting of the AAAS on the use of satellites to track infectious diseases, such as those spread by water snails. Below is an excerpt of his article:

"It is not possible, of course, to see individual snails from orbit, but specialists will have a very good idea of where these creatures prefer to be and the conditions under which they will thrive. And so it is with the watersnails that carry the larvae of the worms that spread schistosomiasis through human populations in Africa.

"In Kenya, scientists are making satellite maps of all the watercourses where these snail carriers are likely to reside, and plotting how they will move across the landscape. This information is then compared with satellite data on where people live on that landscape.

"The combination of the two maps shows the highest risk locations - the places health programs should be concentrated.

"Uriel Kitron from Emory University in Atlanta, Georgia, conducted the schistosomiasis work in Kenya. 'One of the big challenges that all public health agencies have - and that's true you know in the UK, in the US or in Kenya - is limited resources. If we can help them target the resources in space and time, that is a huge service we can do.'"

Read the whole article at BBC News.

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The hunt for alien life forms, on Earth and beyond

Thermophiles, a type of extremophile, produce some of the bright colors of grand Prismatic Springs in Yellowstone National Park. Extremophiles may provide clues about how life formed in the extreme environmental conditions of early Earth. (Photo by Jim Peaco, National Park Service.)

Emily Conover attended the session at the recent annual meeting of the AAAS on "Searching for Alternative Chemistries of Life," co-organized by Emory chemist David Lynn. She wrote about the session's panel discussion for Science Magazine. Below is an excerpt from her article:

"Rather than searching for new forms of life on Earth or in the stars, other scientists study the question from the bottom up, looking for possible precursors of life. Chemist David Lynn of Emory University in Atlanta points out that misfolded proteins—like the those implicated in neurodegenerative diseases such as Alzheimer's—show some similarities to life, namely that they can generate diversity in the different ways that they fold, and can undergo chemical evolution, in which those folded proteins are selected not genetically, but chemically. Such precursors could form complex chemical networks, which might be the foundation of radically different life elsewhere in the universe."

Read the whole article in Science.

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Ghosts of the past leading to modern science

Detail from the cover of "History Lessons: A Memoir of Madness, Memory and the Brain," by Clifton Crais.

Among the raft of recent books by Emory faculty are three from historians that draw heavily from science to tell their stories. Below are summaries of the volumes from the latest issue of Emory Magazine.

HISTORY LESSONS: A MEMOIR OF MADNESS, MEMORY AND THE BRAIN, by Clifton Crais.  For those moved to tears easily, prepare for a river. Crais offers a haunting account of his childhood—the parts he can remember. He suffers from chronic childhood amnesia, the most common and least understood form of the disorder. Crais grew up in New Orleans with an alcoholic mother who tried to drown him in the bathtub at the age of three. A year later, she tried to kill herself.

As Crais notes of his training as a historian, “I have spent a lifetime sifting through the records of others . . . revealing the hidden patterns of our common past.” And yet—“It’s my own life I can’t remember.” He turns to plane tickets, postmarks, court and medical records, and crumbling photo albums for answers. And he consults experts about the neuroscience of memory. In the end, Crais reaches, if not an epiphany, at least accommodation with what is. “There is something different now,” he writes. “It’s not memory but still powerful: the knowledge that helps fill in the blank spaces where a child once walked all those lost years ago.”

A CLIMATE OF CRISIS: AMERICA IN THE AGE OF ENVIRONMENTALISM, by Patrick Allitt.  Although environmentalism has been widely reported for more than four decades, this is the first general intellectual history of the movement. Allitt takes readers back, well beyond the first Earth Day in April 1970. In his mind, the movement owes its birth to the “mood of crisis created by the first atom bombs and the Cold War arms race,” which influenced ideas about population, resources, and climate change. 

Does the media hype the dangers to the planet? The answer is almost certainly, in part because the science is complicated. As Allitt notes, “Only when scientists’ cautious conclusions were turned into thrilling headlines predicting disaster would citizens take notice.”

VACCINE NATION: AMERICA'S CHANGING RELATIONSHIP WITH IMMUNIZATION, by Elena Conis.  The sugar cube that many of us remember containing our polio vaccine was a treat for the tongue. The recent history of vaccination in the US is more bitter, but it wasn’t always so.

As Conis reports, in 1943 New York health official Leona Baumgartner reported results of a poll exploring Americans’ attitudes toward immunization: more than 90 percent trusted in vaccines. This is a far cry from conditions in the new millennium, as the role of the MMR (measles, mumps, and rubella) vaccine in autism is debated endlessly; the vaccine against HPV (human papillomavirus) sparked controversy when lawmakers attempted to require it for sixth graders; and parents marched on Washington. As Conis points out, “The larger debate over vaccination . . . wasn’t just about vaccine risks. At a deeper level, it was a debate about the roles of children in our society, our heath care politics, gender relations, chronic disease risks, and more.”

The search for alternative chemistries of life heats up

Research into alternative chemistries of life has implications for everything from the health of humans to the health of Earth’s ecosystems. (NASA photo)

By Carol Clark

Ideas about directing evolution of life forms on Earth and finding life on other planets are rapidly morphing from science-fiction fantasy into mainstream science, says David Lynn, a chemist at Emory University.

“These areas of science are rapidly coming of age because of our increasing knowledge and advancing technology. It’s an exciting time. We’re on the threshold of answering fundamental questions including: What is life? Are there forms of life that we haven’t even yet imagined? Are we alone in the universe?”

A panel discussion, “Searching for Alternative Chemistries of Life on Earth and Throughout the Universe,” is set for Friday, February 13, at 3 pm, during the annual meeting of the American Association for the Advancement of Science (AAAS) in San Jose. Lynn co-organized the panel with Jay Goodwin, an Emory research fellow and an AAAS Science and Technology Policy Fellow.

In 2012, Lynn, Goodwin and four other scholars led the “Workshop on Alternative Chemistries of Life: Empirical Approaches,” supported by the National Science Foundation and the National Aeronautics and Space Administration. They pulled together an international group of nearly 40 scientists working at the boundary of non-living and living systems for the Washington workshop. The group included microbiologists, marine biologists, biochemists, geochemists, synthetic chemists, atmospheric chemists, and virologists.

The resulting report, now available online, developed a set of research findings and next steps for exploring the concept of alternative chemistries.

The AAAS panel session will discuss many of the main ideas outlined in the workshop report, and the key question: How do we unravel the complex interplay of planetary, chemical and biological evolutionary networks, and what might we gain from the confluence?

“We’re at a critical point where we need to mobilize resources and bring together different research realms and take a holistic approach to this question,” Lynn says. Such research could have implications for everything from the health of humans to the health of Earth’s ecosystems as the planet undergoes climate change and a sixth mass extinction of life’s diversity, he adds.

Lynn is one of four speakers set for the AAAS panel. He will discuss his own research, which involves a bottom-up approach to exploring how organisms evolved from non-living to living systems.

Caltech geo-biologist Victoria Orphan will discuss taking a top-down approach to studying alternative chemistries of life by tracing the biological diversity back through time to its origins.

Biochemist John Chaput, from Arizona State University, will talk about his work at the interface of research into alternative chemistries of life, where the bottom-up and top-down approaches meet.

Astrophysicist Carolyn Porco, from the Space Science Institute, will discuss efforts underway to answer one of the most beguiling questions facing humankind: Is there life beyond Earth?

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Amazonian study quantifies key role of grandparents in family nutrition

A Tsimane grandmother (right) provides support for her infant daughter, her adult daughter (left), granddaughter and grandson.

By Carol Clark

Anyone who has ever loved a grandmother or grandfather knows the nurturing role that grandparents can play. A study of indigenous people in Amazonia, who survive on food they hunt, forage or cultivate, quantifies the evolutionary benefit of that role. The results show that grandparents contribute a biologically significant amount of food calories to their extended families.

Proceedings of the Royal Society B published the results of the study of the Tsimane people of Bolivia, led by Paul Hooper, an anthropologist at Emory University.

“We quantified the net flow of calories among individuals in an environment where access to food is limited and depends on people generating it themselves,” Hooper says. “The results support the theory that grandparents are key to our relatively long childhood and long lifespan, which are a big part of what makes us human. Their efforts have likely been underwriting human society for hundreds of thousands of years.”

The study found that fathers and mothers contributed the most net calories to their nuclear family unit, followed by grandfathers and grandmothers, then uncles, aunts and children above the age of 12.

Relative to other primates and mammals, humans mature later and live longer, including many post-reproductive years. Evolutionary theories have proposed that intergenerational resource transfers bolster these distinctive features of human life history. This new study is the first to fully unite the production of resources over a lifetime with inclusive fitness theory, and then test the unified model in an empirical analysis.

Members of a family work together to prepare a meal from ingredients they have gathered from their environment. "About 95 percent of their food comes directly from their own labor," Hooper says.

“Our data give a clear picture of how the life history of our species is supported by high surplus food production in older age and the redistribution of that surplus to younger kin,” Hooper says. “Beyond showing that food resources flowed from older to younger generations, we were able to predict how much each person gave to each other, based on their relative productivity and the closeness of their relationship.”

Hooper led the research as a graduate student at the University of New Mexico and then as a post-doctoral fellow at the Santa Fe Institute. His co-authors include anthropologists Hillard Kaplan, Michael Gurven and Jeffrey Winking.

The researchers spent five years collecting data on 239 Tsimane families from eight villages. The Tsimane (pronounced Chee-mahn-AY in Spanish) live in small, isolated communities along the Maniqui River in the Amazonian rainforest that are only accessible by canoe or logging roads. These communities speak their own language, lack modern sanitation and electricity, and have access to few consumer goods beyond axes, machetes and other basic supplies.

The Tsimane clear small patches of forest to cultivate cassava, plantains, rice and corn. They also forage plants and fish and hunt meat in the form of peccary, deer, tapirs, monkeys and capybara (a large rodent). “About 95 percent of their food comes directly from their own labor,” Hooper says. “It’s an isolated, small-scale society that gives us an idea of the way humans lived before modern industrialization.”

The study broke down average caloric intake by various age groups of the participants, ranging from about 700 calories per day for an infant to more than 3,000 calories per day for adults. They also quantified the amount of calories each family member contributed to the household, from a bushel of plantains or a kilo of rice to the meat of a butchered deer.

The evolutionary value of grandfathers has been largely overlooked, Hooper says.

The results showed that Tsimane parents and grandparents provide net economic contributions to kin into the seventh decade of life. Households with higher food productivity and fewer dependents provided net transfers to closely related, usually younger, households with lower productivity and more dependents.

The value of grandmothers had been highlighted in previous studies linking them to improved outcomes for grandchildren. The contribution of grandfathers, however, has been largely overlooked, Hooper says.

While food is a limiting resource among the Tsimane, Hooper notes that in order to conduct a similar study in an industrialized society the focus should shift from food to money and time.

“Whether you’re a hunter-gatherer or an accountant, you’re good at what you do because someone supported you while you developed and learned skills,” Hooper says. “The economics of learning are what makes grandparents so important to humans compared to other primates.”

In modern, fast-paced societies, undergoing rapid technological change, the value of grandparents may be overlooked, he adds. “When technology moves at a fast rate, it can shift the age of competence to younger ages. We’re in danger of not recognizing the wisdom of older people, accumulated over lifetimes.”

Hooper, who lost his last grandparent, his maternal grandmother, a few weeks before the study was published, says she influenced his career choice. “She completed a graduate degree in biology during the 1930s, so she was way ahead of her time,” he says. “I learned about Darwin and evolution from her. She taught me the importance of biology for understanding ourselves and our place in the universe.”

Photos courtesy of Paul Hooper

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How 'Fifty Shades' is coloring views of fantasy

Anastasia Steele (Dakota Johnson) and Christian Gray (Jamie Dornan) in the movie version of "Fifty Shades of Grey," which is only rated R but reportedly shows at least 20 full minutes of sex.

Emma Green writes in The Atlantic about the social implications of the blockbuster fantasy novel and movie "Fifty Shades of Grey." Below is an excerpt from the article:

"In some ways, it’s remarkable that a phenomenon like 'Fifty Shades' has even been possible. 'Oral sex, anal sex—those are all things that were at one time illegal,' said Paul Wolpe, the director of the Center for Ethics at Emory University. Sodomy, for example, was considered a felony in every state until 1962, and until the Supreme Court ruled against sodomy bans in its 2003 decision in Lawrence v. Texas, it was still illegal in 14 states.

"Today, 'there are lots of differences in the moral composition,' he said. 'There’s no unified moral view, so … the argument then becomes: My morality is different than yours—what right do you have to oppose me?'

Read the whole article in The Atlantic.

The other butterfly effect

Humans have come up with many ways to protect ourselves from infectious diseases.

“We used to think we were alone with this, but now we know we’re not. Now we know there’s a lot of animals out there that can do it, too,” says Emory biologist Jaap de Roode in a TED talk. (TED is currently featuring de Roode's talk from last November on its national Web site.)

In recent decades, scientists have learned that chimpanzees can use plants to treat their intestinal parasites, as can elephants, sheep, goats and porcupines. “And even more interesting than that is the fact that recent discoveries are telling us that insects and other little animals with smaller brains can use medication, too,” says de Roode.

For the past 10 years, de Roode has studied monarch butterflies and how they get sick from parasites. He discovered that female monarch butterflies are able to use medicinal milkweed plants to reduce the harmful effects of the parasites on the butterflies' offspring.

“This is an important discovery, I think, not just because it tells us something cool about nature, but also because it may tell us something more about how we should find drugs,” de Roode says. “Most of our drugs derive from natural products, often from plants. In indigenous cultures, traditional healers often look at animals to find new drugs. In this way, elephants have told people how to treat stomach upset and porcupines have told people how to treat bloody diarrhea. Maybe one day we will be treating people with drugs that were first discovered by butterflies. And I think that is an amazing opportunity worth pursuing.”

De Roode is one of the featured speakers for the 2015 Darwin Day Dinner in Atlanta on Sunday, February 15. The title of his talk is "How Darwin laid the groundwork for understanding infectious disease." Tickets for the event, sponsored by Atlanta Science Tavern, sold out within days after they came available a few weeks ago.

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In the Balkans, resilience is rooted in knowledge of wild plants

The unripe fruit of Prunus domestica, in the rose family, is a favorite snack for Gorani children.

By Carol Clark

Traditional communities living in isolated, rural areas with little money or infrastructure tend to have one thing in common: Resilience rooted in intricate knowledge of their natural environment, especially plants.

This knowledge may be relevant to some of the biggest problems in plant science, including climate change, conservation biology, food security and human health, says Cassandra Quave, an ethnobotanist at Emory University.

Quave led an ethnobotanical study centered on a remote corner of the Balkans that was published in the journal Nature Plants. Her co-author is Andrea Pieroni from the University of Gastronomic Sciences in Pollenzo, Italy.

“Ethnobotany is the study of the interactions of people and plants,” Quave says, “but it has also been described as ‘the science of survival.’ People’s knowledge of which plants are beneficial, and how to harvest and preserve those plants, can make a huge difference in the overall well-being of a community.”

An Albanian describes plant uses.

Emory’s Center for the Study of Human Health funded the study, with additional support from the University of Gastronomic Sciences.

The study compared how two different cultures used plants in the Gora region of northwestern Albania, near the border with Kosovo. The researchers focused on a rural district of Gora that is one of the most economically disadvantaged in Albania. The two cultures in the study, Albanians and the Gorani ethnic minority, were both Muslim and subsisted primarily on small-scale agricultural, especially potato farming. The area is mountainous and many “roads” are unpaved, rocky paths. Some communities can be cut off completely from the outside world by heavy snows during the long winters.

“This area was heavily affected by the Balkan conflict of the 1990s,” Quave says. “The adults there have living memories of extremely challenging times. Even in peace time, life is difficult.”

The researchers conducted interviews with more than 100 residents about 104 different species of plants in their local environment. They recorded 418 uses of these plants for a broad spectrum of food, health, ritual and economic purposes.

The plant uses of the two cultures tended to overlap when it came to food, the study showed. Stinging nettle, for example, is a dietary staple among both the Albanians in the study and the Gorvani. “They boil nettle and use it the way we would spinach,” Quave says, sometimes mixing it with cheese, and baking it into local pastries known as byrek or pita.

A willow tree next to a Gorani home.

The researchers also found 77 divergent uses for plants between the two cultures, including 43 plant species. “Culture affects the way people view the natural environment,” Quave says. “And those views can affect everything from home healthcare practices to diet and local economies and conservation issues.”

The Albanians in the study, for example, reported less of an affiliation with a species of willow tree known as Salix alba, while the Gorani often choose to plant this tree around their homes and have many uses for it. “It’s what we call a cultural keystone species because it is so entwined with their way of life,” Quave says.

When a Gorani man wants to propose marriage to a woman, he may dig up a willow sapling and place it by her front door. If the woman accepts the proposal, the family plants the sapling in their field. If she rejects the suitor, the sapling becomes firewood.

Both the Gorani and Albanians use willow branches with leaves as protective amulets over their doors. And they add willow leaves to the fodder of their livestock once a year, along with some other plants, because they believe it helps keep the animals safe and healthy, Quave says.

Another example of a tradition used primarily by the Gorani involves the use of the plant Nepeta cataria, commonly known as catnip, to treat fright. “If a child has a nightmare,” Quave says, “they might brew a cup of catnip tea to soothe them.”

To store up supplies for winter months, both the Albanians and Gorani in the study use lactic fermentation to preserve food. If they need starter culture for fermentation, they use the roots from certain plants.

“They have a great deal of knowledge about their local environment that has been handed down to them through generations,” Quave says. It’s important to record that knowledge, she says, both because it could have possible relevance for science and because it could help communities improve their well-being.

“A lot of international attention has been focused on the Balkans to try to support reconciliation and development,” she says. “If you really want to help local communities in a way that’s sustainable and culturally sensitive, it’s important to have a detailed understanding of how they interact with their environment.”

Photos courtesy of Cassandra Quave

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