Letters to the Editor 7,3

To the Editor:

All through my nearly 20 years of exploring the experience of being born non-labor caesarean I have struggled with a scientifically trained inner voice that kept saying things like, "What I am writing isn't scientific, its all in my imagination, and its too subjective."

As I re-read your series of editorials in PPPJ on the place of experiential data in scientific research, all the pieces fell into place and a split in my being was healed. see the new section, "A Scientific Perspective," near the beginning of my article.

Much of what you express is not new to me; in the article, "A Scientist's Experience With Tarot," recently published in Wheel of Tarot (Merrill-West, 1992), I speak of the complementarity of subjective and objective data, and I've often thought of myself as an "inner astronaut."

But seeing your discussion in print in a scientific journal was what brought things together for me with regard to my caesarean birth explorations which are very "close-to-home" for me, as close as my own body. Thanks for the help!

Sincerely,

Jane English, Ph.D.

Dear Editor:

After reading with great interest all the letters eliciting the various points of view concerning the abortion question in the last issue of PPNPJ (Vol. 6, Number 4, Summer 1992), I have to point out that the views are essentially one-sided or possibly incomplete.

As a scientific journal of pre- and peri-natal psychology, the arguments naturally and logically focus on either the welfare of the prenate or the welfare of the mother and the respective psychological and emotional consequences. However, such an argument comes down to a discussion of the rights of an individual and qualities of individual lives, such as a mother having to live with the psychological/emotional consequences of having gone through an abortion, or of an unwanted child given up for adoption. I cannot but feel that a crucial philosophical and political aspect must be at least mentioned, if not addressed as well. The point I am about to bring up concerns every man, woman, child, and prenate in this country.

If the government can claim the right to outlaw abortion, then every individual in this country is deprived of a basic inalienable right: Selfdetermination will no longer be our political heritage. The philosophy that gave birth to our nation will cease to be ours. If we the people allow the government to rule our lives by making abortion illegal, we set a precedent that gives the government the power to dictate other measures in the future, such as limiting the number of children a family can have. China's current laws, for instance, obligate couples to practice family planning, and penalties are imposed on families with more than three children. In India between 1975 and 1977, the government forced sterilizations upon certain segments of its population. Many countries, including Canada, have directly subsidized children by providing family allowances. If the government is given the power to outlaw abortion, by the same token it can reverse such a position and take it a step further by demanding abortions of prenates who may prove to become a burden to society, such as those with Down syndrome, with deformities, etc., etc.

The question of government intervention in relation to abortion is a legitimate topic for investigation by PPPANA and for discussion in the PPNPJ because the emotional and psychological consequences upon prenates, children, mothers, and families resulting from possible governmental dictates will be just as serious as those presently known and discussed in the various letters. PPPANA and PPNPJ should make an effort to truly "air the full range of information and thought" so personal decisions and positions can be truly informed ones where, in this case, the question of abortion is concerned.

Sincerely yours,

Paula M.S. Ingalls

Dear Charlie,

Because several questions about my prelearning pilot study (Volume 6, Number 1) posed in William Emerson's letter (Volume 6, Number 4) were not specifically answered in those remarks of mine (also Volume 6, Number 4) on G. Justus Hofmeyr's article-and since Dr. Emerson's other concerns were covered in my original piece but may need reiterating-the following should be of help.

Although Dr. Emerson does acknowledge "there is little doubt that prenatal stimulation enhances cognitive and intellectual development" (how refreshing when contrasted with those video pediatricians who even rail at learning in the first year), his apparent difficulty with my test results is their magnitude beyond "what might be expected." Having been similarly astonished at the prelearners' prodigious performance, I certainly appreciate his incredulity. But good science must not anticipate any particular outcome, instead keeping its senses and judgement vigorously open to input from whatever source, never impugning data before it is acquired; this is a classic observational problem, one which we must ever guard against as it prejudices so readily from our too-recent mammalian if not reptilian past, evoking survival defenses no longer required.

For example, Dr. Emerson's expectation that my Cardiac Curriculum involves "high frequency levels" overlooks or misunderstands technology which limits stimulation to the identical sonic parameters of maternal blood pulsing past the womb-this is described both textually and schematically on page 13 of my article. First, in utero hydrophones (tiny liquid-impervious microphones passed through the dilating cervices of women pending labor, noninjurious to either mother or prenate) record on audiotape those sounds the unborn customarily experiences. Then, by employing the digital sampling device (a converter of sound to an electronic medium), heartbeat variants are devised which conform precisely to such information, altered only for abdominal wall attenuation-all verified on a real time analyzer (visually allowing sonic comparisons).

What therefore reaches the fetus-to sequentially exercise nascent dataprocessing and memory, which in turn mitigates overwhelming but normal neural attrition about week 40 (confirmed through prenatally stimulated animal tissue examination)-becomes a progression of stimuli no different than if its mother's heart were orchestrating interesting themes to which the unborn's protobrain can relate with intimate familiarity. It is not patterned sound an adult ear can fairly evaluate (as Dr. Emerson tried), rather that curricularized communication which is age-appropriate to a prenate's unique situation. Perhaps the most important lesson my investigations in this young field (initiated by Rene Van de Carr over a decade ago) have taught me is to not presume anything about the uterine universe: employ the best tools of our time to map the fetal environment-including its own incredible neuroanatomy-and learn to read the unborn's cues as credible expressions of response as well as need. In other words, treat these diminuitive persons as absolute equals legally, philosophically, and psychologically, even if their DNA has them participating in formative processes unlike any they will again encounter.

Do we have any idea what our own voice-let alone music-sounds like to the fetus? Simple hydrophone eavesdropping in utero will permanently correct our well-intended misinterpretation: heavy muffling and gross distortion render even the loveliest maternal language, or Mozart, ludicrous. Truly surprising, the womb is hardly that tranquil haven we romanticize, but more like a crucible of titanic influences with indigenous sonic levels exceeding 95 decibels-loud as a rock band-from which birth must seem a relief (the frequently-voiced desire for returning to such overpowering origins suggests psychotherapy is on target in ascribing projective and revisionist motives). When Dr. Emerson felt "agitated" by sounds not yet translated by the womb's considerable tissue and fluid filter, he bares an understandable ex utero bias, just as our culturally mature perceptions too often misread that essentially biologic nature of neurogenesis: it is a very different world where some quite contrary rules of development obtain. Here genes, chemistry, and implacable growth mechanisms-with exclusive formulations like cell death and imprinting-hold primary sway. Whatever influences bonding exerts prenatally, so much greater does that which Donald O. Hebb names "the assembly" progress according to a genetically-coded, lockstep clockwork. Considering ourselves free agents beyond what is wholly warranted (why sociobiology aggravates), we may not like to hear about such fatalistic forces and events at work during our inception-that special period defining plasticity-but they must be manifested on schedule if the subsequent creation is to make minimal sense.

Even so, drawing upon certain developmental excesses, the "slop" of natural overproduction (such as spermatozoa) which insures minimal survivalistic competence, there is ample latitude for optimizing potential through interstices evolution has unintentionally allowed. There prelearning seeks to safely and effectively intervene (just as barren couples are advantaged by in vitro fertilization)-what engineering prides itself on. As Dr. Emerson may have detected, the sonic format he listened to includes what is called a "trailer" for each note; this descending tone moves from higher through lower frequencies specifically to compensate for substantial diversity in sound attenuation resulting from normative physical differences attending the abdomens of individual gravidae.

Moreover, because fetal motility increases throughout term the unborn situates itself variously, hence abdominal filtering of my Cardiac Curriculum from its ex utero sound source-twin speakers with preset ceilings against excessive volume or frequency levels-always differs; a wide sonic range is also required to access moving sensory receptors in the active prenate, where distance from the transducers ever changes (though infants tend to orient their heads toward the stimulation, as if seeking proximity). In short, every technical effort has been made to provide the unborn with environmental enrichment exactly meeting those acoustic requirements of its particular status-steps pilot evaluations vouch for as circumspect.

In regard to Dr. Emerson's request for controlled studies, it should be emphasized that the nature of initial approaches is quintessentially a beginning pass-to determine whether particular phenomena merit further attention. All the points he expresses are axiomatic, and were so understood long before my pilot work was undertaken-but first efforts first. Where good science starts is with the leading instrument for a subject area, and in recent years the Clinical Linguistic and Auditory Milestone Scale (CLAMS) has distinguished itself as a far superior tool for earliest prediction of later abilities than visuospatial or motor measurements. Its sensible thesis is that infant informationprocessing via receptive and expressive language skills most accurately determines childhood performance, impressively tracked and standardized (see A.J. Capute, F.B. Palmer, B.K. Shapiro, R.C. Wachtel, S. Schmidt, and A. Ross, "Clinical Linguistic and Auditory Milestone Scale: Prediction of Cognition in Infancy," Developmental Medicine & Child Neurology, 1986, Volume 28, pages 762-771).

To address Dr. Emerson's selection criteria question, as detailed in my article on page 14, choosing potentially gifted prenates for our stimulation project strains credulity-the subject population was just too diverse, with no consistent socioeconomic nor genetic advantages; also, even if parental expectations were extravagant-and ours were hardly that-scores like we were seeing simply do not materialize from hope alone. Instead, what took place for hundreds of hours before birth became the only viable explanation.

Further, parental reports achieve quite high levels of accuracy when not prejudged by that professional elitism so quick to discount any but a peer viewpoint, and such veracity is additionally enhanced when corroborated independently. The reason statistical norms are published for a vehicle like CLAMS is to achieve pilot efficacy precisely as it stands, controlled at the clinical level when that next stage of testing becomes appropriate.

Responding to Dr. Emerson's query about the Vineland Social Maturity Scale, in fact pertinent data is tabulated in the right three columns on page 18 of my article, and summarized on page 26, the difference between prelearners and nonstimulated peers clearly shown. Reinforced indication of consistently reduced stress levels, emotional stability, and increased interpersonal skills support these early Vineland conclusions.

Prelearning Institute is always imploring any legitimate individual or organization to engage whatever prelearner examination they wish (several current clinical examples are noted in my Volume 6, Number 4 letter, along with my recent article, "Prelearning: Trials and Trends," International Journal of Prenatal and Perinatal Studies, Volume 4, Number 1/2), including replication of my original CLAMS work though I do not personally endorse raising false parental expectations through double-blind or placebo testing- see my relevant comments also in the Volume 6, Number 4 issue-but we have sometimes found this latitude either less than impartial, very expensive, or both. Unfortunately, one recent invited investigation had to be abandoned for procedural concerns, while a major university wanted $30,000 to conduct same. When the lion's share of private annual income has already been expended over a decade for basic prelearning research, one weary reply to those who would like to see elaborate and protracted clinical studies is purely pragmatic: please send check (especially acute for electroencephalographic, magnetic resonance imaging, or positron emission tomographic analyses). How ironic that when innovation outside academia shows promise, it is faulted for not immediately embracing those genteel benefits institutionalized research enjoysbut that is perhaps why some of science's most progressive discoveries arise in backwaters off the mainstream (Dr. Emerson may take personal heart in this observation).

Finally, to repeat what I explained on page 26, prelearner scoring declines after the first year merely mirror that normal growth curve of all learning; we never acquire information about our environment to the extent when first exposed-the rate of knowing tapers inversely proportionate to memory-thus our developmental trajectory for such mastery subsides with age, approximating a semiparabola. The point is that prelearners seem to follow a less precipitous modification in potential than do the rest of us-which is what this putative breakthrough is all about-thus experiencing increased breadth and depth to their journey. If prelearning theory is being validated in humans as it has been with animals, imprinted in utero optimization confers lifetime neuroanatomical amplification (past the permanently closed developmental window of brain cell dieoff), producing corresponding behavioral gains.

I cannot quibble with Dr. Emerson's characterization of my findings as "off the scale" because at the proper points of investigation I entertained every available countermeasure to fiercely play devil's advocate with some indeed extraordinary first outcomes. Frankly, in the history of science there occasionally occur discoveries whose efficacy looms so immediate they cry out for application beyond that clinical conservatism which would unnecessarily procrastinate what careful yet tantalizing pilot results reveal-especially when cloned by other observers. Therefore, faced with rapidly expanding numbers of families worldwide who were stimulating their unborn by demonstrably dangerous or idiosyncratic means, as a mission of prenatal mercy I felt an ethical compulsion to offer a repeatedly beneficial contribution to the marketplace, standardizing the practice through an approach whose safety has been controlled by scrupulous engineering-the eagerly appreciative fetus deserves no less. Now that this egalitarian giftedness appears to be establishing a new norm for human performance as over 2000 prelearners on every continent continue to replicate the early findings-with not a single contrary instance-we more than welcome amplified testing, but are looking primarily to neuroanatomical and neurophysiological instruments for further quantification ... let us hope well before these fortunate offspring themselves intuitively respond with the essential vision if not fiscal enlightenment as they come of age.

Very truly yours,

Brent Logan, Ph.D.