Tuesday, 16 December 2014

Are you a nuisance?

I can only guess, but I assume that my readers sometimes reflect on their achievements, and within the bounds of modesty assume they have contributed, however mildly, to the societies in which they live. Frontiers of science, alleviation of suffering, careful driving, scrupulous payment of invoices: that sort of thing. Of course, such self-assessments are often delusional. Memory can be selective, and the occasional important publication shines in recollection, while the large pile of unfinished projects, disgruntled colleagues and abortive grand designs fade into oblivion. Pereunt et imputantur.

What if we were to take an objective measure? Track a thousand newborns, and keep a close account of the profit and loss ledger. At this point you may feel a trifle uneasy. Who are we to judge these matters? What price the jocular remark of a mute inglorious Milton? How could one possibly assess the wit of someone who lacks a Twitter account? Furthermore, you may recoil at the possible results of such an enquiry. If some individuals turn out to be a nuisance and a high cost to society, what then? Should they be exiled to some other land whether the natives are even more generous and gullible, or should we intervene as best we can to make them into productive citizens? These are not trivial matters, and the researchers were at pains to highlight the moral choices which arise from a clear headed evaluation of costs and benefits. In particular, their discussion pre-supposes a compassionate society, with redistributive taxation providing educational, health and welfare benefits. The question barely arises outside a welfare states. In such less kindly states, if people are a nuisance they are simply a nuisance, but not a direct cost, since no one will be paying them any benefits.

Terrie E. Moffitt & Avshalom Caspi used the ISIR 2014 conference to test reactions from assembled researchers about the findings so far, and about the issues which arise from them. They presented their data on the Dunedin study, a four-decade longitudinal study of a birth cohort of 1000 New Zealanders. They examined risk factors in childhood and measures of social, health, and economic costs in adulthood.

Adult social and economic outcomes fit the Pareto principle: 20% of the cohort accounted for approximately 80% of every outcome: the cohort’s months of social welfare benefits, years of absent-father childrearing, pack-years of cigarette smoking, hospital admissions, pharmacy prescription fills, criminal court convictions, and injury-related insurance claims. Moreover, high-cost individuals with one problem outcome tended to also have multiple problem outcomes. An ultra-high-cost sub-segment of the cohort was identified who accounted for 80% of multiple problems.

I can remember my interest in the Pareto principle when I first came across it, but I now see it as part of what I call “the comparative percentages muddle”. For example, would you be outraged to hear that 90% of national acne is owned by 10% of the population? A moment’s thought will show you that some people have acne and others do not. Comparative percentage obscures a skewed distribution. Teenagers tend to have acne, and some young adults have acne which reaches chronic levels. Then take the more usual diatribe: the top 1% own 10% or 30% or whatever of the national wealth. In the same way that it seemed odd that some some small percentage “own” all the acne it seem iniquitous that another small percentage owns a large percentage of the wealth. The comparative percentage muddle is based on the untested assumption that 1% of the population should own no more than 1% of the wealth. Comparative percentage shares are a clumsy (and perhaps intentionally misleading) way of showing distributions. For example, in a country where every citizen is paid the same wage for 40 years it will still be the case that older workers will have  more savings than the young because they will have had more years in which to build up savings, even in a country where you cannot pass on your wealth to your children. Savings accumulate over the life course, so without age correction the comparative percentage wealth statistic is misleading. Add in compound interest on savings, and add in a mild wage differential for more educated workers and the whole thing becomes a muddle in search of indignation.

The authors know all this, and realise that the beguiling Pareto observation is a post-hoc description, which of itself predicts nothing. In this case it simply asserts: there are some troublesome people, and they will account for most social problems. The critical question is: which kids will grow up to be responsible for a disproportionate amount of trouble (and can anything be done to make them behave better)?

The authors say: Risk factors measured in childhood that characterized this ultra-high-cost group were: low family socio-economic status, child maltreatment, low self-control, and low IQ. Effect sizes were very large. Predictive analyses showed that together, SES, maltreatment, self-control, and IQ measured in the first decade of life were able to predict 80% of the individuals who are using 80% of multiple costly services. We developed an index of the integrity of a child’s brain at age three years. This age-3 brain-integrity index was a strong predictor of the cohort members who four decades later became members of the ultra-high-cost population segment.
Implications: Much research has shown that childhood risk ‘X’ can predict poor adult outcome ‘Y’, but modest effect sizes discourage translation of findings into targeted childhood interventions. This study illustrates that the vast bulk of a nation’s social services, crime control, and health-care are expended on a relatively small population segment. During early childhood, this population segment is characterized by a small set of risk factors: low SES, child maltreatment, low self-control, low IQ, and poor brain integrity. Reducing these factors may bring surprisingly good return on investment.

The comments from the audience were that it would be an error to describe the neurological examination as an “index of the integrity of the child’s brain”. Brains are assumed to be present. Better to say that an examination of behaviour, skills and neurological responses shows that many of the troublesome children can be detected at that age.

The assessment is interesting. It includes the Peabody Picture Vocabulary Test, which is simple and a good predictor. A word is spoken and the child has only to point to the one of four pictures which best describes the word. It has been doing good work since 1959 and is an excellent example of the power of intelligence measures: simple to do but profound in their implications. They also tested language and motor development, and simplest of all, what the child’s behaviour had been like during the 90 minute session.

There were varying views as to whether interventions in early childhood would be effective. I think the Abecedarian project achieved useful results in increasing ability somewhat (by about 4 IQ points on average), but not all researchers are convinced about that. Training parents in how to manage a very difficult and demanding child could be very useful, but that remains to be proved at the scale required, though King’s College has done good pioneering work on this.

The core of the argument is a social one, and goes to the heart of policy making. The authors calculate that about 45% of the population are “low cost users”. In other words, they draw very little on community resources, yet pay most of the taxes that provide those services to others. The authors have identified some ultra high cost users who are a net drain on resources. Compassionate societies pay their bills, including the highest bill, which is often being the target of their bad behaviours. Whilst they remain willing to do so welfare states will survive, and might even invest yet more resources in the hope of bringing about improvements in parenting. If they were to decide to invest all of their resources in their own children rather than divert their earnings to other people’s children the redistributive State would collapse.

15 comments:

  1. "There were varying views as to whether interventions in early childhood would be effective."

    I suppose we would be remiss to not ask this question, but I honestly believe that Gregory Clark's work well answered that, tons of other evidence on that matter (e.g., the failure of Head Start here in the U.S.) not even considered.

    But being the fine Utopian Westerners these folks are, upon hearing news like this they can't help but think that there must be some way to fix it.

    And this...

    "Training parents in how to manage a very difficult and demanding child could be very useful, but that remains to be proved at the scale required, though King’s College has done good pioneering work on this."

    ...I believe was soundly debunked by Judith Harris. Indeed, that would have knocked the winds right out of her sails if this could work.

    But as Misdreavus once put it, if one of the most drastic interventions there is, adoption, fails to make an improvement in outcomes, why on Earth would we expect better parenting classes to work?

    Sorry, on whether there is a way to fix this, I have an answer, but one most won't like, given here:

    “Squid Ink” | JayMan's Blog

    I'd be remiss to not ask if this birth cohort is monoracial? I've seen more than a few pieces of research claiming some adverse outcome of some factor in New Zealand that was the result of confounding between Whites and Maori there.

    I would argue (and have argued, based on an argument I didn't finish elsewhere – but perhaps should at some point) that the welfare state benefits everyone. In Scandinavia, at least, it appears to lead to a type of eugenic breeding. Perhaps this is because when the survivability of each child is improved in poor families, they have fewer of them. Giving people stuff may serve to reduce crime by reducing the need for black markets (I fully admit citation needed on that one). And then there's Gregory Clark's own argument: if no intervention in the world can fix the dysfunctions of those on the bottom, and certainly not uplift them from there, then should we not then make being on the bottom less bad? I buy that argument.

    (The above paragraph along with my pretty permissive attitudes towards sex and such is why I'm branded as a liberal, showing you can be hereditarian and quite to the Left).

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  2. Dear Jayman, I admit I sat through the entire presentation, which I enjoyed, without thinking about the Maoris. Over coffee others brought it up, but mainly as a contrast with Aboriginals in Australia, saying Maoris were more able, and better integrated in New Zealand. So, yes, we need a racial breakdown of the results.As to training of parents, we are not talking about Headstart type IQ boosting, but intensive behavioural techniques with very difficult children, aimed at improving parent management of their behaviour. I haven't looked at that work for a long time, so was quoting from memory. To give the authors their due, adoption studies are not an entirely fair comparison (though as an indicator of likely effect sizes they certainly show that it will be hard to do anything on a large scale).

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    1. "As to training of parents, we are not talking about Headstart type IQ boosting, but intensive behavioural techniques with very difficult children, aimed at improving parent management of their behaviour."

      I know. That's specifically what I meant. Judith Harris discussed such interventions in her book. What they found was that they (sometimes) improve the child's behavior at home, but have no effect on the child's behavior in school or otherwise outside the home. While adoption isn't perfectly comparable, it is extremely informative of what to expect (that is, pretty much nothing), even in terms of major life outcomes, which is what's of interest here.

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    2. This is a bit too pessimistic. Intervention can shift the developmental trajectory in useful ways - for example, programs like Multi-Systemic Therapy for conduct disorder can reduce time in out-of-home care (foster care or incarceration). That can be a huge cost-saving for the state.

      This is not to say that children with key risk-markers at age 3 can consistently be shifted into the normal range, but there is always an upper and lower limit of what can be achieved for any individual - lets look at what we can do (through environmental intervention) to help as many children as possible to approach their upper limit?

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    3. Paolo:

      Does it have any effect on adult outcomes? I'm pretty certain the answer is no, since I know of no such effective intervention.

      Hence, does such deserve to be called an intervention, or just a different (and perhaps cheaper) way of dealing with problem youth (as opposed to juvie)?

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  3. I think the observations are interesting, but not surprising, because I find that Pareto's principle holds fairly well for almost all spheres of experience. With respect to your comment about the usual economic diatribes, keep in mind that Pareto's principle is based on his empiric observation that 80% of the land in Italy was owned by 20% of the people. This sort of split can be found in many instances. Most GPs would probably agree that 80% of their patient care work over a given period of time is devoted to 20% of their patients - though the 20% who created the bulk of the work this year, might not be the same 20% who will be responsible for it next year. In many cases, I think, 80% of the results we achieve are gained with 20% of our effort, and the remaining 20% requires 80% of our effort to get. These are crude figures, and not intended to be exactly accurate. But the finding that most social services expenditures of time and energy are devoted to a rather small minority of the total population is not at all unexpected.

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    1. Thanks. We agree on the main point, that the 20% of patients who require 80% of the GPs time changes from year to year. Therefore the predictive value of the observation is very low. What it really means is that every year you will see many patients you can deal with very quickly, and a few who will require a lot of attention and who they are depends on who gets a serious illness in any particular year. The ubiquity of the observation renders it of little value. So, I am not refuting the 80:20 observation, but merely pointing out (as you do) that it is no bloody use. What may be of use is a powerful predictive heuristic, and we lack those, even with many screening techniques. When i reached a certain age I wondered whether I ought to have a health check. I knew the literature was against it, my GP agreed it was of no use, so I have never had one. Contrary to popular belief, old people don't take up much hospital time until the last year of their life. However, no one knows when that last year will be.

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    2. You're quite right. But here's another example from today's Journal:

      "When it comes to spreading viral and bacterial infections, some people are more contagious than others—much more contagious.

      Known as superspreaders, they amount to roughly 20% of the population, but they account for transmission of about 80% of certain infectious diseases, scientists estimate. The phenomenon has been observed, among other contagions, during the global SARS outbreak in 2002 and 2003 and as far back as Typhoid Mary, a cook in New York who infected dozens of people with typhoid fever in the early 1900s without falling ill herself."

      http://www.wsj.com/articles/the-20-who-spread-most-disease-1418686476?tesla=y&mg=reno64-wsj

      I agree with you that the fact that this sort of distribution appears to be ubiquitous makes demonstrating it, as in the work you describe above, of little novel value. In and of itself.

      What would be more useful, is something that would render the 20% less demanding.

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    3. Fascinating. However, I still want proof that they are always superspreaders for all things. As for Typhoid Mary, quite a number of people with various conditions spread it without succumbing themselves. Genomics will probably explain why before too long.

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  4. Best social system to manage “low cost users" vs "high cost users" is feudalism which runs country like a landlord of apartment buildings.

    Basically to run a country like a corporation. The lords can evict non-productive subjects from fertile land into wildness.

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    1. Re: Anonymous at 22:35: "The best system?" Wilderness?

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  5. After I talked with Terrie Moffitt she went off and spoke to the original Dunedin researchers to find out how they developed their measure for Self-control, which has been shown to have such huge predictive power, 40 years down the line.

    She learned that it was partly based on assessment of stages of ego development developed by Prof Jane Loevinger.

    There are interventions that successfully foster growth in ego development; indeed it also has very strong parallels with Prof Kegan's 'Self-authorship' stage that some make a focus for Higher Education. Kegan even has tens of thousands of people doing an edX MOOC on overcoming 'Immunity to Change' which may well foster shifts in adult ego stage and - presumably - self-control.

    I suspect that ego stage/self-control might be a whole lot more malleable than IQ - and I don't know why people don't focus on it more, except that Piaget-like stuff is rather out of favour these days. (Interestingly Macrae and Costa have talked about how ego development correlate with Openness to Experience on the Big 5).

    Perhaps we're often looking at effects of Ego stage and mistaking it for IQ.

    Time to be a bit more careful in distinguishing which factors are at work?

    Terrie has talked about how we perhaps need a sort of ethical revolution to overcome low self-control, as there once was against illiteracy.

    Interesting thought!

    Another thing, as far as I know the questions that Terrie belatedly added to her Dunedin assessments about creativity, entrepreneurship etc have not yet given rise to research findings, as funders haven't got interested yet...

    Matthew

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  6. Dear Mathew, Fascinating extra insights. I certainly questioned whether interventions would have long term effects, and another person in the audience assured me that the Headstart data were good for non-IQ type outcomes, about which I am unsure, and need to do more reading. What I need to know is the correlations between the IQ measures and the behavioural disinhibition measures.

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  7. Is that behavioural disinhibition as in lack of self-control?

    I think there's a gradual rise in self-control, with rising (Loevinger) Ego stage (which correlates .50 with IQ).

    But it's somehow a bit curvilinear too - it reaches a maximum and then lessens somewhat. Can't remember the details I'm afraid...

    There was even a society-wide intervention around increasing self-control/conscientiousness in the Dutch Antilles in the 60s. 5,000 ego stage assessments...

    One interesting finding was that months after all the training events etc the participants tended to have stayed in touch with only those people at the same ego stage as them, or very close. An intriguing example of homophily.

    I suspect that it's the fostering of self-authorship that is at the heart of education - and this relates more to ego stage than to IQ.

    And I'm personally very intrigued by the prospect that the only the 4 or 5 million (older) people in the UK have the capacity to solve our 'wicked' issues. As Harvard's Prof Kegan explained in his RSA lecture last year (I invited him): http://www.thersa.org/events/audio-and-past-events/2013/the-further-reaches-of-adult-development-thoughts-on-the-self-transforming-mind

    (You can have an IQ of 125 and be at any of the three major developmental stages found in adult (with very different capacities and capabilities), Prof Kegan says - which is why I'm always a bit incredulous when some people seem eager to reduce everything to IQ).

    Maybe you should ask Terrie herself about these areas - at least show knows about Loevinger and IQ and self-control? Does she still want to some of social campaign around enabling self-control?

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    1. "Low self control" was the actual phrase she used. I did not know about Kegan's work, and will need to look into it. I think that "conduct disorders" and "challenging behaviour" are all in the same ball park.

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