Faking Sick for a Living

Lying to your doctor is encouraged in one situation: when your doctor is a student and you're an actor asked to portray a certain condition. My friend Amy Savage does this for work. In between fake symptom bouts, I asked her to write a guest post sharing what she's learned from being poked for practice.

Have you ever been asked to “please dislocate your left breast,” or if you “have noticed any hairs growing in places you normally wouldn’t have hairs"? Or maybe someone told you to “have a nice day” after your spouse just passed away or you’d received a cancer diagnosis. Not only do I hear things like this from time to time at my job, but I have grown to expect them.

I have been working for several months as a so-called standardized patient. The local medical school runs an excellent program that lets students conduct histories and physical exams in a simulated, standardized setting. This means I (and many others) pad around in rubberized socks and breezy hospital gowns and feign myriad diseases, syndromes, conditions, and (sometimes nasty) habits. It also means I overuse hand sanitizer and have many strangers listen to my heart, palpate my abdomen, and poke me with a broken wooden Q-tip to test my sensation. One time I even let someone stick their gloved hand in my mouth and squeeze my tongue a little.

As a standardized patient, I have to memorize case materials for fictional patients. This means memorizing not just a list of symptoms and how long the “patient” has had them, but also the patient’s occupation, education, diet, marital status, drinking habits, exercise, stress, family history, and past medical history. If I am supposed to experience or not experience pain when they poke me, or have a knee jerk reaction (literally), I’d better be ready with a realistic response. This involves a bit of groaning, some crying (in the case of bad news), and some bona fide reflexes.

Most often the students show concern and empathy. In the rare case, though, that they say something a patient could perceive as judgmental, we “patients” get to act grumpy and less compliant.

I am expected to give specific, memorized lines about my symptoms, but only if the students ask the right questions in the right way. For example, if a student asks if I use tobacco, that is different from asking if I use or have ever used tobacco products. Asking a woman if she has ever been pregnant is different from asking if she has any children. And, of course, those types of oversights in questioning can lead to different diagnoses.

Luckily, I am not just a living cadaver for the medical students to practice on. I also give feedback. We evaluate the students on things such as how they organize their questions; whether they display empathy; how they perform the physical exam; and how they communicate the possible diagnoses to the patient. After the exam we have time for students to ask questions and for the standardized patients to give suggestions—like how to encourage patients to change their habits, or what would be better wording to deliver bad news.

From this experience, I have learned what to expect from an ideal physician, what to ask, and what not to tolerate. For example, your doctor should not ask leading (or possibly judgmental) questions such as, “You don’t smoke, right?” Nor should they run off a list of questions such as, “Do you smoke, drink, or use drugs?” without giving you time to think. They should ask open-ended questions: “Have you noticed any other changes lately?”

I've also learned that it's important to pay attention to symptoms that may seem unrelated to your chief complaint. If you were experiencing extreme fatigue, for example, you might not think that your newly brittle hair had anything to do with your energy levels, but it could be a thyroid problem.

Even though I am trained to train medical students, this only means I know what (or how) they are supposed to ask or not ask. It did not necessarily mean I knew what to ask when I saw my own doctor.

Recently, I went to my own physician for knee pain. The doctor instructed a medical student to ask about my symptoms while she (the doctor) went out of the room, presumably to doctor someone. The medical student reviewed my complaints. What made the pain better? Worse? Did the knee make any sounds? The student said that it sounded like a very common problem; she just couldn’t remember the name exactly. (Whether she really couldn’t remember or was refraining from diagnosing me without a medical license, I will never know.)

The student left to get the doctor, and when they returned the doctor moved my knee cap around a bit and then suggested that I might have premature arthritis (I’m close to thirty) and that I may need cortisone shots and physical therapy. I refused to believe this, but said “Oh, okay,” nodding complacently. The student and the doctor left the room to give me time to get my pants on, and when they returned, the doctor admitted that the medical student had come up with another possibility: runner’s knee. I read the photocopied pamphlet they handed me, and it fit all of my activities and symptoms.

I was grateful that my physician was willing to listen to the medical student, though a bit terrified to think what I would have put myself through if she hadn’t. Though I know better now from my work as a standardized patient what the doctor could and should ask me, I am still at their mercy if they do not ask the right questions and listen carefully to the answers.

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How to Make Your Doctor’s Appointment Better Than Standard: Advice from a Standardized Patient

• Find a physician who will ask you many questions and listen carefully to the answers. Do not assume, if you’ve talked to a medical student or other proxy, that they have conveyed all the information to the physician.

• Your physician should give you more than one possible diagnosis. In other words, they should tell you what they are thinking, unless they are absolutely certain what is wrong. This should be like a conversation between you and your physician. Don’t be afraid to ask, “Are there any other possibilities for what this could be?”

• Pay attention to your own body. Notice when the pain started and what makes it better or worse. Does it happen at a certain time of day or after certain activities? Have you changed your diet recently? Tell your physician about everything you’ve noticed that is not normal for you, even if you don’t think those other symptoms or changes are relevant.

• As I learned with my knee problem, some medical students—because they are not overly confident and are willing to ask, not assume—are better than some doctors.


Image: Craig Breil/University of Michigan MSIS (not a picture of Amy)

The More Your Friends Change, the More Your Social Network Stays the Same

For the most part, people move in and out of our lives at a trickle: a new coworker becomes a friend; a neighbor moves away. But there's at least one cataclysmic monsoon in a young person's social life, and that's high school graduation. So long, hometown chumps! Hello, dorms! When scientists used cell phone records to track the social networks of people graduating from high school and starting the next phase of their lives, they saw a huge turnover in friends and acquaintances. Remarkably, though, the overall structure of each person's network stayed the same.

"We wanted to see what happens to social networks when there is a big disruption," says Jari Saramäki. A professor at Aalto University in Finland, he leads a research group studying complex networks.

In 2007, Saramäki and his coauthors gave cell phones to 24 soon-to-graduate high schoolers in a large city in the United Kingdom. The phones came with an 18-month contract and a guarantee that all their call data during that time would be collected by researchers. After graduating, a quarter of the subjects stayed in their home city and got jobs; the rest went off to universities nearby or in other cities.

At three points during the study, the young people filled out questionnaires about their phone use. They listed all the friends, acquaintances, and family members for whom they had contact information, and rated the closeness of their relationships with each person. The researchers combined this information with the call records to piece together each person's network: who were they calling, how often, and how close were they to the people they called?

Researchers didn't calculate the absolute numbers of people in each subject's social network, Saramäki explains, because a graph of anyone's call frequencies shows a long "tail" of numbers dialed just once or twice. Are these doctor's office receptionists? School administrators? Does a virtual stranger count as a member of someone's network? Instead, Saramäki says, they focused on the top of the graph. Each subject's acquaintances were ranked by the number of phone calls they got, then graphed according to the fraction of total calls this was. Here's an example. "Ego" is the person we're interested in, and A-J are the people he or she called the most:

The graph on the right is this person's "social signature." There were some patterns among subjects. For example, an average of 20 to 25 percent of calls went to each person's top-ranked acquaintance, and nearly half of calls to their top three acquaintances. Nevertheless, each subject's social signature had a distinct shape. 

Over time, the graduating students had huge turnover in their networks. Within all top-20 contacts, 42 percent were people added in the middle section of the study. Yet statistical analysis showed that for the most part, the shapes of these social networks stayed the same.

"I would have expected that when the participants begin their first university year, there is some dramatic, temporary effect on their network shapes," Saramäki says. "What was really surprising is that [network structures] do not change much, even when this turnover is there."

Of course, phone calls don't give a complete picture of a person's social activity—there are also text messages, for one thing. But Saramäki says texts can be "problematic." Not everyone's parents text, for example, and some interactions might be completed in one message while others take a dozen back-and-forth volleys. "We do have data on text messages for this study and are working on it," Saramäki says. "But judging from what we have seen so far, it looks like the text message data tells pretty much the same story."

Even when people overhaul nearly all their friends at once, they seem to just slot the new acquaintances into the old social structure. The researchers point out that people have a limited amount of time to spend on their friends, and the brain may have a finite capacity for keeping track of others. So it's possible that people allot those resources in a consistent way, no matter which friends they currently have. It seems you can't shake your social network—wherever you go, there you (and they) are.

Jari Saramäki, E. A. Leicht, Eduardo López, Sam G. B. Roberts, Felix Reed-Tsochas, & Robin I. M. Dunbar (2013). Persistence of social signatures in human communication. PNAS : 10.1073/pnas.1308540110

Image: Mine. All mine.

This post has been edited from an earlier version.

Laughter Is OK Medicine, Unless It Kills You

Careful with the bedside banter, doctors. Before you put on your best Patch Adams impression, you might want to consider whether your attempts at humor will ease your patient's discomfort or give him a protruding hernia.

That's the conclusion of a review paper in the Christmas issue of BMJ that asks the jolly question of whether laughter can kill. The two authors, R. E. Ferner of the University of Birmingham and J. K. Aronson of Oxford University—no JK-ing, those are his real initials—take a tongue-in-cheek approach. They even give their research question an acronym: MIRTH (Methodical Investigation of Risibility, Therapeutic and Harmful).

Ferner and Aronson scoured medical literature for studies having to do with laughter. After "excluding papers on the Caribbean sponge Prosuberites laughlini and with authors called Laughing, Laughter, Laughton, or McLaughlin," they were left with three categories of study. One had to do with the benefits of laughter, one with its dangers, and the third with medical conditions that have laughter as a symptom.

Let's hear the bad news first. Laughter, according to various researchers, can lead to syncope (fainting), arrhythmia, and cardiac rupture. In asthmatics, laughing can trigger an attack. Laughing can even cause pneumothorax, a collapsed lung. People with cataplexy, a rare condition tied to narcolepsy, may suddenly lose all their muscle strength and collapse during a fit of laughter. An especially good laugh can make a person's hernia protrude, or dislocate someone's jaw.

Among the more pedestrian dangers, breathing in sharply when you start to laugh can make you choke. Laughing in someone's face can spread germs. And, of course, there's the danger of pee coming out when you laugh, which doctors call "giggle incontinence."

The authors also gathered a list of about three dozen medical conditions that have been reported—commonly or not—to cause laughter. These include epilepsy, brain tumors, multiple sclerosis, and kuru (a disease you are unlikely to contract unless you're a practicing cannibal).

Now for the good news. Laughter may increase your pain tolerance, reduce stiffness in the walls of your arteries, and even lower your risk of a heart attack. In patients with chronic obstructive pulmonary disease (COPD), laughter can improve lung function. Fifteen minutes of laughter reportedly burns 40 calories, which fitness-wise makes it similar to a very slow walk (or, according to Fitness magazine, barbecuing.)

Most strangely, one study used clowns to try to (indirectly) get women pregnant. Immediately after undergoing IVF, women were subjected to 12 to 15 minutes of entertainment by "a clown, dressed as a chef de cuisine." Among these women, 36 percent became pregnant, compared to just 20 percent in a control group.

Perhaps aspiring clowns themselves, the authors can't resist throwing in a few puns of their own: "Laughing fit to burst can cause cardiac rupture." "Perhaps surgical patients derive no advantage from being in stitches." "It remains to be seen whether...sick jokes make you ill, [or] dry wit causes dehydration." I'll give them the benefit of the doubt and assume that, knowing the potentially serious side effects of laughter, they chose to spare their audience the risk.


Image: Urban Combing (Ultrastar175g) (via Flickr)

R E Ferner, & J K Aronson (2013). Laughter and MIRTH (Methodical Investigation of Risibility, Therapeutic and Harmful): narrative synthesis. BMJ DOI: 10.1136/bmj.f7274

World's Ugliest Fish Jam Each Other's Mating Calls

Perhaps understandably, the male toadfish doesn't rely on his looks to attract females. He uses a bellowing, foghorn-like call to lure the ladies instead. But he'd better beware of his neighbors—nearby toadfish, a scientist has discovered, use short grunts to stealthily jam each other's signals.

In the spring, at the start of breeding season, male oyster toadfish nestle into rocks and debris on shallow seafloors in the western Atlantic. From his hidden nest, the male sends out his tuba blasts. A female who hears something she likes comes to the nest and glues down her eggs. Then she leaves the homely male to fertilize the eggs and guard the young till they're grown.

The breeding season stretches to the beginning of fall, and during this time male oyster toadfish have been observed grunting as often as 200 times an hour. When sending out their signature mating calls, neighboring males alternate with each other so as to be heard more clearly. But more often, they make quick little grunts that do overlap with others' calls.

To find out why toadfish interrupt each other like this, biologist Allen Mensinger of the University of Minnesota, Duluth, gathered a small group of male toadfish in an artificial pond. The pond was lined with underwater microphones to capture the fishes' calls. Bricks and concrete slabs were stacked into simple shelters on the bottom of the pond. After a couple days in their new home, the oysterfish agreeably moved into their "nests" and started calling out for females. (Those, however, were lacking.)

Each toadfish that Mensigner recorded had a distinct "fundamental frequency" (the lowest note it produced) to its mating call. In other words, each fish called with its own voice. But out of the thousands of recorded toadfish sounds that Mensigner analyzed, the majority were short grunts that interrupted other fishes' calls. And when a grunt overlapped with another toadfish's mating call, that call's fundamental frequency—its voice—was altered.

Mensinger thinks the grunts essentially jam the signals from the bellowing toadfish. In this way, interrupting toadfish might make their neighbors' carefully tuned calls less attractive to listening females.

The interrupting fish time their quick grunts to end before their neighbors' mating calls do. Mensinger thinks this protects the interrupters from being detected. Don't worry too much for the toadfish, though—despite their apparent gamesmanship, a few males managed to breed successfully when Mensinger threw some female fish into the artificial pond later in the season.

To hear the oyster toadfish in all his uninterrupted beauty, click here.


Image: by EricksonSmith (via Flickr)

Allen Mensinger (2013). Disruptive communication: Stealth signaling in the toadfish. Journal of Experimental Biology DOI: 10.1242/jeb.090316

Unempathetic Kids Don't Get Sarcasm

A crucial tool in your social survival kit is the ability to tell when someone means the opposite of what they're saying. For centuries, writers have tried to aid readers' detection of sarcasm with various typographic contortions: backward question marks, upside-down or zigzagged exclamation marks, even left-leaning italics dubbed "ironics."* (None of these have stuck, probably because pointing out when you're being sarcastic totally ruins it.)

For kids, sarcasm is a developmental hurdle to clear. At some point while they're growing up, they learn that positively worded statements—"Wow, great job"—aren't always positive. When psychologists at the University of Calgary began their recent study of kids and sarcasm, they started with a group of 6- and 7-year-olds. They expected that the children would be just beginning to grasp the skill. But when these kids showed "near-zero accuracy" at detecting irony, the researchers had to try again.

Thirty-one 8- and 9-year-olds became the new study group. For the experiment, each kid watched a series of 12 short puppet shows. The shows involved two puppet characters and ended with one of them saying either "That was so good" or "That was so bad"—sometimes literally and sometimes sarcastically. For example, one puppet misses a soccer goal; the other says, "That was SO GOOD." (A separate panel of adults had vouched for the sarcastic tone of the recorded dialogue.)

Kids had to decide after each show whether the final line of dialogue was nice or mean. They indicated their answers by picking up either a small plush duck or shark. (The actual niceness or ironic tendency of these animals was not addressed in the study.)

When the puppets' statements were literal, kids had no difficulty interpreting them as nice or mean. But the sarcastic statements gave them more trouble. Their accuracy as a group was a little under 50 percent; the researchers explain that about half the kids seemed to get it consistently, while the other half were "quite inaccurate" at spotting sarcasm.

Subjects' parents also filled out questionnaires about how empathetic their children were—a good understanding of other people's emotions might go along with an understanding of when people are being shark-ish or duck-ish. Kids with higher empathy scores did better in the sarcasm test. Additionally, explains senior author Penny Pexman, video footage revealed that kids with better empathy were slower when reaching for the wrong toy than their less empathetic peers. In other words, when empathetic kids failed to find the sarcasm, they struggled more with their answers. They may have sensed that there was another layer to the puppet's words: was that missed soccer goal really "so good"?

"We need to offer children extra supports when we use sarcasm," Pexman says. A second- or third-grader might have only a dim understanding of your clever one-liner. A first-grader will likely miss it entirely.

Additionally, "Encouraging children to be more empathetic has great benefits for understanding sarcastic speech," Pexman says. "We know from other research that empathy helps with other aspects of social functioning too." I mean, I GUESS that's a good thing.


*I learned about ironic punctuation in Keith Houston's book Shady Characters. There are a lot of good tidbits in there, from ampersands to octothorpes. The chapter on irony is summarized at Brain Pickings.

Image: by Spamily (via Flickr)

Andrew Nicholson, Juanita M. Whalen, & Penny M. Pexman (2013). Children's processing of emotion in ironic language. Frontiers in Psychology DOI: 10.3389/fpsyg.2013.00691

Mice Mark Their Territory with Song

Like warring street-corner troubadours, certain mice sing to claim their territory. They may not get any tips in their guitar cases, but by knowing where it's safe to sing, they keep the whole neighborhood harmonious.

Two related species of singing mice share the mountains of Costa Rica and Panama. One, Scotinomys teguina or Alston's singing mouse, lives at lower altitudes and is widespread in the forests of Central America. The other species, Scotinomys xerampelinus or the Chiriquí singing mouse, resides on the tops of the mountains. Males of both mice make chirping calls, unique to their species, that attract mates and advertise to competitors.

But the two tuneful rodents don't exactly meet up for karaoke duets. Bret Pasch, a biologist at the University of Texas at Austin, investigated three mountains where a clear boundary line divides the territory of Alston's mice below from Chiriquí mice above. Why, he asked, is this division so sharp?

Using traps baited with peanut butter and oats, Pasch and his colleagues first documented where the boundary between mouse species was. Then they set up face-offs between males of the two species. Placing pairs of trapped mice in enclosures together, they saw that S. xerampelinus, the higher-altitude mouse, was more aggressive and tended to attack the lower-altitude species. (The lower-altitude mouse is probably wise to retreat, since it's a smaller animal.)

Returning to spots on the mountainside where they knew each species lived, the researchers broadcast recordings of both kinds of mice singing, and listened for responses. Chiriquí singing mice, the more aggressive species, responded to calls of either kind. But Alston's singing mice were more likely to hush up when they heard a song from their rivals. When a male Alston's singing mouse was by itself in an enclosure, the sound of the other mouse's song—played from a speaker—was enough to make it retreat to a far wall and stay there.

Pasch concluded that the higher-altitude mice aren't intimidated by their neighbors, but are restricted to the mountaintops by temperature. The lower-altitude mice, wary of encounters with their larger and more aggressive upstairs neighbors, stay away whenever they hear that mouse's song. When Pasch removed all the Chiriquí mice from certain boundary-zone areas (by trapping them and then carrying them across a river), he saw that Alston's mice quickly moved into the vacant territory.

Alston's singing mice use their relatives' song as a hint to stay away, and Pasch says this sort of interaction could be widespread. "Closely related species often share similar ecological requirements—eating similar foods and living in similar places—as well as similar means of communication," he says. Because of this, communication between species "is probably common." Just don't expect them to appear together in concert.


Image: Alston's singing mouse, by Bret Pasch.

Bret Pasch, Benjamin M. Bolker, & Steven M. Phelps (2013). Interspecific Dominance Via Vocal Interactions Mediates Altitudinal Zonation in Neotropical Singing Mice. The American Naturalist DOI: 10.1086/673263

Gibbon Moms Help Daughters Practice Their Singing for Future Mates

Before their daughters grow up and leave home, mothers may impart some lessons in the womanly arts—for example, the proper way to whoop and hoot with your mate while sitting in a tree branch. As an adult, a female gibbon sings elaborate duets with her male partner. But before she leaves the family, her mother seems to take responsibility for the daughter's vocal lessons.

Young gibbons spend many years learning to vocalize like adults. By age six or so, "sub-adult" apes can match the vocal prowess of a grownup. Mothers and daughters often sing at the same time, though it's not clear why. Researchers traveled into the rainforests of Sumatra to make audio recordings of gibbon families and try to figure out whether these sing-alongs are significant.

Lead author Hiroki Koda of Kyoto University and his colleagues studied six families of agile gibbons (that's a species name, not just a descriptor). Koda explains that gibbons are monogamous, and male and female young grow up with their parents before departing the group to find their own partners. Each family in the study included a nearly adult daughter, and the researchers captured recordings of these daughters and their mothers singing together.

They found that some daughter gibbons were better than others at singing in sync with their mothers. They were also better at matching their mothers' tunes. But these talented daughters actually duetted with their mothers less often. Koda thinks that's because the ones who "showed more skillful songs" are the most mature, and are nearly ready to leave home. Daughters who still need the practice sing with their mothers more often.

Here, a mother and daughter gibbon match each other's calls as they sing together:

The researchers also found that mothers who sing more often with their daughters—the ones who are still giving lessons—modify their own songs more when they do so. Koda says this may be similar to the "motherese" that humans speak to their babies. Like human moms talking slowly and at a high pitch, gibbon moms alter their vocalizations when duetting with their daughters.

Koda says that in the past, primate calls have been seen as "completely different from human language development." Rather than learning from their parents, young monkeys and apes seem to figure out their calls on their own. But this is the first evidence of mothers helping offspring learn to vocalize in gibbons—or any other nonhuman primate.

By paying more attention to vocal interactions between parents and offspring, Koda thinks scientists might discover other examples of primate parents getting involved in their children's learning. (After that, maybe they'll discover primate parents getting too involved. "Don't you take that tone with me, young lady! I heard what you just hooted!")

Images: Top, singing gibbon by patries71, via Flickr (not, as far as I know, the study species). Bottom, a mother gibbon from the study by Hiroki Koda.

Hiroki Koda, Alban Lemasson, Chisako Oyakawa, Rizaldi, Joko Pamungkas, & Nobuo Masataka (2013). Possible Role of Mother-Daughter Vocal Interactions on the Development of Species-Specific Song in Gibbons PLOS ONE DOI: 10.1371/journal.pone.0071432

Uncoordinated Eyeballs Keep Kids from Reading like Adults

Before new readers can move from Dr. Seuss to Doctor Zhivago, it's not only their vocabulary and appreciation of the Russian aesthetic that have to mature. Young eyes just don't move across words as easily as older eyes do. Like Thing One and Thing Two, the eyes bounce around independently and cause disorder.

The difference is in saccades, the little horizontal or vertical hops that ratchet our eyes through sentences. French researchers Magali Seassau of e(ye)BRAIN and Maria-Pia Bucci of Hôpital Robert Debré have been studying how this system develops in kids, including those with dyslexia.

For their latest study, the authors gathered 69 kids ages 6 to 15, as well as 10 adults. While using an eye-tracking device, the subjects silently read a paragraph of text from an age-targeted book. (Experimenters asked questions afterward to make sure the kids had actually read it.) In a separate task, subjects were given the same paragraph—except that all the vowels had been replaced by consonants. They had to skim the text and count the number of r's.

Seassau and Bucci saw evidence of several ways in which a person's reading machinery gets more efficient with age. As subjects got older, they made fewer saccades: their eyes took bigger, smoother jumps forward through the text, and fewer backward jumps. They also paused for less time in between leaps.

These findings fit with what the researchers had seen in earlier studies of reading. "The process becomes automatic" as kids age, Seassau says. "Reading gets to be faster, better and easier."

Younger kids are also worse than older kids or adults at keeping their two eyes coordinated with each other. This means saccades happen unevenly. In kids, "Eyes aren't coordinated when they jump forward on the letter or on the word," Seassau explains. Like competitors in a three-legged race, the eyes have to learn how to match their stride if they want to reach the finish line quickly.

Whether subjects were reading words or searching nonsense text for a certain letter, they got faster with age. Yet there were revealing differences in how their eyes and brains handled the two tasks.

Adults were faster and more accurate at reading than at searching. In the search task, their eyes worked inefficiently, making more saccades. The same thing was true of kids 10 and older. But kids ages 6 to 9 made the same number of jumps whether they were reading real words or hunting for letters in the nonsense paragraph. Younger kids read more like it's a scavenger hunt; older kids and adults read like they're running on a track. The results are in PLOS ONE.

None of the kids or adults in this study had unusual reading difficulties, but Seassau and Bucci are planning to expand their current research to kids with dyslexia in different countries. Earlier eye-tracking studies have hinted that dyslexic kids move their eyes through text in an immature, uncoordinated way. Learning more about how they read may help get everyone's eyes acting their age.


Images: Peter Rohleder (via Flickr); Seassau and Bucci.

Magali Seassau, & Maria-Pia Bucci (2013). Reading and Visual Search: A Developmental Study in Normal Children PLOS ONE DOI: 10.1371/journal.pone.0070261

Everyone Underestimates Fast-Food Calories (But Especially at Subway)

At a McDonald's shareholder meeting last week, a nine-year-old girl accused CEO Don Thompson of sneaky advertising. Stop "tricking kids into eating your food," she demanded, saying that McDonald's ads tell kids to "keep bugging their parents" until they get that Happy Meal. In the world of fast-food chains, though, the golden arches may not be the sneakiest purveyor of excess calories. Diners in all kinds of fast-food restaurants underestimate the calories they're taking in—and the most dramatic underestimation happens at Subway.

Thompson may not have been swayed, but Jason Block of Harvard Medical School and a group of other researchers writing in BMJ do care what consumers think about their fast food. Specifically, they care how many calories people think they're eating. To find out, they went into the trenches: 80 fast-food restaurants in New England cities.

Researchers stood outside their chosen dining establishments (which included McDonald's, Burger King, Subway, Wendy's, KFC, and Dunkin' Donuts) in 2010 and 2011. They asked customers on their way in whether they'd be willing to save their receipts and answer a few questions when they came back out. (Only a few restaurants kicked the researchers off the premises.) At dinnertime, they targeted adults, either eating on their own or with kids. At lunchtime and after school let out, they went to fast-food places within a mile of a school and talked to adolescents.

In all, more than 3,000 people participated. Across all the restaurant chains, the average dinnertime meal for adults was 836 calories, and the average afternoon meal for adolescents was 756 calories. Yet when asked how many calories they thought their meals held, people consistently guessed too low. And the bigger their meals were, the more severely they underestimated.

The researchers also asked subjects whether they'd noticed any calorie information indoors. "All of [the chains] provide information in some way," says Block—"on a wall poster, on napkins/cups, on sandwich wrappers and tray liners, and on 'special menus' that might present items that are below a certain number of calories."

Yet less than a quarter of adults said they'd even noticed this information. Those people didn't do any better at estimating their calories than others. Did they use the information to help them make menu choices? Only five percent of all adults said yes. Of adolescents, two percent.

Block says it's easy for diners to miss the calorie information provided by fast-food chains today. But soon, as part of the Affordable Care Act, all chain restaurants with more than 20 locations will have to post calorie information in a standard format. "The menu labeling regulation will require the calories to be up front and highly recognizable," Block says.

Even this kind of prominent labeling has had mixed results in past studies. However, Block adds, the new law will also require menus to post an "anchoring statement" pointing out that people only need about 2000 calories a day. This might make, say, the 970 calories in a Wendy's Baconator more meaningful to a customer.

Anchoring was effective in at least one small study, Block says. Other studies have looked at "traffic light" labeling (in red, yellow, or green), or listing calories in terms of how much exercise you'd need to burn them back off. "We'll be in a position to know much more after the federal law is implemented," Block says. His group is collecting data this year and next year to see how well the new labeling works.

If people do start noticing how many calories their favorite chains are offering, they may be surprised. When researchers broke down their results by restaurant chain, they found that people underestimated their calories more dramatically at some restaurants than others. At McDonald's, adults guessed too low by an average of 100 calories, and adolescents by a little more than 200. The guesses were off by a bit more, on average, at Burger King and Wendy's. At Subway, the errors were most extreme: adults underestimated their calories by an average of about 350, adolescents by close to 500.

Five hundred calories is equivalent to all the bread in a 12-inch sub (or, if you opt for multigrain, all the bread plus four American-cheese triangles). It's a lot not to know you're eating. This mistake, the authors write, may happen because people view Subway with a "health halo." After seeing TV ads featuring fresh vegetables, smiling Olympians, and Jared's old pants, consumers may think they're making a healthier choice than they are.

The new calorie labeling could help most in places like this. A fast-food chain that brands itself as healthy is even sneakier than someplace like McDonald's, which even little girls know is bad for you.


Image: by Jeremy Brooks (via Flickr)

Block, J., Condon, S., Kleinman, K., Mullen, J., Linakis, S., Rifas-Shiman, S., & Gillman, M. (2013). Consumers' estimation of calorie content at fast food restaurants: cross sectional observational study BMJ, 346 (may23 3) DOI: 10.1136/bmj.f2907

Even People Without Synesthesia Find Colors in Music

It’s time to stop scoffing at the synesthetes: linking music to colors is totally normal. It’s not really about the notes, though. Researchers say the colors we find in music are actually the colors of the emotions the music makes us feel.

Synesthetes are people whose sensory experiences overlap; they most often link letters or numbers to certain colors. Music-color synesthesia, in which hearing music triggers the colors, is rarer. In fact, when Stephen Palmer and Karen Schloss at the University of California, Berkeley, set out to do a pilot study of music-color synesthetes, they couldn’t find any. So instead they began looking at the connections between music and colors in everybody else.

As part of a larger study called the Berkeley Color Project, Palmer and Schloss included questions about music. Participants saw a grid of colors while listening to 18 brief clips of classical pieces, and chose the colors that were “most consistent” and "least consistent" with each selection.

The researchers suspected that a connection between music and color, if there was one, might be emotional. So they separately asked their 48 subjects how happy, sad, angry, calm, strong, weak, lively and dreary each piece of music was. Subjects answered the same emotional questions about each color. (If you’re the kind of person who hates attributing personality traits to color swatches, you would not have enjoyed this study.)

There were 18 music samples, representing every possible combination of 3 composers (Bach, Mozart, Brahms), 3 tempi (fast, medium, slow), and 2 modes (major or minor). The Andante movement of Bach's Brandenburg concerto in F major, for example, was Bach/major/slow.

What emerged from this sea of lively Mozart and sad burnt-orange was a clear pattern. People linked uptempo and major-key music to colors that were warmer (yellower), lighter, and more vivid. Pieces with a slower tempo or in a minor key provoked the opposite colors: cooler (bluer), darker, and less saturated.

Additionally, music that was both slow and in a major key tended to be greener. And although there wasn’t a difference between Mozart and Bach, Brahms—a Romantic composer who wrote the most recently of the three—leaned more to the slow and minor colors.

To learn whether this consistency was strictly cultural, Palmer and Schloss found a collaborator at the University of Guadalajara who wanted to repeat the experiments with Mexican subjects.

The researcher, Lilia Prada-León, “initially complained that she didn’t want to study classical music because her Mexican participants don’t listen to that music much,” Parker recalls. “She wanted to do it with mariachi bands, which we may still do sometime later.”

Despite Prada-León's hesitation, the results from her Mexican subjects fit snugly with the results from Americans. “The pattern of results for tempo, mode, and composer were remarkably similar,” the authors write.

Also similar were the emotional ratings that Mexican and American subjects gave the musical selections, as well as the colors themselves. The emotions linked to each piece of music matched the emotions linked to that music's colors. This suggests that music itself doesn't make most people think of color. Instead, music triggers emotion—and that emotion is linked to a certain set of colors in the mind. The results are published in PNAS.

Out of the eight emotions in the original list, only four were needed to explain the results: happy, sad, strong and weak. Happier and stronger colors were associated with upbeat, major-key tunes, while weaker and sadder colors were tied to slower, minor-key pieces.

So what does all this tell us about actual synesthesia?

Palmer says his group has now repeated a version of their experiments with real music-color synesthetes (after finally rounding some up). The results looked different. While non-synesthetes chose different colors depending on the tempo of a piece of music—even if it was the same musical line artificially sped up or slowed down—synesthetes didn't.

"My current opinion is that synesthetes’ color experiences arise from direct mappings from sound to color," Palmer says. In their minds, emotions don't act as the middleman. However, "non-synesthetes’ color associations are indirect and do involve emotional mediation."

But when researchers asked synesthetes to choose the colors that were most "emotionally consistent" with the music, rather than the colors they experienced in their minds, the synesthetes picked out the same colors as everyone else. Additionally, when researchers altered melodies just enough to change them from minor to major, synesthetes—like everyone else—"chose happier colors," Palmer says.

There may be some common ground after all between synesthetes and others. The two groups probably won't agree, though, on the color of the mariachi music playing there.

Images: top by tanakawho (via Flickr); bottom Palmer et al.

Palmer, S., Schloss, K., Xu, Z., & Prado-Leon, L. (2013). Music-color associations are mediated by emotion Proceedings of the National Academy of Sciences DOI: 10.1073/pnas.1212562110

Tone-Deaf Birds Disrupt Society, Are Easier to Get into Bed

While male birds are singing elaborate arias and flashing their feathers, it's easy to imagine their female counterparts are unimportant actors. Duller and quieter, all a lady bird has to do is hold still and let one of these frantic performers mate with her. Yet in brown-headed cowbirds, at least, the quiet female keeps the whole society in order. Scientists discovered this by targeting a tiny portion of the female brain and frying it.

Males of the species Molothrus ater use their songs to compete with each other and to woo females. Once a a mating pair forms, they stay faithful to each other for the whole mating season, the male guarding his partner from rivals.

Near the top of the bird brain, a region called nucleus HVC controls females' choosiness toward their potential mates. Scientists at the University of Pennsylvania and Wilfrid Laurier University performed brain surgery on female cowbirds, carefully destroying only this region. Then they put their lobotomized females back into the dating arena to see what would happen.

First, the ladies listened to recordings of male songs. The researchers played tunes sung by a variety of males and observed the females' responses. (When they like what they hear, female cowbirds show it by crouching down in a copulation-ready pose.)

Normal females were choosy, only responding to the highest-quality male songs. Females who'd had brain surgery, though, responded positively to every song.

The researchers wanted to see what effect the females' new, lax attitude would have in cowbird society. So they put post-surgery females, normal females, and males in one big group together. Then they watched.

At first, it looked like nothing was different. Females missing their HVC seemed to act the same as females with intact brains; once they were all together in the aviary, there was no clear difference in how often females approached male birds or in how they "chattered" back at males to encourage their singing.

Nevertheless, something had changed. The other birds in the aviary treated post-surgery females differently. For one thing, females missing their HVC were serenaded by a greater variety of males, even once they'd chosen a mate. Normally, a female who's bonded with a male hears his song almost exclusively. This is a measure of how strong the bond between partners is, says study author David White. Now, with more males bending a female's ear, her pair bond was weaker.

There were other changes too. With the altered females introduced into the group, female birds competed more for mates. And the whole hierarchy of male birds, which is established before the breeding season starts, was disrupted. Male cowbirds sing at each other to show who's dominant. After the HVC-less females came to live with them, the rules about which males were dominant singers shifted significantly.

"The result in this paper turned everything around for us," White says.

Previously, it had seemed to be the male cowbird's responsibility to create a strong bond with his partner. Females appeared to be passive agents in the group. "They don't sing, they don't fight," White says. "They don't, to our eye, do much of anything." Yet when the choosiness was erased from females' brains, the whole group dynamic changed. "Now we could see that it was the female that was playing a much more active role in pair-bonding, and in all sorts of other roles within the social network," White says. Everything depended on her song preferences.

Incidentally, it's not clear why female cowbirds bond with males at all.

Females have likely evolved to pick mates whose songs demonstrate—somehow—that they have the best genes. Then the males keep singing to the females throughout the breeding season, strengthening the bond between them.

Usually, White says, bird couples only form strong bonds when both parents will need to care for the young. But cowbirds "are very bad parents overall" who abandon their eggs in the nests of other birds. The powerful bond between cowbird partners "really makes no sense," White says.

Yet once they're bonded, males direct almost all their singing to their partner and never try to mate with other birds. "They follow each other around, they eat together, he comes when she calls him," White says. If a female dies or disappears, he adds, "her pairmate just becomes a wreck. We call it the widowed male phenomenon."

After the loss of his mate, the male gives up for the season. "He flies around looking for her," White says. To him, at least, the quiet female never seemed unimportant.


Maguire, S., Schmidt, M., & White, D. (2013). Social Brains in Context: Lesions Targeted to the Song Control System in Female Cowbirds Affect Their Social Network PLoS ONE, 8 (5) DOI: 10.1371/journal.pone.0063239

Image: female brown-headed cowbird by JanetandPhil (via Flickr)

Google Promises We'll Feel Better in the Summer

Shakespeare wasn't kidding about the "winter of our discontent." In the colder and darker months, people do more internet searches for mental health terms, from anxiety and ADHD all the way to suicide. Search patterns also promise that like a refreshed browser window, better times are due to arrive soon.

John Ayers, of the Center for Behavioral Epidemiology and Community Health in San Diego, and other researchers dove into Google Trends to explore whether certain searches vary by season. "Seasonal affective disorder is one of the most studied phenomena in mental health," Ayers says, "with many individuals suffering mood changes from summer to winter due to changes in solar intensity." He wanted to find out whether any other mental health complaints changed with the seasons, as some studies had hinted.

Since Google Trends breaks down searches by category, the researchers started in the "mental health" section. Looking at all mental health searches in the United States between 2006 and 2011, they saw a consistent cycle with peaks in the winter and troughs in the summer. (If you do this search yourself, you'll see that there's also a dip around the December holidays—but the curve reliably bottoms out in July of each year.)

The team did some statistical smoothing and found that mental health searches overall were about 14% higher in the winter than in the summer. To confirm that the difference was due to the season, they ran the same analysis on data from Australia. Searches cycled in the same way—about 11%  higher in winter than summer—but the peaks in the southern-hemisphere country were almost exactly 6 months out of sync with the United States.

When the scientists broke down searches by specific symptoms or illnesses, the seasonal cycle remained—and in some cases got much stronger. "We were very surprised" to see this, Ayers says. Searches including the terms ADHD, anxiety, bipolar, depression, anorexia or bulimia, OCD, schizophrenia, and suicide all rose in the winter and fell in the summer.

One of the most dramatically cycling search terms was schizophrenia, at 37% higher in the winter. Eating disorder terms varied just as strongly. (The smallest seasonal difference was for anxiety, which was just 7% higher in the winter in the United States, and 15% in Australia.)

Some of this seasonality might be due to the schedule of the school year, Ayers points out. Referrals for kids with ADHD and eating disorders may come from their schools.

Other explanations involve winter itself. The effect of shorter days on our circadian rhythms and hormone levels might be a factor, the authors write, as in seasonal affective disorder. They speculate that a lack of vitamin D (which we make using sunlight) in the winter might contribute. Even omega 3 fatty acids might matter: we consume less of them in winter, and omega 3 deficiency has been linked to some mental illnesses.

There's also the question of what we're doing all season. People hunkered indoors during the colder months may have fewer chances for socializing, which is "a well-known health emollient," the authors write. The same goes for physical activity.

"There is a lot more we need to learn about mental health and seasonality," Ayers says. "For instance, is there a universal mechanism that impacts our mental health?"

Of course, sometimes our malaise isn't about the season.

Whatever portion of mental health is predictable, though, doctors would love to know about it and use that information to help.

This study doesn't reveal much about low-income or elderly populations who aren't online. And knowing what people are searching for isn't exactly the same as knowing what symptoms they're experiencing. "We are actively working to address these limitations," Ayers says. Working with Google.org, the charitable branch of Google, he hopes to develop systems similar to Google Flu Trends that can track a population's mental health.

"Intuition suggests that these results are reflective of an important link between the seasons and mental health," Ayers says. For now, we have the reassurance of computer algorithms that skies will be clearer soon.


Ayers, J., Althouse, B., Allem, J., Rosenquist, J., & Ford, D. (2013). Seasonality in Seeking Mental Health Information on Google American Journal of Preventive Medicine, 44 (5), 520-525 DOI: 10.1016/j.amepre.2013.01.012

Image: Skaneateles, NY, by me.

Kids Learn Better When Teachers Wave Their Hands

Maybe it's no mistake that we talk about "grasping" new ideas. When we find our hands moving wildly as we try to explain something, maybe we shouldn't feel ridiculous. Research in math classrooms has found that kids learned better when a teacher used gestures—and their grip on the new material improved even more after the lesson ended.

Teachers who gesture more or less while they speak can have other differences too, of course: they might use different intonation or vocabulary, or have more or less energy. University of Iowa psychologist Susan Wagner Cook and her coauthors, though, were only interested in the effect of teachers' hand motions. To isolate this factor, they created a series of videos.

In the videos, aimed at elementary schoolers, a teacher taught a single scripted lesson. The subject of the lesson was equivalence, the idea that what's on one side of an "=" must be equal to the other side.

In one set of videos, the teacher used her hand to indicate "one side" and "the other side" of an equation. A second set of videos showed the same teacher reading the same script, but she kept her hands at her sides. The researchers made several recordings and chose the ones in which the teacher's intonation was the most consistent, ensuring that the only difference between the lessons was her hands.

The kids who watched the videos were 184 boys and girls from 22 classrooms in central Michigan schools. Most were in second or third grade, and a few were in fourth. The kids had taken a pretest to make sure they weren't already familiar with this mathematical idea.

Each classroom watched a videotaped lesson, either the one with hand gestures or the one without. Immediately afterward, they took a test with questions such as:

7 + 2 + 4 = 7 + __

Kids who had understood the lesson would answer "6."

A day later, the kids had a second set of test questions spring on them. First they answered the same type of questions that they had the day before. Then they saw a second set of questions designed to make them "transfer" the rules they'd learned to new situations. For second graders, this meant trickier addition problems such as:

6 + 4 + 2 = __ + 3

in which none of the numbers on the right side matched the left. Third and fourth graders had to transfer their new skills to multiplication problems such as:

5 x 2 x 3 = __ x 3

Kids who had seen the lesson with gestures did significantly better than the no-gesture kids on the first test. A day later, they again outperformed the hands-free group—and beat their own test scores from the day before. Their understanding of the lesson seemed to have gotten even better in the 24 intervening hours. (This wasn't true of kids who watched the hands-free lesson.) Finally, the gesture group did better on the test of transferred skills.

A couple factors could explain why students learned better from a gesturing teacher, the authors write. Hand movements might help them pay better attention to the teacher, for example. And seeing a repeated hand motion across different problems might reinforce how those problems are similar.

That doesn't answer the question of why students continued to improve over the next 24 hours. Susan Wagner Cook explains that shortly after we form new memories, those memories are stabilized or "consolidated" in our minds. Consolidation can make new memories even stronger.

"We do know that motor memory is often consolidated during sleep," Cook says. Seeing another person's hands moving may have built motor (movement) memories in kids' minds, as if they were pointing and waving their own hands. "One possibility is that memories encoded with gesture are more likely to be consolidated during sleep," Cook says. "We are trying to figure this out!"

Although being able to point to the two sides of an equation seems like a clear advantage in this particular lesson, Cook says the benefit of gesturing goes beyond arithmetic—or even math. Other studies have shown that hand motions help kids learn in a wide range of subjects.

What's new is the idea that gestures help in the future, not only the present. Cook points out that even though some kids learned the lesson just fine without gestures, they didn't show the same improvement over time that the other kids did. Instead of only clarifying, gestures may help kids grasp their new knowledge more tightly. (Please imagine a fist-closing gesture to drive home this idea.)


Image: sleepinyourhat (via Flickr)

Cook, S., Duffy, R., & Fenn, K. (2013). Consolidation and Transfer of Learning After Observing Hand Gesture Child Development DOI: 10.1111/cdev.12097

Why People on Cell Phones Are the Worst

If it were urgent, maybe we could be more forgiving. But the subject of that phone call one table away at Starbucks never seems to be vital. A bathroom renovation, maybe. Or a phrase-by-phrase recounting of a text message dialogue with an ex. If you suspect overheard phone conversations are inherently more awful than people talking face to face, you're right: research shows that these conversations reach across our espresso cups, grab our attention, and don't let go.

Psychologist Veronica Galván studied this problem recently at the University of San Diego. To bring the coffee shop into the lab, she started by lying to about 150 undergrads. The students believed themselves to be in an experiment about reading comprehension. When they sat down at a table to solve a worksheet full of anagrams, another student sat down next to them and launched into a seven-minute conversation. This person, of course, was a plant.

The neighbor had a scripted conversation, either over the phone or with a second actor in the room. (The discussion covered three typically scintillating topics: "a birthday party for dad, shopping for furniture, and meeting a date at the shopping mall.") Meanwhile, subjects tried to ignore the noise and dutifully completed their worksheets.

When subjects filled out questionnaires afterward about how distracting they'd found the conversation in the room, their answers depended on what they'd heard. People who heard the one-sided conversation (a person on a cell phone) found it significantly more noticeable, more distracting, and more annoying than those who heard two people talking.

Even so, all the subjects performed about the same on their anagram-solving test. Galván had expected to see a difference between people who heard a phone conversation and people who didn't, but she says the anagrams may have been too easy to show an effect. Conversely, they may have been too difficult to allow people's attention to wander. Galván hopes her future experiments will reveal what kinds of tasks are most vulnerable to distracting phone conversations.

After their anagram test, subjects took a pop quiz about the conversation they'd just overheard. They saw a series of words and had to decide whether each one had been spoken in the conversation. In this case, the test results were clear. People who'd heard a one-sided conversation remembered it better than people who'd heard a two-sided conversation, Galván reports in PLOS ONE. Additionally, they rated their confidence in their responses higher than people who heard the two-sided conversation.

It's possible people remembered two-sided conversations less clearly because they heard more words overall. But the idea that a one-sided conversation seizes more of our attention agrees with previous research on the subject.

Because we can follow along with a two-sided conversation, its content is more predictable and therefore (the theory goes) easier to ignore. One person yakking away into a phone, however, is unpredictable and confusing. We can't stop our minds from trying to puzzle it out.

The subjects in Galván's study were all undergraduates. "College students are fairly accustomed to overhearing cell phone conversations," she says. "Yet even they reported more annoyance and had better memory for the one-sided conversation." She suspects older adults might find cell phone conversations even more annoying and distracting than college students do.

Until science finds a way to make other people's phone calls less bothersome, you're doomed to catch every word of that half-a-business-meeting being conducted two chairs over. On the bright side, you may remember it well enough to blackmail the guy in the future.


Galván, V., Vessal, R., & Golley, M. (2013). The Effects of Cell Phone Conversations on the Attention and Memory of Bystanders PLoS ONE, 8 (3) DOI: 10.1371/journal.pone.0058579

Image: Ed Yourdon (Flickr)

11 People Trace Synesthesia to One Set of Alphabet Magnets

Most people with synesthesia can't tell you exactly why they perceive the letter M as purple and not orange, or a high C-sharp as bright yellow and not blue. For one group of synesthetes, though, there appears to be an answer. For their green D's, red G's, and so on, they can thank the toy company Fisher-Price.

Stanford researchers Nathan Witthoft and Jonathan Winawer discovered, through word of mouth and from synesthetes contacting them online, a group of people who share a "startlingly similar" set of letter-color associations. Out of the eleven subjects, ten remembered owning (or still owned) a particular set of alphabet refrigerator magnets that was manufactured in the 1970s and 1980s.

The leftmost column below (labeled "set") shows the actual colors of this toy. The colors that the eleven subjects associate with the alphabet are listed as S1 through S11, in order of how well they match the magnetic letters. (And to the right are the magnets themselves.)

Subject S1 was carrying around mentally a perfect replica of the Fisher-Price letters, as the authors report in Psychological Science. The others had some differences—but were close enough to the toy's colors that, the researchers figure, it can't be a coincidence.

All eleven subjects also had number-color synesthesia. For the numerals 0 through 9, five of these people turned out to have color associations that matched sets of magnetic numbers sold along with some Fisher-Price alphabet sets.

Witthoft and Winawer don't think the magnets themselves made anybody synesthetic. But among this group of people who became synesthetic (and they may have been predisposed; it runs in families), many of the associations they learned came from a childhood toy.

Not that synesthesia should be confused with memory. Someone with synesthesia doesn't recall the color green when he sees the letter K the same way he sees Kansas and recalls that Topeka is the capital. Instead, synesthetes automatically experience that color when they read that letter or number (or experience a taste when they hear a sound, among other rarer combinations). Some even see the color on the page.

The authors say that the case of the Fisher-Price magnets shows synesthetic associations can be learned, rather than plucked from nowhere by the brain. "The idea that the colors would be learned has been around for a long time," Witthoft says, "but it has been difficult to turn up any examples." In this case, a mass-produced toy—combined with the powers of the Internet—helped.

But they don't think most synesthetes learn their associations from objects around them. These people appear to be, the researchers write, "anomalies among the anomalous."

When the colors of these subjects' mental alphabets differed from the Fisher-Price letters, it was often in ways that made them less anomalous—that is, more like the synesthetic population in general. "Color-grapheme synesthetes as a group have some shared tendencies," Witthoft says.

For example, 40 to 50 percent of English-speaking synesthetes associate the letter Y with yellow. Out of three subjects in this study who deviated from the red Y of the magnets, two went to yellow. It's also common to associate the letter X with black, as four subjects did (deviating from Fisher-Price purple).

Besides yellow Y's, studies have also found a lot of red R's, blue B's, and violet V's among synesthetes. These associations seem to come from language. The origin of most connections, though, is still mysterious.

One study, Witthoft says, argues that the brightness of a synesthetic color is related to how common that letter or number is. Other research "suggests that letters with similar shapes end up with similar colors." And in some types of synesthesia, he says, there are hints that the associations come from some basic way the brain is set up. For example, "pitch-color" synesthetes tend to see higher pitches as brighter colors. Non-synesthetes, if asked, make the same connection.

For now, childhood toys seem to be only a small part of the answer. To help dispel more of the mystery, you can take tests for synesthesia at synesthete.org—even if you weren't a Fisher-Price kid.


Witthoft, N., & Winawer, J. (2013). Learning, Memory, and Synesthesia Psychological Science DOI: 10.1177/0956797612452573

Images: Manon Paradis (Flickr); Witthoft & Winawer.