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Alexandra Sifferlin

For the last two years, Spanish photographer José Antonio de Lamadrid has quietly documented the daily lives of the Morillo Aguilar triplets; three 18-year-old boys at various stages on the autism spectrum. The Morillo Aguilar boys, Álvaro, Jaime and Alejandro, will likely never live independently, and rely on one another to navigate the world around them.

Lamadrid, whose own nephew is autistic, met the Morillo Aguilar triples through his volunteer work at Autismo Sevilla, a non-profit that offers support for parents of autistic children. “I thought that by taking pictures of these three, it would help people understand more about the illness,” says Lamadrid. “Although they are dependent on their family, it is possible for them to live normal and happy lives.”

It’s estimated that autism affects over 2 million Americans and tens of millions worldwide. As with the three brothers, symptoms vary depending on where a person falls on the autism spectrum.

Since he has the most normal social abilities, Jamie is the spokesperson for the three boys, and has a startling intelligence for trivia. “If you give him a random date, like May 2, 2001, he can very quickly tell you if that was a Friday or Saturday,” says Lamadrid. “He is the voice of the children and will often represent the three.”

Alejandro speaks significantly less than Jamie, but has his own unique skill of putting together entire 1,000 piece puzzles in only a couple hours. Alvaro, who has significant brain damage hardly ever speaks, but he still enjoys watching movies with his brothers. Although the three boys arelegal adults now, Lamadrid says they have the mental state of three-year-olds.

Lamadrid says the three boys are some of his favorite–and most cooperative—subjects to photograph. Whether the boys are getting dressed for the day in matching outfits or riding the public bus through Sevilla, Lamadrid says they never questioned his constant trailing as he snapped pictures. “They allowed me to be in their life, and didn’t care about me or my camera,” he says. “They’re the subjects all photographers want to have in their life.”

The mother of the three boys, Noelia Aguilar, stuck out the most to Lamadrid during his work. “I was stunned by her,” says Lamadrid. “She is really trying to give them a normal life. Both parents are taking care of them on their own and they know when to push them and when to stop and listen.”

Through his photos of the triplets, Lamadrid hopes he will spur greater support from the Spanish government and autism organizations for families like the Morillo Aguilars. “I’ve learned that despite the condition, this family lives very positively,” says Lamadrid. “Every day is quite hard for them, but they go to bed happy.”

José Antonio de Lamadrid is a photographer based in Seville, Spain. He is represented by Bluephoto.

Alexandra Sifferlin is a writer and producer for TIME Healthland.

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Soldiers and veterans looking to alleviate the devastating symptoms of post-traumatic stress disorder might soon have a new way to help themselves. Strangely, it involves using their gray matter to control a videogame.

The process is known as neurofeedback, or NF, and it’s the latest in a long, increasingly out-there list of potential PTSD remedies — from neck injections to memory-zapping drugs — being studied by military researchers. This week, scientists at San Diego’s Naval Medical Center announced plans for a clinical trial on 80 patients, designed to compare neurofeedback with a sham control procedure. The trial, the first of its kind, is meant to determine whether or not NF can avail soldiers of symptoms like nightmares, anxiety attacks and flashbacks.

“The proposed study could expand treatment alternatives for servicemen with PTSD,” the announcement reads. “If [neurofeedback] is shown to improve symptom reduction [...] it would offer a non-pharmacological intervention that would avoid undesirable side effects, and accelerate recovery.”

While the idea sounds pretty odd, the process of neurofeedback isn’t so intimidating (and I would know, having undergone the procedure myself for The Daily last year). A clinician affixes EEG electrodes to specific regions on a patient’s scalp, designed to read the output of the patient’s brain activity. Then, as the clinician monitors those brain waves from a computer console, the patient controls the key element of a videogame — like a car racing through a winding tunnel — using nothing more than their mind.

If a patient’s brain activity remains calm and steady, the videogame responds with enhanced performance — the car moves more quickly and navigates smoothly. If activity is wonkier and less controlled, that race car will veer out of control and, say, smash into a brick wall. Game over.

The idea behind NF is grounded in the emerging science of brain plasticity, or the ability of the adult brain (previously thought to reach stasis in adulthood) to change throughout life. Neurofeedback clinicians suspect that the brain, in “seeing” its own activity on-screen, is spurred to fix defects in order to work on a more optimal level. Over a series of several sessions, those repairs then supposedly become more permanently entrenched.

“When the brain sees itself interacting with the world, it becomes interested in that,” Dr. Siegfried Othmer, chief scientist at LA’s EEG Institute and responsible, along with his neurobiologist wife Sue, for “The Othmer Method” — a specific approach to neurofeedback being used in the military trial — told me last year.  ”Likewise, when it sees the signal on-screen and realizes it’s in charge, it becomes interested. You might not notice, but the brain takes notice.”

The realm of brain plasticity is relatively new, but neurofeedback actually isn’t. The procedure first gained notoriety in the 1960s as a treatment for everything from migraine headaches to bed-wetting. Still, in part because of a paucity of mainstream scientific research, the approach has long been relegated to the realm of bunk science. “I think the practice has gotten ahead of the science,” Dr. Andrew Leuchter, a professor at UCLA’s Semel Institute for Neuroscience and Human Behavior, told me. “It wouldn’t be surprising … if much of the benefit was attributable to the placebo response.”

Despite such mainstream skepticism, neurofeedback is already being used by several military doctors and psychologists. Maj. Michael Villaneuva — nicknamed “The Wizard” by his patients — has performed NF on several hundred active-duty soldiers, and even brought his game console and electrodes on a deployment to Afghanistan this year. And Dr. Jerry Wesch, who leads a PTSD recovery program at Fort Hood, describes the results of his own neurofeedback trials on patients as “jaw dropping.”

Upwards of a thousand former soldiers have also tried neurofeedback, thanks to Homecoming 4 Veterans, a non-profit started by the Othmers that offers free NF to veterans through a network of 200 practitioners nationwide. The two are also responsible for training Villaneuva and other military docs in the art of NF.

Already, the Othmers are confident that the military’s clinical trial, expected to kick off in December, will yield positive results. And they hope that the trial, once complete, lends more credence to the therapy they’ve helped pioneer. “I think the trial could be huge, not only with [medical] academia, but for clinicians,” Sue tells Danger Room. “They’re often wary of adapting procedures that haven’t seen evidence-based study. So this checks off an important box.”

But the trial won’t be easy: Controlled tests of processes, rather than pharmaceuticals, are notoriously tough. That’s because designing and executing a “sham” procedure is much more difficult than, say, just doling out sugar pills instead of the real drug.

Then again, for soldiers who credit neurofeedback with their recovery from PTSD, the execution or academic impact of a clinical trial is hardly the most important thing. “How it works doesn’t matter to me,” Staff Sgt. Justin Roberts, who underwent the process at Fort Hood, told me. “Just as long as it does.”

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by NPR Staff

In the 19th century, the mentally ill were often sent to horrific asylums. Today they fill the nation's jails; the conditions aren't much better. Last year, almost 1.1 million people with serious mental illnesses were arrested nearly 2 million times.

It's those old asylums — mostly closed, often abandoned — that have fascinated photographer Christopher Payne. A few years ago, he put together a book of images from those buildings, titled Asylum: Inside The Closed World Of State Mental Hospitals.

Photos by Christopher Payne

Credit: Christopher Payne

Payne's photos reveal a world surprisingly suffused with color — a room full of rust-colored urns filled with the ashes of long-dead patients, a long hallway with brilliant teal paint peeling from the walls, a wall of multicolored toothbrushes still hanging on their hooks.

It's that photo in particular, taken at the old Hudson River State Hospital in New York, that still confounds Payne:

"For some reason, everyone left their toothbrushes there," he tells Laura Sullivan, guest host of weekends on All Things Considered. "The fact that this little box of toothbrushes had survived on the wall while the rooms around it were crumbling was incredible."

While the words "insane asylum" conjure up images of dark, scary places, his photographs reveal buildings that are stunning, beautiful almost castle-like.

"The asylums of the 19th century — some of them were the largest buildings of their time," he says.

Those compounds were also self-sufficient; patients produced their own food and even generated their own electricity.

"In the beginning they had this notion — it was called moral treatment," Payne says. "The idea is that the afflicted would be removed from the city and put in one of these utopian environments and put to work."

Many state hospitals were closed down decades ago, as states radically reshaped their mental health systems and de-emphasized institutionalization. Most have remained empty since. Payne says it is likely they will be demolished, but perhaps his photos will, in a way, preserve them.

Copyright 2011 National Public Radio. To see more, visit http://www.npr.org/.

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