When people ask Frank Symons to describe his work, he points to a drawing on his white board. It is a generic stick figure, and above its head is the word “ouch.” Symons investigates pain and how the “ouch” is communicated, especially by people who can’t use words.
As a professor of educational psychology, Symons works to understand the severe behavior problems of children and adults with special needs, primarily those with developmental disabilities and emotional or behavioral disorders. In particular, Symons asks why people injure themselves and whether they feel pain. Conventional wisdom, he notes, is that people who inflict such pain on themselves must not be able to feel it.
“Does self injury hurt?” Symons asks. “And if it does, how do we treat it? The answer to this question we’re exploring is tricky.”
He borrows from many disciplines, including geriatrics, degenerative diseases, pain neuroscience, and the study of infants to find answers. One strategy these disciplines use is observing facial expression, coding changes in the face for objective measures for pain. The facial expression from an act of self injury can be compared to facial expressions during known painful events such as vaccination or a blood draw.
“Every day is a surprise,” says Symons. “I live in a world of mystery…figuring out how to use the scientific tools we have to look at this. It is never dull. Sometimes data I get don’t look like what I or my colleagues predicted.”
Symons does not work alone. His group includes about seven graduate students—Symons received the 2012 Council of Graduate Students Outstanding Faculty Award—as well as department research associates. Each summer, an undergraduate research assistant also gets a unique opportunity to participate in graduate-level work. The three big areas of focus for Symons’ group are self injury, pain, and Rett Syndrome.
The self-injurious behavior (SIB) that they study can be shocking. Chronic SIB may include head banging, biting one’s self, self gouging, and picking, often injuring the same site repeatedly. The impact of this kind of self-injury can be similar to the upper range of a heavyweight boxing punch or karate kick. For some, the self injury can be the equivalent of dropping a three-pound hammer on one’s forehead every second for up to half an hour. It is not known whether this behavior is a cause or consequence of pain. Outcomes can include institutionalization or reinstitutionalization, social stigmatization, and decreased learning opportunities. Those who severely injure themselves can face permanent tissue damage, disfigurement, brain damage, or death.
Above his computer monitor is a quote from naturalist John Muir: When we tug on a single thing in nature, we find it attached to everything else.
“This was not something I could walk away from,” says Symons. “What’s the alternative—not ask the questions? We are trying to ask the tough questions and then get answers to improve outcomes.”
Exploring Rett Syndrome is a convergence of the tracks that interest Symons. This syndrome strikes one in 10,000 people, almost always females, most of whom have lost their verbal skills. About 50 percent are non-ambulatory, and symptoms can include scoliosis and growth failure. Symons has built a collaborative partnership among the University of Minnesota, the state’s parent group known as the Minnesota Rett Syndrome Research Association, and Gillette Children’s Specialty Healthcare and Lifetime Clinics. His observational work involves going into the field—working in schools and group homes.
“Our Rett Syndrome work is grounded in the experience of real people,” he says. “This is academic work with a purpose—a problem with severe consequences. The University has the slogan ‘driven to discover’ and I would add, ‘to make a difference.’”
One of the most satisfying aspects of his career is when parents of children who suffer from SIB give him positive feedback after treatments help their child.
Next for Symons is trying to figure out a better approach to linking the biology of what he sees with behavior.
“Our work has added a biomarker approach, including saliva,” he explains. “There are so many biological markers from saliva, which has practical advantages because it’s not invasive to collect. The tricky part is making sense of how the biomarkers relate to behaviors of a population that’s not verbal.”
Symons was born in Ontario, Canada, and has lived in disparate locales, from Winnipeg and Edmonton to Nashville, Tennessee. His wife, on the faculty at St. Catherine’s University, is from Tampa. Part of the year, Symons is a youth hockey coach. During the summers he plays some golf—albeit “poorly,” he says. He holds up a trophy of a broken doorknob with a yellow sticky note attached.
“There’s an annual golf tournament between Special Education and School Psychology,” he says. “We just got trounced by School Psych—they got the winner’s cup and we got the doorknob—so now my Special Ed colleagues and I have a year to regroup and get the cup back!”