Scientific American Podcast Interview on Neuroplasticity

Scientific American correspondent Christie Nicholson interviews journalist Sharon Begley about the changing landscape of brain science.

http://www.sciam.com/podcast/episode.cfm?id=465B1677-E7F2-99DF-36E1378B1640D492

Podcast: Neuroplasticity of the Brain – Interview with Sharon Begley

This is an interesting interview with Sharon Begley who is the author of Train Your Mind, Change Your Brain.  Barbara Lewis, host of Sound Medicine conducts the interview.

http://soundmedicine.iu.edu/segment.php4?seg=1146

Podcast: Power of Plasticity – Interview with Dr. Jeffrey Schwartz and Dr. Norman Doidge

This is an in-depth interview on neuroplasticity with Dr. Jeffrey Schwartz and Dr. Norman Doidge.  See link below:

http://www.abc.net.au/rn/allinthemind/stories/2008/2359328.htm

Broadcast with Dr. Erik Kandel on Memory

This interview with Dr. Erik Kandel focuses on memory, and how memories are formed by the increase in the strength of synapses between neurons and consequential alteration of genes. Dr. Kandel is a leading figure in research on memory and neuroplasticity.  See link below:

http://video.google.com/videoplay?docid=-6962604448570511609&q=tvshow%3ACharlie_Rose&pl=true

Podcast Interview with Dr. Norman Doidge

Dr. Doidge is the author of The Brain That Changes Itself.  The book focuses on the remarkable findings of neuroplasticity, and includes a chapter on Barbara Young who created a cognitive remediation program for children with learning disabilities.  Dr. Ginger Campbell interviews Dr. Doidge in this Podcast.  See link.

http://docartemis.com/brainsciencepodcast/2007/12/14/brain-science-podcast-26-author-norman-doidge-md-discusses-neuroplasticity/

Podcast on Neuroplasticity

Dr. Ginger Campbell does an excellent job reviewing studies conducted on neuroplasticity.  Please see the following link and download Podcast #10 on Neuroplasticity.

http://www.podcastdirectory.com/podshows/1429167

Broadcast on Neuroplasticity

This link will get you to a show produced by Dan Rather on Neuroplasticity.  It is very informative and I encourage you to take a look if you have an interest on the remarkable capacities of the human brain to change.

http://www.hd.net/drr313.html

Reading Disabilities: Is It Just About Phonological Awareness?

We are over-focused on reading disabilities being caused by phonological awareness difficulties.  True, this is a huge aspect of reading, and critical for children.  I do not question the value of this knowledge and the importance of phonological awareness training.  I also do not question how important it is to teach phonics (sound/symbol associations) to all children, especially children with reading disabilities such as Dyslexia.

Here is the problem I would like you to consider.  Not all reading problems are directly related to phonological weaknesses.    There are a significant number of children that struggle with reading due to Symbol Recognition problems.  This term is used by Barbara Young in her Arrowsmith Program.  Symbol recognition relates to the ability to hold language symbols (letters, letter patterns) in the brain and to sequence them quickly.  For children with this weakness they struggle to look at a word, and remember what they just read even within seconds of seeing it previously in another sentence.  Researchers often use the term Visual Dyslexics to describe this type of reading failure.  When a child with this Symbol Recognition problem tries to spell, they use phonetic spelling most frequently.  They might spell the word “people” as “peple”, or spell the word “done” as “dun”.  Their brain struggles to retrieve the visual memory for words.  Reading is often very slow and laborious as their brain tries to identify the letter patterns and associate them to a sound.

Children may also struggle with reading due to slow reading speed.  That is, they can decode words and understand what they are reading, but it takes them forever to get through one page.  This often results in a child that doesn’t want to read.  Of course, this is a huge problem, as they avoid reading in school resulting in lower grades as they do not have as much exposure to content.  Educators do not focus on this problem enough – in fact, this may be the primary reason for school underachievement in many adolescences at the high school level – along with comprehension problems.  Again, we can improve reading speed through cognitive remediation.

Comprehension is another area of reading that is overlooked in terms of remediation at the elementary and high school level.  Asking a child to read a textbook and comprehend what the author(s) are trying to communicate is not an easy task.  It requires the sequencing and comprehension of numerous concepts being introduced to the reader.  In one paragraph there may be six concepts being interrelated to each other, and associated with other paragraphs previously read by the student.  If a child has trouble understanding concepts, and comparing concepts with other concepts, reading failure will be automatic.  These students often require tutors for each of their key subject areas.  This is done in order to re-teach the subject material to the child.  Children with this problem often try to utilize memory to get through their classes successfully.  They will study for hours trying to remember facts, dates or answers to questions, but not truly understand what they are learning.  It is sad, really – that this happens to students daily in our schools today.  Can we train the brain to improve conceptual thinking?  In short, yes.

Reading failure can also be a result of a combination, or all, of these neurological weaknesses.  If a child has all of these neurological weakness (i.e., phonological, symbol recognition, visual tracking, conceptual reasoning) than reading failure is even more problematic.  Teachers and parents need to be aware of how complex reading really is.

A More Complex Understanding of Learning Differences

It is important that parents, educators, psychologist, psychiatrist and medical doctors begin to understand that a child’s neurological profile is much more complex than we are currently conceptualizing.  Today, we often analyze a child’s success or failure in school by trying to understand their current levels of reading, writing and math ability.  Is that child a grade 2 reader?  Is that child who is in Grade 5 able to do Grade 5 math, or is that child at a Grade 2 level.  This information is of course valuable to know, as we don’t want to teach at a level above that current child’s achievement levels.  But, is this really giving us an insight into how to best deal with this child’s weak achievement skills?

Let’s take mathematics for example.  We will create a fictitious child named, Trevor.  Let’s say Trevor is in Grade 6.  He has good attention abilities,  has a happy family life and loves participating and watching sports.  Unfortunately, Trevor is struggling with math and often struggles to understand peer relationships.  The parents are worried, the teacher is worried.  The school recommends an assessment or psycho-educational assessment.  This will help the teachers and parents understand what is going on with Trevor.  The school psychologist performs the assessment several months later and discovers that indeed Trevor is below grade level in math, and from interviewing Trevor and his teachers, is struggling with peer relationships.  A meeting takes place where the psychologist reports these findings and emphasizes that indeed Trevor has a learning disability in Math.  This is due to Trevor having average intelligence, but performing well below grade level in math.  The psychologist notes that math is difficult, because Trevor is struggling with math concepts and makes careless mistakes when he performs calculations on paper.  The psychologist is not sure why Trevor is struggling socially, but recommends counseling and help from the teacher to form friendships.  The teacher is grateful for the assessment as now Trevor can get Learning Assistance for math, and she does not have to worry as much about his struggles in this subject. She will also do her best to help Trevor socially, but she knows she has tried over the last 3 months of school.  The parents are happy to get learning assistance help, as is thankful to the school for helping out and caring about Trevor.  Success!

Here is the problem with this approach to assessment and remediation.  First, we still do not understand neurologically why Trevor struggles with math.  We know he is below grade level, but why?  Was it bad teaching?  Was Trevor not trying?  What is going on?  Second, Trevor struggles with math and will get small group help in Learning Assistance, but will this end his problems in mathematics?  Will Trevor not continue to struggle with math for the rest of his life?  Will he need Learning Assistance for the rest of his education for mathematics?  Finally, how are we going to help Trevor with social skills.  The teacher noted that she has tried to help him, but it doesn’t work.  Trevor is actually becoming anxious about this problem, and struggles to fall asleep at night.  In fact, it is causing him to loose focus in class due to the his lack of sleep and nervousness.  His struggles with social perception may in fact be more serious than his math problems.

This is where an understanding of neurodevelopment makes a huge difference in understanding the complexity of learning differences and also in how we might remediation these cognitive weaknesses.   Mathematics requires good conceptual thinking abilities.  As well, the brain needs to be capable of manipulating and sequencing numerical information quickly.  If the child struggles with understanding cause and effect or seeing patterns in concepts, one can almost guarantee that math problem solving will be weak.  In fact, even reading comprehension can become problematic – as this achievement ability requires cause and effect thinking.  With this understanding we can then target cognitive remediation for these areas of the brain.  For example, Barbara Young created a cognitive exercise that builds the brains ability to form and relate concepts to each other.  This exercise, within the Arrowsmith Program, is called Symbolic Relations or Clocks.  The child might spend one to three years working on this cognitive exercise slowly building this capacity in the brain.  After moving this area of neurological functioning to the average range the child begins to find math problem solving and reading comprehension less problematic.  As well, Barbara Young created a cognitive exercise that helps a child build mental math sequencing abilities.  This again, can take one to three years to complete based on the child’s initial level of neurological weakness.

As a result of this intervention, over a period of one to three years, mathematics becomes easy to grasp.  Trevor would not require Learning Assistance, instead he will get the concepts taught in class and be capable of doing his own homework without tutoring.

In terms of social perception, we are also realizing that the brain can improve this area of functioning.  Instead of just hoping the child can deal with his peers, and trying to avoid possible social conflicts, we can now directly remediate this region of the brain.  Again, the Arrowsmith Program can provide cognitive exercises that get children to study social situations and begin to analyze them effectively.  As well, the child can begin to build object recognition abilities, that can interfer with accurate perceptions of social scenes.  In short, the child develops the area of the brain involved with social perception.  Over a period of years Trevor could begin to grasp the social world around him with more accuracy and thus reducing his own anxiety, likely improving his sleep patterns.

Trevor would normally be diagnosed with a Math Learning Disability.  What is actually accurate is that Trevor has significant neurodevelopmental weaknesses with conceptual thinking, numerical sequencing, social perception and object recognition.  These are real neurological functions in the brain.  If we just give the label and then try to help Trevor bypass his problems (i.e., with a calculator, and extra tutoring) we are not directly resolving the brain dysfunctions.  Thus, in our current model of understanding, assessing and remediating Learning Disabilities, Trevor would continue struggling for the rest of his life with mathematics.  By assessing neurological profiles and matching that with cognitive remediation Trevor would be able to handle mathematics independently and even seek careers that require mathmatical understanding.  In addition, by understanding that social perception accuracy is also a neurological function, we can develop these areas of the brain to function normally.

The key to this neurological change is the understanding of brain neuroplasticity.  That is, that the brain can change and is not fixed.  There is an ever increasing amount of research highlight just how neuroplastic our brain is.

Assessment of Children with Learning Disabilities

Parents are usually the ones to first identify that a problem at school is apparent.  This is due to the child’s dropping self-esteem that shows up at home, or the child refusing to go to school and not letting the parent know why.  Yes, teachers can also be the first to identify a problem, but parents are often the ones who see the emotional shifts showing up at home in their child.

The parent then approaches the teacher and asks them for advice.  Teachers can respond in a variety of ways including agreeing with the parent, or saying the problem is not significant and could be just a developmental issue.  The use of the word developmental often relates to the teachers opinion that time will take care of the issue and the child will slowly develop the abilities necessary to be successful at school. One just has to be patient, and things will get better.  Other teachers might agree with the parent, and begin the process to see if the child can be assessed for possible learning problems.  Depending if you live in Canada or the United States, and depending what province or state you live in, a sequence of events take place to monitor the child’s progress and to determine if assessment is necessary.

At some point, some of these children are assessed either by the school system or privately.  Most often the child is in Grades 3, 4 or 5 by now, and struggling with the work load at school, and likely underachieving in basic skills.  A date is set for the assessment.  A psychologist or educational assessor will conduct a series of tests to identify possibly learning difficulties.  In terms of the assessments used, this often includes a measure of intelligence, cognitive ability and achievement.  The intelligence measure is used as the definition of Learning Disabilities North American wide includes the fact that a child needs to have at least average IQ to be classified or diagnosed with a Learning Disability.  As well, discrepancies, or differences within measures, are used with IQ tests and measures of achievement (reading, writing, spelling and math).  That is, if the child has average IQ then they need achievement scores well below what is considered average intelligence in order to also be classified as having a learning disability.  The psychologist or educational assessor will then determine achievement levels by administering tests of reading, writing and math.

If the child has a learning disability the assessor will report that in the full report (i.e., psycho-educational assessment).  At a meeting the psychologist or assessor will tell the parents and teaching/administration staff whether the child meets the local district or states definition of a learning disability. If the child does have a learning disability than services are discussed with the parent.  This may include some kind of pull-out special education service such as small group reading instruction, study-skills support, learning resource help and accommodations such as extra time on tests, scribe to help with writing, or use of technology – like a laptop to be used in class.  The focus on this meeting is how to help the child bypass the weaknesses that result in the learning problems.

This method of assessment is flawed.  First, the assessment is often brief.  Psychologist or educational assessors are not given enough time to really assess the child’s learning profile.  They often are permitted two or three hours of testing – just enough time to do an IQ test and achievement measures to determine if a diagnosis is possible.  Thus, many areas of brain functioning are not assessed.  This provides an inaccurate assessment of the child’s ability to learn, and can miss key neurological weaknesses that will impact the child’s ability to succeed in the regular classroom – such as Oral Language functioning or Social Perception skills.  This is not the fault of the psychologist or assessor, but rather the limits put on these individuals to spend time with the child.  The second reason that this method of assessment is flawed is that it does not lead to appropriate remediation of the learning disability.  The focus of the assessment is to diagnose the problem in order to get the funding necessary to provide the staffing necessary to support the bypass techniques used in the school.  The assessment is not designed to pinpoint the neurological weaknesses and then to create a program to directly remediate them.  Learning disabilities result from neurological weaknesses in the brain, in fact this is part of the definition of Learning Disabilities used thoroughout North America.  If we can identify these neurological weaknesses do we have to tools to improve these brain functions?  Yes, there are now cognitive remediation programs that can do this directly.  The third reason that the current method of assessment is flawed is based on the reality of IQ testing.  Again, to diagnose a learning disability a child needs average IQ.  What is interesting about IQ is that it is alterable – it can change depending on the child’s environment.  That is, the brain is plastic and can improve capacities such as language processing, visual-perceptual thinking, working memory and visual processing speed.  These are measures tested on most IQ batteries.  If a child is tested and comes out having a Low-Average IQ (not Average) does that mean the child should not be diagnosed with a Learning Disability, and thus not receive special education services?  What if we can provide cognitive remediation to improve brain functioning and thus raise that child’s IQ?  Should we not rethink the use of IQ testing and assessment all together, and rather figure out how to determine what child can best respond to cognitive remediation training.

Assessment practice should be directly linked to remediation, and not be designed for labelling and funding, which it often is today in schools across North America.  As well, we need to realize that assessment should be focused on cognitive functioning and how to improve these weaknesses in children that underly the reason for the existence of learning disabilities in the first place.  If we focus on the assessment of reading, writing and math we are in reality missing the underlying reason that learning disabilities exists in the first place.