The intervention programs available to children with learning disabilities are numerous. In the city of Vancouver, for example, students with learning disabilities are offered a variety of services, from tutors and typing programs, to organizational coaches and occupational therapists. Parents who watch their child struggling in school often request an assessment from a school psychologist or seek a private assessment from a registered psychologist. The psychologist then analyzes the student’s profile and makes program or referral recommendations. Due to the breadth of learning disability subtypes the number of recommendations can be numerous. It can be difficult for parents and teachers to both plan out, and then implement, the many recommendations from these psycho-educational assessments.
The questions I get from parents and professionals are: how does the Arrowsmith Program fit into the array of services already available, and, how could the Arrowsmith Program help students in conjunction with other programs currently being offered? I hope this article provides some clarity on these matters. The key concept is that the Arrowsmith Program works in conjunction with other programs. My focus is working together toward a common goal of improving the educational and life outcomes of individuals with learning disabilities and attention disorders.
The Arrowsmith Program is a relatively new intervention method available in Vancouver for students with learning disabilities and attention difficulties (although it has been available in Toronto for over 30 years). The Arrowsmith Program focuses on improving the underlying cognitive weaknesses that cause learning disorders. In short, it works on improving the neurological dysfunctions that hinder the acquisition of achievement skills or learning in a classroom environment, including social perception and life functioning.
Take the act of reading for example. The Arrowsmith Program targets brain regions that are involved with the acquisition of this skill. Areas in the brain that recognize letter symbols, process speech sounds, scan visual symbols and increase reasoning ability are targeted for neurological improvement. The Arrowsmith Program itself does not explicitly teach sound/symbol letter patterns in the English language; rather, once the neurological areas for reading acquisition are improved, the student can be introduced to sound/symbol letter patterns through various reading programs available and is now neurologically capable of acquiring reading skills such as decoding and comprehension. This is just one example of how the Arrowsmith Program focuses on improving the neurological weaknesses which contribute to learning disorders. Additional areas of weakness are also targeted with the same focus on the improving neurological ability to acquire language, motor abilities, social skills, reasoning, attention control, planning and organizational ability, and math and written expression skills.
By strengthening the foundation of the underlying neurological capacities, The Arrowsmith Program lays the groundwork for other services which build academic skills. In harmonizing the Arrowsmith Program with achievement-based intervention programs, professionals in the field of Learning Disabilities can work together to improve the educational outcomes of students with Learning Disorders. Following is a discussion of various intervention programs and an outline of how the Arrowsmith Program strengthens cognitive capacities, creating a foundation that allows students to benefit from the services described below.
1) Classroom Teacher Support
Being able to function in a classroom environment is no easy accomplishment. Teachers deal with large numbers of students, with each student having a unique neurological profile. Often the teacher needs to instruct to the average student. That is, they have to sense what the average rate of acquisition is in their student body. If a child learns more quickly, the teacher might provide some form of enrichment. If the child learns at a slower pace, significant complications can exist in both instructional practice and ability to find solutions for that child.
When I was conducting psycho-educational assessments, I found that the majority of children with learning disabilities struggled in classrooms not because of a reading disorder, but because of other types of learning disabilities. This may sound shocking as our interventions for children with learning disabilities had historically focused on reading remediation. The psycho-educational practice taught me that slow cognitive processing, weak memory for instructions and slow reasoning ability often resulted in the student’s academic difficulties. The combination of these neurological weaknesses meant that a student fell behind in class and could not understand what was going on, resulting in the student’s parents often needing to re-teach the subject or to hire a tutor.
Interestingly, many students in private schools for children with learning disabilities are placed in small classrooms and given multisensory instruction and compensation methods to improve their chance of understanding the curriculum, often in a modified program. This often works successfully, but only during the time that they attend these schools. Once students re-enter the regular education environment or move on to post-secondary education, these underlying neurological weaknesses reappear, making learning increasingly frustrating. In fact, these underlying neurological weaknesses with cognitive processing speed, memory for information and reasoning ability can also affect employment options.
A neurological intervention to improve these specific learning dysfunctions enables students to re-enter the regular education environment without the primary reasons for their academic difficulties; thus facilitating the acquisition of academic skills. A student with weak reasoning, or cause and effect understanding, works on brain exercises that increase the efficiency of this neurological function. The student who reads slowly, takes longer to get thoughts on paper or struggles to retain auditory information will work on brain exercises that increase the efficiency of these neurological functions. The Arrowsmith Program does not bypass these neurological weaknesses; rather, the Arrowsmith Program asks: why teach the majority of the curriculum until a student has the neurological capacity to actually learn and retain that material? The Eaton Arrowsmith School is, on average, a 3 to 4 year intervention program. Once students complete their neurological interventions, they re-enter the mainstream school without the need for accommodations or program modifications and ultimately have many more options regarding post-secondary education and employment opportunities.
2) Attention Deficit Hyperactivity Disorder (ADHD) Specialists
The number of children diagnosed with ADHD is significant. When I was conducting psycho-educational assessments, roughly 30% of the children diagnosed with Learning Disabilities also had symptoms of ADHD. I would often refer them to a medical doctor that specialized in ADHD. The outcome was often the diagnosis of ADHD with intervention consisting of stimulant medication. For many children with the diagnosis of ADHD the results were positive. In fact, the medication helped them at school and home.
There were those cases where the medical doctor was unsure of the diagnosis of ADHD. As well, I would be puzzled as I was unsure as to whether the ADHD was the primary problem or a secondary result of the severity of the learning disability that was also diagnosed. For example, if one has trouble with written output and cannot listen to information without losing it in memory would one not exhibit ADHD-like behaviours?
Providing neurological remediation will help to determine if the ADHD symptoms are primary or secondary. Through the Arrowsmith Program a student can work on improving the underlying neurological weaknesses that are causing learning problems. Once these neurological weaknesses are moved to or close to the average range of functioning the signs of ADHD will either be eliminated altogether or remain constant. For example, many students who start the Arrowsmith Program while taking stimulant medication for ADHD are able to stop taking the medication within one to two years.
That is, they no longer need the stimulant medication as the ADHD cause was in fact the combination of their neurological weaknesses unrelated to attention. The child may have had neurological weaknesses with memory for information, visual-motor copying when printing or writing from the board and struggles with reasoning. Once these neurological functions are strengthened, the student no longer exhibits signs of attention related problems. It is also true that some of the children who come in with ADHD need to continue with stimulant medications even after Arrowsmith Program intervention. This is due to the fact that the ADHD is indeed a primary problem and not a result of a combination of other neurological weaknesses resulting in a learning disability. In cases such as this the ADHD stands alone and requires ongoing medical intervention.
Medical doctors, teachers, psychologists and parents can work with the Arrowsmith Program to determine if the ADHD diagnosis is a primary or secondary concern. Many children that are currently taking stimulant medication for ADHD may not require this form of intervention if indeed the cause of their ADHD symptoms is due to underlying neurological weaknesses related to a learning disability. This can be a wonderful partnership in order to determine the underlying causes of attention disorders in children.
3) Speech-Language Pathologists
Remediation of speech-language dysfunctions requires intensive and repetitive intervention. The Arrowsmith Program can be used both in tandem with, and/or as a foundation preparing a student for, work with a Speech-Language Pathologist. Through the use of specific and systematic interventions designed to target the weaker areas of the brain, the Arrowsmith Program can strengthen the cognitive abilities required for improvement in speech-language capacities. For example, the Arrowsmith Program can be utilized to improve a child’s ability to discriminate speech sounds. Additionally, this program can be used for children with weak memory for information and instructions, and for children who struggle to express ideas.
Children working in the Arrowsmith Program are required to work on cognitive exercises with high levels of active engagement, and need to master specific levels of difficulty in order to move these areas of cognitive weakness into the average range of functioning. The progress made by these students is constantly monitored by teachers in order to ensure that they are not using bypass strategies. (Use of a bypass strategy would enable the student to complete the exercise without targeting the area of weakness.) After a child has completed the Arrowsmith Program Speech-Language Pathologists can continue with further intervention to teach language skills.
4) Orton-Gillingham Tutoring
I was trained as an Orton-Gillingham Tutor during my graduate school training at Boston University. I took a summer course at the Kildonan School by Diana Hanbury King. I tutored at their summer camp, Camp Dunnabeck, and then at Fraser Academy in Vancouver. I also served on the BC Dyslexia Branch organizing conferences that often had an underlying focus on the Orton-Gillingham method.
I observed success using this method of reading and spelling intervention for the students I was tutoring. Nevertheless, there were some students who did not respond as well to the Orton-Gillingham method. Progress was slow for some students. I also recognized this when working with registered psychologists conducting psycho-educational assessments. Parents who had hired an Orton-Gillingham tutor for over two or three years were noticing slow progress. Of course, there were many cases where we saw significant progress, however, it was puzzling, even to private schools in the Vancouver area that use the Orton-Gillingham method, that some children with Dyslexia were not progressing using this method of reading and spelling intervention.
The Arrowsmith Program appreciates reading remediation programs as they are often necessary to help children to acquire the code of the English language. What is evident in the research conducted with the Arrowsmith Program is that some children with Dyslexia first need to improve the underlying neurological functions used to acquire reading and spelling skills. A student attending the Arrowsmith Program will spend hours on improving the cognitive area related to the ability to learn sound-symbol correspondence, automatic visual recognition and memory of symbols and ability to scan visual symbols. Thus, when it is time to introduce the sound/symbol system of the English language, using the Orton-Gillingham or Wilson Reading Program, the acquisition rate is much faster.
In summary, those using the Orton-Gillingham method should consider the Arrowsmith Program if the child they are working with is making slow or little progress. The child can then be referred back to an Orton-Gillingham tutor or school using this method once the neurological intervention has taken place. It is also clear that children with reading disorders often have multiple learning disabilities including such areas as written expression, reasoning, visual-motor integration and memory for information and instruction. If this is the case the Arrowsmith Program can assist in the areas that the Orton-Gillingham practitioner cannot offer assistance.
5) Occupational Therapist
Occupational Therapists know how important it is to improve the motor abilities of children with various learning disabilities. They spend countless hours assessing fine and gross motor abilities in children. The Arrowsmith Program can support Occupational Therapist by providing motor dysfunction remediation in children with learning disabilities before and/or during the child’s work with the Occupational Therapists. Errors in written expression such as miscopying, irregular spelling, careless written errors in mathematics, overall poor written performance and handwriting ability can be improved through Arrowsmith’s brain exercises, which target the motor systems of the brain. Specific cognitive exercises in the Arrowsmith Program suite can also improve gross motor and kinesthetic abilities such as body awareness in space and the recognition of objects by touch. Once the Arrowsmith Program is complete the Occupational Therapist can provide additional support in developing fine and gross motor abilities; thus, Occupational Therapists could recommend the Arrowsmith Program for the children they work with who require intensive intervention.
6) Social Skills Training Practitioners
Children with learning disabilities often struggle with social acceptance. Research highlights the fact that a majority of children with learning disabilities struggle to make friends, can be bullied and are often isolated from peers at school. As a result, self-esteem can be low and there can be an increase in possible psychological problems such as anxiety and depression. The need to improve social perception should not be understated.
To my knowledge, there are no programs that target brain areas involved in social perception in order to improve the child’s capacity to make sense of the world around them. Rather, the focus is on self-help groups or counselling with a therapist. We often tell the child to be proud of their strengths and realize that we all have weaknesses. We hope that this provides enough encouragement for the child to accept their differences and not take social rejection as heavily as they do. In some cases group therapy or individual counselling can help a child with a learning disability.
When I worked on conducting psycho-educational assessments I had many parents ask me what they could do to improve their child’s social skills. I often made recommendations to group therapy or individualized counselling. I mentioned that teaching their child to be a good self-advocate would also be beneficial. What I did not have available to me was a brain remediation program that focused on improving the underlying neurological weaknesses that caused the social skill deficits in the first place.
The Arrowsmith Program can in fact help counsellors, psychologists and psychiatrists in these situations. The Arrowsmith Program is the only remediation system that offers the ability to improve the underlying neurological functions related to social perception. Children with social perception weaknesses have to work on brain exercises that make them interpret facial cues and social pragmatics along with the various social environments in which they are found. This builds the capacity of that child to both improve social perception and to increase social skills. The child can then better work with counsellors, psychologists and psychiatrists. The ability to improve social perception is extremely important; the child who is unable to cope socially is at a significant disadvantage for a successful life outcome.
7) School Psychologists and Registered Psychologists
Psychologists spend countless hours meeting with teachers, parents and students. They have keen insights into why a child might be struggling at school. They are often knowledgeable about intelligence, cognitive ability and achievement skills. They are aware of the emotional disorders that can get in the way of successful school outcomes.
When a child is struggling in school the psychologist is asked to conduct a psycho-educational assessment. The psychologist will often first talk to the team of teachers working with that child, and also consult with the parent. The psycho-educational assessment often consists of measures of intelligence, cognitive ability and achievement skills. If the assessment shows discrepancies between ability (intelligence/cognitive levels) and achievement (reading, writing, spelling and math) then the identification of a learning disability may occur. The psychologist will then make recommendations to the school and parent.
When I was involved in conducting psycho-educational assessments, my primary goal after identification of a disability was to ensure the correct services were available to help that child succeed in school. I connected with the private schools in Vancouver that dealt directly with students with learning disabilities. I worked to gain an understanding of the speech-language and occupational therapy services available in town. I also got to know reading and math tutors and the variety of methods they used in order to help the children they were working with. For ADHD, it was key to know medical doctors that understood this condition and knew the various stimulant medications available. I also familiarized myself with those involved in providing natural supplements to improve attention control and with those involved in neurobiofeedback therapy for ADHD. It was key to fully understand the supports available. The parents found an assortment of success, partial-successes and no success with the variety of options I made available to them. What was apparent to me is that there was no one method that seemed to be the magic answer. Each child responded differently to the various intervention methods available to them. This makes sense, as each child’s brain is so uniquely different. We are really still learning how the brain responds to the variety of interventions available to them.
The Arrowsmith Program provides another remediation option to the variety of learning disabilities that exist. For example, when I assessed a child and found that he had a non-verbal learning disorder there were few options I could consider. This child would often struggle with mathematics, written expression and social perception. They also showed significant academic frustrations when they got to the higher grades where conceptual reasoning was more prominent. No longer could they trust their memory to do well on tests or exams. I could recommend a math tutor, use of a laptop and social skills training with group therapy. This provided some help. The Arrowsmith Program is the first available cognitive remediation program that improves the brain’s capacity to acquire math skills, get thoughts on paper fluently and to understand social interactions. As well, it provides the child with non-verbal learning disorders that capacity to reason efficiently, thereby improving math problem solving skills and reading comprehension. This is one example of a service that was not available to children with non-verbal learning disorders prior to the Arrowsmith Program’s arrival in Vancouver.
In addition, children with severe language impairments were often struggling to receive cognitive remediation. The Arrowsmith Program is the first program that I know of that address the underlying cognitive problems. Children can work on speech pronunciation weaknesses, oral language processing and memory, and expressive language deficits.
The Arrowsmith Program can also provide an intensive cognitive remediation program for children with visual-motor integration or motor symbol-sequencing deficits. These particular deficits can lead to written expression learning disabilities. Occupational therapists are well aware of the large number of children struggling in school due to these neurological deficits. In fact, research shows that this is the most common type of learning disorder in North America. Children with this disability require intensive and repetitive cognitive exercises that improve motor-symbol sequencing required for printing and copying. Interestingly, as the Arrowsmith Program points out, these children may also struggle with speech, careless errors in mathematics and can be slow readers. The Arrowsmith Program has discovered over the last 30 years that, through cognitive exercises, these learning functions can be improved.
Finally, it is interesting to note that the definition of a learning disability seems to exclude reasoning problems as a cause of a learning disability. The Learning Disability Association of Canada (LDAC) definition states that, “These disorders affect learning in individuals who otherwise demonstrate at least average abilities essential for thinking and/or reasoning.” What I have learned in conducting psycho-educational assessments is that many of these children diagnosed as having a learning disability showed significant reasoning problems. What LDAC was trying to state was that these children often have average intelligence. Intelligence is a different concept than reasoning, although LDAC appears to use the terms as one and the same. Reasoning deficits are clearly a significant issue for children with learning disabilities. Psychologists might see it on measures of intelligence such as Matrix Reasoning, or on the Woodcock-Johnson Tests of Cognitive Ability measure of Fluid Reasoning or Conceptual Reasoning. Again, for the first time in Vancouver children with reasoning deficits can receive the necessary cognitive remediation through the Arrowsmith Program, thereby improving their capacity to reason. Cause and effect problem solving becomes more fluent and accurate. In turn, achievement areas such as reading comprehension and math problem solving improve without direct instruction and without tutoring or the use of workbooks on reading comprehension or math problem solving.
When I was conducting psycho-educational assessments these cognitive remediation services were not available to my clients. The Arrowsmith Program now is available in Vancouver, so that children struggling with these particular learning disability subtypes can receive the intensive remediation they so badly need.
Summary
The Arrowsmith Program can assist a number of educational and medical professionals that work with children with learning disabilities and attention disorders. Professionals who have worked with Arrowsmith students have found that, as students’ capacities increased, learning occurred at a more rapid pace and was a more rewarding experience. The focus of the Arrowsmith Program is on identifying specific neurological weaknesses and remediating them through brain exercises. This improvement in neurological functioning can then improve the intervention delivered by other professionals working with children struggling in school.
