Dyslexia and Arrowsmith Program

Dyslexia and Arrowsmith Program: A Language-Based Disability That Can Require More Than Just Phonological Awareness Training and/or Phonics Remediation

There is no question that early phonological awareness training is critical for children who are learning to read. There is a substantial bank of research available now that shows how important it is to give children this early training in the sound structures of spoken words. The International Dyslexia Association highlights this point, stating that “If children who are dyslexic get effective phonological training in Kindergarten and 1st grade, they will have significantly fewer problems in learning to read at grade level than do children who are not identified or helped until 3rd grade. 74% of the children who are poor readers in 3rd grade remain poor readers in the 9th grade.”

In 1972, I was diagnosed with Severe Developmental Dyslexia. I was in Grade 2. I was not reading. My teachers had tried to use the “whole word” method of teaching reading. They would hold up index cards with words printed on them and then ask the class to look at the word and say it. I would sit at the back of the classroom, looking at the word, waiting for the other children to pronounce it so that I could follow them with my pronunciation milliseconds later. When it was my turn to read on my own I would turn red in the face with embarrassment and look down at the floor. The teacher would move on to the next child.

The child psychiatrist who diagnosed my Dyslexia informed my parents that I should receive an intensive phonics program called Orton-Gillingham. My parents quickly hired a tutor and, over a period of five years, I slowly began to learn to read, although my spelling remained inconsistent for some time. There was no doubt that the Orton-Gillingham program gave me the ability to decode the English language. It was not easy, but I eventually mastered the skill of word decoding. Despite my gains in this area, however, I struggled with spelling, fluency and comprehension for years.

My problems with Dyslexia did not just affect my reading skills. I also had difficulty with auditory memory for phrases of information and instructions. I struggled to acquire a second language as a result of my continued auditory discrimination difficulties. My word findings abilities were weak; thus, my expressive language was weak. As a result, I was quiet and shy as a child and adolescent. The phonics program that I received did not provide the necessary cognitive remediation to improve my weaknesses with language processing, memory and retrieval. I did learn to read – this was critical; however, if there were a way to improve these other language weaknesses that are so often apparent in children with Dyslexia, would one not want to consider this path?

The International Dyslexia Association provides a definition of Dyslexia. It is important to review this definition and to consider the type of intervention that could most directly affect each of the symptoms of Dyslexia highlighted. The association states:

Dyslexia is a language-based learning disability. Dyslexia refers to a cluster of symptoms, which result in people having difficulties with specific language skills, particularly reading. Students with dyslexia usually experience difficulties with other language skills such as spelling, writing, and pronouncing words. Dyslexia affects individuals throughout their lives; however, its impact can change at different stages in a person’s life. It is referred to as a learning disability because dyslexia can make it very difficult for a student to succeed academically in the typical instructional environment, and in its more severe forms, will qualify a student for special education, special accommodations, or extra support services.

The description of Dyslexia continues:

Some dyslexics manage to learn early reading and spelling tasks, especially with excellent instruction, but later experience their most debilitating problems when more complex language skills are required, such as grammar, understanding textbook material, and writing essays.

People with dyslexia can also have problems with spoken language, even after they have been exposed to good language models in their homes and good language instruction in school. They may find it difficult to express themselves clearly, or to fully comprehend what others mean when they speak. Such language problems are often difficult to recognize, but they can lead to major problems in school, in the workplace, and in relating to other people. The effects of dyslexia reach well beyond the classroom.

It is clear that learning problems related to Dyslexia can go far beyond reading and spelling difficulties. Intervention programs for Dyslexia often focus on reading and spelling. The other neurological weaknesses connected with Dyslexia, such as problems with spoken language and the understanding of more complex language, are often not addressed. The child with Dyslexia therefore learns to read and improve spelling ability through the use of a phonics program, but still struggles with reading comprehension, finds it difficult to memorize auditory information and instructions, and has limited expressive language ability.

Researchers now consider Developmental Dyslexia and Specific Language Impairment to actually be the same problem, differing only in severity and developmental stage. A Specific Language Impairment is a developmental disorder than can impact expressive and receptive language. Researchers are discovering that children with Developmental Dyslexia often have the same problems as children with Specific Language Impairments (SLI). Those studying this association have stated that Dyslexia researchers seem to over-emphasize weak phonological processing as the cause of reading difficulties.

In the field of dyslexia, there has been an overwhelming emphasis on poor phonological processing as a cause of reading difficulties. However, study of children with oral language problems indicates that difficulties with semantics, syntax, and discourse will also affect literacy acquisition; in some children (so-called poor comprehenders) these difficulties may occur without any phonological impairment. In more classic cases of SLI, there can be both phonological and nonphonological language impairments that affect learning to read.

As noted previously, oral language problems impact not only literacy, but classroom functioning as well. If a child with Dyslexia struggles with receptive language, he or she may experience significant problems following classroom instructions and understanding general information. If this child has expressive language difficulties he or she may not speak up in class, self-advocate, or share knowledge with peers.

It is also important to note that Dyslexia may be caused by additional neurological deficits not addressed through phonological training. Reading and spelling requires not just sound discrimination processing, but also the ability of the child’s brain to process, memorize and retrieve the orthographic patterns (letter patterns) of words. Researchers have used the term Visual Dyslexia, or Orthographic Dyslexia, to describe children who struggle with this area of neurological functioning. Nathlie Badian in an article entitled: Does a Visual-Orthographic Deficit Contribute to Reading Disability (2005) stated:

In spite of the significant roles of phonological awareness and naming speed in reading development, these two variables leave a considerable proportion of the variance in reading unexplained, which leads to the logical hypothesis that other, unspecified, variables are contributing additional variance to reading. Basic visual-orthographic skills such as the accurate recognition of letter orientation may be among those variables.

Badian continues:

This study indicates that there are some children whose reading development continues to be hampered by a problem in orthographic memory for the orientation of letters (and numerals) long after most children have easily mastered this task. The problems of such children require special attention, but may be overlooked, especially if, as is frequently the case, they also have naming speed and/or phonological awareness deficits.

The cause and symptoms of Dyslexia are quite varied, and depend on the specific neurological strengths and weaknesses of each child. It is important to recognize that phonological awareness training is not the only intervention for students with Dyslexia, and that it does not address all causes and symptoms of Dyslexia. However, as noted at the beginning of this article it is a very important intervention and should be implemented at the early stages of reading instruction. Additionally, phonic-based reading remediation programs are also valuable and provide a critical component of an intervention program.

The problem for children with Dyslexia today is that these intervention programs do not provide all of the necessary cognitive training required to improve language impairments and possible visual-orthographic weakness. In addition, in some cases of severe Dyslexia, the number of neurological deficits may be so significant that a phonics-based reading program may not be immediately helpful for that child. Cognitive training to strengthen these neurological capacities is required prior to the effective utilization of a phonics-based reading program.

The Arrowsmith Program is a unique cognitive training opportunity available to children with Dyslexia and other learning disabilities. The program focuses on the many symptoms of Dyslexia, including the specific language impairments often observed (namely receptive and expressive language problems). The Arrowsmith Program also recognizes the different subtypes of Dyslexia that can exists – auditory, visual, or combined auditory/visual neurological deficits. The primary goal of the program is to improve the underlying neurological dysfunctions that are causing Dyslexia. For example, if a child with Dyslexia struggles with receptive language (i.e. difficulty processing speech sounds, and difficulty processing and memorizing general information and instructions), or expressive language, specific cognitive exercises are implemented to improve that particular neurological capacity.

Many areas of the brain are responsible for success, or difficulty, with reading and spelling ability. Arrowsmith Program assessments first identify which of these neurological functions are weak. The student then works on cognitive activities in order to strengthen these areas. For example, when analyzing the activity of reading, four brain regions are considered including Symbol Recognition (orthographic), Brocas (speech sounds), Lexical Memory (memory for words) and Motor-Symbol Sequencing (visual scanning and tracking of symbols). It has been observed in Arrowsmith Program research that a higher number of neurological weaknesses is correlated with more severe reading disorders. (Please see: http://www.arrowsmithschool.org/images/Arrowsmith_study_11_20_05.pdf.) Additionally, as these neurological weaknesses improve and move to an average range of function, the child begins to develop reading and spelling abilities. Phonics-based programs can then be introduced and the child can further develop reading and spelling skills. The Arrowsmith Program recognizes the importance of teaching the sound/symbol structure of the English language once these neurological deficits are improved. Some children working on the Arrowsmith Program had previously received years of phonics training with little success. The same children, after months of cognitive training, begin to develop reading skills; thus, an increase in neurological capacity was required prior to achieving success with reading.

In summary, the Arrowsmith Program does not focus on one particular reason why children with Dyslexia struggle to read and process language. Rather, the program looks at the neurological functions required for these abilities, and generates a cognitive training program specific to each child’s profile. Recognizing the relationship that exists between strengthening cognitive capacities and the acquisition of skills related to academics is an important step in ensuring that each child’s educational plan is designed for success.

http://www.interdys.org/FAQLearnToRead.htm

http://www.interdys.org/FAQ.htm

http://www.interdys.org/FAQ.htm

Bishop, D., & Snowling, M. (2004) Developmental Dyslexia and Specific Language Impairment: Same or Different? Psychological Bulletin, 130, 6, 858-886.
Bishop, D., & Snowling, M (2004) p. 858

http://findarticles.com/p/articles/mi_qa3809/is_200506/ai_n13644137/

Baden, N. (2005) Does a Visual-Orthographic Deficit Contribute to Reading Disability? Annals of Dyslexia, June 2005.
Baden, N. (2005) Does a Visual-Orthographic Deficit Contribute to Reading Disability? Annals of Dyslexia, June 2005

Reflections on 17th National Conference On Learning Disabilities

October 6th, 2009

Dear Friends and Professionals:

On September 25th, 2009, I had the wonderful opportunity to speak at the 17th National Learning Disabilities Conference in Whitehorse. I was invited to speak on the topic of neuroplasticity and learning disabilities. This was the first ever talk about the impact of brain plasticity findings on the field of Learning Disabilities at a national conference in Canada. Psychologists, principals, teachers and parents were present, as were representatives from Learning Disabilities Associations throughout Canada, including the Learning Disabilities Association of Saskatchewan, which is now offering the Arrowsmith Program in their facility.

I began my presentation discussing how the field of Learning Disabilities has focused on reading difficulties. For decades, the focus of remediation and intervention has been on reading and spelling; thus, research funding and practice have focused in on this area of academic achievement. While it is true that there are many children who have reading-based learning disabilities, this focus means that the other types of learning disabilities that impact school, such as written expression and mathematics, are forgotten. In fact, the schools for children with learning disabilities in BC focus exclusively on reading and spelling intervention. As a result, thousands of children in BC are not being given appropriate cognitive intervention. For example, written expression learning disabilities are the most common type of learning disability. There is little support for children with written expression disorders, other than the use of assistive technology such as a laptop or scribe to bypass their learning problems. Additionally, math-based learning disabilities are another common type of problem for children. There is little cognitive intervention or support, other than extra tutoring and allowing these students to use a calculator. Also, approximately 65% to 80% of children with learning disabilities struggle with social perception. Again, little cognitive intervention is available to help children with this neurological difficulty. Finally, reasoning and critical thinking learning disorders are common for children, and there is no cognitive intervention for children with these learning problems. Those listening to my presentation recognized that this is true in schools today – that the focus has been on reading and spelling intervention and that children with other types of learning problems seldom get the help they so desperately need.

The Arrowsmith Program is the first cognitive remediation system that addresses multiple types of learning disabilities. This was a surprise to many who listened to my presentation, who had looked at the Arrowsmith Program solely as a reading intervention, similar to the programs they had been using for years. For many, this was the first time that they had fully recognized the broad scope and potential of the Arrowsmith program. The fact that the Arrowsmith Program addresses reading, math, written expression, reasoning, memory, spatial thinking, social perception, attention, planning and organization was a novel idea to them.

The Arrowsmith Program, founded on neuroscientific research, involves intensive and graduated mental exercises that are designed to strengthen the underlying weak cognitive capacities that are the source of the learning disabilities. Over 30 years of experience has demonstrated that these affected brain areas can be improved through mental exercises, resulting in increased mental capacities and strengthened learning abilities. Underfunctioning areas of the brain are treated like weak muscles and are intensely stimulated through mental exercises to produce strengthened learning capacities. Research at Arrowsmith School has also shown that when the deficient area is improved, the individual’s ability to perform complex tasks such as reading or writing also improves.

The Arrowsmith Program has conducted research showing positive results of the program, and we are excited about the possibility of more research. I believe that this research will be ongoing and will last more than my life time. I hope that educational researchers and policy makers will embrace the contributions from the field of neuroscience and capitalize on scientists’ abilities to measure the brain during learning activities, thereby enabling educational researchers to measure programs and interventions for students with learning disabilities in a new way. For example, many currently-used reading intervention programs, which have been helpful for many children, lack conclusive empirical evidence on their effectiveness – a finding that was somewhat shocking to many of those listening to my presentation, who had believed that these reading intervention methods had been proven by rigorous scientific study. By recognizing the relationship that neuroscientists and educators can have, new measures can be used to investigate claims made about intervention methods currently being promoted, which may have limited empirical evidence behind them. In short, all of us involved in the education of children with learning disabilities need to continue improving our programs through rigorous scientific research.

Recently, an awareness of how important the relationship between education and neuroscience has resulted in the formation of the International Mind, Brain, and Education Society . One of their mandates is to bridge the gap between education and neuroscience. Current research published in Mind, Brain and Education Journal in March 2009, in an article entitled How Many Brains Does It Take to Build a Scientific Groundwork for Learning and Teaching, investigated the challenges of bringing both educators and neuroscientists together for the common purpose of improving educational practice, stating:

Some educational researchers seemed to perceive neuroscience research as a potential threat to principles about learning established by social science research, which they had built their careers on. Furthermore, only a few education policy makers accepted invitations to our meetings, possibly because some of them were intimidated by arcane neuroscience and some of them saw a political danger related to the concerns of educational researchers. Namely, that education had thus far always used the social sciences (psychology, sociology, philosophy, etc) as reference disciplines and they feared that these disciplines would suddenly be neglected and replaced by neuroscience (p 21).

Despite these challenges, many educators and policy-makers understand that, through advances in neuroscience, great progress in educational methods can be made. Advances in neuroscience increase our understanding of how to create and apply educational methods in order to better serve all students.

The final remarks in my presentation referred to the definition of learning disabilities, which states that a learning disability is lifelong. We are observing through the Arrowsmith Program that this does not always need to be the case. Some children who have completed the Arrowsmith Program are no longer classified as having a learning disability in subsequent psycho-educational assessments. This is due to the fact that their cognitive functions and achievement abilities have improved to the point that there is no longer a significant discrepancy between cognitive/intellectual ability and achievement. Thus, the statement that a learning disability is lifelong needs to be questioned with the brain’s ability to change itself.

In closing, I was grateful for the chance to speak at the 17th National Conference on Learning Disabilities. It is exciting to see the Learning Disabilities Associations throughout Canada interested in implementing the Arrowsmith Program. The success of the LDA Saskatchewan Arrowsmith Program is helping the other associations realize what is possible for children with these broad and diverse disabilities. I hope that educational researchers and policy makers will feel inspired by recent research in neuroscience, and visit Arrowsmith schools to witness for themselves the program in action. The Arrowsmith Program is the first intervention program that has utilized both education practice and neuroscience theory to provide comprehensive brain remediation for children with learning disabilities. It is my belief that so much that can be learned by the combined efforts of educators and neuroscientists, and it is my hope that a continued dialogue will further efforts to advance the field of Learning Disabilities.

Sincerely,

Howard Eaton, Ed.M.

Mayes, S.D., & Calhoun, S.L. (2008) Challenging the Assumptions About the Frequency and Coexistence of Learning Disability Types. School Psychology International, 28, 437-448.

http://www.arrowsmithschool.org/research.htm

Florida Centre for Reading Research: Orton-Gillingham Approach http://www.fcrr.org/FCRRreports/PDF/Orton_Gillingham_Approach.pdf
Florida Centre for Reading Research: Wilson Reading System – http://www.fcrr.org/FCRRReports/PDF/wilson.pdf

http://www.imbes.org/

Chiesa, B., Christoph, V., & Hinton, C. (2009) How Many Brains Does It Take to Build a New Light: Knowledge Management Challenges of a Transdisciplinary Project. Mind, Brain, and Education, 3, 17-26.

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.