APD: What It Is and What You Can Do About It

Tuesday, August 30, 2016 - 08:00
  • Kristina Birdsong

What is APD?What is Auditory Processing Disorder?

APD stands for Auditory Processing Disorder, a disorder that affects about 2-5% of the population.

Auditory Processing Disorder occurs when the ears send imprecise information to the brain. This may mean a mixing up of similar words like “fair” and “hair” or “let” and “wet.” It may also mean an inability to filter out other sounds. Imagine hearing only the last part of the word. You may not immediately understand, and you will need some time to use contextual clues to figure out the speaker’s intended meaning.

Auditory processing difficulty may result in the inability to remember the first part of a sentence or a list. Especially if there are distractions, listening can prove difficult and overwhelming. Imagine being in a loud, crowded room. A fan whirring nearby or a blender grinding fruit, or even a collective buzz of other voices can interfere with reception of sound. While people without APD can target the specific sound they want to hear, those with APD hear everything at once and at the same decibel, like a carnival of noise where no one sound can be isolated or deciphered. Children with APD haven’t yet learned how to cope when all the sounds are muddled or when information gets lost before it can be stored properly in the brain for immediate retrieval.

APD can be especially challenging in conversation because someone with APD may not receive extra time from others, which often creates feelings of frustration and confusion. A child with APD may stop listening altogether if it proves too difficult, time-consuming, or overwhelming. They simply avoid the burden of asking questions to understand a conversation that’s moving much too fast.

What Auditory Processing Disorder is not

Because of the particular challenges APD presents, it often goes undiagnosed. Also, commonly, a child’s auditory processing deficits are mistakenly attributed to other disorders or are dismissed as intentional poor behavior. Here is a list of some of the most common assumptions made about a child's behavior that is undiagnosed with APD.

A child with APD may be (mistakenly) thought to have:

  • Attention Deficit Disorder (ADD)
  • Attention Deficit Hyperactivity Disorder (ADHD)
  • Autism
  • Deafness
  • Lack of intelligence
  • Willful stubbornness
  • Voluntary defiance

A child with APD may also possess any of these problems, but it is important to consider these symptoms as signs of APD so we can properly diagnose APD and work to minimize its effects.

A child may have APD if he or she exhibits the following signs:

  • Trouble paying attention
  • Trouble following directions
  • Low academic performance
  • Behavior problems
  • Poor reading and vocabulary

What should you do if you suspect APD?

If you suspect that a child or student has APD, you can have them tested by an audiologist and also rule out some of these other issues. The American Speech Hearing Association indicates most APD testing requires children to be at least 7 or 8. Often, audiologists recommend retesting around age 12 because test results can be skewed by younger childrens' brain variability. The important thing to remember is that with an accurate diagnosis, even despite the challenges APD presents for children, there are viable treatments and accommodations available.

What can you do about APD?

  1. Use an evidence-based intervention to build processing speed. Studies have shown that the Fast ForWord program actually changes the brain’s ability to process auditory information, which results in lasting and meaningful achievement.
  2. Use visual cues to aid in understanding. Providing some context by using another learning mode can soften the stress a child may feel since words are often overwhelming.
  3. Give time to think and answer. Patience goes a long way in helping children understand because it gives them a moment to put the pieces of the puzzle together.
  4. Read aloud regularly. Have your child or students follow along and practice sounding out the words after you say them. By reading aloud and using clear language, you can have a direct role in the improvement of language acquisition, reading ability, and auditory processing.
  5. Enunciate words and check for understanding. Often, parents and teachers make assumptions about why a child won’t answer a question or why they seem obstinate. APD can be especially challenging because it is impossible to truly know what the child hears. By asking a child to repeat your request or to answer in context, you can know whether or not he/she hears you accurately.

Most kids want to please, and they are truly trying their best even when that may not appear to be the case. By giving each child the benefit of the doubt and choosing kindness first, you will build a loving connection. An emotionally safe environment encourages children to put fears aside, and when they do this, they will be better equipped to focus on learning.

 

How to Improve Auditory Processing Speed Using Fast ForWord

Tuesday, June 28, 2016 - 08:00
  • Ann Osterling, MA CCC-SLP

Sky GymDr. Paula Tallal, one of the premier cognitive neuroscientists in the nation, started out researching the cause of language impairments in children. As most parents and specialists in language know, language is a naturally acquired skill, similar to walking. All a baby needs is to hear language spoken around them and they will begin talking. But some children are not able to do this easily or naturally. Dr Tallal was interested in why that might happen. She originally hypothesized that children who develop language slowly might have problems with underlying sequencing skills, since words and grammar depend on getting the sequence correct – for example perceiving the difference between spot and pots requires putting the /s/ sound into the word in the correct sequence. To test this she had children with and without language problems sequence tones to see if that could be a basic skill that would differentiate children having trouble learning language. She noticed that learners with no language difficulties could sequence two sounds very easily no matter how quickly they occurred in time, but children with language problems had difficulty sequencing sounds only when they occurred quickly, not slowly. This blog post explains how Fast ForWord can train struggling learners in rapid auditory sequencing tasks through exercises called Sky Gym and Jumper Gym.

What are Sky Gym and Jumper Gym?

Sky Gym and Jumper Gym are the names of exercises in Fast ForWord that help improve the speed at which a participant identifies and understands rapid, successive changes in sound (listening accuracy), and the ability to recognize and remember the order in which a series of sounds is presented (auditory sequencing).

The object of these exercises is to correctly identify sequences of two to five sound sweeps.

Struggling in Sky Gym/Jumper Gym? That’s actually a good sign.

These exercises are incredibly powerful and important training tools – but they're also considered two of the hardest exercises in Fast ForWord. These exercises were the topic of many discussions (online and in person) in the early days. It's easy for some of us, like me, to forget that there are many new Fast ForWord providers and coaches who don’t have this background. I truly know of no other way to improve the speed of auditory processing skills. 

A little background.

The inclusion of these tone-sequencing exercises in the Fast ForWord products goes back to the 1970's when Dr. Paula Tallal did research that showed how individuals with a Specific Language Impairment (SLI) had problems processing auditory information if it was presented for too short of a time and/or presented too soon after another auditory stimulus. But, if the auditory stimulus (a tone) was given for a longer period of time, these people could get it.  Their errors on the rapid tones weren't a cognitive or “not smart enough” issue, but due to the fact that the information was presented too quickly. Kind of like when we hear people speaking a language that is not our native language, we always think they speak "too fast.” Another way to make these listening tasks easier for a person with SLI (which is probably an auditory processing problem) is to present one tone, and then have a longer period of time in between the first and second tone. So, Dr. Paula Tallal's research in the 70's identified a core underlying problem for people with auditory processing issues. 

Meanwhile, in Dr. Michael Merzenich's labs, more and more research was being done that proved neuroplasticity existed beyond the initial critical window of development. He was also in the process of discovering the most efficient ways to train the brain to learn new information. 

In the 1990's, Tallal and Merzenich began discussing how to improve the ability to understand spoken language if you had SLI, auditory processing problems or dyslexia. Dr. Tallal wondered if a device could be worn that would stretch out the speech to make it longer. Dr. Merzenich told her that the brain could actually be trained to learn to process these rapid sounds by using the principles of neuroplasticity. These conversations led to the early trials of Fast ForWord at Rutgers in 1994 and 1995.

That is the story of how these exercises came to be.

So, what about the students who struggle with these exercises?

Typically, if a participant is struggling with these exercises, it means they really do need to be doing Fast ForWord – particularly this type of exercise.  Don't let the fact that there are no speech sounds, words or language mislead you (it did me, in the beginning). Slow progress on these exercises are usually not because the learners aren't motivated or aren't listening hard enough (how exactly does a person "listen harder" anyway?). It's usually because the brain is not able to process rapid information quickly, efficiently or accurately. 

Coaching strategies for Sky Gym/Jumper Gym

It is very important that these participants complete their training time on Fast ForWord in a quiet and distraction-free environment. They should be wearing enclosed headphones and the volume should be loud enough for them to hear clearly. There are a number of activities that can be done to try to motivate the person to really work hard – such as the “10 in a Row” challenge, where the goal is for a student to achieve a minimum of 10 correct answers in a row. You can also try a “Beat the Teacher” challenge, where students compete with their provider, coach, or fellow participant by earning points for being consistently accurate.  You can find these and other intervention strategies in MySciLEARN.

 

Get Outside, It’s Good For Your Brain

Tuesday, June 14, 2016 - 08:00
  • Kristina Birdsong

cognitive benefitsWhen it comes to ways of improving cognitive ability, much of our discussion centers on complex interventions. But additional avenues for broad-based cognitive improvement could be as simple as a walk in the park. While spending more time outside may sound like practical folk wisdom, research shows that natural environments provide real and measurable psychological benefits. Let’s look at some of the findings.

Two kinds of cognitive attention

It has long been accepted among psychologists that attention and concentration are a finite resource that is depleted throughout the day as we perform cognitively demanding tasks. But research on this topic makes a crucial distinction between two different ways that our attention can be engaged.

Much like the cognitive tasks we are faced with at school or at work, urban environments deplete our resources by demanding “directed attention”, where one must focus on processing specific stimuli while filtering out others and suppressing physiological or emotional distractions. There is traffic that must be avoided, signs that must be read, and street grids or transit systems that must be navigated among constantly moving crowds, all of which leads to mental fatigue

Natural environments, on the other hand, interact with our cognition in the radically different manner of fascination or “effortless attention”. Stimuli like a beautiful sunset or a green meadow capture our attention involuntarily and non-threateningly, without requiring conscious focus or demanding a response. Like stretching muscles between workouts, such natural environments engage our cognitive function in a way that restores rather than drains their capacity.

Research proposed in the 1980s by Rachel and Stephen Kaplan has consistently validated the benefits of exposure to nature. In multiple studies, exposure to natural environments significantly improved participants’ performance on attention, memory, and cognition tests when compared to either urban or indoor environments. Amazingly, these benefits appear to extend to more artificial substitutes such as indoor plants or even just looking at nature photographs.

Mental and physiological health

Natural environments have also correlated with reduced stress and better mental health outcomes. According to Stanford researcher Gregory Bratman, “nature scenes activate our parasympathetic nervous system in ways that reduce stress and autonomic arousal, due to our connection to the natural world.” For example, office workers with windows facing natural scenery have reported higher job satisfaction and less workplace frustration. When a recent study added brain scans into the mix, nature walks were shown to reduce activity in the subgenual prefrontal cortex, a brain region associated with depressive rumination.

Exposure to nature appears to have physiological benefits as well. Nursing home residents suffering from dementia showed improved mobility after spending time in a garden, and hospital patients with green window views recovered faster from surgery.

Social and behavioral intelligence

Supporting the age-old refrain of being told to go play outside, studies suggest that nature has even greater significance for children. The variety of objects and patterns found in natural landscapes encourages imaginative play, which is linked to social as well as cognitive development. A study focusing on inner-city children found that, at least for girls, greener home surroundings correlated with greater impulse control and self-discipline. Likewise, playing in natural spaces was associated with a reduction of symptom severity in children diagnosed with Attention Deficit Disorder. In a broader sense, the open and unstructured nature of outdoor natural spaces encourages social cohesion through group activity and cooperative problem-solving. And this benefit of green spaces also extends to adults, especially those belonging to marginalized urban populations.

Implications

Something as simple as exposure to nature can be an additional avenue for improving learning outcomes alongside more targeted cognitive interventions. However, access to natural spaces is already scarce in the areas where many educationally disadvantaged children are concentrated, and the issue is becoming more pressing as the rate of urbanization increases worldwide. Given what we know about the interlocking relationship between cognitive, behavioral, and emotional development in early childhood, it behooves educators to lend more consideration to environmental factors, so that we can provide children with the best possible space in which to grow.

References

New research suggests nature walks are good for your brain

Just looking at nature can help your brain work better, study finds

Mental Health and Function

 
 
 

10 Ways to Help Your School-Age Child Develop a “Reading Brain”

Tuesday, May 31, 2016 - 08:00
  • Hallie Smith, MA CCC-SLP
reading brainAs children start their summers, it’s important to keep in mind that a number of activities can be done at home to help children develop a ‘reading brain’ and become more fluent readers. “We take reading for granted, and yet numerous statistics find that too many of our nation’s students, regardless of age and background, struggle with reading,” said Dr. Paula Tallal, a world-recognized authority on language-learning disabilities and a founder of both the Center for Molecular and Behavioral Neuroscience at Rutgers University and Scientific Learning. “What scientific research tells us is that the ability to read is one of the most complex skills we can learn in our lifetime. It also shows us that the brain can change and learn at any age and, in effect, be rewired for reading.” According to the National Institute for Child Health and Human Development, National Reading Panel, National Institute for Literacy and other research organizations, the reading skills of phonemic awareness, phonics, fluency, vocabulary and comprehension as well as the cognitive skills of memory, attention, processing and sequencing are critical to reading fluently.
 
Dr. Tallal provides the following ten pointers on how parents can help their school-age children develop and fine-tune these essential skills at home:
 

1. Phonemic awareness

Phonemic awareness is the ability to hear, identify and manipulate the sounds of spoken language and to understand that words are made of sequences of phonemes, the smallest units of sound that make a difference in the meaning of words. Students with developed phonemic awareness skills can judge whether two words rhyme, for example, and are able to isolate and substitute the beginning, middle and ending sounds in a word.
 
How to work on phonemic awareness at home: By teaching rhymes, songs and short poems and playing simple word games (e.g. “How many words can you rhyme with sat?”).
 

2. Phonics

Phonics are the understanding that there is a predictable relationship between phonemes (the sounds of spoken language) and graphemes (the letters and spellings that represent those sounds in written language).
 
How to work on phonics at home: Parents should help younger children practice the alphabet by pointing out letters whenever they see them and teaching them their name and other everyday words. Playing games like, “How many words can you make using the letters in spaghetti?” works well with older children.
 

3. Fluency

Fluency is the ability to read a text accurately and quickly. Fluent readers can recognize words automatically and understand their meaning at the same time.

How to work on fluency at home: Children should be encouraged to read aloud to their parents and even re-read the same story several times. Parents should read to their children as well as have them follow along as they read.
 

4. Vocabulary

Vocabulary consists of the words readers must know to communicate effectively.
 
How to work on vocabulary at home: Parents can help children build a strong vocabulary by teaching them the meaning of important words and promoting the use of a dictionary. They can also teach their child how to use context clues while reading to figure out unknown words and learn base words and affixes to decode words.

 

5. Comprehension

Compehension is the ability to derive meaning from text. Good readers have a purpose for reading.
 
How to work on comprehension at home: Parents should help their children find time to read for pleasure and find interesting books that they want to read on their own. Parents who discuss with their children what they’re reading are also helping them read for meaning.

 

6. Memory

Memory is the ability to store information and ideas, which is essential for word recognition, comprehension of complex sentences and remembering instructions.
 
How to work on comprehension at home: Engaging children in memory games like ‘Concentration’ and encouraging them to re-tell stories help improve memory skills.
 

7. Attention

Attention is the ability to focus on information and tasks, while ignoring distractions. Fluent reading requires sustained and focused attention.
 
How to work on attention at home: To increase attention span, parents should have children set time goals for sticking to a task, like doing homework or reading quietly. Children should also learn to read or study in a quiet room, free from television, radio and other distractions.
 

8. Processing

In the context of reading, processing is the ability to distinguish and associate individual speech sounds with their corresponding letter and word forms.
 
How to work on processing at home: Listening games, such as identifying sounds in words that sound like something else (e.g., the 's' sounds like a hissing snake), help train the ear to capture and interpret sounds clearly and accurately.
 

9. Sequencing

Sequencing skills are used for maintaining order, such as the order of letters within words or words within a sentence.
 
How to work on sequencing at home: Creating picture stories in which the order of the images is used to tell the story is an effective way to develop sequencing skills in young children. For those learning how to spell, mixing up letter tiles and having them unscramble the letters to form a word also helps.
 

10. Early intervention

“The final and perhaps most important thing that parents can do to help their kids develop a reading brain is to recognize that reading problems require intervention,” Dr. Tallal added. “Early intervention is important, especially with the aid of scientifically-based reading intervention programs that target different areas of reading instruction, but it’s never too late to help children become better readers.”
 
Download a PDF of the 10 Ways Parents Can Help School-Age Children Develop a "Reading Brain" by clicking here.
 
 

Pay Attention! Why It's Not as Easy as You May Think

Tuesday, April 19, 2016 - 08:00
  • Martha Burns, Ph.D

Pay Attention!How often do you say to your child, “Pay attention?”  Or, how often does a teacher reprimand a student for “not paying attention?” We tend to think that attention is something simple, either you are paying attention or you are not. But, it is actually much more complex than most people realize.  For example, do you ever find yourself distracted enough when walking into a room to get something that you forget what you came into the room for? Or, have you ever been listening to an audio book only to realize that you stopped paying attention several pages back?

In fact, trying to figure out exactly what attention is, and why some children have more trouble attending than others, especially in school, has been the focus of psychologists for years.  As adults, we realize that the ability to attend carefully to a task, ignore distractions and stick with it, is something that takes time for children to develop. But, what exactly is attention? Why is some information easier to attend to than other kinds? What is an attentional disorder? And, perhaps most important, are there ways to improve our attentional skills?

What is attention?

Perhaps the first attempt to define "attention" was made in The Principles of Psychology by William James. He wrote, "Everyone knows what attention is. It is the taking possession [in] the mind...of one....of several simultaneous objects or trains of thought." (James, The Principles of Psychology, 1890, page 403). But knowing what we think attention involves doesn't help us understand how this ability develops in children or why is it so difficult for all of us some of the time -  and for some, a lot of the time. The fields of cognitive psychology and cognitive neuroscience have begun to help us understand how very complicated something that seemed so simple to William James, really is.

Attention redefined

Neuroscientists like Dr. Michael Posner Attention impacts different neural networksand his colleagues have helped us understand that attention isn't just one thing. There are several types of attention. To begin with, there are different components of attention that correspond to different connected brain areas (networks). Dr. Posner and colleagues have identified three of these: alerting, orienting and executive.

Alerting

You know that when you are alert you feel wide awake and responsive to what is going on in the world around you. An alert state is very important for performing any task well and we all know what it is like when we are groggy and mentally foggy, perhaps when we first wake up in the morning. There is a chemical, norepinephrine, that modulates alertness largely in frontal and parietal brain regions. Alertness can be triggered by warning signals of any kind which rapidly allow us to change from a resting state to being more receptive to a new stimulus; a good example is the yellow light on a traffic signal that prepares us for when the light changes to red.

Orienting

The second component of attention is orienting. When you are oriented, you know where you are, who you are with, the day and time and most important, what is needed to perform the relevant task at hand. We rely on orientation to efficiently navigate a large airport during a connection, for example. Our senses are very important for orientation, allowing us to take in visual, auditory and tactile information from the world around us and use it to figure out what is the most relevant information to accomplish a task. Navigating an airport during a tight connection requires looking for appropriate signage and maps, asking officials if necessary, noting the boarding time and figuring out how quickly we need to move to get to the correct gate on time.

Executive

The third component  of attention that Dr. Posner and colleagues have studied involves the executive network. This is tied to our goals and helps us resolve competition for our attention when there are distractions or conflicts.  We can think of this level of attention as akin to self-control, maintaining attention in a regulated and purposeful way to accomplish a goal. The areas of the brain involved are complex and distributed widely through the brain. The executive attention network enhances activity in brain regions related to our goals and inhibits conflicting activity. This control requires coordination of our executive functions (goals, priorities, organization), emotions and other cognitive functions like memory and knowledge so that irrelevant feelings or thoughts don't interfere with getting a job done. This kind of effortful control and self-regulation takes time to mature, and can be quite variable from person to person (and task to task).  Executive attention (sometimes referred to as cognitive control) is highly correlated with success in school and later life.

Selective attention

One facet of executive attention known to be critical for academic success is selective attention. Dr. Courtney Stevens and her colleagues have studied the relationship between selective attention and academics over the past decade. Selective attention, depending on the activity, can involve one sense more than or in combination with others. For example, listening to an audio book or a newscast on the radio requires auditory selective attention while photography or drawing would require visual selective attention. When watching a newscast on TV we can use the visual information to augment our auditory attention. Dancing and athletics often require selective attention to movement and bodily senses, as well as visual and spatial attention to those moving nearby. For each of our senses, children need to learn to selectively attend. Dr. Alison Gopnik and her colleagues have studied the maturation of selective attention in young children as well as adults when they are in new environments. She has found that young children, as well as adults in a new stimulating environment (like a first trip to Paris during an exciting time like a honeymoon), are often global attenders - taking in many sights and sounds at once.  That makes for a fun day at the park or vacation, but to get a job done or accomplish a goal, we need to be selective about what we pay attention to (and ignore).

What is an attention deficit disorder?

Selective auditory attention may be especially challenging, especially in today's world, where we are bombarded with rapidly changing information and frequent technological interruptions. For many children, moving from the world of multi-sensory experiences in play, sports and media (especially tablets and television) to sitting still and selectively attending to a teacher in a classroom can be particularly difficult.  For some children, there appears to be a physiological limitation, beyond that expected for their age, on their ability to listen and learn on demand - this is referred to as an attentional deficit hyperactivity disorder (ADHD) if the difficulty involves both selective attention and behavioral control, or ADD if there is not a problem sitting still. Although ADHD and ADD are considered medical diagnoses and often treated with medication, there is evidence that attentional skills are malleable.

The good news: attention is trainable!

In fact, many scientists including Drs. Posner, Stevens and their colleagues have found that attentional skills are amenable to training. Dr. Stevens and colleagues found that a short (six week) period doing exercises in the Fast ForWord Language program, that train selective auditory attention in several different contexts (language listening tasks, two-tone rapid sequencing tasks, speech-sound discrimination tasks) resulted in improved auditory selective attention for listening to stories read aloud, among both language impaired and typically learning second graders compared to students who had a regular classroom curriculum but did not participate in the specific auditory attention exercises.  

In an article reviewing the research on the relationship between selective attention and academic achievement, Dr. Stevens and her colleague Daphne Bavelier conclude, “there may be large benefits to incorporating attention-training activities into the school context” (page S44).  Luckily, neuroscience-based interventions are now available to help educators build attentional skills in their students, to free them up so they can focus on covering curriculum content.

How did you do? Did you scan the page, get distracted by your phone (alerting attention), or stop mid-stream to think about your next vacation? Or did you maintain selective and executive attention all the way through the article?  Let us know in the comments!

References:

Posner, M., Rothbart, M., Sheese, B and Voelker, P. (2014) Developing Attention: Behavioral and Brain Mechanisms. Advances in Neuroscience Article ID 405094.

Posner, M., Rueda, R. and Kanske, P. (2007) Probing the Mechanisms of Attention. In J.T. Caciopo, J.G. Tassinary & G.G. Berntson (eds), Handbook of Psychophysiology. Third Edition. Cambridge U.K.: Cambridge University Press (pp 410-432).

Stevens, C. and Bavelier, D. (2012) The role of selective attention on academic foundations: A cognitive neuroscience perspective. Developmental Cognitive Neuroscience  25:S30-S48.

 

How Do ADD, Dyslexia, and Auditory Processing Disorder Overlap?

Tuesday, December 15, 2015 - 08:00
  • Lynn Gover

Key Points:

  • Children who are perceived as not paying attention or not trying may actually be tuning out because they are having trouble understanding the words they hear.
  • Children with a family history of dyslexia also have more difficulty with auditory processing.
  • The parts of the brain that handle sensory input develop earlier than those responsible for focus and attention.
  • Early intervention to improve auditory processing can have a significant positive impact on a child’s learning.

The following is a summary of Dr. Marty Burns' webinar “How Do ADD, Dyslexia, and Auditory Processing Disorder Overlap?”. Read below for the key takeaways, or view the recording now.

The rise in diagnoses of ADD and ADHD in children over the last couple of decades has been a great cause of concern and controversy for parents and scientists alike. But new research suggests that for many of these children, the symptoms may actually indicate a more fundamental problem with understanding and processing speech.

While attention is closely related to sensory and language processing, they begin in different parts of the brain. Attention is mainly controlled by the frontal lobe, responsible for many of our higher cognitive functions such as planning and organization. This brain region develops slowly, only reaching maturity in the late 20s. And as we might expect, both children and adults with attention deficit disorders show lower levels of frontal lobe activity.

Our sensory processing, however, is concentrated among three lobes in the back of the brain, with an area called the angular gyrus integrating their audio, visual, and spatial information. These brain regions, which develop at a much earlier age, play a major role in language acquisition. And one of the crucial elements is learning to recognize the internal details of words, so that we can distinguish ‘bad’ from ‘pad’ or ‘moon’ from ‘noon’. By hearing speech in one’s native language, our brain eventually builds a map of all the sounds in that language – sounds that we then learn to reproduce and to associate with visual symbols.

Auditory processing disorders occur when there has been some impediment to the development of this mental sound map, making it difficult for children to distinguish units of speech. It’s important to note that this is a distinct problem from hearing impairment, as the problem is not with hearing the sounds, but with understanding them. However, hearing obstruction due to a prolonged ear infection or a cold can lead to auditory processing disorders by disrupting a critical learning period. And such disorders may have a genetic aspect as well. Children with a family history of dyslexia, previously thought to affect only higher levels of language learning, also show lower activity in sensory regions of the brain and difficulty with speech processing even before they learn to read.

Although attention is localized in the frontal lobe, it relies on the sensory networks developed in other brain regions. And this is where attention problems and auditory processing problems overlap. Attention involves learning to sort through all the sensory data around you and pick out what’s relevant. But you can’t recognize something as relevant until it’s part of your knowledge base. So it’s hard to pay attention to speech when you’re having trouble distinguishing its sounds from one another, or from other sounds in the environment.

The result is that children with auditory processing disorders may exhibit symptoms similar to those of attention deficit disorders, such as being easily distracted, not engaging in class, or not following directions. Teachers may perceive them as not trying, not paying attention, or being disruptive when in fact what’s happening is that they try to pay attention but can’t follow what’s being said and eventually give up. Such children may also receive a diagnosis of ADD or ADHD, with treatments that fail to address the underlying issues.

The good news, however, is that Fast ForWord provides targeted exercises designed by neuroscientists to remedy auditory processing disorders, which have also proven effective in addressing overlapping problems with attention and language processing.  

For more information, watch Dr. Marty Burns' full webinar “How Do ADD, Dyslexia, and Auditory Processing Disorder Overlap?”.

 

New Study Suggests Fidgeting Helps Students With ADHD Learn

Tuesday, December 1, 2015 - 08:00
  • Cory Armes, M.Ed.

Key Points:

  • Fidgeting may help students with ADHD concentrate on complex learning tasks.
  • Allowing students to fidget and move during class can help improve academic performance.
  • Try creating a "Jumping Corner" in the back of the classroom for students who need to move while learning.

ADHD: The Most Common Behavioral Disorder

Attention Deficit Hyperactivity Disorder (ADHD) is the most common behavioral disorder diagnosed in children. Common signs include restlessness, continual talking and inability to concentrate and pay attention. About 11 percent of school-aged children have been diagnosed with ADHD, with 1 in 3 having received treatment with medication and behavioral therapy. Some of these students end up falling behind their peers academically.

New Insight Into Hyperactivity

adhdnew study published in The Journal of Abnormal Child Psychology suggests that hyperactivity may actually help students overcome their attention problems. Common hyperactive behaviors like running, jumping, rolling on the floor and continual talking are typically viewed as a disruptive problem that should be treated in addition to the attention problems. New research shows these behaviors aren't always present; instead, they are displayed when students are asked to complete tasks involving the executive functioning centers of the brain.

Researchers found that when students with ADHD were asked to perform a task that involved working memory and organization, those who were allowed to move or fidget did significantly better than those who were asked to keep still. Conversely, children without ADHD did better when sitting still, but worse when moving around.

These findings suggest that students with ADHD actually need their gross motor movements to help them complete challenging intellectual tasks. Rather than being part of the problem, it's likely that hyperactive behaviors help these students stay focused and attend to the task at hand. Researchers describe "excess motor activity as a compensatory mechanism that facilitates neurocognitive functioning in children with ADHD." This means that hyperactivity may be a feature to encourage rather than a bug to fix.

Translating Research Into Effective Teaching

Because traditional classroom management programs seek to reduce or eliminate disruptive behavior, these findings require some new thinking about how to effectively teach students with ADHD. It's a major challenge to maintain a learning environment that respects the needs of traditional learners who thrive in quiet, orderly spaces while allowing students with ADHD the freedom to move. Student safety is also important, so it's crucial for teachers to create a classroom with designated times and spaces for movement. Some strategies for teachers to employ in the classroom include:

  • Allowing students to keep a fidget toy in their desks is a small start. Students can take the toy out when they feel like interrupting or jumping up. This can be a ball to squeeze or another toy with interesting tactile properties to keep them physically engaged so they can pay attention.
  • Designating a corner of the classroom as an "Activity Zone" or a "Jumping Corner" creates a place where students can retreat when they feel the need to move around. This area is ideally placed in the back of the room where other students will not be distracted, but will allow clear sight lines to the teacher so the student can continue to follow the lesson.
  •  A yoga ball chair or therapy bands tied to chair legs can help students with ADHD bounce and move without leaving their seats. This is especially effective during tests or writing sessions that require quiet thinking and movement at the same time.

As more research indicates that hyperactive behavior helps students with ADHD overcome concentration struggles to master complex material, it's more important than ever for teachers to find creative ways that support these students within their comfort zones. Allowing students to fidget in a controlled, respectful way can improve academic performance and create a classroom environment that is more comfortable for all learners.

 

10 Tips for a Great Parent-Teacher Connection This Year

Tuesday, September 1, 2015 - 08:00
  • Lynn Gover

You may just be starting school or you may be in full swing. Either way, it's important that you start your relationship with your child's teacher on the right foot. Prepare for parent-teacher conferenceResearch indicates that family engagement is a key factor when it comes to a child’s academic success. Make the most of your time when you first meet the new teacher or during Parent-Teacher conferences by doing your homework and showing up prepared with questions and talking points that are relevant to you and your child.

  1. Make a list of your questions. Sometimes we have a whole list of topics and questions that we’re thinking about, but when we’re put on the spot we can’t recall any of them. Write down your questions to use as a reference during your meeting.
  2. Write down your child’s strengths and weaknesses. Having an open discussion about your child’s strengths and weaknesses can bring valuable insight to your child’s teacher that she might not have witnessed in the classroom. Also share specific rewards and motivations that you use at home.
  3. Review your child’s work, grades and progress reports. Pay special attention to teacher communications sent home and how your child has been progressing so far. Walk into the meeting prepared with specific questions or items you want feedback or clarification on.
  4. Keep the lines of communication open. Ask the teacher about communication preferences.  Is he/she available after hours to talk about your child’s progress? Or maybe email works better? Be sensitive to a teacher's schedule and workload when asking for support - praising a teacher's strengths goes a long way in building good rapport.   
  5. What support services are available? How does she handle it if your child needs some extra help? If your child does need extra assistance, what is the school's Response to Intervention process? Is afterschool support available?
  6. Ask about your child’s reading progress. Although you may have a good idea if your child is reading on grade level (or not), find out about the specifics of your child’s reading skills. Some questions to ask include:  When working in a small group with my student in reading, what is an area of strength or weakness that you notice? How is my child’s decoding? Fluency? Comprehension? Vocabulary? How can I help support these reading efforts at home?
  7. Don’t forget to ask about cognitive skills! Cognitive skills are the foundation for all learning, which makes this conversation so important. Some questions to ask include:

How would you say my child is doing, as compared to peers, in these areas:

Memory: How well does my child learn and remember new information? Does he or she require more or less support than peers? How easily is information retained?

Attention: How is my child’s attention during different types of activities? One-on-one? Small group? Whole class?

Processing: How well is my child able to “make connections” as compared to peers? In reading, is my child decoding new words, making educated guesses about the meaning of a new word, using background knowledge, or predicting and inferring? In math, is my child showing signs of struggling during computations or retrieving simple number facts? In writing, is my child generating coherent ideas without a lot of support and putting them into words?

Sequencing: How well is my child able to organize his thoughts for writing or explain his understanding of a new concept?

8. How about social skills? Find out how your child interacts with other students in the classroom. How is he without direct supervision? How does he handle conflict with other students? Ask about how you can help to improve his social skills at home.

9. Find out about State Testing & Advancement. Is there a schedule available? Ask your child’s teacher if they have any concerns about your child’s ability to prepare for and take the state tests.

10. Ask how you can help support your child’s academic success (and how you can help support the teacher!). Are there specific ways you can stay informed about what your child is currently learning in school? Can you carry those lessons through in your day-to-day activities with your child? Some teachers have websites to keep parents in the loop; some may send newsletters home or have a specific bulletin board or binder you can check in the classroom. Coming to your teacher with supportive questions can go a long way. Keep in mind that teachers are under significant pressure and it goes a long way to acknowledge what they're doing for your child and the others in their class. You are on the same team! 

In addition to this list, you can print out our Top 10 Brain-Based Questions for Your Child's Teacher. If you have any concerns about your child falling behind or about his academic performance before Parent-Teacher Conferences, don’t wait! Contact your child’s teacher right away and arrange a meeting earlier.

Having an open line of communication with your child’s teacher is so important, both to your child’s academic success as well as to your involvement in your child’s academic career. You may also find out about parent volunteer opportunities and planned field trips, so that you can see how your child interacts with his or her peers and teachers in a natural setting. Take advantage of this opportunity to work together with your child’s teacher to set him up for a successful school year!

 

New Research Shows How to Minimize Side Effects of Chemo

Tuesday, August 4, 2015 - 08:00
  • Martha Burns, Ph.D

Key Points:Fast ForWord and chemotherapy

  • Regardless of age, cancer treatments impair learning, memory and attention
  • The speed of processing information can also be diminished
  • These effects can last for months, or even years, after cancer treatment is finished
  • Research study shows Fast ForWord can help prevent learning problems in cancer survivors when used during cancer treatment

The cognitive impact of chemotherapy on children

When any of us are told someone we love has a diagnosis of cancer, “The Emperor of all Maladies” so aptly named by Siddhartha Mukherjee, it is very upsetting. But, when it is a parent who learns of a cancer diagnosis in their child, time seems to stand still for months, often years, as treatments are administered.  The good news is that the overall mortality rate from cancer has decreased markedly in the last 20 years. For children diagnosed with cancer, today’s cure rate exceeds 80% for some types of cancer. Earlier diagnosis and more specifically targeted forms of chemotherapy, combined with evidence-based protocols, mean many children are now miraculous survivors of this age-old, but very complex, illness.

After cancer – what are the implications on learning?

However, the success of targeted chemo and radiation therapy does come with a price. With improved survival rates, oncologists have become more aware of the aftereffects that childhood cancer treatments have on thinking, learning and remembering.  According to Jorg Dietrich at Massachusetts General Hospital and his colleagues at Stanford University and Anderson Cancer Center, conventional cancer therapies like chemotherapy and radiology for brain tumors in patients of any age frequently result in a variety of thinking and memory of problems. These neurocognitive deficits, as they are called, include impaired learning, memory, attention, and negatively impact the speed of information processing.

Increased survival rates = increased studies on effects

Interested specifically in those effects on children treated for cancer, Raymond Mulhern and Shawna Palmer at St. Jude’s Research Hospital have reported that the neurocognitive effects of cancer treatment on children can linger for months, or even years, after cancer treatment has been successfully completed. This new understanding of the long term effects of successful cancer treatment has resulted in an increase in the study and understanding of cancer treatment-related learning problems.  Fortunately, it has also led to an increase in research on effective methods for treating the cognitive aftereffects of successful cancer treatment.

According to Mulhern and Palmer, the two most frequent types of childhood cancers that are associated with neurocognitive disorders after successful treatment are acute lymphoblastic leukemia and brain tumors.  The authors state that although neurocognitive effects of cancer therapy are quite variable – depending on the actual diagnosis and age, length and dosage of therapy – researchers generally agree that a high percentage of children will experience problems with learning and thinking, which can interfere with academic achievement after successful cancer treatment.  Oncologists have been working to change their treatment approach when possible to reduce the cognitive aftereffects, but their primary goal is first to maintain the high cure rate.

Research study: can we counteract these cognitive after effects?

Very recently, an exciting new controlled study was published indicating that the neuroscience-based intervention, Fast ForWord, provides significant improvements in learning to read after chemotherapy and radiation therapy for a kind of brain tumor called meduloblastoma. Ping Zou at St. Jude Research Hospital and his colleagues investigated whether Fast ForWord could prevent learning problems in cancer survivors when used during cancer treatment.

They studied two groups of school-aged children who either used Fast ForWord during their cancer treatment or a standard-of-care without the Fast ForWord intervention. Then, about 2 and one-half to three years after successful completion of chemo and radiation therapy for this type of brain tumor, the survivors received functional measures of brain function as well as a series of educational tests. A control group of 21 typically developing children with no history of cancer were included for comparison. The education tests included assessment of phonological skills (known to be a critical component of reading skill) and a variety of reading measures.  Their brain function was evaluated by using functional brain imaging (fMRI).

The results

During the time of the brain imaging, the researchers found that the tests of phonological skills were significantly higher among the cancer survivors who had received the Fast ForWord reading intervention during their cancer treatment, than among those who received standard-of-care. Even more important, the measures of functional brain activation across those brain areas recognized as important for reading showed a trend towards normalization among the children who received the Fast ForWord intervention.  This led the authors to conclude that the results of the study provide evidence for the long-term value of this type of reading intervention in children after surviving a serious form of brain cancer.

A diagnosis of cancer in a child is frightening and overwhelming, but fortunately the cure rate of many childhood cancers is now very high. With the high cure rates, doctors now recognize that these very effective cancer therapies may have long term aftereffects on learning and thinking. However, the best news is that there are interventions, such as the Fast ForWord programs, specifically designed by neuroscientists to normalize brain functions for learning that can prevent and/or remediate some of these learning problems.  

References:

Dietrich, J.Monje, M., Wefel, J. and Meyers, C. Clinical Patterns and Biological Correlates of Cognitive Dysfunction Associated with Cancer Therapy. The Oncologist. 2008;13:1285–1295

Mukherjee, S. The Emperor of All Maladies: A Biography of Cancer. Scribner; 2010

Mulhern, R. and Palmer, S. Neurocognitive late effects in pediatric cancer. Current Problems in Cancer. July–August 2003, Pages 177–197

Zou, P et al. (2015) Functional MRI in medulloblastoma survivors supports prophylactic reading intervention during tumor treatment. Brain Imaging and Behavior, 2015. Available at: http://link.springer.com/article/10.1007/s11682-015-9390-8. Accessed July 27, 2015.

 

Parent Checklist: Is My Child At-Risk for Learning Issues?

Tuesday, June 2, 2015 - 08:00
  • Kristina Collins


parent checklistWe developed the following parent checklist to learn what concerns parents see in their children and to help them decide if their child is in need of help. Choose one answer for each question and indicate how often the behavior is exhibited in your child’s daily life with the following options: Never, Rarely, Sometimes, Often, or Always.

  • Misunderstands what you say
  • Needs instructions repeated
  • Misunderstands jokes
  • Has difficulty understanding long sentences
  • Needs questions repeated
  • Has difficulty retelling a story in the right order
  • Cannot finish long sentences
  • Has trouble saying the same thing in a different way (rephrasing)
  • Has trouble finding the right word
  • Pronounces common words incorrectly
  • Gets confused in noisy places
  • Has difficulty engaging in conversation with others
  • Has behavior problems
  • Lacks self-confidence
  • Avoids group activities
  • Has trouble paying attention
  • Has trouble sounding out words
  • Has trouble reading
  • Has trouble spelling
  • Cannot tell you about the events of his/her school day

If you answered Sometimes, Often or Always to several of these, your child may be at-risk for a language-based learning disability and will likely require intervention to prevent these issues from affecting him/her academically in the future.   Why are we posting this now? Because summer is one of the best times to tackle these issues.

We hear from countless parents like you who are looking for help for their bright child who struggles with reading, writing, attention, or other issues. You’re in the right place. We can help you help your child this summer.  

Related Reading:

Preventing Summer Brain Drain with Dr. Martha S. Burns

What’s on Your Kids’ Summer Reading List?

 

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