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It’s not exactly news that there’s a relationship between auditory processing skills and reading disorders in children. But with research by scientists such as Elise Temple and Nadine Gaab helping to establish and confirm the connection, the mounting evidence points to just how strong the correlation is—especially for children with dyslexia.
In a recent study by Jane Hornickel and Nina Kraus published in the Journal of Neuroscience, the authors set out to determine whether inconsistency in the brain’s response to speech sounds is correlated with poor reading skills. The study evaluated 100 normal-hearing children from 6 to 12 years of age who were divided into 3 groups—good readers, average readers, and poor readers—based on their fluency scores.
The researchers asked the children to listen to the syllables “ba” and “ga” while measuring the children’s auditory brainstem response. They also measured the children’s brainstem response to a simple clicking sound for comparison.
The authors found that the auditory brainstem response was considerably more variable for poor readers than for good readers, but only when listening to the relatively complex speech sounds—not when listening to the simple click sound. They also found that the inconsistencies in brainstem response were more closely associated with the consonant portion of the syllable than the vowel portion.
The variability in brainstem response occurred intermittently throughout the testing rather than building over time, and was primarily seen among the poor readers rather than all three groups, indicating that neural fatigue was likely not a factor. The authors note that the more likely explanation for the intermittent variability is poor encoding of speech sounds in the brains of the struggling readers.
According to Kraus, it’s this inconsistency of brain response that prevents some children from making the crucial connection of sound to meaning that is the foundation of language and reading skills. Strong readers, on the other hand, typically make the connection with ease. The relationship between reading ability and auditory processing skills, she says, is “a highly significant relationship.”
Distinguishing between consonants can be particularly difficult for children with dyslexia, as this study shows, because they are spoken so much more rapidly than vowels. But consonants typically give meaning to words (think “cat” vs. “bat”), so that missing bit of information can make learning to read enormously difficult. The takeaway is that when children with normal hearing experience reading difficulty, auditory processing plays a role.
Fortunately, our students’ brains are highly adaptable and responsive, enabling dramatic improvements with appropriate intervention. When the auditory processing issues are corrected, children are then able to make the critical sound-to-meaning connections that lead to proficient reading and improved learning all around.
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Summary: A recent study by Nicole Russo of Northwestern University and her colleagues, published in Behavioral and Brain Functions in 2010, evaluates whether auditory training programs such as Fast ForWord® can alleviate the auditory processing deficits so frequently seen in ASD children.
Russo’s study examines how effectively Fast ForWord could strengthen the auditory processing of speech sounds in similar ASD children. Her team hypothesized that such training would modify the neural processing of sound in children with ASD, and that such children “would show improvement in the neural encoding of speech syllables, including faster response timing, greater fidelity of the response relative to the stimulus, and more accurate pitch encoding over time.” (p. 3)
Results showed that training appeared to have benefited all participants in the experimental group, affecting their neural transcription of speech. According to Russo and her team, “each of the five children who underwent FFW training improved on at least one measure of cortical speech processing relative to the control group, with response timing improving in both quiet and noise for some children.” (p. 13)
Russo and her team were able to conclude that directed auditory training using Fast ForWord shows great promise for improving auditory processing in children with ASD – specifically, those high-functioning children who have hearing in the typical range.
Content: This study was published in Behavioral and Brain Functions in 2010 and was done at Northwestern University by Dr. Nicole Russo and her colleagues. It evaluates whether auditory training programs, such as Fast ForWord, can alleviate the auditory processing deficits so frequently seen in children with autism spectrum disorders. Children with autism spectrum disorders or ASD demonstrate impairments in their use of language for social and communicative purposes. These impairments are typically apparent prior to three years of age.
There is emerging evidence that the neural encoding of speech sounds may be impaired in some children with autism spectrum disorders leading to atypical auditory brainstem responses to speech sounds and difficulties processing speech-specific stimuli such as detecting speech in background noise.
Since the Fast ForWord products provide auditory training including listening and sound-sequencing exercises, as well as exercises on auditory attention, auditory discrimination, phoneme discrimination, and memory, Dr Russo and her colleagues were interested in investigating the impact of the products on children with ASD.
High-functioning children with ASD who had participated in an earlier study were invited to partake in this one. The children all had a formal diagnosis of autism spectrum disorder. They had typical peripheral hearing, average mental abilities and average or near-average language scores.
Eleven boys with an average age of 9.2 completed the entire testing protocol and met the criteria. The children were then given the option of taking part in the intensive auditory training. Five children opted for the training and formed the experimental group. The other six children who opted not to take part in the training were willing to take part in the post-test and formed the control group. There was not a significant difference between the two groups in terms of age, IQ, or language ability.
Students in the experimental group used the intense intervention: the Fast ForWord Language Series which entailed the Fast ForWord Language product for an average for 20 days followed by Fast ForWord Language to Reading for an average of 32 days.
Auditory brainstem responses (ABRs) and Event-Related Potentials (ERP’s) were recorded from both groups. These tests measure the size and the timing of electrical activity that occurs in the brainstem and brain in response to a sound. In this case, the sounds were synthesized vowels that were heard in the presence of background noise, as well as in quiet. Auditory brainstem responses are subcortical events occurring less than 10 ms after the stimuli is presented while event-related potentials are cortical events occurring a few hundred milliseconds after the stimuli is presented. Both ABR’s and ERP’s measure the aggregate response of neurons and neither requires active involvement by the participant.
Due to the small number of participants, and the variations between them, the analysis involved defining a “typical change” as the average change for students in the control group plus one standard deviation, and defining a “significant change” for one of the participants as a change that was more than the control’s change plus one standard deviation.
The researchers were particularly interested in subjects that had two or more measures with significant change. All five students improved more than one standard deviation on at least two tests. The researchers concluded that there is Initial evidence that directed auditory training may improve auditory processing in a specific population of children with ASD – specifically high-functioning children with ASD who have hearing in the typical range.
They also concluded that computer-based training may benefit some children with ASD by acting on biological processes.
Read the complete report on this research at the link below:
Nicole M Russo, N., Hornickel, J., Nicol, T. Zeckler, S. Kraus, N. Biological changes in auditory function following training in children with autism spectrum disorders. Behavioral and Brain Functions 2010, 6:60.
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Note: This post is the 3rd in a series on Scientific Learning Value Added Representatives (VARs)who provide our products around the world.
LearnFast Australia was founded by Devon Barnes, a speech language pathologist and audiologist. Devon has worked with children struggling with language, learning and reading difficulties for over 40 years. Many times during those decades when working with a learning disabled child she would remark to her colleagues, “If only there were some way to get into their brains and reorganize them, perhaps we could fix the problems.”
Devon had read about the work of Dr. Paula Tallal, a renowned neuroscientist. In 1997 she decided to travel to the University of York in England to hear Dr. Tallal present the results of the early trials of a set of exercises which were to become the foundation for the development of Fast ForWord®.
The results were so impressive, Devon realized she had found something that could potentially ‘re-wire’ the brains of learning disabled clients.
The following year Devon completed the Fast ForWord Professional Provider Training in New York and commenced offering the programs at her clinic, Lindfield Speech Pathology Learning Centre, in Sydney.
Today, LearnFast provides Fast ForWord to thousands of students and adults via schools, professional learning practitioners, and in homes.
LearnFast has offices in Sydney, Australia and in Auckland, New Zealand. The company has developed a staff of passionate learning experts who genuinely care about helping as many children and adults as possible overcome their learning and reading struggles, and to help every person achieve his or her potential. This passion is reflected in everything LearnFast does, from the people who work for the business, to the way the Fast ForWord programs are implemented and supported.
As well as providing Fast ForWord, LearnFast is active in supporting the development of innovative ways to improve education for all, and in bringing the latest research and knowledge to parents, educators and learning professionals.
LearnFast’s Facebook page was launched recently and has developed an active community of people who are interested in the science of learning and how the findings from the research can be applied to help all those who want to improve their ability to learn and to read.
There is also a valuable source of video content made available to the public (mostly free of charge) via LearnFast Education’s Video Store which provides information about Fast ForWord and learning and reading difficulties, including auditory processing disorders, attention deficit disorders and dyslexia, as well as adult literacy development, autism and other topics. For more about LearnFast and Fast ForWord, visit www.fastforword.com.au.
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Ben was just over two when his mother brought him to my office for a speech and language evaluation. She was a speech pathologist herself and knew he was late to start talking. She had seen another speech language professional before me but wanted a second opinion; that professional had told her she thought Ben might be developmentally delayed.
Both mom and I sat on the floor with a few toys, a car and a truck, trying to entice Ben to play with us. Ben ran around the room, very anxious, probably because of the unfamiliar environment and a new stranger, me, to contend with. He threw the car against the wall and began to cry uncontrollably. I suggested that I leave the room for a few minutes to let Ben settle down and acclimate to the surroundings with his mother. Waiting outside I could hear her attempts to calm him down being frustrated by Ben's increasing agitation.
Finally I reentered the room and mom told me sometimes Ben would settle down in new places if he could have some place to hide for awhile. I opened the door to my materials closet and in he ran, slamming the door behind him. While Ben was "hiding" I asked mom to recount his history. I had heard very similar stories many times before. Ben was a first child, a beautiful responsive baby. He began smiling when a few weeks old and sat and crawled by six months. But sometime around his first birthday he began to change. He resisted being held, threw frequent temper tantrums, and his early first words disappeared. He had several ear infections so mom and his pediatrician thought these might account for his delayed speech so he had an operation at 20 months to place tubes in his ears to reduce the fluid in his middle ear. But when he still wasn't talking by his second birthday mom began to worry. She also noticed he had started rocking and biting his right hand when he became frustrated and screamed if she tried to take him shopping with her.
He loved riding in the car in his car seat but the second she unstrapped him and he recognized and unfamiliar locale, his back arched and he would thrash and yell. One day, she recounted, a woman who had apparently overseen such a display in the store parking lot, came over to her and told her she needed some parenting lessons. Devastated, Ben's mom said she called her pediatrician who recommended a local social worker who specialized in helping parents deal with problem toddlers. It was the social worker who recommended mom bring Ben to me.
Ben eventually emerged from hiding after I enticed him with his favorite toy from home, Thomas the Tank Engine. He sat in the floor staring at the toy train car and quietly spun the wheels for several minutes. Mom and I sat silently because if either of us spoke Ben would cover his ears and start rocking.
I enrolled Ben in speech therapy sessions three times a week and recommended that he also receive Occupational Therapy to provide sensory integration therapy to help Ben learn ways to calm himself. After about six months of therapy Ben was talking some but most of his speech was repetitive. "Teeze an kako" was one of his favorite repeated phrases as a request for cheese and crackers that we used in therapy to reinforce his good behavior. Mom said she had stopped trying to take Ben out to dinner or to the store because everyone stared at him, and she felt, blamed her as a bad mother when he yelled or threw things.
By three and one -half Ben was very hyperactive, not yet potty trained, and walked on his toes with his hands flapping in the air. He was speaking in short sentences but his speech was still repetitive and sing-song like. A typical phrase was, "You Ben friend? You Ben Friend?" and, "Ben want Tom Tom! Ben want Tom Tom!" At this time Ben was diagnosed with autism by a well regarded psychologist in the area.
For many years mom rejected the autism diagnosis. She and her physician husband felt Ben was very bright and that his behaviors and speech problems masked his other strengths. For example, by four years of age Ben had memorized many nursery songs, word for word. By five Ben could name all the major dinosaurs and tell you the era in which they lived and whether they were plant or animal eaters. But Ben's parents were crushed when the expensive private school they enrolled him in for kindergarten rejected him for first grade.
By the time Ben was seven his parents had invested thousands of dollars in private therapies, private schools, parent counseling, and ABA (applied behavioral analysis) interventions. Ben's mother had hired several different daytime babysitters to help her when a new baby girl arrived, but all would quit after a few months because Ben was so difficult to manage. They had tried ADHD medications which helped calm Ben down during the day but then he could not sleep at night, so either mom or dad ended up, night after sleepless night, trying to supervise Ben as he ran around the house at two a.m.
I have worked with many children like Ben and their parents. These children are dear and very smart in many ways. Yet these children are often locked in a mental prison that keeps them in a perpetual internal turmoil when they are young. As they age and receive therapy they usually emerge, finding solace and relief in their passionate interests. But their unique interests and strengths are rarely as comforting for the parents who see their child stop being invited to birthday parties and play-dates. Parents watch with constant anguish as other adults stare as their child rocks, spins, or obsessively recites favorite poems or perhaps counts windows or red shirts, on planes, in restaurants, at the park. As Ben's mother explained, "If Ben had a visual sign of impairment others would show compassion, I'm sure. But he looks normal, just acts oddly, so I know people think I did something wrong as a mother."
As we learn more about Autism Spectrum Disorders, we are able to identify signs earlier, and our therapy can begin sooner and have more profound effects. Ben (which is not his real name), I am happy to say, was one of an early group of children to go through an experimental computerized language program out of Rutgers University in 1996, shortly after his seventh birthday which is now available to parents as part of the BrainPro Autism service from Scientific Learning. The first change Ben’s mother and I noticed after he completed six weeks of the program was that Ben began speaking in full sentences and started to initiate conversations. One day shortly after the program ended, he told me that his sister had “opened his lose tooth,” meaning that she had knocked out a wobbly baby tooth. His intonational contour also changed dramatically, from being rather stereotyped to emotional and natural. Within a month or so he began relaying other stories about home and for the first time started enjoying games that involved pretending. On a standardized language test administered before and after the program, he had gained almost two years growth in receptive language skills. Some of the growth on the test appeared to be attributable as much to his ability to pay attention to test questions as well as new language skills he had acquired from the language tasks within the program.
A few years ago Ben’s mother informed me that he attended a junior college program in computer technology and, as of my last communication with her, was working as a computer technician for a local computer retail outlet. He lived at home then but had friends at work and a hobby, not surprisingly, of building dinosaur models. Mom said, Ben “seems happy now" and his parents did as well. They were encouraged by his job, circle of friends, and hobby. With the years of anguish they were trying to help other parents cope with the fears and pain that surround an autism diagnosis in the early years, but inform on the hope emanating from new research on early identification and new technological intensive interventions that can supplement therapies.
Ever since we began to understand the autistic spectrum, researchers and laypeople alike have been fascinated by the mysteries of the disorder. The fact that high-functioning individuals with Asperger’s syndrome like Dr. Temple Grandin and Daniel Tammet have become public figures speaks to our fascination with what people on the autistic spectrum can achieve outwardly, as well as our desire to empathize with what they struggle with internally.
According to the CDC, approximately 9 in 1,000 children in the United States are diagnosed as being on the autism spectrum each year.[i] They are characterized as having “deficits in social reciprocity and communication, as well as by repetitive behaviors and restricted interests.”[ii] That said, how can we as educators better help them to not only become integrated into our classrooms, but more importantly, help them reap as much benefit as possible from the experiences we provide? What foundational information can we use to start constructing successful strategies for these children?
First, we can try to better understand the nature of autism spectrum disorders (ASD). Recent studies have demonstrated linkages between ASD and auditory processing. Researchers at Vanderbilt University found that while typically developing (TD) children performed on par with ASD children on certain visually-oriented tasks, ASD children experienced greater challenges with auditory tasks.[iii] Likewise, researchers in Haifa, Israel showed that certain abnormal speech patterns directly correlated to ASD, further reinforcing the conclusion that auditory processes in the brain are implicated in those on the autism spectrum.[iv]
Understanding these linkages will not only help us better understand the ASD child’s experience, but it will help researchers and educators develop more effective learning strategies to help them achieve success.
At Scientific Learning, researchers performed a study in 2007 to evaluate how ASD children could benefit from Fast ForWord®, a program that engages and improves reading based on visual as well as auditory input. We were happy to find that developmentally delayed children—specifically those with ASD—“made significant gains in their language ability.” The data suggest that Fast ForWord helped strengthen the foundational skills needed to help these students get more out of their classroom experiences, as well as function better in society.[v]
Nicole Russo led another study of ASD children related to auditory processing. In short she had two groups of ASD children, one who received Fast ForWord training, and a control who did not. Their data showed that the group who received Fast ForWord training showed changes in brainstem response timing, pitch-tracking, and cortical response timing, indicating that the technology may indeed prove to be a useful tool in the future for helping ASD children improve their processing capabilities.[vi]
Overall, our greatest hope for these students is to achieve a better understanding of two pieces of the autism puzzle: the neurology of the disorder, as well as the psychology and emotional struggles that these students deal with every day. I have found that along with reading the research cited above, I have also gained great insights by reading more personal accounts penned by those with ASD. It is in some of those personal writings that I find my greatest inspiration as these individuals work so hard—often with great success—to make themselves understood.
To increase your understanding of ASD, here are a couple of additional readings:
[i] Newschaffer CJ, Croen LA, Daniels J et al. The epidemiology of autism spectrum disorders [PDF]. Annu Rev Public Health. 2007;28:235–58. doi:10.1146/annurev.publhealth.28.021406.144007. PMID 17367287.
[ii] Kwakye L, Foss-Feig J, Cascio C, Stone W, Wallace M. Altered auditory and multisensory temporal processing in autism spectrum disorders. Frontiers in Human Neuroscience. Jan 5, 2011, 4:129. p 1.
[iv] Bonneh Y, Levanon Y, Dean-Pardo O, Lossos L, and Adini Y. Abnormal speech spectrum and increased pitch variability in young autistic children. Frontiers in Human Neuroscience, Jan 19, 2011, 4:237, p 1.
[v] Scientific Learning Corporation. (2007). Improved Language Skills by Students with Developmental Delays who used Fast ForWord® Products, MAPS for Learning: Educator Reports, 11(12): 1-5.
[vi] Russo, M. Hornickel, J. Nicol, T. Zecker, S. Kraus, N. Biological changes in auditory function following training in children with autism spectrum disorders. Behavioral and Brain Functions. 2010, 6:60.
Finally! I am pleased that Emily Iland, the author of the recently released book, Drawing a Blank: Improving Reading Comprehension for Readers on the Autism Spectrum, has addressed the issue of hidden reading comprehension problems in some children on the autism spectrum. For more than 30 years I have been working with children with a diagnosis of hyperlexia. Occasionally also diagnosed with High Functioning Autism or Asperger's Syndrome, these are children who can read words-with ease- often without any reading instruction, and sometimes at a very early age. These children, who invariably show problems in socialization skills, also may exhibit significant impairments in language and auditory processing, yet they have been able to miraculously “break the code.”
These children may perform well on early tests of reading readiness and decoding. The term Hyperlexia is applied because they are often sounding out words (decoding) better than their peers who have no developmental issues. Because of their decoding skills, these children may not be identified as needing any special support in reading through the IEP process. In reality, they need help with comprehension and vocabulary of the sentences they can read aloud so easily. Like Emily IIand, I have delighted in seeing this incredible ability to decode words develop and have recognized the issue of the comprehension problems that are often hidden in these children on the Autism Spectrum Disorder.
Iland writes from the perspective of a mother turned researcher and educational therapist. Her son’s spontaneous abilities to read and spell as a toddler were regarded as an exceptional talent (later diagnosed as hyperlexia). Although his ability to decode words continued, by fourth grade he began to struggle academically due to undetected comprehension problems. At age 13, he was tested and found to have a 12-year gap between his reading comprehension skills (4th grade level) and mathematic skills (16th grade level). Eventually he was diagnosed as being on the autism spectrum. But after intensive intervention, he was able to earn his bachelor’s degree in accounting, pass the CPA exam, and obtain employment as an accountant. However, many students like her son do not have this happy outcome because reading comprehension issues are not identified or properly remediated.
In her review of typical reading skill development, Iland points out where the breakdowns in comprehension begin for children with autism. She discusses the impact of the social deficits associated with autism spectrum disorders on comprehension of language and reading. The child’s narrow range of interests can lead to limited exposure to the world and restricted vocabulary. Difficulties with interpersonal relationships can interfere with the ability to learn that other people may have different perspectives, motivations and beliefs. Rigid thinking can restrict the children from understanding that words can have multiple meanings and that different words can be used to mean the same thing.
The reading comprehension problems of individuals with autism are often “masked,” or hidden, by their strengths in decoding, fluency, rote memory, and understanding of concrete information. This is especially true during the early school years when there is a focus on teaching children HOW to read. There are specific difficulties in young children that correlate with later difficulties in reading comprehension that should be closely examined in children with autism. For example, a child who is reading fluently may not have good phonemic awareness abilities due to the auditory processing problems, which are common in children with ASD. Receptive language problems may also be present in these children. Iland discusses appropriate assessment tools for different ages, as well as the importance of identifying the underlying comprehension difficulties of these children.
A significant part of the book focuses on reading comprehension strategies to improve skills for these children. Iland shares the implications of the limited research on effective remediation of reading comprehension for learners with ASD. She addresses the recommendations of the National Reading Panel, pointing out the best strategies for students with ASD and helping the reader recognize strategies that would likely be a mismatch. While Iland selects strategies because of their value for children with ASD, many of them are useful for other children as well. Drawing a Blank: Improving Reading Comprehension for Readers on the Autism Spectrum is a welcome and needed resource. Emily Iland’s multiple perspectives and clear writing style make this book user-friendly for parents, educators, speech-language pathologists, students and others interested in helping individuals who are on the autism spectrum become more successful readers.
As we look ahead to the 2011 webinars and get ready to hear more experts in the field of brain fitness and education, I wanted to take a moment to review the 2010 webinars and share the top 5 points of the webinars that I am still thinking about today.
It’s almost here! I’m happy to announce Scientific Learning’s Spring Webinar Series 2010 featuring five must-hear presentations by experienced, committed educators.
Register for one or all five of the webinars and stimulate your own brain while you absorb ideas and techniques that you can use with your own students.
1) Building Brain Fitness for Struggling Students to Succeed
Presenter: Dr. Deborah Kolonay, Superintendent at Penn Trafford SD
Date & Time: Wednesday, May 12 at 10:00am Pacific
2) Teaching Fluency: The Neglected Goal of the Reading Program
Presenter: Timothy Rasinski, Ph.D.
Date & Time: Wednesday, May 19 at 11:00am Pacific
3) Moving Students to Proficiency
Presenters: Dr. Mark Keen & Cindy Keever at Westfield Washington SD
Date & Time: Wednesday, May, 25 at 10:30am Pacific
4) Autism: Support and Interventions
Presenter: Ann Osterling
Date & Time: Thursday, May 27 at 10:00am Pacific
5) Autism: What is the Latest Research?
Presenter: Ann Osterling
Date & Time: Tuesday, June 15 at 10:00am Pacific