5 Myths About Dyslexia

Tuesday, October 20, 2015 - 08:00
  • Martha Burns, Ph.D

Dyslexia: fact versus fictiondyslexia facts

Dyslexia’ is a term that has been used many different ways during the past century. As a result, many myths have emerged about the diagnosis and how the term applies to children who struggle to learn to read.  As a parent or teacher, if we are to effectively help children with the diagnosis, it is essential that we are clear on what is “known” about dyslexia versus what may be assumed but not based in fact or science. There are too many myths to cover in one blog post, but I have begun with five of the more common ones about dyslexia and included the scientific research from a variety of sources that support each fact.

MYTH #1: Dyslexia is a specific type of reading disorder that can be diagnosed using standardized tests.

FACT: Almost from the first use of the term, dyslexia has been defined in many different ways. The term comes from the Greek prefix dys – disorder and lexis – word or language. So, technically the term would mean “disorder of language." Most authors now use the term to refer to problems with reading; however, when originally used decades ago, it referred only to individuals with known brain injuries. So, a more accurate term often used today is “Developmental Dyslexia.”  That term distinguishes children who have trouble learning to read from adults who acquired a reading disorder after a stroke or other type of brain injury.  New genetic and neurobiological research suggests that developmental dyslexia is quite variable - there are likely many different subtypes of developmental dyslexia (Fragel-Madeira et al., 2015).

MYTH #2: Dyslexia is a visual disorder causing those with the disorder to see words and letters backwards.

FACT: Children have to learn that letters, unlike other types of pictures and objects, have a specific orientation in space. A d and a b are different letters whereas   and    are both either new moon or crescent shapes – orientation does not matter. Many young children reverse letters, both in reading and writing, but that is not a diagnostic sign of dyslexia. Conversely, many children with dyslexia do not reverse letters (Dehaene, 2013; Blackburne et al, 2014).

MYTH #3: Dyslexia is more common in boys than girls.

FACT: A few decades ago, dyslexia was diagnosed much more frequently in boys than in girls. More recent research conducted by Dr. Sally Shaywitz and colleagues at Yale University, first published in the Journal of the American Medical Association, indicated that dyslexia probably affects a comparable number of girls and boys, although boys may be diagnosed more frequently because they may be more likely to exhibit problems sitting still and learning in early grades. However, there is some newer conflicting research that suggests that dyslexia may be two to three times more prevalent in males than females. Furthermore, neurobiological characteristics of dyslexia reported in males may be very different than those found in females (Evans et al., 2014)

MYTH #4: There is no way to determine if a child is at-risk for developmental dyslexia until they enter school and begin to show problems with reading.

FACT: There is a great deal of new research pointing to developmental dyslexia risk factors that may be observable during preschool years. Dr. Sally Shaywitz has listed a few clues in her book “Overcoming Dyslexia”. They include:

  • Trouble learning common nursery rhymes
  • Difficulty learning and remembering letter names
  • Problems learning to recognize letters in their own names
  • Persistent speech problems or “baby talk”
  • Problems recognizing rhymes

There is also mounting evidence that problems with speech perception during early development are a major risk factor for dyslexia in school age children.  For example, Doctors Steven Zecker, Nina Kraus and their colleagues at Northwestern University have found that they can predict reading problems in school-age children years before the children enter school by testing for problems perceiving speech sounds in noise.

MYTH #5: Dyslexia is a life-long problem and those with the diagnosis will never be able to read very well.

FACT: Although many individuals diagnosed with dyslexia initially struggle to learn to read, effective reading interventions are available and do enable individuals with dyslexia to learn to read and excel in school. According to research conducted by Dr. John Gabrielli and his colleagues, neuroscience-based interventions like the Fast ForWord® programs have shown to result in neurophysiologic repair, which can be seen as increased activation of frontal and temporal-parietal regions in the left hemisphere of the brain. These types of interventions are especially effective for children with dyslexia and have lasting effects.    


Blackburne, LK., Eddy, MD., Kalra, P., Yee, D., Sinha, P., and Gabrieli, J. (2014) Neural Correlates of Letter Reversal in Children and Adults. PLOS ONE 9(6)

Dehaene, S. (2013) Inside the Letterbox: How Literacy Transforms the Human Brain. Cerebrum. May-June:7. Published online 2013 Jun 3.

Evans, T.M., Flowers, D.E., Napoliello, E., and Eden, F. (2014) Sex-specific Gray Matter Volume Differences in Females with Developmental Dyslexia. Brain Struct Funct. 2014 May; 219(3): 1041–1054

Fragel-Madeira, L., de Castro, J.S.C., Delou, C.A., Melo, W.V., Alves, G.H., Teixeira, P., Castro, H.C. (2015) Dyslexia: A Review about a Disorder That Still Needs New Approaches and a Creative Education. Creative Education. 6, 1178-1192.

Gabrieli, J. D. E. (2009). Dyslexia: A New Synergy between Education and Cognitive Neuroscience. Science, 325, 280-283.

Shaywitz, E. (1998) Dyslexia. N Engl J Med 1998; 338:307-312

Shaywitz, E. (2008) Overcoming dyslexia:  A new and complete science-based program for reading problems at any level. New York:  Random House.

White-Schwoch, T., Carr, KW., Thompson, EC., Anderson, S., Nicol, T., Bradlow, AR., Zecker, S. and Kraus, N. (2015) Auditory Processing in Noise: A Preschool Biomarker for Literacy. PLOS Biology. 13(7)


Problems with the Human “Letter Box”: A Component of Dyslexia

Tuesday, October 6, 2015 - 08:00
  • Martha Burns, Ph.D

Key Points:

  • The human brain is not “wired” for reading.
  • Children need to perceive speech sounds and letters quickly and accurately as a precursor for reading.
  • In the occipital lobe, there is a “letter box”—the visual word form area of the brain.
  • Recent research indicates that dyslexics have trouble with both hearing the sounds within words & recognizing letters.
  • For many with dyslexia, the “letter box” part of the brain is not responding the way it does in typical readers.

How much of dyslexia is visual vs. auditory?

The human brain is designed to naturally acquire many skills. As all parents know well, most children easily learn to walk and talk without any special instruction. But what many of us don’t realize is that the human brain was not designed to read.  Anthropologists say that Homo sapiens has been on earth for 200,000 years but the alphabet is only 4,000 years old. Even after human written language appeared, very few adults could read or write. In fact, it wasn't until 1917 that all states in the U.S. had compulsory education laws.

Stanislas Dehaene, one of the foremost experts involved in research on reading and math in the brain, has noted that in order to read, we have to recruit brain architecture that was designed for other purposes. We can think about this as a kind of neurological recycling – using brain circuits specifically adapted over centuries for one purpose, like communication, to become part of newer circuits, like those needed for reading.  Fortunately, the language and visual object recognition networks of the brain mature in early pre-school years, and then multitask in a way to reconfigure for reading.

To understand this brain recycling process, it is helpful to remind ourselves of what underlying capacities are needed for reading. With an alphabetic language like English, reading requires that we integrate the speech sounds of our language, the phonemes, with the letters, graphemes. This “sound-letter (or phoneme-grapheme) correspondence” necessitates two capacities - the ability to perceive speech sounds quickly and accurately as well as the ability to perceive letters quickly and accurately. It is the latter skill that Dr. Dehaene discusses in a journal article entitled “Inside the Letter Box”.

According to Dr. Dehaene, the visual word form area of the brain, a region at the base of the the visual part of the brain (the occipital lobe) in the left hemisphere, is the brain’s “letter box”. It is called the “letter box” because it shows stronger activation to written words than to other kinds of visual stimuli (like faces or places). And, for all of us who can read, it is located in the same spot, very specifically  housed between the areas of the occipital lobe that are activated when we see pictured objects and faces. Dehaene and others have noted that if the “letter box” is damaged or disconnected from other brain regions by a stroke or other form of localized brain injury, the individual often loses the capacity to read.

Interestingly, Dr. Dehaene states that the “letter box” doesn’t just enable us to recognize words. It has other highly sophisticated capabilities that are essential for fluent reading.  For example, it lights up first when a person is asked to determine whether the words written as “READ” and “read”, are the same words. Although to most readers of the this blog, that seems like a simple task,  uppercase and lowercase letters such as “A” and “a”  or “R” and “r” or even “D” and “d” are actually not at all alike in shape or configuration. We have to learn to “see” them as the same letter even though they are very different shapes. That doesn’t happen with other visual objects – we don’t ever see a circle and triangle as the same shapes or our husband’s and brother-in-law’s faces as indistinguishable. So letters are unique in that way – in fact, not only are upper and lower case letters identified as equivalent, we also read script letters, from many different handwriting styles as the same.

A logical question raised then, when trying to understand children with dyslexia, is whether the visual word form area is functioning the same way when children struggle to learn to read or to read fluently. Former blog posts have discussed how most children diagnosed with dyslexia show problems with the ability to perceive speech sounds, the other half of the “sound to letter” correspondence capacity. But are there also problems with identification of letters visually? Dr. Dehaene research suggests the answer is ‘yes'. 

Recent brain imaging research reported in the journal Neuroimage by Dr. Dehaene, and his colleagues confirmed that good readers do, in fact, show a well-developed visual word form area (the letter box). Dyslexics, on the other hand, showed no such specialization for written words. So, not only do children who struggle to read have problems perceiving the sounds within words, they also appear to have trouble recognizing letters – at least the “letter box” part of the brain is not responding the way it does in typical readers. It is interesting that the first efforts to treat dyslexia in the 1950’s and 60’s actually focused on the importance of letter recognition. But early researchers may have misunderstood what was happening. Some early dyslexia researchers thought that children with reading problems were reading words and letters backwards. Dehaene has shown, though, that all young readers have a tendency to confuse letter orientation. Children have to learn that a d and a b are not the same even though they have a line and a circle at the bottom.  Children also have to learn that a word is not an object, and that the internal detail of a word is as important as the outline. House and Horse look a lot alike at first glance, but the difference in the third letter makes a huge different in pronunciation and meaning. It takes time for children to figure this out – but it does not mean they have dyslexia. And research in the last few decades has emphasized that many children who do have dyslexia have marked problems with auditory perceptual, phonological awareness and language components of reading. So, it now appears that both sides of the reading equation – auditory/linguistic and visual are important.

This new research points to the importance of reading interventions that improve all components of reading disorders: auditory perception, phonological awareness, language skills and visual letter recognition. It also points to the importance of interventions that have evidence-based data revealing the underlying brain structural changes that coincide with the intervention components. Neuroscience-designed interventions like Fast ForWord that have research with dyslexic children and adults employing brain imaging technology are helpful because they indicate when brain area activation increases and the correlation to standardized reading test improvements. Such a study, performed by Elise Temple and her colleagues using fMRI actually showed that with children who were diagnosed with dyslexia, the Fast ForWord Language program actually increased activation in language areas as well as the visual word form area.

Reading is a relatively new skill for the human brain, but underlying language areas and visual perceptual skills that have strong neurological underpinnings are recruited to make that wonderful capacity of understanding the written word possible. However, in some children and adults diagnosed with dyslexia, decreased activation of certain brain areas seems to be a factor in the problems those individuals have learning to read. Fortunately, brain science is not only helping us understand these important brain regions, it is also providing research to show how specific targeted interventions, like Fast ForWord, not only improve reading skills but activate those very areas that appear essential to successful reading achievement.

Suggested readings

Dehaene, S. (2013) Inside the Letterbox: How Literacy Transforms the Human Brain. Cerebrum. May-June:7. Published online 2013 Jun 3.

Monzalvo, Fluss, Billard, Dahaene, & Dehaene-Lambertz, (2012).  Cortical networks for vision and language in dyslexic and normal children of variable socio-economic status. Neuroimage, 61 (2012) 258-274

Temple, E., Deutsch, G. K., Poldrack, R. A., Miller, S.L., Tallal, P., Merzenich, M. M., & Gabrieli, J. D. E. (2003). Neural deficits in children with dyslexia ameliorated by behavioral remediation: Evidence from functional MRI. Proceedings of the National Academy of Sciences, 100(5), 2860-2865.


13 Questions About The Build English Fast Solution

Tuesday, September 15, 2015 - 08:00
  • Carrie Gajowski, MA

Build English Fast with ELLs

Are you faced with more English language learners in your class, school or district? You may not know that Fast ForWord® is the top-ranked intervention for English Language Development on What Works Clearinghouse. Our unique Build English FastTM solution incorporates the power of both Fast ForWord and Reading Assistant to accelerate English language development. In one of our most popular webinars this year, Dr. Martha Burns fielded the following questions from educators like you!  Click here to view the full webinar.

Q: What is the best age for teaching a second language to benefit the development of the second language?

A: Birth to seven is generally the time when it is easiest to learn and become proficient in a second language. However, that period of time is extended in people who are bilingual, such that bilingual people can learn additional languages extraordinarily well, even at older ages. It seems that just being exposed to two languages when you are young makes your brain more flexible for learning languages in general.

The general rule is that the best time to learn an additional language is before age seven -- but that rule can be broken by lots of different things, including bilingual proficiency.

Q: Does the Fast ForWord program help with native language delays?

A. The Fast ForWord program helps build the whole language network in the brain.  In doing so, it improves the brain’s ability to process language and thereby can help the development of both the native language and any second language (such as English).

Q: What about special needs students who are second language learners?

A: The Fast ForWord program was originally designed for use with children with special needs but has been found to be extraordinarily effective with ELL students. The original group of study participants included students with developmental language problems of one kind or another that could be associated with autism spectrum disorder, developmental delays, and specific language impairments. All these groups of children benefited from the Fast ForWord program. The only caveats are that the child needs to have language skills in their native language of at least a three-year-old, and the child must be able to use a computer or iPad with headphones.

Q: What age range is the Fast ForWord program good for?

A: For English language learners, the program can be started as early as age five.  There is no upper age limit for program use.

Q: What about kids without basic literacy?

A: Students can benefit even if they are not reading in either their native or their second language. Two of the products that are particularly appropriate for English language learners (Fast ForWord Language for students in elementary schools and Fast ForWord Literacy for students in secondary schools) focus on sounds and oral language, and have no written letters.  These are appropriate starting points for students who are not yet literate.

Q: Is there progress monitoring and data to support the program?

A: Yes. A great strength of the Fast ForWord program is the ability of educators to monitor each student’s strengths and weaknesses. Every grammatical error the student makes is recorded, as well as every error in speech sound discrimination, vocabulary, or listening/reading comprehension.  Each student’s responses on every item are included in a report.

Q: Is there a pre-test that can be administered to know where to begin?

A: When the program is used in a school setting, there is an assessment called Reading Progress Indicator that typically runs automatically when students initiate use (although it can be turned off during enrollment).  This assessment evaluates a student’s early reading skills and determines whether the student has a reading discrepancy.  Coupled with the student’s current grade level and education classification, this determines where in the program the child should start.  As long as the auto placement option has been selected, the program will place the student at that point and continue to move them onto the next product within the Fast ForWord program as appropriate.    

Q: Does it work on all modalities – reading, writing, listening and speaking?

A. The Fast ForWord program and Reading Assistant software work directly on reading, speaking and listening. Although there are no actual writing exercises that use pen and paper, research has shown improvement in writing. For information on this specific research, please see the blog post on our website "Building Better Writers (Without Picking Up a Pen)" by Dr. Beth Rogowsky.

Q: Is this a program people can access at home or just at school?

A: You can access the Fast ForWord program at home or school. The three ways through which the program can be accessed are:

  1. School district that is using the Fast ForWord program;
  2. Clinical professional who is trained on the Fast ForWord program and using it, such as a speech and language pathologist.  Trained professionals can be found on the Search for a Provider page; or
  3. BrainPro online service, which combines the Fast ForWord program with the services of a professional consultant. Learn more about the BrainPro service.

Q: Can this program be compared to other ESL programs?

A: Many other programs teach language through sentence structure. A student sees a picture and hears a word or sentence that goes with the pictures. They do not have specific training in speech sound discrimination by itself. The Fast ForWord program complements these other programs by developing some of the necessary foundational skills, including the ability to discriminate between sounds and the ability to identify specific phonemes. 

Q: Is the Reading Assistant program helpful for strengthening literacy?

A: Yes, the Reading Assistant program is a literacy product. Students start working with real text leveled around mid-first grade. Initially, students have the stories or the content read to them while they look at a printed page and see the words and phrases highlighted as they are read by the computer. The students then read aloud the text themselves. In order to use the Reading Assistant program, children must be able to correctly read 25 words per minute.  For students who use it, Reading Assistant is a wonderful tool for building fluency, reading vocabulary, and comprehension.

Q: How many minutes do you need to use the Fast ForWord program to get the most benefit?

A: ELL students, who have average native language skills, should use the products at least thirty minutes, three times a week. For students whose native language skills are not at age level, the minimum is thirty minutes, five times a week. These protocols are appropriate for both the Fast ForWord Language (elementary school students) and the Fast ForWord Literacy (middle or high school students) products and can be completed in anywhere from 12 to 27 weeks based on the abilities of the student and whether the students use the  products thirty minutes for three or five days a week.  Students can also use the products for more minutes each day, and thereby reach completion in fewer weeks.

Q: If a child starts in the Reading Assistant program at the first grade level, does it adjust to match the student’s level as he/she does the activity?

A. The Reading Assistant program has many different levels of difficulty, becoming more difficult as students progress.  In order to use the software, students must be able to correctly read at least 25 words per minute, which corresponds to a mid-first grade reading level.  However, difficulty ranges up through high school with content that aligns with the interest and content material for the corresponding grade levels:  K-3, 4-5, 6-8, and 9-12. 

Not all students start at the same level.  Teachers can select the appropriate level of reading for each student, or students can take the Reading Progress Indicator assessment and be automatically placed in to the appropriate level of the Reading Assistant program.



Brain Science and Reading Instruction

Friday, August 14, 2015 - 08:00
  • Timothy Rasinski, Ph.D. and Martha S. Burns, Ph.D.

Reading Achievement

Key Points:

  • Reading achievement has largely remained the same in the US in the past 30 years, despite various efforts
  • Five critical factors for reading are phonological awareness, phonics or word recognition, fluency, vocabulary and comprehension
  • Research indicates many children who struggle with reading have difficulty processing the “fast parts” of speech
  • One school saw students reading at a Basic or above level increasing from 19% to 81% after using Fast ForWord

How to improve student reading achievement

The past three decades have seen substantial efforts at the national, state, and local levels to improve reading instruction and reading outcomes for students in the United States. These have ranged from the Reading Excellence Act, to the National Reading Panel, to Reading First, to various standards movements, to high stakes testing of students, and higher degrees of teacher accountability. Yet, despite these and other efforts, reading achievement among students in the United States has largely remained unchanged during this period. The National Assessment of Educational Progress reports that the most recent assessment of 12th grade students’ achievement in reading (2013) is actually lower than it was in 1992 (U.S. Dept. of Education, 2013). Clearly, we have yet to find the “magic bullet,” if there is one, for improving student reading achievement.

One major advance in our understanding of effective reading instruction came at the turn of the century with the advent of the National Reading Panel (2000). The panel was made up of a group of distinguished literacy scholars who were given the task of laying a scientific foundation for effective reading instruction. After reviewing the existing scientific research into reading and reading instruction, the panel identified five critical factors that students must develop competency in and that teachers should emphasize in instruction. These factors were:

  • Phonological awareness
  • Phonics or word recognition
  • Fluency
  • Vocabulary
  • Comprehension

Phonological Awareness

Phonological and phonemic awareness refer to the ability to perceive, segment, blend, and otherwise manipulate sounds, particularly the sounds of language. Research has demonstrated that this competency is required for effective phonics instruction. If students have difficulty in perceiving and manipulating language sounds, they will certainly be challenged when those language sounds become associated with written letters as in phonics.

Phonics or Word Recognition

Phonics or word recognition refers to the ability of readers to produce the oral representation of a written word using, primarily, the sound symbol representation of letters and letter combinations.


Fluency is the ability to produce the oral representation of written words effortlessly so that readers can direct their attention to the meaning of the text. Fluency also includes the ability to read with appropriate expression that reflects and enhances the meaning of the written text.


Like phonics, vocabulary refers to competency with words. However, vocabulary deals with the meaning of the oral and written words rather than the ability to “sound out” words. Clearly, comprehension is not possible if readers do not know the meaning of words, even if they can sound them out correctly.


Finally, comprehension refers to the ability of readers to gain meaning from a written text. Comprehension is the ultimate goal of reading and requires meaning-making effort and strategies on the part of the reader.

Brain plasticity and reading

During this same period in which the scientific foundation was being laid for reading instruction, advances were being made in our understanding of how the brain works. One of the earliest discoveries was that of the human brain’s ability to change itself, or brain plasticity, even beyond the early stages of development. The prevailing scientific view had been that once the critical period of development had passed, infancy to early childhood, the human brain operated within a limited and fixed range of ability. Although changing the brain or learning was clearly possible after the critical stages of development, there were limits.

Through a series of studies conducted in the 1990s, neuroscientist Dr. Michael Merzenich and colleagues discovered that our brains had the ability to change in significant ways well beyond early childhood. However, the stimuli (i.e. instruction) that lead to brain changes need to be intentional, intense, focused and repetitive. Early in life, our brains seem to learn effortlessly. Beyond that early period, more intentional effort is required to change the brain.

During this period, neuroscientists, using ever more sophisticated methods, were developing more detailed maps of the brain. That is, they identified specific locations of the brain that were associated with cognitive tasks and competencies. Brain locations and functions were identified for phonological or sound awareness, visual awareness and perception, fluency, vocabulary, and language comprehension.

Reading and brain science meet

We know that there are competencies that need to be mastered in order to become a proficient reader. We also have learned that there are specific areas of the brain that are associated with these competencies. Moreover, we have discovered the brain’s ability to change itself in response to intentional stimuli. Do these understandings offer some new approaches for conceptualizing, implementing, and monitoring reading instruction? The answer is, of course, yes.

One of the first approaches came in the areas of phonological awareness and auditory processing. Research indicated that many children with language and reading difficulties had difficulty processing the “fast parts” of speech - common combinations of consonants and vowels that are pronounced quickly (e.g., the plural suffix that distinguishes the word cat from cats). It was the ability of the brain to perceive rapid auditory input that lagged behind other aspects of language use. This resulted in difficulties in distinguishing differences in similar sounds as well as perceiving grammatical prefixes and suffixes in some contexts.

A program was developed that eventually evolved into Fast ForWord®, a program that trains students in sound perception by using technology to initially slow down or enhance the production of the “fast” sounds. Through frequent, repeated, focused and sustained practice with reinforcement, the sound production was gradually modified until it approximated normal speech speed in exercises that emphasized speech perception in words and oral language comprehension. Clinical research indicated that students who were put into such an enhanced auditory processing program made significantly greater progress in speech discrimination, language processing, and grammatical comprehension than students who were placed in a similar program using natural speech production (Tallal, et al., 1996). Similar findings of improved language processing were also reported in a study of special education students.

Evidence from students’ reading achievement

Although examining changes in the way the brain processes linguistic stimuli is encouraging, the real proof for educators and the general public is the extent to which an intervention can affect actual reading outcomes in students. An early clinical study (Temple et al., 2003) of the use of Fast ForWord Language over 6-8 weeks with dyslexic students found that the students made significant and substantial improvements in word reading and passage comprehension. School-based studies, of course, provide even more convincing evidence of the effectiveness of a particular intervention as the intervention is actually implemented in a real school setting with real school personnel. Thomas Gibbs Elementary School in St. Mary Parish implemented Fast ForWord over the course of two years with fourth-grade students. Students’ performance on the statewide high-stakes reading achievement increased dramatically, with the percentage of students identified as reading at a Basic or above level increasing from 19% to 81%. During the same period, the statewide average of students identified as Basic or above readers increased from 51% to 69%. Gibbs students went from performing well below the statewide average in reading to substantially above the average in two years.


Albert Einstein was famous for, among other things, defining insanity as doing the same thing over and over and expecting different results. It seems that major educational publishers have been offering the same generic type of reading program for students for years. And the result has been reading achievement that has not substantially changed in 20 years. Perhaps it is time to consider new approaches to reading education and intervention, approaches that tap into informative uses of technology and new understandings about how the human brain works, while at the same time holding on to understandings of the competencies students need to master in order to become fully literate. Fast ForWord and Reading Assistant appear to offer some new ways of thinking about and approaching reading instruction that use technology and understandings of the workings of the brain and brain functions, and that correlate with our understandings of what is important in learning to read. Perhaps it is time to try something new; perhaps it is time for schools to give Fast ForWord and Reading Assistant a try.

    This blog post is an adaptation of a white paper written by Dr. Timothy Rasinski and Dr. Martha S. Burns.


    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 aftereffects?

    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.  


    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.


    Path Out of Poverty? Education Plus Neuroscience

    Tuesday, July 14, 2015 - 08:00
    • Martha Burns, Ph.D

    Key PointsNeurological implications of poverty on kids

    • Children raised in poverty are exposed to millions of fewer spoken words at home
    • Income level negatively impacts cognitive functions
    • There are links between family income and memory and attention
    • Poverty is associated with chronic stress which can have a toxic effect on brain architecture
    • Computer games designed to target the skills that are impacted can turn around some effects of poverty

    How family income impacts children neurologically

    Poverty impairs the brain’s ability to develop and learn. Perhaps as toxic as drugs and alcohol to a young child’s brain, poverty not only affects the development of cognitive skills in young children, but it also changes the way the brain tissue itself matures during the critical brain “set up” period during early childhood.  We have known for decades, since Hart and Risley’s seminal research published in 1995, that children who come from homes of poverty are exposed to millions of fewer spoken words in the home environment by the time they enter school than children who are raised in homes where the parents are professionals. Neuroscientists have recognized that human brain maturation is experience-dependent and one of the most important times for experience to mold the brain is from early childhood through the elementary school years.  It goes without saying that the less language a child is exposed to the fewer opportunities the brain has to develop language skills. But language function in the brain is not the only casualty of poverty; there are many other cognitive skills that are affected by low socioeconomic status.

    Kimberly Noble, an Associate Professor of Neuroscience and Education at Columbia University Teacher’s College, has been studying the effects of poverty on many aspects of cognitive development and brain structure for over a decade. As early as 2005, with M. Frank Norman and Martha Farah, she published research on the relationship between socioeconomic status and specific cognitive functions. Her findings show that children who come from homes of poverty have limitations in a range of cognitive skills, including the following:

    • Long and short term (working) memory
    • Visual and spatial skills
    • Executive functions like self-control
    • Ability to learn from reward

    What is the link between brain development and household income?

    More recently, Dr. Noble and Elizabeth Sowell, Professor of Pediatrics at The Saban Research Institute at Children’s Hospital Los Angeles, have found compelling links between family income and brain structure as well, especially affecting those areas of the brain important for memory and attention, regions essential for academic success. In a recent article in the journal Nature Neuroscience they reported that increases in both parental education and family income were associated with increases in the surface area of numerous brain regions, including those implicated in language and executive functions. Family income, however, appeared to have a stronger positive relationship with brain surface area than parental education.

    What causes the correlation between poverty and brain development?

    The reasons for the effect of poverty on brain development are complex. Elizabeth Sowell has asserted that family income is linked to factors such as nutrition, health care, schools, play areas and, sometimes, air quality, all of which can affect brain development. Others, like Jack Shonkoff and Pat Levitt of the National Scientific Council on the Developing Child at Harvard, have emphasized the role of stress in brain development.   Stress is associated with the release of the hormone cortisol which, in the short term, activates the body to respond to problematic situations.  With chronic stress, however, the authors review research which indicates the sustained cortisol can have a toxic effect on brain architecture.  

    How can educators help reverse these effects?

    As educators, the new research begs the question, “Are children raised in poverty doomed to educational struggle, no matter how well we teach?”  The answer, fortunately, is that neuroscience has not only clarified the problems caused by poverty but provides solutions as well.  In a recently published report titled “Using Brain Science to Design Pathways Out of Poverty”, Dr. Beth Babcock, CEO of Crittenden Women’s Union, argues that because those areas of the brain affected by the adverse experiences of poverty and trauma remain plastic well into adulthood, neuroscience research offers promise for coaching and other methodologies that can strengthen and improve brain development and function.  In her report, Dr. Babcock advocates, in part, for the use of "computer games” designed to, “improve memory, focus and attention, impulse control, organization, problem solving, and multi-tasking skills [that] are now widely available and beginning to create positive outcomes” (page 13).

    The Fast ForWord programs, designed by neuroscientists at UCSF and Rutgers and tested for over a decade in many school districts with high poverty rates around the nation, have been repeatedly shown to increase academic performance in school districts with high levels of poverty. Read about the inspiring results at Highland View Elementary School, Hattie Watts Elementary School, and J.S. Aucoin Elementary School.

    The beginning levels of the Fast ForWord programs (Fast ForWord Language  and Fast ForWord Literacy) target attention, memory, processing and sequencing skills – core cognitive skills essential for learning.  The later level programs (Fast ForWord Reading Levels 1-5) add specific technological instruction in reading comprehension, spelling, phonological awareness,  and decoding while also building in components to continue to build attention and memory skills.  

    Research-proven: increased reading skills & neurological changes

    Neuroscience imaging research  conducted at Stanford and replicated at Harvard with students who exhibited reading disabilities and used the Fast ForWord programs for six weeks indicated not only significant improvements in reading skills on standardized testing, but also neurological changes in areas of the brain critical to reading success.

    The Reading Assistant programs, designed to improve oral reading fluency, incorporate speech recognition software to provide students with a one-on-one patient reading tutor/coach. Especially effective for students of poverty who may have little opportunity to read independently to an adult at home, Reading Assistant first provides a fluent oral reading model of every grade appropriate passage to be read, then, while the student reads aloud into the computer, the program corrects the student’s oral reading errors as they occur in real time. 

    Summary: education is the key!

    Poverty is toxic to the developing human brain and thereby endangers academic success. Education offers the key to a path out of poverty.  However, increasing class sizes and limitations on teachers’ time to individualize instruction, especially in school districts with high poverty rates, limit the ability of teachers to be as effective as they might if they could work with students individually. Furthermore, even the best curriculum does not include courses to improve attention, memory or other underlying cognitive functions compromised by lives of poverty. Neuroscience now offers not only an explanation of the problem but low cost solutions that can change the brains of all students to enable learning so that teachers can then do what they do best: teach!


    Babcock, E. (2014) Using Brain Science to Design Pathways Out of Poverty. Crittenton Women’s Union Report

    Hart, B. and Risley, T. (1995) Meaningful Differences in the Everyday Experience of Young American Children. Paul H. Brookes Publishing Co.

    Noble, K., Norman, M.F., Farrah, M (2005) Neurocognitive correlates of socioeconomic status in kindergarten children. Developmental Science 8:1, pages 74-77.

    Noble, K. et al. (2015) Family income, parental education and brain structure in children and adolescents. Nature Neuroscience. Published online 30 March

    Shonkoff, F., Levitt, P., Bunge,s. et. al. (2014) Excessive Stress Disrupts the Architecture of the Developing Brain. National Scientific Council On The Developing Child, January.


    Carter’s Story: Diagnosing and Treating Dyslexia

    Tuesday, June 16, 2015 - 08:00
    • Hallie Smith, MA CCC-SLP

    “I knew there were leaves on trees, but had never really seen them.”

    Joanne Gouaux remembers when she was 8 years old, sitting in an ophthalmologist’s office, waiting to put on her first pair of glasses. As soon as she put them on, she looked out the window. She saw leaves clearly for the very first time.

    “I feel like that’s what’s happening with Carter and words. It’s like he knew words were for reading, but couldn’t quite make sense of them himself.” She went on to say “I knew leaves existed, but had never truly seen them.” Joanne is the mother of Carter, who was just recently diagnosed with dyslexia.

    Carter loves Legos, spy trap inventions, and 9-year-old humor. He’s always been a good problem solver, talkative, social and curious. But he was not learning how to read.

    Now, after Fast ForWord, things have changed. He’s reading signs outside and making jokes about them.                                                                                          

    “Mom, if you take the ‘gr’ off of that sign 'Keep off the Grass'…and he bursts into laughter.”


    Early clues

    When Carter started school, he attended an academically rigorous private school. By the spring of kindergarten, the teachers noted that he was experiencing a few problem areas:

    1. Connecting sounds and symbols
    2. Remembering things he had just written
    3. Struggling to read and write.

    His teachers suggested that Carter be withdrawn from private school and seek services in public school. The resource specialist also recommended that Carter receive specialized vision testing to rule out perceptual difficulties. Vision problems were ruled out by a neuro-ophthalmologist, and a developmental pediatrician was also able to rule out traumatic brain injury. The pediatrician did suggest the possibility of a ‘budding learning disability’.  Joanne explained, “She assured us that public school would have the best resources to support Carter.”

    Searching for the right school


    Joanne enrolled Carter in a public school known for its high test scores. It was poor fit from the start. “His teacher refused to recognize his struggles as legitimate,” Joanne recalls. “She called him lazy in front of me, and took away recess time for not finishing his writing assignments quickly.” Carter went from loving school to feeling sad and anxious each morning. After just three months, Joanne transferred him to a school “more in line with his learning style” - an independent school with a kinesthetic learning curriculum.

    Carter made friends quickly at his new school, and his teachers appreciated his curiosity. But in the spring, Joanne was called into a meeting with Carter’s teacher, the resource specialist, and the head of the school to discuss Carter’s results on the Woodcock Johnson tests, which measure cognitive performance. “The scores clearly showed how little he was retaining from the classroom,” she says. At the time, Joanne was told it was just a stage and Carter would come through it with continued team effort.

    Almost held back

    But two weeks before the end of the year, she was called back for a team meeting with the recommendation that Carter be held back. Joanne was exasperated with the late notice.

    “I did not believe that Carter needed another year of first grade,” she says. “He had a rich Kindergarten experience, and lots of reading support at home. I knew there had to be something else underneath that was preventing him from emerging as a reader and writer. Faced with possibility of being held back a year, Carter was heartbroken and discouraged.”

    Finding the right intervention

    Joanne decided to look for help elsewhere. Her mom, who is dyslexic, suggested that she contact the fraternal organizations, such as the Shriners. Joanne found the Scottish Rite Childhood Learning Clinic in Oakland, CA, and met with the director, Pamela Norton. Norton told Joanne about Fast ForWord, which, she said, could bring his grade level performance up one to two years. “I cried,” Joanne says. “I finally found someone who not only believed in Carter, but was also willing and capable of helping.”

    In June of 2013, Carter began using the Fast ForWord Language program, with weekly support from the Scottish Rite Childhood Learning Clinic. By August, Joanne says “he was within norms for second grade. Fast ForWord allowed him to enter second grade, rather than being held back and repeating first grade.”

    At last…The right diagnosis!

    Beginning that summer, when Carter was starting to catch up with his peers, Joanne pursued further testing at her own expense. After WISC testing and a battery of Woodcock Johnson assessments by a Developmental Pediatrician, Carter was finally diagnosed with dyslexia in September, 2013.

    Carter’s progress

    Currently, Carter has daily support through the school "learning center" (1/2 hour per day). He has an IEP which became effective last fall, 2014. Carter continues to struggle with writing and motor planning -- but his skills are emerging and accommodations like voice-to-text typing allow him to be a more independent learner.

    At Carter's last parent teacher conference his teacher and resource specialist noted mental focus and a desire to learn as major strengths. Carter is an avid audio book listener, which allows him to access some much needed academic stimulation, and supports the continued growth of his language skills. 

    Now that that he is in 4th grade, Carter is reading Level 2 readers and decoding words. His confidence has soared. “He no longer dreads opening a book,” his mother says, and “he's proud of himself when he writes. He still experiences bouts of frustration and discouragement like any student, only now he feels confident that he can break things down into smaller steps to accomplish his assignments and goals.”


    Can Auditory Training in Babies Impact Speech and Language Development?

    Tuesday, May 12, 2015 - 08:00
    • Hallie Smith, MA CCC-SLP

    Monitoring a baby’s speech and language patterns can yield important insights about the child’s possible developmental trajectory. Although some children simply acquire speech more slowly than others, delayed speech or atypical development of verbal skills may be signs of learning disabilities, hearing problems, language impairment, auditory processing problems or autism. There is new research that suggests that very early interventions can boost a baby’s auditory system, in the hopes that this will lead to accelerated speech and language development.

    Can We Intervene? New Insights Into Language Development in Infants

    Speech and language is an incredibly complicated process that requires us to distinguish auditory patterns only a few milliseconds in length. This allows us to understand individual speech sounds (e.g., “bay,” “bee”) and put them together into more complicated words (“baby”).  Very early on, an infant makes brain maps of the speech sounds of his/her language. These maps make it easier to piece sounds together to understand spoken language in a fast, effortless way.

    In infants, early exposure to certain sounds seems to help their brains to more effectively process auditory information. That is, hearing certain sounds may change brain pathways, making an “acoustic map” for the building blocks of speech. A recent study led by April Benasich, a researcher at Rutgers University, sought to find whether early intervention could improve this acoustic mapping ability.

    During the study, 4-month-old babies were presented with tones while hooked up to an electroencephalogram (EEG) machine, which records electrical activity from different brain regions. The babies were divided into two groups: an “active engagement” group that was rewarded for successfully discriminating between two sounds, and a “passive engagement” group that heard the same sounds but did not receive a reward. The researchers hypothesized that active engagement would encourage babies to pay attention to important sounds in the environment.

    All of the babies received six weeks of active or passive auditory training. The parents were asked to bring them back at 7 months of age to see whether the babies who received active training had more well-developed acoustic maps. They found that from 4 to 7 months of age, all of the babies showed better acoustic processing. However, those in the active engagement condition got an additional boost. These babies were faster and more accurate at detecting sound differences. Additionally, they showed differences in brain waves associated with acoustic maps.

    Implications of the Research

    This research suggests that very early interventions may significantly change the brain patterns and acoustic maps of developing infants. This is crucial, because early sound discrimination lays the foundation for speech and language development throughout childhood.  Dr. Benasich has not investigated whether the active engagement intervention continues to boost sound discrimination in children over 7 months of age. However, other scientific evidence suggests that children who go on to develop reading disabilities, language impairments or attention deficit hyperactivity disorder may exhibit early deficits in auditory abilities. Thus, it is possible that early interventions that boost auditory processing may support speech and language development and in turn, prevent the onset of some learning problems. More research is needed to develop the links between early auditory interventions and later academic outcomes.

    Further Reading:

    Plasticity in Developing Brain:  Active Auditory Exposure Impacts Prelinguistic Acoustic Mapping

    Study Shows Benefits of Building Baby's Language Skills Early

    Related Reading:

    Overcoming Language and Reading Problems:  The Promise of Brain Plasticity

    Language-Based Learning Disabilities and Auditory Processing Disorders

    4 New Research Findings About Autism

    Tuesday, April 21, 2015 - 08:00
    • Martha Burns, Ph.D

    Autism AwarenessWith approximately 1 in 68 children diagnosed with autism spectrum disorder (ASD) in the United States, millions of families are looking for research progress in this area. For Autism Awareness Month, we’ve compiled 4 of the latest research findings.

    1.  Autism is in the Genes

    One of the most exciting recent developments in ASD research stems from large, genome-wide studies that have identified genes and genetic mutations that may contribute to ASD. Two such studies have uncovered 60 genes that have a greater than 90 percent chance of contributing to ASD among 500 or more genes associated with ASDs overall  [Ronemus et al, (2014) Nature Reviews Genetics 15, 133-141].  More investigation is needed to dig deeper into the roles of these genes and how they affect the developing brain, but those data are emerging.

    For example, a recent review of the genetic research published by Michael Ronemus and his colleagues has specified de novo mutations (that is, new mutations) in 12 genes that show strong causality of ASDs among boys.  In another recent study, conducted by researchers at the University of California, Los Angeles, the authors reported on the impact of the gene CNTNAP2 on brain function. CNTNAP2 is associated with ASD and has been implicated in impaired language and thinking abilities. Scientists performed functional magnetic resonance imaging scans to compare brain function in carriers and noncarriers of the genetic risk factor. The study demonstrated that the nonrisk group had significantly lower activity in the medial prefrontal cortex during a task requiring processing of reward information. Additionally, there was increased and more diffuse functional brain connectivity in carriers of the genetic risk factor. Although higher connectivity may seem like a good thing, it may actually reflect an inefficient, immature profile of brain functioning. New research just published this month identified a gene that is very important to the development of neurons in utero, CCNND2, associated with ASD in girls found in families in which two or more females are diagnosed with ASDs. [Turner et al., (2015) Loss of δ-Catenin Function in Severe Autism. Nature 520, 51-54)].

    2.  Problematic Brain Pruning May Contribute to ASD

    To understand exactly how these genetic mutations affect brain maturation, neuroscientists are also investigating what happens differently in the brains of children who have been diagnosed on the autism spectrum.  From this perspective, researchers have begun investigating how the process of brain cell pruning may go awry in children with ASD. Pruning is the process by which a brain weeds out unimportant connections and strengthens the important ones, based on experience. In a recent report published in Neuron, the scientists reported that ASD may be associated with higher levels of a molecule that may impair the ability of brain cells to get rid of dysfunctional cell components.

    3.  White Matter Fiber Tracts Differ in Children with ASD

    Another area of investigation of brain differences in children with ASDs has investigated white matter tracts,  the superhighways of the brain  that allow efficient information transfer between brain regions. Scientists at the University of North Carolina-Chapel Hill studied the development of white matter tracts in infants who later went on to be diagnosed with ASD. They found that at 6 months of age, infants with ASD had higher fractional anisotropy (FA) in key white matter tracts. FA is a measure of the directionality of white matter fibers, with higher FA signaling better microstructural organization. However, those infants with ASD had a slower change in FA over time, such that they had much lower microstructural organization by 2 years of age. This suggests that the trajectory of white matter development may be abnormal even a few months following birth in those who go on to receive an ASD diagnosis. In simple terms, the superhighways of the brain are not working as efficiently in children with ASD as they are for typically developing children. 

    4.  Early Intervention Helps!

    Scientists using the Early Start Denver Model (ESDM), a behavioral intervention, previously showed that this treatment significantly improved IQ and language abilities in toddlers with ASD. Researchers also investigated whether the intervention changes brain functioning. They used electroencephalography to assess electrical activity in the brain during a task involving looking at faces versus objects.  Children who completed the ESDM intervention had faster neural response and higher cortical activation when looking at faces compared to objects. Those who received treatment as usual (a common community intervention) showed the opposite pattern.  Additionally, higher cortical activation during face-viewing was associated with better social behavior. This suggests that the ESDM intervention may cultivate brain changes that result in higher IQ, language abilities and social behaviors.

    Together, these exciting findings highlight the excellent work that is being done by scientists around the world to combat autism. From understanding the impact of individual molecules on brain cell structure to constructing more effective interventions, researchers continue to answer important questions about autism and give loved ones hope for the future of ASD care.

    Further Reading:

    Loss of mTOR-Dependent Macroautophagy Causes Autistic-like Synaptic Pruning Deficits

    Early Behavioral Intervention Is Associated With Normalized Brain Activity in Young Children With Autism

    Dozens of Genes Associated with Autism in New Research

    Altered Functional Connectivity in Frontal Lobe Circuits Is Associated with Variation in the Autism Risk Gene CNTNAP2

    Differences in white matter fiber tract development present from 6 to 24 months in infants with autism

    The role of de novo mutations in the genetics of autism spectrum disorders

    Related Reading:

    Understanding Autism in Children

    Ben's Story:  Intensive Intervention Helps a Young Boy on the Autism Spectrum Succeed


    Alternatives to Medication in the Treatment of ADD

    Tuesday, March 24, 2015 - 08:00
    • Martha Burns, Ph.D

    Options for treating attention problems

    ADD MedicationIn this op-ed in the New York Times, Richard A. Friedman, Professor of Clinical Psychiatry and Director of the Psychopharmacology Clinic at the Weill Cornell Medical College, discusses the urgent need to address the needs of students with attention problems.  Given the dramatic recent increase in the prevalence of ADHD diagnoses in school-aged children [according to the Centers for Disease Control, the lifetime prevalence in children has increased to 11 percent in 2011 from 7.8 percent in 2003 — a whopping 41 percent increase], Dr. Friedman argues for a need to find more natural (non-medical) ways to help these students. In his op-ed he states, “In school, these curious, experience-seeking kids would most likely do better in small classes that emphasize hands-on-learning, self-paced technology-based assignments, and tasks that build specific skills.”

    Whereas many parents and educators consider medication as a first approach to management of disorders of attention, the recent dramatic increase in the incidence and the call for consideration of non-medical interventions for school-aged children is important for parents and teachers to consider when managing learning issues within the classroom. One important type of attention disorder that has been treated successfully without medication is auditory attention disorders associated with some types of learning disabilities. Research conducted by Courtney Stevens and her colleagues at the Brain Development Lab at the University of Oregon has shown that children with specific language learning disorders have problems with auditory attention. Parents and educators rarely use the term “auditory attention”; however, the Stevens et al. research is increasingly supportive of its important role in learning.

    We all recognize students who have problems with auditory attention: those who cannot stay focused on listening long enough to complete a task or requirement (such as listening to a class discussion in school). In fact, when educators use the term “listening skills,” they are referring to auditory attention.  It is virtually impossible to imagine a classroom where paying attention to the teacher for sustained periods of time is not critical to academic success.  According to the International Listening Association (www.listen.org), 45 percent of a student’s day is spent listening, and students are expected to acquire 85 percent of their knowledge through listening. Auditory attention skills mature over time, and like many other skills important for learning (memory, thinking skills), students vary in their ability. Children with ADHD have a known diagnosis of significant auditory (and visual) attention problems. However, according to the Stevens et al. research, even across typical learners there is a variation of ability ranging from those with average auditory attention skills to those with excellent auditory attention skills. And like with other cognitive skills, independent controlled research indicates that Fast ForWord training can significantly improve auditory attention and/or reading skills in a variety of students:  typical students and those with specific language impairment.

    For those interested in the specifics of the Stevens et al. study, she and her colleagues examined whether six weeks of Fast ForWord Language training would influence neural mechanisms of selective auditory attention previously shown to be deficient in children with specific language impairment (SLI). Twenty 6-8 year old students received Fast ForWord Language training, including 8 students diagnosed with SLI and 12 students with typically developing language skills. An additional 13 students with typically developing language received no specialized training but were tested and retested after a comparable time period as a control group.  Before and after training, students received a standardized language assessment as well as a highly objective electrophysiological neural measure of attention using Event-Related Potentials (ERP).

    Compared to the control group, students receiving Fast ForWord Language training showed increases in standardized measures of receptive language as well as an improved effect of attention on neural processing. No significant change was noted in the control group. The enhanced effect of attention on neural processing represented a large effect size (Cohen’s d = 0.8, indicating that the average child in the experimental group is comparable to the child at the 79th percentile of the comparison group). These findings indicate that the neural mechanisms of selective auditory attention, previously shown to be deficient in children with SLI, can be remediated through training and can accompany improvements on standardized measurements of language development.

    Other controlled research, presented by Deutsch et al. at a CHADD conference several years ago, also showed improvement in attention among those students with a diagnosis of ADHD or ADD plus language impairment. In fact, if one considers Dr. Friedman’s finding that children with attention disorders benefit from “self-paced technology-based assignments and tasks that build specific skills,” there are no better designed self-paced e-learning programs than the Fast ForWord and Reading Assistant solutions. The Fast ForWord Reading products and Reading Assistant tasks are self-paced online tasks that require sustained auditory attention.  The tasks in Reading Assistant especially require activities that include listening to modeled reading, reading aloud while receiving corrective feedback through listening, listening to your own reading, and then answering questions about what was read.  Answering “think about it” comprehension questions further exercises both auditory memory and executive function skills.

    In conclusion, the effort to find more natural, non-medical ways to help students with attentional disorders is at hand.  Self-paced technology programs like the neuroscience-based Fast ForWord series provide one proven alternative for improving attentional skills in students with language-based learning issues as well as those diagnosed with ADD and ADHD. 

    Further Reading:

    Stevens, C., Fanning, J., Coch, D., Sanders, L., & H Neville (2008). Neural mechanisms of selective auditory attention are enhanced by computerized training: Electrophysiological evidence from language-impaired and typically developing children. Brain Research, 1205, 55-69.

    Students Show Improved Auditory Attention and Early Reading Skills After Fast ForWord Intervention

    Related Reading:

    Improved Auditory Processing With Targeted Intervention

    Why Auditory Processing Disorders (APD) are Hard to Spot



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