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After a decade of working alongside Barbara Arrowsmith-Young, the Founder of the Arrowsmith Program, I wondered if there was a way to bring her program to more children and adults with learning disabilities. Was there a way to reduce the intervention length, but maintain the quality of the outcome? I began to discuss with Ms. Arrowsmith-Young this idea, for which she had also considered for some time. I asked her if we could take the Symbol Relations (reasoning) program and provide an intensive version of it over 6 weeks.
The reason that Ms. Arrowsmith-Young looked at the Symbol Relations was due to the fact that this program was theorized to engage an association area of the human brain. In neuroscience this cognitive function is considered an “association area of association areas” in the brain which simultaneously processes multiple stimuli – both external and internal – necessary to understand the world, oneself and others. It is involved in processing concepts in all academic principles, understanding and quickly grasping what we read and hear, logical reasoning and flexibility in thought.
Ms. Arrowsmith-Young agreed that if the intervention could have the same number of hours as a 10-month intervention during a school year then one could consider this option. The concern was the intensity of the intervention for children. Could they manage to engage in such an intensive intervention? As well, it would be important to find researchers who would study the outcome of this idea.
In the Summer of 2017 the researchers were found, children enrolled in the research, and the study coordinated. The students brain networks would be imaged both pre-and-post Symbol Relations intervention. In addition, cognitive measures of behaviour were also measured pre-and-post. If the research found that this method of intensive delivery was getting results then it was possible that the intervention could be offered to more children who did not have the opportunity to engage in the year-round school-based programs.
In September 2018 and March 2019, Dr. Greg Rose and his colleagues presented their data. It is one of the most important pilot studies to date in the field of Learning Disabilities and was presented as poster sessions at two conferences in North America.[i] [ii]
First, the studies presented discovered that children with learning disabilities have brain network connectivity problems.[iii] This was not a novel finding as research has been underway at various universities around the world showing that children with learning disabilities have brain network problems.[iv] That is, the major brain networks responsible for executive functioning or attention control regulation showed hyper-connectivity concerns.[v] In other words, being hyper-connected indicated less efficient brain network communication resulting in potential learning problems.[vi] The students about to undergo the 6-week intensive Arrowsmith Program also showed this problem further validating these discoveries in neuroscience.
What was extraordinary about the September 2018 presentation by Dr. Greg Rose and his colleagues, from Southern Illinois University, was that his research was showing that the Arrowsmith Program was changing this connectivity dysfunction and transforming the brain network activity to improved functional connectivity with related improvements in the cognitive abilities these brain networks are associated with such as processing speed and cognitive efficiency.
It is important to restate why this research should transform our thinking of the field of Learning Disabilities. First, the current definition of learning disabilities states that these disabilities are lifelong as the brain cannot change. Second, the recommendations for intervention in the definition of learning disabilities focus on compensations or the use of technology to work around neurological dysfunctions. Finally, the most common form of intervention in our schools today is to have children with learning disabilities focus on their strengths and avoid thinking about learning weaknesses. The research coming from Dr. Greg Rose and his colleagues put to question these assumptions and recommendations.
It is also important to note that the brain networks that showed improvement in connectivity also impact mental health. Thus, the salience network is implicated in problems with anxiety[vii] and depression[viii], a common secondary diagnosis after a child has dealt for years with learning problems. As well, attention disorders (ADHD) are also being researched as to their relationship with brain network connectivity. Again, connectivity concerns within the salience and default mode network have been shown to be correlated to ADHD.[ix] Finally, brain injuries resulting from TBI are also showing that brain network hyper-connectivity is likely a result of post-acute higher order cognitive dysfunctions in this population.[x] This hyper-connectivity for TBI has also shown to be alterable through intensive cognitive rehabilitation interventions like the Arrowsmith Program.[xi]
Based on the pilot research coming from Dr. Greg Rose and colleagues, it appears that the Arrowsmith Program is fundamentally transforming the neurological capabilities of children with learning disabilities. Psychologist, psychiatrist, medical doctors, speech pathologist, special education teachers, school administrators, adults with learning disabilities, and parents of children and adults with learning disabilities need to all take note of this new paradigm of intervention. The brain can change for those with learning disabilities. Research is showing that one can improve brain network connectivity that is likely part of the neurobiological basis of various learning disabilities such as dyslexia, dysgraphia and dyscalculia.[xii]
Howard Eaton, Ed.M.
Eaton Arrowsmith School
[i] Jagger-Rickels, A. C., & Rose, G. M. (2018) ‘Exploring the Relationship Between Improvement in an Intensive Learning Intervention and Changes in Resting state Functional Connectivity’, paper presented to Sixth Biennial Conference on Brain Connectivity in Montreal, 26-28 September, presented 27 September 2018.
[ii] Jagger-Rickels, A. C., Rose, G. M., & Kibby, M. Y. (2019) ‘Effect of Comorbid Learning and Neurodevelopmental Disorders on Resting-state Functional and Effective Connectivity in Adolescents’, poster presented to Cognitive Neuroscience Society Annual Conference in San Francisco, 23-26 March, viewed 26-28 March 2019.
[iii] Finn, E. S., Shen, X., Holahan, J. M., Scheinost, D., Lacadie, C., Papademetris, X., Shaywtiz, S. E., Shaywitz, B. A., & Constable, R. T. (2014). Disruption of functional networks in dyslexia: A whole-brain, data-driven analysis of connectivity. Biological Psychiatry, 76(5), 397-404.
[iv] McCarthy, H., Skokauskas, N., Mulligan, A., Donohoe, G., Mullins, D., Kelly, J., Johnson, K., Fagan, A., Meaney, J., & Frodi, T. (2013). Attention network hypoconnectivity with default and affective network hyperconnectivity in adults diagnosed with attention-deficit/hyperactivity disorder of childhood. Journal of the American Medical Association Psychiatry, 70(12), 1329-1337.
[v] Sripada, C., Kessler, D., Fang, Y., Welsh, R. C., Prem Kumar, K., & Angstadt, M. (2014). Disrupted network architecture of the resting brain in attention-deficit/hyperactivity disorder. Human Brain Mapping, 35(9), 4693-4705.
[vi] Rosenberg-Lee, M., Ashkenazai, S., Chen, T., Young, C. B., Geary, D. C., & Menon, V. (2015). Brain hyper-connectivity and operation-specific deficits during arthimetic problems solving in children with developmental dyslexia. Developmental Science, 18(3), 351-372.
[vii] Geiger, M. J., Domschke, K., Ipser, J., Hattingh, C., Baldwin, D. S., Lochner, C., & Stein, D. J. (2016). Altered executive control network resting-state connectivity in social anxiety disorder. The World Journal of Biological Psychiatry, 17(1), 47-57.
[viii] Kaiser, R. H., Andrews-Hanna, J. R., Wager, T. D., & Pizzagalli, D.A. (2015). Large-scale network dysfunction in major depressive disorder: A meta-analysis of resting-state functional connectivity. Journal of the American Association Psychiatry, 72(6), 603-611.
[ix] Qian, X., Castellanos, F. X., Uddin, L. Q., Loo, B. R. Y., Liu, S., Koh, H. L., Poh, X. W. W., Fung, D., Guan, C., Lee, T. S., Lim, C. G., & Zhou, J. (2019) Large-scale brain functional network topology disruptions underlie symptom heterogeneity in children with attention-deficit/hyperactivity disorder. Neuroimage Clinical, 21:101600.
[x] Hayes, J. P., Bigler, E.D., & Verfaellie, M. (2016). Traumatic brain injury as a disorder of brain connectivity. Journal of the International Neuropsychological Society, 22(2), 120-137.
[xi] Porter, S., Torres, I. J., Panenka, W., Rajwani, Z., Fawcett, D., Hyder, A., & Virji-Babul, N. (2017). Changes in brain-behavior relationships following a 3-month pilot cognitive intervention program for adults with traumatic brain injury. Heliyon, 3(8).
[xii] Michels, L., O’Gorman, R., & Kucian, K. (2018). Functional hyperconnectivity vanishes in children with developmental dyscalculia after numerical intervention. Developmental Cognitive Neuroscience, 30, 291-303.
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