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Arrowsmith Program Research: From Self-Experimentation, to Student and Classroom Observation and Behavioural Testing, to Neuroimaging

Posted on July 15, 2016

Self-Experimentation

“It is common sense to take a method and try it. If it fails, admit it frankly and try another. But above all, try something.”
Franklin D. Roosevelt

President Franklin D. Roosevelt knew a thing or two about trying. The definition of “try” is described as “the effort to accomplish something”. From his diagnosis of polio, to using leadership abilities to lift the United States out of the Great Depression, President Roosevelt breathed the definition of “try”. The above quote, spoken during the Great Depression, comes from the depths of his experience, both personal and public.

In the early days of Barbara Arrowsmith Young’s work with children and adults with learning disabilities, trying to find ways to improve their lives was a personal and public endeavour. In her book, The Woman Who Changed Her Brain, she describes the struggles she went through in learning and her attempt to reshape her brain based on the concept of neuroplasticity.

I strongly encourage you to read this story, and will not attempt to summarize it here, but her personal struggle and suffering due to her learning disabilities were intense. It is rare to see someone with a disability develop their own intervention. But Arrowsmith-Young didn’t just use her program to strengthen her own cognitive weaknesses; she realized it could help millions of others with learning disabilities too.

Self-experimentation is not a new concept in research. In fact, many exceptional researchers launched discoveries using this methodology, including five Nobel Laureates. One can understand how a researcher would be interested in testing an idea, but unsure if it has any validity, and thus says to oneself, “Let’s see if it works for me, first.”

There really is nothing to lose, as the researcher is often faced with the problem themselves, or is absolutely fascinated with the idea of solving a significant question. Arrowsmith-Young had interest, self-experimentation leading to a happier life, and complete interest in seeing if her idea could reshape the field of learning disabilities.

Arrowsmith-Young was desperate for self-improvement, but also wanted to discover a way to reduce the suffering of others faced with learning and social frustrations. As she started the first cognitive exercise on her brain, she had no idea what would occur. It was a hopeful and courageous act in the face of a lifetime of previous hardship and exhaustion.

Self-experimentation is often required when ideas challenge current paradigms. Researchers like Arrowsmith-Young can’t often turn to current academics who are engrossed in their own ideas and promoting them to other academics and the public at large. These academics and professionals have studied their own ideas for so long that new ideas are difficult for them to incorporate into their reasoning. This is not the case for all, though certainly an issue for many.

Thomas Khun, in his book, The Structure of Scientific Revolutions, wrote, “Almost always the men who achieve these fundamental inventions of a new paradigm have been either very young or very new to the field whose paradigm they change.”

Researchers who believe in the old paradigm often react harshly to ideas and findings by those in the new paradigm. Stories of academic ridicule and personal insults are numerous. Interestingly, I was just reading the book, The Second Brain: Your Gut Has a Mind of Its Own, by Michael D. Gershon, M.D., when I came across some lines describing his experience with introducing a paradigm shifting concept.

He wrote, “Since I had not anticipated that my suggestion that serotonin might be a neurotransmitter in the gut would be viewed by the scientific world as outrageous, I was upset by the reaction I actually encountered. My first impulse was to feel empathy with those of my ancestors who faced that Inquisition.”

Student and Classroom Observation

“Nothing has such power to broaden the mind as the ability to investigate systematically and truly all that comes under thy observation in life.”
Marcus Aurelius

“There is no more difficult art to acquire than the art of observation, and for some men it is quite as difficult to record an observation in brief and plain language.”
William Osler

In 1980, in a small classroom on Yonge Street in downtown Toronto, Arrowsmith-Young began a journey that would transform learning disability intervention. She moved from self-experimentation at home to observing students with learning difficulties engaged in her cognitive exercises. Her ability to observe as a researcher was critical and provided keen insight into the effectiveness of her cognitive exercises. She has continued this observational ability to insightfully create and continually redesign her cognitive program.

Arrowsmith-Young remarked to me one day how she admired the observation skills of Dr. Alexandra Luria, the Soviet Neuropsychologist and Developmental Psychologist who helped formulate the theory behind the Arrowsmith Program.

Dr. Luria was capable of observing clients and determining what specific neurological systems were most likely impaired. She was recognized for this talent in her postsecondary studies when working directly with children. She used this talent when determining how her cognitive programs were influencing behavioural change in clients, and created cognitive exercises to help reshape the area of the brain and/or neurological system responsible for a set of behaviours (i.e., cause and effect reasoning, or accurate social perception). Without her observational abilities, the Arrowsmith Program would never have been developed.

What is clearly fascinating is how Arrowsmith-Young not only developed the Arrowsmith Program, but also how she designed the exercises so they could work in a classroom environment of either adults or children. Anyone involved in instructional design understands how difficult it is to create programs that keep the attention of all students. But full engagement and progress occur in Arrowsmith Program classrooms.

The reasoning behind this relates to how students feel progress is being made. They feel safe to take risks due to the ability of the program to match current levels of progress with difficulty levels. As we know, children and adults with learning disabilities can negatively respond to challenges. As a result, a challenge has to be attainable within a given time period, or the individual will quit or stop. Arrowsmith-Young created both individualized cognitive programs, and a classroom instructional program that allowed large numbers of children and adults to experience cognitive functioning progress without fear or ridicule and to even share their successes with other students.

The scientific method is a set of techniques used to observe information and develop new insights in order to scrutinize current knowledge for further development. These techniques include making an observation, thinking of a question related to the observation, formulating a hypothesis, creating a test on the hypothesis, gathering data in various forms, and creating a theory based on the observations.

Arrowsmith-Young has used the scientific method to develop her theory and methodology in the cognitive intervention of thousands of children and adults with learning disabilities since the 1970s.

Use of the scientific method also requires high levels of intelligence, creativity and a keen imagination. Arrowsmith-Young has these traits in abundance. Her observations challenged the conventional idea that learning disabilities are life-long, and caused by neurological dysfunctions that are not alterable. At the beginning stages of her research, she used the scientific method to understand her own brain. She then advanced her work into the world of instructional design and remediation for children and adults with learning disabilities.

Behavioural Testing

“An intelligence test sometimes shows a man how smart he would have been not to have taken it.”
Laurence J. Peter

Some humour is always appreciated, and thus the above quote. Intelligence testing, as will be stated below, is a significant part of testing for a learning disability. This is a measure of behaviour, often used – at times ineffectively – to show who might do well in school and who might not. The pros and cons of this form of testing are discussed frequently by academics.

Behavioural testing or assessment of children and adults with learning disabilities has been used for decades. Any parent with a child struggling in school most likely has first-hand experience with this type of assessment. It’s how children are first identified as having learning disabilities. It ensures an individual has average or above average intelligence needed for the learning disability diagnosis. Measures of cognition (reasoning, memory, etc.) are given alongside measures of achievement in reading, writing, spelling and math.

Expert debate the effectiveness, or even need, for behavioural testing though it occurs frequently in the life of a child struggling in school. What behavioural testing does provide is data. Arrowsmith-Young was intrigued with data and the questions it provided in her search to understand cognitive improvement in children and adults with learning disabilities.

From the beginning, Arrowsmith-Young not only recorded her observations of children and adults, but also used behavioural testing or assessment to analyze before and after changes in both cognitive capacity and achievement skills. She did not only rely on her own observations. Instead she realized the importance of standardized assessments of behaviour.

Measures of reasoning, memory, executive functioning and cognitive efficiency were given before students engaged in the Arrowsmith Program and again after one year and sometimes at the end of their programs. Achievement measures in reading, writing, spelling and math were also given, and compared year to year to analyze progress along with cognitive change.

This approach provided additional research evidence of the effectiveness of the Arrowsmith Program, and also how it might be further developed to improve rates of neurological change.

Dr. William Lancee, a well-respected academic from Toronto’s Mount Sinai Hospital and University of Toronto professor, was the first person to independently research the Arrowsmith Program. He was not involved in the development of the Arrowsmith Program when contacted to conduct studies on its effectiveness in individuals with learning disabilities. He was fascinated with the program, but analyzed the results as an independent researcher.

Dr. Lancee conducted behavioural tests, looking specifically at achievement changes in children engaged in the program. Interestingly, he not only looked at achievement results, but also at correlations between cognitive change and achievement change.

For example, as a child improved cognitive capacities (through the Arrowsmith Program) for reading ability, did he also see the predicted changes in reading achievement, such as word decoding and reading comprehension? Dr. Lancee was able to observe this correlation in support of the Arrowsmith Program.

The Toronto Catholic School Board (TCSB) also studied the effectiveness of the Arrowsmith Program. The TCSB was interested in seeing how Arrowsmith Program students were doing before and after their interventions. Again, the results were supportive of the Arrowsmith Program, dramatically reducing students’ needs for support services. Improvements were observed in achievement, classroom functioning, homework completion and social development.

Behavioural testing has played a significant role in the research methods used to better understand the Arrowsmith Program. Today, neuroscientists are using it to conduct brain imaging on children and adults engaged in the program. The behavioural testing will be analyzed in conjunction with the brain imaging to observe relationships in the data. This is a new development that Arrowsmith-Young is fascinated to participate in.

I recall the first time she observed an image of the brain of a child who had engaged in the Arrowsmith Program for just three months. Dr. Lara Boyd, who is leading the brain imaging study at the University of British Columbia (UBC), asked her if she would like to see what the brain of a child doing one of her cognitive exercises looked like. The excitement and then wonder was evident in Arrowsmith-Young’s eyes as she scanned the image of this child.

Neuroimaging

“Neuroscience is by far the most exciting branch of science because the brain is the most fascinating object in the universe. Every human brain is different – the brain makes each human unique and defines who he or she is.”
Stanley B. Prusiner

“Neuroscience over the next 50 years is going to introduce things that are mind-blowing.”
David Eagleman

Arrowsmith-Young did not have a group of neuroscientists and neuroimaging technology for her research efforts back in the late 70’s when she first developed her program. In fact, these researchers and access to this technology to peer into the brain of a child with a learning disability is only a relatively recent possibility.

Neuroscientists, back then, were not overwhelming supporters of the idea of brain change or neuroplasticity. So for decades Arrowsmith-Young’s work could not seen through neuroimaging. Instead, she used her best insight into neuroscience to determine what areas and systems of the brain were changing based on the tasks involved in her cognitive exercises.

I think it is important to step back a minute, and realize this was a problem for Arrowsmith-Young. She was not part of a university faculty with tenure. She could not therefore conduct her own academic research at a university. Even if she could, no journal in the field of Learning Disabilities or Neuroscience would have published her findings.

I recall a presentation by Dr. Michael Merzenich who discovered neuroplastic brains in monkeys in the late 1960s. He stated that it was such a revolutionary finding in neuroscience that he could not get his own work published at the time. Arrowsmith-Young was alone, on a tiny island of insight, with little support to row her revolutionary ideas into their solid and undeniable community of knowledge in the late 1970s and early 1980s. This isolation continued for decades, and still does.

From 2012 to 2014, with Arrowsmith-Young’s encouragement, excitement and support, I was able to connect with three well-respected neuroscientists: Dr. Brad Hale, Dr. Greg Rose and Dr. Lara Boyd. Dr. Hale has extensive knowledge on learning disabilities and neuroscience, with numerous publications. His most recent position was at the University of Calgary. Dr. Greg Rose is currently the Director of the Center for Integrated Research In Cognitive & Neural Sciences at Southern Illinois University. Dr. Rose is working with Dr. Richard Collins, Director of the Brehm Institute, to study brain change in students engaged at the Arrowsmith Program at the Brehm School. Finally, Dr. Lara Boyd, is a Canada Research Chair (Tier II) in Neurobiology of Motor Learning, Director of the Brain Behaviour Laboratory, and CIHR Delegate & Health Research Advisor to the VP of Research at UBC. Dr. Boyd and her colleagues are also researching the Arrowsmith Program by conducting behavioural assessments and brain imaging on students at Eaton Arrowsmith Schools in Vancouver, BC, Canada and Redmond, WA, USA.

These neuroscientists are now into their second year of data collection. Control groups have been included in their research designs. For Arrowsmith-Young, this is another step in her research efforts to better understand how the Arrowsmith Program is positively impacting the lives of children and adults with learning disabilities. She is not only keen to see how the brain is engaging in the Arrowsmith Program, but also to receive insights from researchers on how to improve the program.

There is no doubt that even with changes in brain functioning, more and more questions will be raised that will require further research efforts. This is just the beginning. As with any revolutionary idea, new ideas generate from additional observations and data collection, which lead to insights and eventually additional theories. This is what the scientific method means for Arrowsmith-Young. The goal should not be to have the absolute answer, but rather to raise more questions so we can get better at what we do.

In 2015, Dr. Naznin Virji-Babul, Director of the Perception-Action Laboratory at UBC, was asked to research how the Arrowsmith Program might improve the lives of those with traumatic brain injury. A nine-month study was recently completed, with data (behavioural tests and brain imaging) collected at the third, sixth and ninth months. Initial results are promising with improvements noted in both behaviour and brain imaging. Dr. Virji-Babul is busy analyzing the nine month data, but she has already submitted a paper for publication.

Summary

“The transition from a paradigm in crisis to a new one from which a new tradition of normal science can emerge is far from a cumulative process, one achieved by an articulation or extension of the old paradigm. Rather it is a reconstruction of the field from new fundamentals, a reconstruction that changes some of the field’s most elementary theoretical generalizations as well as many of its paradigm methods and applications. During the transition period there will be a large but never complete overlap between the problems that can be solved by the old and by the new paradigm. But there will also be a decisive difference in the modes of solution. When the transition is complete, the profession will have changed its view of the field, its methods, and its goals.”
Thomas Khun, The Structure of Scientific Revolutions

The Arrowsmith Program has been engaged in the scientific method of inquiring for over 40 years. Starting with Arrowsmith-Young’s self-experimentations and eventually moving to neuroimaging, her dedication to her passion for research and discovery is quite evident. She challenges the current learning disability paradigm that clearly states through definition (Learning Disabilities Association of Canada, Learning Disabilities Association of America) that disabilities are life-long. This old paradigm, over time, needs to reconstruct itself with the changes that are being observed in both behavioural and neuroimaging research on children with learning disabilities and, most recently, with adults with traumatic brain injury – all engaged in the Arrowsmith Program.

As Thomas Khun states in the above quote, there is a transition period, and I do believe we have begun this transition. The Arrowsmith Program is now being implemented in over 90 schools in seven countries around the world.

Educators, psychologists, medical doctors and other professionals in the field of learning disabilities are now faced with the question of neuroplasticity and learning disabilities. What is the potential of the brain to change itself for a child diagnosed with a learning disability? Are there important cognitive functions that we currently do not address due to the fact that we have been so focused on achievement and neurology? Do we change the definition of learning disabilities? Do we add cognitive intervention as a recommended approach to helping children and adults with learning disabilities?

One day the transition will be complete, as Thomas Khun, also notes in his above quote. This might not occur in Arrowsmith-Young’s lifetime, and she is well aware of this fact. Though, for now, she has been and will continue to be one of the foremost researchers in the field of learning disabilities for some time to come. She will continue to be challenged, criticized and congratulated by various participants in the learning disability community. This is a sign of the importance of her research. Though, and most importantly, over time the benefits of the Arrowsmith Program to children and adults with learning difficulties will be realized for a wider population. Debate of scientific revolutions often brings about awareness, which will only be a good thing for those suffering from learning difficulties.

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