Working Memory, Attention, and Executive Function: Critical Factors for Success in Math

The recent interest in how brain function affects learning has brought into focus the role of working memory, attention and executive function. These three cognitive functions are interwoven in a complex system of neural networks, and they are crucial to the learning process. Strong working memory results in functional attention networks and good executive function, all of which correlate strongly with academic achievement (Tannock, 2008). Below is a brief explanation of these three cognitive processes and their effect on mathematical learning.

What is Working Memory?

Working memory consists of the brain processes used for temporary storage and manipulation of information. It operates over only a few seconds, and it allows us to focus our attention, resist distractions, and guide our decision-making. Low working memory is a barrier to both the efficiency and learning of both calculation and higher level problem solving. The most current research on working memory describes it as a passive store component, plus attentional control. Researchers have also shown that working memory is necessary for the control of attention. Working memory and control of attention are inseparable (Klingberg, 2008).

The majority of studies on math disabilities suggest that children with a math disability have memory deficits. (Swanson 2006) Memory deficits affect mathematical performance in several ways:

• Performance on simple arithmetic depends on speedy and efficient retrieval from long-term memory.
• Temporary storage of numbers when attempting to find the answer to a mathematical problem is crucial. If the ability to use working memory resources is compromised, then problem solving is extremely difficult.
• Poor recall of facts leads to difficulties executing calculation procedures and immature problem-solving strategies.

Research also shows that math disabilities are frequently co-morbid with reading disabilities (Swanson, 2006). Students with co-occurring math and reading disabilities fall further behind in math achievement than those with only a math disability. However, research shows that the most common deficit among all students with a math disability, with or without a co-occurring reading disability, is their difficulty in performing on working memory tasks.

Inattention

Inattention is most commonly associated with ADHD, but it is present in many brain disorders. Inattention is a widespread problem for learners. Inattention is a risk factor for poor math achievement, and low working memory is a causative factor.
Inattention has three cognitive aspects that are determined by three neural networks, which are anatomically and cognitively separate.

1. Alerting
   • Critical for optimal performance, the alerting network prepares an individual for perceiving and receiving new stimuli.
   • Symptoms of dysfunction include:
     • Complaining that a task is too boring or hard
     • Yawning
     • Laying one’s head down on a desk
2. Orienting
   • This network selects and sorts relevant information from general sensory input.
   • Symptoms of dysfunction include:
     • Focusing on irrelevant stimuli
     • Easily distracted by anything
3. Executive Attention
   • This is the network that is responsible for planning, organizing, recognizing errors, and involves the working memory
   • Symptoms of dysfunction include:
     • Getting sidetracked and not noticing signs in math
     • Missing words in written work
     • Forgetting instructions
     • Difficulty organizing materials and academic work

The risks related to inattention are many (Tannock, 2008). Inattentive behavior predicts a poor response to reading instruction, as well as math achievement. Poor attenders do worse on tests of oral reading fluency. Despite the attention given to students with hyperactivity and conduct problems in the classroom, those students have more academic success than students who are poor attenders.

References

Klingberg, T. (2005). The concept of working memory. Retrieved April 24, 2008 from www.workingmemory.com.
Swanson, H. Lee, Jerman, O. (2006). Math disabilities: a selective meta-analysis of the literature. Review of Educational Research, 6(2), 249-274.
Tannock, R. (2008, March 7). Paying attention to inattention. Paper presented at the Harvard Learning Differences Conference.

Retrieved from: http://usablealgebra.landmark.edu/instructor-training/working-memory-attention-executive-function/

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Under-Achieving Kids: Low Intelligence Or Poor Working Memory?

Children who under-achieve at school may just have poor working memory rather than low intelligence according to researchers who have produced the world's first tool to assess memory capacity in the classroom.

The researchers from Durham University, who surveyed over three thousand children, found that ten per cent of school children across all age ranges suffer from poor working memory seriously affecting their learning. Nationally, this equates to almost half a million children in primary education alone being affected.

However, the researchers identified that poor working memory is rarely identified by teachers, who often describe children with this problem as inattentive or as having lower levels of intelligence.

The new tool, a combination of a checklist and computer programme informed by several years of concentrated research into poor working memory in children, will for the first time enable teachers to identify and assess children’s memory capacity in the classroom from as early as four years old.

The researchers believe this early assessment of children will enable teachers to adopt new approaches to teaching, thus helping to address the problem of under-achievement in schools.

Without appropriate intervention, poor working memory in children, which is thought to be genetic, can affect long-term academic success into adulthood and prevent children from achieving their potential, say the academics.

Although the tools have already been piloted successfully in 35 schools across the UK and have now been translated into ten foreign languages, this is the first time they are widely available.

Working memory is the ability to hold information in your head and manipulate it mentally. You use this mental workspace when adding up two numbers spoken to you by someone else without being able to use pen and paper or a calculator. Children at school need this memory on a daily basis for a variety of tasks such as following teachers’ instructions or remembering sentences they have been asked to write down.

Lead researcher Dr Tracy Alloway from Durham University’s School of Education, who, with colleagues, has published widely on the subject, explains further: “Working memory is a bit like a mental jotting pad and how good this is in someone will either ease their path to learning or seriously prevent them from learning.

“From the various large-scale studies we have done, we believe the only way children with poor working memory can go onto achieving academic success is by teaching them how to learn despite their smaller capacity to store information mentally.

“Currently, children are not identified and assessed for working memory within a classroom setting. Early identification of these children will be a major step towards addressing under-achievement. It will mean teachers can adapt their methods to help the children’s learning before they fall too far behind their peers.”

The checklist, called the Working Memory Rating Scale (WMRS), will enable teachers to identify children who they think may have a problem with working memory without immediately subjecting them to a test. A high score on this checklist shows that a child is likely to have working memory problems that will affect their academic progress.

If the teacher feels significantly concerned about a child’s performance in class, he or she can then get the child to do the computerised Automated Working Memory Assessment (AWMA). The tools also suggest ways for teachers to manage the children’s working memory loads which will minimise the chances of children failing to complete tasks. Recommendations include repetition of instructions, talking in simple short sentences and breaking down tasks into smaller chunks of information.

Both tools are published by Pearson Assessment. The research that provided the foundation for the AWMA was funded by the Economic and Social Research Council and the British Academy.

Case study – Head teacher from Lakes Primary School in Redcar, Cleveland

Lakes Primary School has been working with Dr Alloway in learning how to identify poor working memory using the new tools. A number of teachers have been trained to screen the children for working memory.

Head teacher Chris Evans said: “Dr Alloway’s research into working memory really caught my interest as I could readily recognise how some children at Lakes School may well suffer from poor working memory. With some of the staff now trained to identify problems, we have the knowledge and tools to carry out a proper assessment and have the skills to help these children be more successful in school.

“We are already beginning to see children in a different light knowing more about the difficulties faced by children with impaired working memory. We realise that they are not daydreamers, inattentive or underachieving, but children who simply need a different approach. We think these new ways of learning can help both the teacher and the children to successfully complete their work.”

When do we use working memory in everyday life?

* Multiplying together two numbers such as 43 and 27 spoken to you by another person without being able to use a pen and paper or calculator.

* Remembering a new telephone number, PIN number, web address or vehicle registration number.

* Following spoken directions such as go straight over at the roundabout, take the second left and the building is on the right opposite the church.

* Remembering the unfamiliar foreign name of a person who has just been introduced to you for long enough to enable you to introduce them to someone else.

* Measuring and combining the correct amounts of ingredients (rub in 50g of margarine and 100g of flour, and then add 75g of sugar) when you have just read the recipe but are no longer looking at the page.

Source: Information booklet on working memory produced by Dr Tracy Alloway and Professor Susan Gathercole.

Retrieved from: http://www.science20.com/news_releases/under_achieving_kids_low_intelligence_or_poor_working_memory

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Grandparents Can Help Recognize Autism in Children

By Nancy Shute Posted: April 9, 2010

Grandparents are often the first to realize that a young grandchild has autism, but they often hesitate to say something to the child's parents, which can delay the best available treatment for autism: early intervention. That's the news from a first-ever survey of grandparents of children with autism, conducted by the Interactive Autism Project (IAN), the largest online autism research registry in the world. More than 2,600 grandparents responded to the online survey, which was sponsored by the Kennedy Krieger Institute in Baltimore and the advocacy group Autism Speaks.

"I was the first to put a name to his condition," one grandmother reported. "I knew earlier, but [it is] extremely difficult to tell your child that you believe her child has autism." Another grandmother said she noticed signs of autism in her grandson at age 2, but didn't know how to voice her concerns without hurting the boy's parents. "What is wrong with him?" was a third grandmother's initial response to meeting her three and a half month old grandson. "My daughter said nothing was wrong; we were scaring him," she recalled. But her grandson wouldn't tolerate anyone touching him, he screamed constantly, and he wasn't eating well, she said, behavior she didn't feel was typical for a child his age. "Three-month-old babies love all the attention and love they receive," she said.

We parents shouldn't be so quick to brush off suggestions from our parents or in-laws that something doesn't seem quite right with our young children. "Grandparents may have had a lot more experience with toddlers and infants and just know," says Connie Anderson, community scientific liaison for IAN. But any parent—or grandparent— can tell you that family dynamics can make that type of communication painful, if not impossible. "Back when I suspected it, my son got bitter with me, and still is," said one grandmother.

Once a child is diagnosed with autism, grandparents often find themselves trying to help both grandchild and adult child. Fifty-seven percent of those surveyed said they worried about the stresses on their adult child a great deal. Some grandparents quit work to help care for the child, while others said they left retirement and went back to work so a parent could stay home. Some struggled to meet the challenges of caring for a severely disabled grandchild, but many said they treasured their relationship, and confided that the grandchild with autism was their favorite.

"This is the largest set of data on autism and grandparents in the world," says Paul Law, a pediatrician who directs the IAN project (and who has a son who was diagnosed with pervasive developmental disorder not otherwise specified). "In the future, the IAN project hopes to involve grandparents in its research project on the genetics of autism, which includes 11,000 families." But the project doesn't yet have the resources to include grandparents in its database, which would enrich the research by providing another generation of genetic data. In the meantime, Law says, he hopes that grandparents will encourage their children to get involved in IAN or other autism research projects. Or, they can do what many grandparents are already doing and become advocates for autism awareness through fundraising walks, advocacy, or legislation in the their states.

For more on the IAN Project, check out my interview last fall with Paul Law last fall on the project's effort to create a research database of families with children on the autism spectrum disorder, and how that can help speed research on causes and cures.

Retrieved from: http://health.usnews.com/health-news/blogs/on-parenting/2010/04/09/grandparents-can-help-recognize-autism-in-children.html

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Growing up with autism Brothers and sisters of children with autism: Learn early to cope with differences

April 21, 2010|By Joe Burris and Rob Kasper, The Baltimore Sun

During a recent first-grade class session at the McDonogh School in Baltimore, 7-year-old Aidan Wade gave an impromptu discussion on what it's like to have a sibling with autism.

"My brother Conor is 11, but his brain thinks he's 5," said the Baltimore boy. "He acts kind of different, but that's OK."

Aidan's words reflect a broad spectrum of attitudes that one might find in siblings of children with autism, a complex set of developmental brain disorders. How a sibling reacts is often dependent upon the severity of the autism, where the child with autism falls in the birth order and how parents model behavior they expect from each of their children.

Siblings of children with autism can face difficulties forming healthy sibling bonds, some studies suggest. Researchers from the University of Washington found in 2007, for example, that some young siblings they studied used fewer words and social smiles than those without autism in the family. The study found that parents reported some "social impairments" in siblings as young as 13 months.

Siblings can face the prospect of tantrums and unexpected behavior from brothers and sisters with autism. They might have to compete for attention. But they can also learn empathy early, experts say.

"We know that there are special demands growing up in a home with a child with autism," said Cathy Groschan, a social worker in Kennedy Krieger Center for Autism and Related Disorders. "But if children view their parents and their peers as responding positively to their sibling's disability, and if they have good factual understanding of the disability, they tend to have positive relationships and a positive outcome."

Peter Bell, vice president of Autism Speaks, a New York-based autism science and advocacy organization, says one thing siblings of children with autism learn is tolerance. "Many of these siblings grow up knowing that a brother or sister might be a little bit different than others," Bell said.

The Pennington, N.J., resident has a 17-year-old son, Tyler, with autism, and two younger children, Derek, 15, and Avery, 11.

"They see it as a part of everyday life and OK to be different and unique," Bell said, "and that sometimes there will be good and bad days, but at the end of the day, you are who you are and what you stand for."

Autism Speaks says that an estimated one in every 110 children is diagnosed with autism, making it more common than childhood cancer, juvenile diabetes and pediatric AIDS combined. And Bell said that many services for children with autism are not covered by insurance, creating significant financial strains on families.

That, he says, sometimes affects what a family has to spend in general, let alone on each child. But he added that siblings of children with autism generally adapt well to the challenges, and because of it foster a keen sense of selflessness and caring.

Some grow up to devote themselves to careers in autism awareness and research.

Conor Wade was diagnosed with autism about two weeks after younger brother Aidan was born, said their mother, Alisa Rock of Baltimore. "Aidan has not known anything different," she said.

"The first couple of years were more stressful for us. My older son did have challenging behaviors, and Aidan didn't understand why Conor would have tantrums, bit his hand or hit [Aidan]," said Rock. "Conor had tantrums from age 5 to 8 at varying levels of intensity, but he could have them for hours."

When Conor turned 8, that behavior subsided significantly, and the two of them became very good friends, Rock said. "Aidan took on the caregiving role, and I was able to say to him, ‘Keep an eye on your brother,' or ‘Help me here.' "

Rock said that Conor's tantrums have recently returned.

She added, "Aidan doesn't understand. He doesn't remember those challenging behaviors, and he's feeling very stressed with the re-emergence of those behaviors. But still, he's a happy-go-lucky kind of kid with a positive attitude."

Marlo Lemon of Randallstown calls her 5-year-old twin boys Matthew and Joshua a "double blessing." To hear her tell it, the boys have been a blessing to one another as well.

Matthew has autism. Joshua, born a minute earlier, does not.

"Joshua is such a good big brother, and though he's older by just a minute, he takes his responsibility very seriously," said Lemon, who also has a daughter, Victoria, 4. "No matter what Joshua's doing, he wants Matthew to be included. If we're in a public place, and Matthew wants to run off, Joshua will say, ‘Mommy, I'll go get him.' "

Lemon said that for a time, Matthew would run away from Victoria, but she and Joshua eventually got him engaged in their activities. And, in making sure that he fits in with all they do, they show him that he, too, must put his plate in the sink after meals.

Sometimes, however, the two wonder: Is Matthew going to talk someday? Why is Matthew allowed to jump on a chair and eat chicken nuggets while they cannot?

There are times, Lemon says, when she and her husband, Frissell, must devote 90 percent of their attention to Matthew, "and I need them to be good, because you never know if Matthew is going to run off."

But Lemon said she and her husband get plenty of family support; both sets of their parents live within 20 minutes of their home. She added that she makes individual time for each of her other children as well.

For Lemon and Rock, their children without autism were either born after or close in age to the one who has the disorder.

Trish Stone of Towson had her first two children, David, 22, and Megan, 18, well before her son Matthew, 8, who has autism. She also has a younger daughter, Kendal, 6.

"When Matthew was born, they were both excited about having another sibling," said Stone of her elder children, "and then it became difficult. They weren't used to it, and like some other families, it caused a distance between them.

"Shortly after that, David learned how to drive, and when he could get out of the house he did. Megan was 11, and she began to take on the parental role. It was tough on each one of the siblings in different stages, but they ended up being more compassionate and caring than typical siblings."

Many youngsters with siblings who have autism get involved with programs and organizations that promote autism awareness and research. Some have been soliciting donations for Kennedy Krieger Institute's autism research and treatment programs, a task that used to be solely the work of adults.

But this year, a group of about 19 kids and young people, ranging in age from 6 to 20, began doing some of the fundraising. They call themselves Kids Who Roar. They also planned some of the activities at a Kennedy Krieger event to be held Sunday at Oregon Ridge State Park in Cockeysville.

There will be a bike ride called ROAR, short for Ride for Autism Research. Riders pay $5 to $30 to register and pedal anywhere from 5 to 50 miles. Hikers have a similar arrangement for jaunts through the park. This year, thanks to ideas offered by the kids committee, there will also be a dinosaur dig, where toddlers can burrow for hidden treasures, as well as a place to make your own beaded bracelet, and a jump rope station.

Those involved in the fundraising include Hunter Gillin, 15, of Owings Mills, whose 17-year-old brother Johnny has autism. Hunter says that he and Johnny are best friends, that they enjoy watching movies, wrestling or just hanging out. In fact, he says it wasn't until he was 11 that he even discovered Johnny had autism.

"Johnny and I have been best friends through the years, and it really didn't matter," said Hunter. "But I had a couple of friends come up to me, and they were just asking questions, nothing mean or anything, but they would ask, ‘Does your brother have autism?'

"I said, ‘No, I don't think so.' Then I went up to my parents and they sat me down and explained the whole thing to me."

Gillin's experience reflects how many children with a sibling who has autism seldom view the development disorder in a negative way, if at all.

"Our goal has always been to see our son first, and his autism second. We have focused on, and celebrated, what Johnny can do, instead of what he can't," said Pam Gillin, the boys' mother

"Because Johnny is the oldest, his other siblings accepted him at face value — they didn't know that he should be any different," she added. "They saw that he was a great reader, well before they could read, and was a master at puzzles. They genuinely saw him for his strengths."

That's why Pam Gillin, who works at Kennedy Krieger, said that there the motto is, "If you've met one child with autism, well then, you've met one child with autism."

"There are many perceptions of autism, affected children, and their families," Gillin added. "These perceptions may be reality in one family, but not in another — so it's important to put them aside altogether and take each child with autism as they come."

Retrieved from: http://articles.baltimoresun.com/2010-04-21/health/bs-hs-autism-siblings-20100421_1_autism-siblings-children

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What Every Parent Should Know About Their Baby’s Developing Brain (Part 1)

August 4, 2010 by Martha Burns, Ph.D

So here you are! In front of you is a newborn, a tiny miracle; a little person that you and your loved one created. This little person looks a little like your aunt Ruth, your father, and you. You have never experienced anything like the love and affection you feel for this little person and you want to guide his or her life the best you can.

What do you do? Does it matter how you hold it, feed it, talk it, attend to it? The short answer is ‘yes’. But the longer answer is that what the infant brain needs in terms of stimulation from parents is relatively simple and very natural. The baby’s brain is a “learning machine” set from day one to absorb and adapt to the world around it.

The parent’s job is a reasonably simple one—to provide an environment that fosters development of skills that will be helpful in later life. If it were an overwhelming task, humans would have died out as a species eons ago. But babies in a host of variable cultures, and subject to many different child rearing practices, in the main, grow up remarkably similar—they walk, talk, play, and eventually become productive adults. However, there is some new research that can guide parents on their journey.

Current research[i] has demonstrated that the primary job of the infant brain is to detect relevant information about language and the environment in which the baby is born and to design itself, in a relatively short period of time, to be an expert at that language and environment. If a baby is exposed to the English language, for example, the brain quickly begins the task of sorting that language into its smallest meaningful elements—the speech sounds—that signal differences in meaning from one word or another.[ii]

In a similar way, a newborn begins to explore his or her environment by observing how objects change in size and position when he or she is lying in a crib and later by observing how objects change when the child can move toward them and manipulate them. In just four months, the research shows, the infant can begin to pick out relevant visual cues that will help to recognize familiar faces, understand space, distinguish two versus three dimensional objects, and perceive a whole object even when only part of the object is observable, such as when a ball is partially hidden behind a block. [iii]

Through experience, the infant brain matures to become a specialist for the world the child is born into.[iv] A French child becomes a specialist in French, the Russian child a specialist in Russian. In this way, the infant brain “maps” itself to the world around it, with groups of brain cells (neurons) in a particular community like the auditory part of the brain, becoming specialists for processing specific types of information. In this way the brain builds itself to become a remarkable machine, eventually capable of understanding new and complex sentences and paragraphs, learning new vocabulary, solving complex new problems that have never been encountered before and realizing the world is full of individuals who have different, yet valid views and opinions.[v]

Since the experiences of the infant form the starting point for the development of the eventual brain architecture, it is important that those of us who are entrusted with this early experience, parents, caretakers, and day care centers, understand the role we play in the building of the brain’s architecture. It is also essential that researchers help those of us who guide an infant’s early experiences to understand which types of stimulation are “beneficial” to brain development and which could be “detrimental”[vi] as I will discuss in next month’s blog post.

What have you noticed about how babies master their environment? Share your observations on our Scientific Learning Facebook page!

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[i] Huttenlocher, P. (2002). Neural Plasticity. Oxford: Oxford University Press.

[ii] Kuhl, P. (2004). Early language acquisition: cracking the speech code. Nature Reviews Neuroscience 5, 831-843.

[iii] Johnson, M.H., (2001). Functional brain development in humans. Nature Reviews Neuroscience 2, 475-483.

[iv] Toga, A., Thompson, P., and Sowell, E. (2006). Mapping brain maturation. Trends in Neurosciences, 29(3), 148-159.

[v] Amodio, D. M. & Frith, C. D. (2006). Meeting of minds: the medial frontal cortex and social cognition. Nature Reviews Neuroscience, 7, 268–277.

[vi] What may be “detrimental” is put in quotation marks because from the standpoint of nature, everything a young child does is important to brain wiring. The infant brain is kind of like the hardware of a computer before it has been programmed with an operating system: it is open and flexible to whatever programs will be installed. Whether those programs are beneficial or detrimental depends on what the computer is expected to do later on.

Retrieved from http://www.scilearn.com/blog/babys-developing-brain.php?sm=babies-developing-brain-fb

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The Brain: Changing the adult mind through the power of plasticity

The Brain: Changing the adult mind through the power of plasticity

July 30, 2010 00:07:00
Theresa Boyle Health Reporter
Psychiatrist Dr. Norman Doidge recalls the first time he examined a human brain. It was 1979, during a neuroanatomy course at the University of Toronto’s medical school.
On rows of tables sat about 100 brains in dissection trays. Doidge and his lab partner were assigned one to slice open.
“Like most medical students, my first exposure to a brain, in a material way, involved holding a dead brain, which was preserved by all sorts of chemicals that made it rather stiff. There was a lack of pliability and all of the cortices, with their folds and peaks and valleys, looked identical.”
The thinking about the adult brain at the time echoed the physical state of this inanimate, three-pound organ from a cadaver. It was thought to be static, fixed and incapable of fundamental change. It was hard-wired so that what you had in your mid-20s was what you had for life — depressing news for anyone who suffered a brain injury or who wanted to stave off age-related cognitive decline.
But our understanding of the body’s most mysterious organ has changed. In recent years, experts have learned that the adult brain can actually rewire itself — changing its physical structure and function through experience, thought and behavior. It’s a property known as neuroplasticity.
The revolutionary discovery is “the most important change in our understanding of the brain in four centuries,” says Doidge, who wrote the 2007 bestseller The Brain that Changes Itself and who is now writing a follow-up book. “Scans show that the neural networks in your brain change when you think differently, perceive differently, imagine things and become aware of things.”
“While there have been brief flashes of insight into this ability over the centuries, they have been dismissed because they weren’t in keeping with the mainstream belief that the brain was like a machine with parts, each performing a single function in a single location,” Doidge says
What all this means, explains Doidge, is that we have been woefully underestimating the brain. Something other than age can change its anatomy. This is good news in the face of studies that show that many cognitive abilities peak in our mid-20s.
While we have always known the structure of our brain drives our behavior, plasticity shows the opposite is also true. The architecture of our brains is constantly changing in response to the lives we lead. New neural networks can be developed, regions of the brain can grow and change function, taking on the tasks of damaged areas. The brain can, in a few locations, create new neurons.
This sea change in thinking has enormous implications. The powers of neuroplasticity can be exploited through rehabilitation, psychotherapy, brain fitness exercises and even meditation.
This gives researchers new hope for treating people with brain injuries, learning disabilities and mental health problems.
The news is also good for healthy adults: Studies show their brains can be changed to make them more compassionate. It can even make them happier.
Research by Dr. Timothy Salthouse at the University of Virginia shows that by about age 22 our ability to make rapid comparisons, remember unrelated information and detect relationships are at their maximum. Speed of thought and spatial visualization also peak around this age. Reasoning peaks a little later, at about age 28, and then typically declines, as do the other skills.
Doidge describes the late 20s and 30s as the beginning of a “less tempestuous” time of life for the brain. It extends into middle age when skills we have already mastered are replayed and replayed.
“Many people have the same hobbies, the same job or profession, the same family members, the same spouse and they live in the same city. Their lives frequently become extremely routinized.” Formal education has typically been completed.
What happens to our brains is that the part that reinforces connections — the nucleus basalis — begins to atrophy.
“It’s a use-it-or-lose-it brain on many scores,” Doidge says.
You might occasionally forget things, like where you put the car keys or the name of someone you recognize.
But it’s not all downhill from there, as was once thought.
While your brain might not be as plastic as it once was, it’s still capable of incredible change. Matthew Linton is proof of that.
Linton was enjoying a weekend at a Collingwood cottage in May last year when he fell from a deck, striking his head on a concrete slab.
The 30-year-old from Toronto was unconscious when found by friends but eventually came to. Linton assured them he was fine and just needed a nap. When they checked on him a few hours later, they couldn’t rouse him. He was in a coma.
Linton was rushed to the local hospital where a CT scan showed he had suffered severe brain damage — bleeding between the dura that covers the brain and the brain itself. Because of the mounting pressure on the brain, doctors told Linton’s friends he likely wouldn’t survive.
A helicopter flew him to Toronto’s St. Michael’s Hospital where surgeons had doubts about operating, since more than five hours had elapsed since the fall. They told his wife he was functionally brain dead.
But surgery was performed and Linton surprised medical staff when he started coming out of the coma just days later. Still, he had suffered permanent damage to the left occipital lobe and left lateral temporal lobe of his brain.
When he was transferred to the Toronto Rehabilitation Institute two weeks later, he was in a wheelchair, his left side paralyzed. His thinking was foggy and his short-term memory was impaired. He’d forget conservations seconds after they were over.
At Toronto Rehab, Linton worked with Robin Green, head of the cognitive neurorehabilitation sciences lab and a Canada research chair in traumatic brain injury. She is investigating the impact of intensive rehabilitation on the neuroplasticity of people who are brain injured.
Linton was given double the normal amount of cognitive, physical and occupational rehab — up to six hours a day instead of three. The regimen included extra memory, sustained attention and visual scanning exercises and high-level balancing and muscle-strengthening training.
Today, Linton can walk, his thinking is clear, he can speak properly and his ability to read continues to improve. The graduate of Upper Canada College and the University of Western Ontario has returned, part-time, to his job as a management consultant. He plans to resume long-distance running; so far he can run 15 minutes straight.
“Things have gotten better than anyone has ever expected,” says Linton.
Because of scarring in the area of his brain that processes vision, he has blind spots in both eyes, making it difficult to take in and store visual information. He is becoming better at learning through listening.
“The part of my brain that works on memory has changed streams, so what I used to rely on (vision), can’t be relied on at all. So now it’s shifting to rely on a completely different input (audio) and it’s getting quite a bit better,” he says.
Linton’s “exceptional” recovery has been helped by his motivation, innate intelligence and social interaction, Green notes, adding that his improvement is consistent with the preliminary findings of others that intense rehab improves outcome.
Doidge cautions that our brains are not infinitely plastic. There are still people with brain limitations who have not improved despite doing neuroplasticity exercises.
“While we have seen a number of new kinds of cures, there has to be some healthy tissue within reach of the damaged area for neuroplasticity to work,” Doidge says. Other requirements include an ability to pay attention, intact motivational brain centres and properly designed interventions.
Nevertheless, if studies like Green’s and others continue to produce such good results, “intensified therapy” could become de rigueur in rehabilitation.
To help explain how brains like Linton’s change with extra stimulation, Green cites a study done on taxi drivers in London, England. Scans showed that the part of their brains that deals with spatial navigation was bigger than for non-cab drivers. What’s more, this part of their brains grew even more the longer they were on the job. Memorizing routes and maps actually made their brains bigger.
Showing a reporter some of the tools of his trade, Doidge dons what look like a cool pair of mirrored, wraparound sunglasses. But these are no normal specs. The sides of the lenses can be raised to admit more light to either of his visual fields. When the side of one lens is raised, the opposite brain hemisphere is stimulated. The glasses can be used to help people with attention difficulties, stress and anxiety.
Another tool, sitting on a tripod in the corner of Doidge’s office, is a special light bar used to treat patients with post-traumatic stress disorder. While recalling a traumatic event, a patient tracks a light as it quickly darts back and forth on the bar. The bilateral stimulation of the brain allows the more sequential processors of the left hemisphere to process the disturbing memory that has been stuck in the emotional right hemisphere.
These tools, plus psychoanalytic psychotherapy and cognitive behavioral therapy, can help change the way the brain works, drawing on the plasticity principle that “neurons that fire together wire together,” Doidge explains. The changes can be more enduring than medication such as anti-depressants.
“Psychotherapy works by rewiring the brain. Every time you become aware of something new in a psychotherapeutic session, you activate an existing rigid neural network, you make it more malleable and you can alter it with the help of awareness,” Doidge says.
In psychotherapy, clients are guided be more aware of thoughts, challenge them and ultimately change their brains at a cellular level.
Ironically, plasticity can lead to flexible behaviors and positive change, as well as to rigid behaviors and habits, both good and bad. Doidge calls this the “plastic paradox” and offers the metaphor of fresh-fallen snow on a ski hill. On your first pass down the hill, you create a new path in the pliable or plastic snow. If it was a good run, you’ll likely stick close to that path on subsequent passes down the hill. But well-worn tracks can eventually become ruts in which you can get stuck, he explains, likening these ruts to the rigid, destructive behaviors patients want to change.
In therapy, patients are, among other things, guided to set up road blocks on those tracks and to discover new pathways through the snow. Sometimes that roadblock can be as simple as learning to recognize and inhibit what had been an unconscious response.
Neuroplasticity can help address obsessive compulsive disorder, schizophrenia, bipolar disorder, stroke and even aspects of multiple sclerosis and Parkinson’s.
And it can help people with obvious brain impairments.
“The fact is . . . we are all on a continuum and all of us have these areas that are not functioning okay and others that are functioning okay,” Doidge says. “Anyone can benefit because neuroplasticity is the modus operandi of the brain. It’s the way it works.”
That means you can change if you’re bad with directions, remembering faces and names or if you’re a slow reader. You can even train your brain to improve your balance on high heels.
Five years ago, Annette Goodman, now 39, decided to tackle something that had long bothered her — an inability to think quickly on her feet.
Goodman had a minor learning dysfunction that meant she struggled to grasp the relationship between two or more ideas or concepts.
“If I was involved in a debate, socially or in a work situation, I’d often freeze up and wouldn’t be able to come up with a counter-argument fast enough,” she explains. “I’d come up with one later but it would be too late and the conversation would be over.”
Goodman took computer-based cognitive exercises developed by Toronto’s Arrowsmith School. She had previously enrolled her two sons in Arrowsmith for learning disabilities. She subsequently was hired as its chief education officer.
“We all have deficits to some extent. No one is good at everything,” she says.
Doidge is a fan of Arrowsmith and devotes a chapter of his book to it. Though neuroplasticity wasn’t part of the lexicon when the school opened 30 years ago, its program is based on rewiring the brain through repetitive cognitive exercises.
Arrowsmith operates as a private school in Toronto, teaching students from Grades 1 through 12 at a cost of $22,000 annually. Arrowsmith has branches across North America, with a total enrolment of about 800.
Goodman spent about 90 minutes a day for six months doing repetitive, computer-based exercises designed to address her weakness with symbol relations.
One exercise involved reading a 10-handed clock, with hands not only for hours, minutes and seconds, but also for days, months and years. The program challenges students to read the clock faster and faster.
Arrowsmith is not alone. Research into neuroplasticity and digital technology has spawned a brain fitness industry, with software aimed at improving memory, increasing processing speed and focusing attention. “Brain gyms” are popping up in the United States.
San Francisco-based Posit Science is a leader in the field. While its programs are marketed mainly to the 50-plus crowd, CEO Steven Aldrich says they can benefit anyone. As knowledge about the power of our brain’s plasticity spreads, he expects demand for brain fitness products to grow among younger age groups.
“I harken back to the 1970s and the physical fitness revolution . . . . I think we are going to see the same kind of revolution with brain fitness as folks realize their brains are critical to their quality of life and that they can take charge of how they work.”
Like mental training, meditation can also change the brain. In her book Train Your Mind, Change Your Brain, Newsweek science writer Sharon Begley cites studies of Buddhist monks who have tens of thousands of hours of mediation behind them. They have significantly enhanced their left prefrontal cortices, the part of their brains that generates feelings of empathy and love.
“Research shows that with a certain kind of mental training you can boost your happiness set-point,” she says.
Remarkably, the same plasticity concept that is helping Linton recover from his brain injury is making monks happier.
“We are really at the beginning of exploring this,” Doidge says. “We just don’t know how far this neuroplasticity revolution is going to take us.”
Brain changes
Examples of people who have literally changed their brains as adults:
• A woman born with half a brain is still able to function in life because her right hemisphere has taken over functions of the non-existent left hemisphere.
• Another woman always felt like she was falling because her inner ear’s vestibular system was damaged as a result of a side effect of medication. Her brain rewired itself, learning to take its balancing signals from electrodes placed on her tongue. She has completely recovered.
• A man suffered a stroke, causing paralysis to the left side of his body. But with intensely practiced exercises, healthy parts of his brain reorganized themselves around the damaged parts and took over the lost functions, allowing him to regain use of his disabled limbs.
From the book, The Brain that Changes Itself, by Dr. Norman Doidge
Retrieved from: http://www.thestar.com/iphone/News/Insight/article/842511

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