The Upside of Dyslexia

This article from Sunday’s NYTimes, is I think, a continuation of a fascinating argument as to whether the learning disability called dyslexia is also a learning style that has built-in skills and attributes.

I’ve heard many times over, some well-argued points against this notion that dyslexia carries its own set of built in, hard-wired talents. Richard Wanderman, founder of this site and my good friend, can always be counted on to dismiss the notion and point out that people develop talents based on how much they work at it. I may be oversimplifying his and others’ similar points of view on this, but I think it’s close. Proponents argue that such things as “three-dimensional thinking’ for example, are often skill-sets that people with dyslexia possess.

Others claim this is nonsense; that there’s no way to categorize all dyslexics as having a consistent set of benefits or associated neurologically-based strengths.

For me, as is my nature, I think the truth lies more towards the middle. While it’s true that not all people with dyslexia have the same profile of weaknesses, there are general things we know about what’s hard for them, and can see them both operationally (in the real world), and neurologically (through testing and brain imagery). By the same token, while we can’t claim that all dyslexics are “holistic thinkers” or artists, or creative, etc.; if I had a dime for every dyslexic kid who I test or work with, that was a phenomenal “Lego” kid or builder of some kind, I’d be a rich guy. The persistence of the conversation that dyslexics have certain visual skills does not in itself mean that it’s likely to be true, but research such as discussed in this NY Times article, is finally specifying specific attributes that may in fact be true.

Intriguing evidence that those with dyslexia process information from the visual periphery more quickly also comes from the study of “impossible figures,” like those sketched by the artist M. C. Escher. A focus on just one element of his complicated drawings can lead the viewer to believe that the picture represents a plausible physical arrangement.

Of course, all styles of information processing have, hopefully, by their very nature, strengths that are very real. But, having inherent strengths that we may be born with, doesn’t mean the old axiom “use it or lose it. isn’t true.” It also doesn’t mean that you can’t develop skills that you just weren’t born with. I sometimes describe myself a mechanical dyslexic in presentations, to make a certain humorous point, but that doesn’t mean that with enough focus, and enough persevering through mistakes, aka the learning curve, that I didn’t put together a very tough outdoor basketball stand and hoop when my kids were going up.

Genetic tendencies, potential talents and weaknesses, all need fertile and supportive environments to gain traction, and bloom, or become somehow less impactful, in the case of weaknesses. Being sleuths or detectives for strengths in children is as important as being clear about their problems.

In the second study, Mr. Schneps deliberately blurred a set of photographs, reducing high-frequency detail in a manner that made them resemble astronomical images. He then presented these pictures to groups of dyslexic and nondyslexic undergraduates. The students with dyslexia were able to learn and make use of the information in the images, while the typical readers failed to catch on.

Know any photographers who are dyslexic?

The piece that I wrote about here at this site yesterday, has a very different take from how quite a few folks are reacting to the NY Times piece.

In Motherlode, a parenting blog featured on the NY Times site and one that I subscribe to and enjoy, claims that Professor Sroufe “demonizes” parents and blames them for the condition of ADHD.

I don’t think he does that at all and I commented on Motherlode itself. See for yourself the overall commentary and join in if you are interested.

In an opinion piece in the NY Times, Dr. Alan Sroufe, a psychologist and professor Ameritus from The University of Minnesota argues that we must reduce our reliance on medicating children with stimulants because there are  no studies that indicate these medications have any long-term benefits.

This is sure to create unrest and unease within the medical, educational and parent communities, not to mention the pharmaceutical industry.

As it should.

This is a hugely important area and for various reasons. I am however, afraid that the level of conversation will begin to resemble a presidential debate; facts be dammed and positions defined with self-interest and hyperbole.  For all concerned, I hope everyone reads past the headlines and that science reporters take their time.

While there are clear and sufficient reasons to take stimulant and other medications to help alleviate the symptoms of ADHD, and while the “short-term benefits” both in and out of school can and do save and change lives for the better, this controversial and important area of research brings to light several crucial truths:

1. Over the past decade an increasing amount of well-done research illuminates that environmental pillars of early childhood such as the presence of trauma, and types of childcare to name just two, absolutely influence the architecture of the brain. Children with avoidant, judgmental and/or indifferent childcare/parenting show behavioral and neurological changes that mimic ADHD or PTSD.  The old “Nature versus Nurture” debate has been shifting to a growing understanding that Nurture works with our Natural genetic blueprint to create, minimize or exacerbate genetic predispositions.

Knowing this dramatically shifts the discussion from early medication to emphasis on early childcare responsibility and resources for the encouragement of healthy brains.

2.  If long-term benefits of medications for ADHD have been overstated or worse are an illusion, then we have to recognize that medication is a tool to buy time and with which to incorporate other changes and supports as part of a multi-faceted approach.  Not the least of these should be creating classrooms and homes that are better suited to meet the needs of highly active and/or inattentive, hands-on learners.

3.  Since it is our children who in the long term suffer, this is another opportunity to reduce our impulse to take pills as a long-term solution.  As Dr. Sroufe writes:

Finally, the illusion that children’s behavior problems can be cured with drugs prevents us as a society from seeking the more complex solutions that will be necessary. Drugs get everyone — politicians, scientists, teachers and parents — off the hook. Everyone except the children, that is.

A Specialists’ Debate on Autism Has Many Worried Observers

A debate among medical professionals over how to define autism has spilled over into the public domain, stirring anger and fear among many parents and advocates of those with the neurological disorder, even as some argue that the diagnosis has been too loosely applied.

Personally, I’m very disappointed that the issue of adjusting the definition of Autism in the as-yet-to-be-completed DSM-5 (American Psychiatric Association’s Diagnostic and Statistical Manual) is first generating controversy about protecting costs and other basic questions concerning eligibility. Changes to the Autism Spectrum Diagnosis have been debated now for a few years and we’re first hearing there’s not even consensus about how many people currently meeting the criteria for Autism Spectrum Disorder would still meet them and how many folks would lose eligibility for services? To hear that the scientific community is still in seeming disarray about fundamental issues such as these seems ridiculous and gives me way less faith in the process already undertaken.

“We have to make sure not everybody who is a little odd gets a diagnosis of autism or Asperger disorder,” said Dr. David J. Kupfer, a professor of psychiatry at the University of Pittsburgh and chairman of the task force making the revisions, which are still subject to change. “It involves a use of treatment resources. It becomes a cost issue.”

Ugh. I’m sorry, but the chairman of the task force is still voicing a concern about that? Really? They haven’t settled that yet and the manual’s due to come out next year? I understand the impetus to refine and not make this diagnosis a catch-all and fall-back category. I really do. There are pressures and self-serving motivations for some parents and professionals to diagnosis shop, but they are not the majority and further, most learning disabilities (like dyslexia) and developmental disorders (such as Autism Spectrum) do run on a continuum from “mild” to “severe.”

I realize everything these days is a “cost issue,” but jeez, are the scientists on task forces designed to protect children the ones who should have that as their go-to concern about which they’re speaking in news interview? Those questions should have been settled long ago. Let the scientists and educators and other expert and interested parties struggle with the data and human questions and let the policy makers and politicians argue out the monitory pieces.

Despite the compelling and alarming statistics on the impact Learning Disabilities (LD) has on the mental health of our youth, there remains a great need to better understand the relationships between language-based LDs, Autism Spectrum, and depression, substance abuse, and defiance, and low self-esteem. While some in the therapeutic community know that upwards of 60% of adolescents in treatment centers have learning disabilities (Hazelton and NICHD), they need to have a deeper understanding of why that is, and how clinicians and counselors can better respond. Similarly, knowing the presence of learning disabilities among clinically depressed, hospitalized children is 7 times higher than in the general population (Journal of Affective Disorders), compels us to learn more about specific experiences and mechanisms at play.

Conscious linking between information processing styles and therapeutic intervention will significantly increase effectiveness and speed up results.

By better understanding the experience of having neurological variance and differences, therapeutic attunement follows. The time is ripe for moving beyond and beneath surface understanding of how self-esteem is negatively impacted from school failure. Experiences and research is beginning to help us see how differences in information processing impact everything therapeutically.

Accepting the fact that many states use literacy and special education statistics from 3rd and 4th grades to accurately predict future prison beds is no longer acceptable. Combining best practices from both Learning Disabilities and Therapeutic disciplines is a key to solving this dilemma and national challenge. Therapeutic education is poised to play the leadership role.

Researchers continue to find that while intensive dietary modifications may help some small sub-groups, kids with ADHD need a overall healthy diet of low processed foods and high on quality proteins, fruits and vegetables, whole grains, and quality fats, such as Omega-3.

A couple of days ago, The New York Times reported further on these medication shortages. According to the report, these shortages are the result of the Drug Enforcement Agency (DEA ) being out of synch with the FDA and others involved with the sale and safety aspects of such medications.

The disconnect between the D.E.A. and just about everyone else involved in the sales of the medicines is so profound that they even disagree over whether there are shortages.

“We believe there is plenty of supply,” Special Agent Gary Boggs of the D.E.A.’s office of diversion control said in an interview.

And yet, among others, multiple drug manufacturers announced that their supply of these medicines are scarce. The Food and Drug Administration also lists these drugs as being in short supply.

Officials at the F.D.A. blame the shortages on overly strict quotas set by the D.E.A. — making for a rare open disagreement between two federal agencies.

Shortages, no shortages, essential medications, ripe for being misused on college campuses and elsewhere.  The government agencies need to get their act together.

The lecture is one of the oldest forms of education there is.

… lecturing has never been an effective teaching technique and now that information is everywhere, some say it’s a waste of time. Indeed, physicists have the data to prove it.

Many of us, me for example, have known this about lecturing for a while.

In this article from NPR, Physicists at Harvard have figured this out after one of their physics instructors,  Eric Mazur, began questioning his own assumptions about teaching and started observing and thinking about what his students actually knew versus formulas they memorized.

Using approaches that asked students to reassess what they think they know, slow down their answering process so that they can work in small groups to ponder and converse with one another about a particular problem, Mazur found that learning improved significantly.

Historically and with frustration, students with learning disabilities have long-known that collaboration and hands-on learning are always more effective that dense lectures.

I’ve felt for years that teenagers and young adults with Asperger’s Syndrome or with High Functioning Autism really need help understanding and negotiating romantic and sexual relationships. Moving from Social Skills or even Social Thinking curriculums (there’s a difference) to dating, sex, love and adult relationships is no easy task when your primary difficulties are recognizing and understanding non verbal communication, emotional fluency and regulating sensory experiences.

This is a wonderfully written piece in the NYTimes.com called Navigating Love and Autism. Compelling in it’s depth, this article captures many of the challenges particular to couples struggling with Autism Spectrum Disorder.

The first night they slept entwined on his futon, Jack Robison, 19, who had since childhood thought of himself as “not like the other humans,” regarded Kirsten Lindsmith with undisguised tenderness.

This is an honest account of their struggles and one that provides glimpses into what it must be like for a young man with ASD, who, despite feeling love and romance for his sweetheart, has to tell her (and I assume because of some sensory overload issues), after she smiled at him one morning, as she leans in for a kiss, seeking his lips, he turned away, “I don’t really like kissing,” he said.

It’s a touching piece and although having ASD adds a particular burden to relationship, I want to tell the young man in the article, that many of their struggles are generic to the confusion we all feel at times in relationships.  You want to put your arm around his shoulder and smilingly tell him you know just how he feels when he’s not sure what his girlfriend wants from him.  Here’s an example:

One might start over Kirsten’s request that Jack hug her when she came home from school, or his perception that she was already angry at him when she came through the door.

“The more we argue, the worse it gets,” Jack said once, close to despair.

One night as Kirsten cooked dinner, he peered into the pan where she was sautéing vegetables to comment on the way she had cut the cauliflower.

“It’s too big,” he explained. “It won’t cook through.”

“It’s better when it’s not all mushy,” she insisted.

“No,” he said. “You’re just doing it wrong.”

Eventually, Kirsten, unable to contain her tears, fled to the living room.

“What I want,” she told him when they analyzed their clashes in less-fraught moments, “is to be held and rocked and comforted.”

I haven’t seen or heard of this happening in the northwest, where I live, but this is potentially very concerning for lots of folks, especially if it spreads and gets worse.

NPR did a story about this emerging shortage of ADHD meds, characterizing it as being part of a nationwide and increasing shortage of other medicines in general, most notably some cancer treatment drugs.

Yikes.

[via Richard Wanderman]

These new guidelines, discussed here on NPR’s On Point Radio Show, are designed to signal parents and professionals that signs consistent with ADHD can appear in children as young as four. As part of early identification, there’s a lot of good that can come out of this. Not surprisingly however, this has begun to generate a firestorm of discussion.

There are pieces to these new guidelines that’s entirely good and fundamentally sound. I have a couple of issues however: Especially with young children, doing a thorough and differential evaluation (which means to look at other or overlapping possibilities that explain the presenting behaviors), one needs to include a complete history and observation of the child in different settings in addition to the office. Evaluation of ADHD or other conditions has to be deep and authentic, and should not rely solely on parent or even teacher rating scales or comments. For this reason, the idea of a general practitioner or family pediatrician being able to diagnose ADHD in a 15-20 minute office visit is nonsensical. However, the idea of a pediatrician alerting or confirming to parents there’s a need to do a more extensive follow-up investigation, is a good thing.

People who are getting frantic already about these new guidelines are jumping to a conclusion that they will quickly lead to getting young kids on medications. This is not the intent of early identification. I’m not unconcerned about over medication, but overall, we applaud early identification measures for physical diseases or developmental disorders (Autism), so why not for other neurological and brain-based conditions?

[via Richard Wanderman]

Too often we as educators and parents, get hyper-focused on the things our/your kids can’t do or struggle with. Even with the best of intentions, adults lose perspective. We run the risk of trying so hard, too hard, to squeeze children with learning disabilities into the mold of what we want for our kids in the future. And in the meantime, you miss moments of opportunity.

Don’t get me wrong, I’m in the business of educating and problem-solving for kids and families with learning and behavioral struggles. I believe very much in early identification of risks and struggle and for planning for the future.

But when we’re too future-focused, we lose sight of the forest for the trees. In the case of kids, that means missing the beauty of their wondrous perfection, imperfections and all. In case you think I’m being too sappy and sentimental, read this article in the NY Times called “Notes from a Dragon Mom”. The author, a professor of writing at a Sante Fe university, has an 18 month old child who will die for sure, because of a rare genetic disorder. It’s powerful piece, and she reminds us all of the importance of loving your child in the present moment. In her case there is no future to hold onto so there isn’t the usual focus on parenting “in the right way.”