Beginning Brain Literacy: Simple Answers Don’T Address Difficult Questions

10/18/2018

Sponsors and Affiliates:

The Neuroscience of Individual Differences in Mathematics Learning and Disability James B. Hale, PhD, MEd, ABPdN Professor of Educational Neuroscience (Ret) Board-Certified Pediatric Neuropsychologist Washington Licensed Psychologist Washington Certified School Psychologist Certified Special Education Teacher (SLD/EBD)

Breakout Session Washington State Association of School Psychologists Annual Conference Seattle, Washington October 19, 2018

Reading, Writing, Math, and the Brain

• Academic achievement is like learning any skill • The goal in classroom instruction is to take new content, learn it, and then make it automatic • Right frontal (new learning) → left posterior (learned) → cerebellum (automatic)! • Practice is necessary to make automatic in cerebellum, frees cortical for new tasks and higher level processing • Must AVOID practicing errors (even if works at first), could lead to automatic dysfunction • Prevention or wait for child to catch up? →The longer a child practices problems in learning or behavior, the more likely the problems are to become automatic!

©James B. Hale, PhD, MEd, ABPdN

Beginning Brain Literacy: Simple Answers Don’t Address Difficult Questions

Touch for Motor for handwriting and handwriting and grip strength playing sports

“Brain boss” Visual for object recognition

Auditory for reading and speech

©James B. Hale, PhD, MEd, ABPdN

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Alexander Luria and The Working Brain

Three Principal Functional Units 1. Unit for Regulating Tone and Mental States ▪ Structures: subcortical 2. Unit for Receiving, Analyzing, and Storing Information ▪ Structures: posterior brain regions, occipital, temporal, parietal lobes 3. Unit for Programming, Regulation, and Verification of Mental Activity ▪ Structures: frontal lobes; frontal- subcortical circuits

©James B. Hale, PhD, MEd, ABPdN

Luria’s Working Brain Three Laws of Functional Organization 1. Hierarchical Organization 1o Primary – Clear brain-behavior relationships 2o Secondary – Integrative association cortex Tertiary Cortex – Highest levels of cognition 3o 2. Diminishing Specificity Primary – One function Secondary – More than one function Tertiary – Many functions, not specific 3. Progressive (Changing?) Lateralization Primary – LH/right body; RH/left body Tertiary – LH/detail-learned; RH/global-novel →Subcortical to cortical, posterior to anterior, primary to tertiary neurodevelopment ©James B. Hale, PhD, MEd, ABPdN

The Posterior-Anterior Axis Luria’s Receiving, Analyzing, and Storing Information Unit

Orientation

Processing Primary

(Space/Direction/ Secondary Somatosensory Motion) Somatosensory Supra- Marginal Gyrus Angular Gyrus Receptive Language Primary Visual

©James B. Hale, PhD, MEd, ABPdN

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Visual Function: Dorsal and Ventral Streams Dorsal “Where” Stream Spatial/Direction/Motion

Ventral“What” Stream Object/Form/Color ©James B. Hale, PhD, MEd, ABPdN

Consider the “Brain Boss” Executive Functions And Affect on Math Functioning

→Working Memory, Memory Encoding and Retrieval Association Motor

Exner’s External Area Control →Plan, Organize, Strategize, Expressive Language Executive Monitor, Evaluate, Modify, Functions & Change Behavior

Internal Control →Attention, Concentration, & Impulse Control

©James B. Hale, PhD, MEd, ABPdN

The Three Axes Interpretation: The Posterior-Anterior Axis Anterior -Executive Functions -Motor Output }OUT

Posterior -Sensory Input -Comprehension }IN ©James B. Hale, PhD, MEd, ABPdN

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Structural Hemispheric Differences Left Hemisphere Right Hemisphere

More More Grey White Matter Matter

More More Primary Association Cortex Cortex

More More Intramodal Intermodal Connections Connections Source: Goldberg, E., & Costa, L. D. (1981). Hemispheric differences in the acquisition and use of descriptive systems. Brain and Language, 14, 144-173.

©James B. Hale, PhD, MEd, ABPdN

The Three Axes Interpretation: The Left-Right Dimension Anterior -Executive Functions -Motor Output

Left Hemisphere Right Hemisphere -Routinized/Detailed/Local -Novel/Global/Coarse -Convergent/Concordant -Divergent/Discordant -Crystallized Abilities -Fluid Abilities

Posterior -Sensory Input

©James B. Hale, PhD, MEd, ABPdN -Comprehension

Cortical-Subcortical Circuits: Executive Control

Running, Decisions, Drawing Keeping track, Doing things Motor Oculo- quickly Cingulate Watching Things, motor Reading

Basal Ganglia/ Managing life, Thalamus Completing Tasks, Writing

Cerebellum

Controlling Own →Can circuit impairment lead to Emotions and math and emotional/behavioral disorders? Behaviour ©James B. Hale, PhD, MEd, ABPdN

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Three Axes Interpretation

Left Hemisphere -Routinized/Detailed/Local -Convergent/Concordant -Crystallized Abilities Posterior -Sensory Input -Comprehension Anterior/Superior -Executive Regulation and Supervision Right Hemisphere -Motor Output -Novel/Global/Coarse -Divergent/Discordant -Fluid Abilities

Inferior -Executive Execution -Automaticity of Action

©James B. Hale, PhD, MEd, ABPdN

Three Axes Interpretation: Easy Model

Left Hemisphere -OLD LEARNING -PARTS/DETAILS

Posterior -GOING IN -UNDERSTANDING Anterior/Superior -GOING OUT -BRAIN BOSS/THINKING Right Hemisphere -NEW LEARNING -WHOLE/BIG PICTURE

Inferior -AUTOMATIC/DOING

©James B. Hale, PhD, MEd, ABPdN

Developmental Issues in Math Skill Development

Developmental Theory and Math Competence →“Operational” thought and math schemas →One-to-one correspondence →Classification of objects →Seriation-sequential processing →Conservation Jean Piaget →Quantity representation is symbolic

©James B. Hale, PhD, MEd, ABPdN

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Developing Math Skills in School: Typical Instructional Sequence (Geary, 2008) • Pre-skills subitizing (size differences), ordinality (< or >), serial counting, arithmetic (make bigger/smaller) • Skill acquisition, practice, proficiency, automaticity • Early instruction: →Concrete Objects (apple + apple = 2 apples) →Semi-Concrete Symbols (// + / = ///) →Abstract Numbers (4 + 2 = 6) • Finger Counting, Verbal Counting, SUM (Count All) or MAX (seven plus two equals 2….3,4,5,6,7,8,9); MIN (“7….8,9), Math Fact Automaticity (7 + 2 = “9”) • Hierarchical: Addition, subtraction, multiplication, division, fractions (geometry, algebra, calculus) • Math word problems and problem solving?

©James B. Hale, PhD, MEd, ABPdN

Numeracy: Major Brain Areas Implicated

Menon V. (2015). Arithmetic in child and adult brain. In K. R. Cohen & A. Dowker (Eds.), Oxford Handbook of Numerical Cognition. Oxford: Oxford University Press.

©James B. Hale, PhD, MEd, ABPdN

Differences in Numeracy and Quantity Magnitude (Kafmann, Wood, & Rubinsten, 2011)

• Numeracy more bilateral frontal-left superior parietal and cerebellum, quantity also bilateral, but more right (especially supramarginal gyrus), suggesting a shift from novel quantity (BA 40) to computation (Intraparietal sulcus region; IPS) • IPS appears to not only do number differences, but ordinal relationships that are not numeric • Controls activate left hemisphere memory systems, children with dyscalculia more right and left homologous regions, with little memory activation • Shift from right to left, and anterior to posterior, with age

©James B. Hale, PhD, MEd, ABPdN

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Neuropsychology of Math Computation

Math Computation Brain Areas/Functions • Quantity-symbol • Superior Parietal Sulcus region (Number) Association • Right parietal for column • Spatial processing alignment (spatial-number (multi-step Problems) sense), left parietal direction or number • Prefrontal important for orientation calculation steps • Sequential processing • Prefrontal for keeping track of for algorythym computation • Working memory to • Right parietal (spatial-number remember pieces/steps sense), left parietal (direction/touch), left frontal • Visual-spatial-motor integration → (motor), white matter graphomotor skills (connecting processes) • Computation vs. Math • Left dorsal stream for Fact Automaticity computation, left ventral stream for math facts ©James B. Hale, PhD, MEd, ABPdN

The Brain on Math: Math Computation

Direction (Left) Spatial-Attention (Right)

Oculomotor- Number- Dorsal tracking Quantity Stream Association Dorsolateral Prefontal Cortex Orthographic

©James B. Hale, PhD, MEd, ABPdN

Alterations of Intraparietal Sulcus in Typical Learners and Those with Developmental Dyscalculia (Molkoet al., 2003)

•Intraparietal sulcus (IPS) activation in calculation tasks (images are controls) •Activity was greater in approximate calculations, related to number sense •“Zones of Overlapping” important for sound-symbol association (decoding), number-quantity association (math computation), and language comprehension (receptive)

©James B. Hale, PhD, MEd, ABPdN

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Neuropsychology of Math Word Problems

Math Word Problems Brain Areas/Functions • Auditory Processing & • Receptive langauge areas Receptive Language • Temporal and inferior • Math semantics and parietal algorthym syntax • Inferior parietal and Gives • Word-number association dorsolateral for keeping Away = working memory content in mind Subtract • Retrieval of Math Facts • Prefrontal; more likely to • Novel problem-solving be right prefrontal (right (quantitative reasoning) > left) • All Computation Components • Prefrontal (right > left) (+ MORE Executive)

©James B. Hale, PhD, MEd, ABPdN

Math Fluency and Math Word Problems

Other Structures: ALL Previous Math Computation Structures

Gave Away = Executive Retrieval SLF Subtract (Dorsolateral Prefrontal)Gave Away Language = Comprehension Subtr Orthographic act Ventral Automaticity Stream Timing

©James B. Hale, PhD, MEd, ABPdN

Math Reasoning and Mental Math (Rivera, Reiss, Eckert, & Menon, 2005)

Prefrontal (dorsolateral, ventral- lateral, and cingulate) circuit involvement greater in young children more than older children, with increasing parietal (left supramarginal and IPS) and hippocampal, involvement in older children →Relevance for dyscalculia?

©James B. Hale, PhD, MEd, ABPdN

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Math Reasoning and Mental Calculations (Prabhakuran, Rypna, & Gabrieli, 2011)

• Prefrontal (dorsolateral, ventral-lateral, and cingulate circuit involvement greater in word problems, both problem solving and working memory required • Mathematics problems solving involving more executive and temporal activation than simple calculation (language and problem solving demands) →Relevance for subtypes of math disability?

©James B. Hale, PhD, MEd, ABPdN

Comparing Dyscalculic and Typical Math Performers (Kucian et al., 2006)

DD < Control only in approximate calculation → Number sense the main problem in dyscalculia?

©James B. Hale, PhD, MEd, ABPdN

Comparing Dyscalculic and Typical Math Performers (Kucian et al., 2006)

©James B. Hale, PhD, MEd, ABPdN

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Functional and Structural Alterations of the Right Fusiform Gyrus in Developmental Dyscalculia (Kucianet al. 2011)

•Region of Interest analysis found children with dyscalculia more activation in the right inferior brain in number magnitude task •Children with dyscalculia also show more activation in the supplementary motor and anterior parietal; difficulty in quantitative or number sense for judging magnitude •Possible spatial number representation deficit in right hemisphere in dyscalculia, poor number sense

©James B. Hale, PhD, MEd, ABPdN

Rourke’s Studies of Math Learning Disabilities and Psychopathology • Byron Rourke’s “nonverbal” SLD; right hemisphere dysfunction and the “White Matter Model” of psychopathology →Prosody, implicit language, neglect of self and environment, limited recognition of faces/social cues, integration of complex stimuli poor →Results in both internalizing and externalizing psychopathology (under socialized delinquency?), no distinction of anterior/posterior • Verbal/Left Hemisphere Dysfunction? →Rourke says no, but early internalizing problems and delinquents show LEFT hemisphere dysfunction (Moffit, 1993, Forrest, 2004) →Could shift from internalizing to externalizing reflect environmental causes (e.g. socialized delinquency)? ©James B. Hale, PhD, MEd, ABPdN

Is Asperger Syndrome on the “Spectrum”?

• In 1944, Hans Asperger described “autistic psychopathy” cases with “normal” intelligence with peculiar social skills, pedantic speech, and preference for routinized activities • Myklebust (1975) – Social judgment and reciprocity impaired due to misperception of external cues and internal experiences • Denckla (1983) – Right hemisphere developmental learning disability: Affects cognition, academic and psychosocial functions • Rourke (1989) – Nonverbal learning disabilities due to white matter syndrome, poor visual-spatial- motor, and novel problem solving, both internalizing and externalizing psychopathology

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Is Asperger Syndrome on the “Spectrum”? • O’Neill (1999) Asperger’s as “little professors who can’t understand social cues” → gist of social discourse • Klin et al. (1996) Asperger > autism on verbal measures, reverse was true for nonverbal (visuospatial, visuomotor, and visual memory), concluding Asperger’s similar to NVLD and distinct from high functioning autism. • Volkmar et al. (2000) describe “Robert”, good reader but eccentric and clumsy, high anxiety levels, poor social and adaptive functioning, found right hemisphere white matter lesion • Bryan & Hale (2001) – Discordant/Divergent processes affect nonverbal (spatial-holistic) and verbal (implicit language) functioning • Look for “Hale’s Sign” to differentiate two ©James B. Hale, PhD, MEd, ABPdN

Is Asperger Syndrome on the “Spectrum”?

J Autism Dev Disord. 2014 Jul;44(7):1577-96. doi: 10.1007/s10803-013- 2025-2. A meta-analysis of differences in IQ profiles between individuals with Asperger's disorder and high-functioning autism. Chiang HM1, Tsai LY, Cheung YK, Brown A, Li H.

Abstract A meta-analysis was performed to examine differences in IQ profiles between individuals with Asperger's disorder (AspD) and high-functioning autism (HFA). Fifty-two studies were included for this study. The results showed that (a) individuals with AspD had significantly higher full-scale IQ, verbal IQ (VIQ), and performance IQ (PIQ) than did individuals with HFA; (b) individuals with AspD had significantly higher VIQ than PIQ; and (c) VIQ was similar to PIQ in individuals with HFA. These findings seem to suggest that AspD and HFA are two different subtypes of Autism. The implications of the present findings to DSM-5 Autism Spectrum Disorder are discussed.

Is Asperger Syndrome on the “Spectrum”? Citation Yu, K. K., Cheung, C., Chua, S. E., & McAlonan, G. M. (2011). Can Asperger syndrome be distinguished from autism? An anatomic likelihood meta-analysis of MRI studies. Journal of Psychiatry & Neuroscience, 36(6), 412- 421. http://dx.doi.org/10.1503/jpn.100138

Background: The question of whether Asperger syndrome can be distinguished from autism has attracted much debate and may even incur delay in diagnosis and intervention. Accordingly, there has been a proposal for Asperger syndrome to be subsumed under autism in the forthcoming Diagnostic and Statistical Manual of Mental Disorders, fifth edition, in 2013. One approach to resolve this question has been to adopt the criterion of absence of clinically significant language or cognitive delay—essentially, the “absence of language delay.” To our knowledge, this is the first meta-analysis of magnetic resonance imaging (MRI) studies of people with autism to compare absence with presence of language delay. It capitalizes on the voxel-based morphometry (VBM) approach to systematically explore the whole brain for anatomic correlates of delay and no delay in language acquisition in people with autism spectrum disorders. Methods: We conducted a systematic search for VBM MRI studies of grey matter volume in people with autism. Studies with a majority (at least 70%) of participants with autism diagnoses and a history of language delay were assigned to the autism group (n = 151, control n = 190). Those with a majority (at least 70%) of individuals with autism diagnoses and no language delay were assigned to the Asperger syndrome group (n = 149, control n = 214). We entered study coordinates into anatomic likelihood estimation meta-analysis software with sampling size weighting to compare grey matter summary maps driven by Asperger syndrome or autism. Results: The summary autism grey matter map showed lower volumes in the cerebellum, right uncus, dorsal hippocampus and middle temporal gyrus compared with controls; grey matter volumes were greater in the bilateral caudate, prefrontal lobe and ventral temporal lobe. The summary Asperger syndrome map indicated lower grey matter volumes in the bilateral amygdala/hippocampal gyrus and prefrontal lobe, left occipital gyrus, right cerebellum, putamen and precuneus compared with controls; grey matter volumes were greater in more limited regions, including the bilateral inferior parietal lobule and the left fusiform gyrus. Both Asperger syndrome and autism studies reported volume increase in clusters in the ventral temporal lobe of the left hemisphere. Limitations: We assigned studies to autism and Asperger syndrome groups for separate analyses of the data and did not carry out a direct statistical group comparison. In addition, studies available for analysis did not capture the entire spectrum, therefore we cannot be certain that our findings apply to a wider population than that sampled. Conclusion: Whereas grey matter differences in people with Asperger syndrome compared with controls are sparser than those reported in studies of people with autism, the distribution and direction of differences in each category are distinctive. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

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Differentiating Right Hemisphere Functions Right Posterior Region Right Anterior Region • Attention to Environment • Sustained Attention • Attention to Self (Body • Planning Awareness) • Strategizing • Spatial/Holistic Processing • Evaluating • Left Hand Sensory Feedback • Flexibility/Shifting • Object Recognition • Immediate Learning • Facial Perception • Working Memory • Affect Recognition • Memory Retrieval • Contextual Comprehension • Novel Problem Solving • Implicit Comprehension • Divergent Thought • Discordant Comprehension • Implicit Expression • Receptive Prosody • Expressive Prosody • Social Comprehension • Social Adaptability

ADHD-Inattentive Type? ADHD-Combined Type? Asperger Syndrome?

WISC-IV/WIAT-II Math Disability Subtypes (Hale, Fiorello, Miller, Wenrich, Teodori, & Henzel, 2008) 11

Mean Scaled Score Scaled Mean 7

Fluid/Quantitative Reasoning 6 Mild Executive/Working Memory Right Hemisphere SLD (NVLD) Numeric-Quantitative Knowledge 5 Dyscalculia-Gerstmann Syndrome Si Vo Co WR In DS DF DB LNS Ar BD PCs MR PCn Cd SS WISC-IV Subtests

SLD Psychopathology Study Participants Hain, Hale, & Glass-Kendorski (2010) • 155 children, age 6 to 16 (M = 10.86, SD = 2.80), with SLD by school district and Concordance-Discordance Model criteria • 42 excluded for not meeting processing asset and deficit (e.g., Hale et al., 2006) Results • WISC-IV, BASC-2 TRS, and achievement scores in average range with mild impairments, but heterogeneity masked significant profile differences • Average linkage within groups variant of the unweighted pair-group method arithmetic average (UPGMA) revealed six neurocognitive SLD subtypes: →Visual/Spatial (V/S) (n = 14) →Fluid Reasoning (FR) (n = 10) →Crystallized/Language (C/L) (n = 15) →Processing Speed (PS) (n = 30) →Executive/Working Memory (E/WM) (n = 19) →High Functioning/Inattentive (HF/I) (n = 25) ©James B. Hale, PhD, MEd, ABPdN

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Preliminary Study of SLD Subtypes and Emotional-Behavioral Disorders

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CDM-Determined SLD WISC-IV Cognitive Results

CDM-Determined LD Psychosocial Dimensions: Eternalizing Behaviors

No LD WMI PSI F P n = 15 n = 17 n = 18 Externalizing M 59.00 56.29 58.72 .25 .784 SD 14.27 11.13 11.50

Hyperactivity M 59.93 60.82 59.33 .05 .950 SD 15.36 14.01 12.21

Aggression M 60.93 54.59 58.50 .93 .401 SD 17.38 11.36 10.95

Conduct Problems M 54.27 52.06 56.67 .79 .460 SD 10.53 8.37 12.96

CDM–Determined SLD Psychosocial Dimensions: Internalizing Behaviors

No LD WMI PSI F P n = 15 n = 17 n = 18 Internalizing M 58.47 55.47 64.17 1.89 .162 SD 11.67 11.36 16.34 Anxiety M 55.87 57.18 59.44 .32 .730 SD 11.77 12.82 14.47 Depression M 61.80 59.71 69.17 1.59 .215 SD 14.61 14.26 19.63 Somatization M 52.27 69.17 55.17 2.07 .138 SD 10.93 19.63 16.33 Withdrawal M 57.13 57.18 68.61ab 4.98 .011 SD 12.29 11.06 13.43 Note. a Greater than No LD group; b Greater than WMI group ©James B. Hale, PhD, MEd, ABPdN

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CDM-Determined SLD Psychosocial Dimensions: Adaptive Skills No LD WMI PSI F P n = 15 n = 17 n = 18 Overall Adaptive Skills M 43.67 41.53 36.22a 5.68 .006 SD 8.14 7.10 4.29 Adaptability M 45.20 45.24 37.89ab 2.58 .087 SD 12.73 11.26 8.90 Social Skills M 46.13 44.47 38.56a 3.94 .026 SD 9.90 8.52 6.34 Leadership M 45.93 42.63 40.89a 3.45 .040 SD 6.89 5.52 4.13 Functional Communication M 43.87 38.81 36.94a 3.68 .033 SD 7.14 6.38 8.54 Note. a Greater than No LD group; b Greater than WMI group ©James B. Hale, PhD, MEd, ABPdN

Predicting Mathematics Response to Intervention: Better White Matter Connectivity and Automaticity Supekar et al. (2013)

Hank and Math Word Problems: Why Doesn’t He Get It?

• Referral: A careful, well-behaved boy who does well in school, Hank’s teacher reported he learned his addition and subtraction facts quickly. When he turns in his homework or takes tests requiring math computation skills, he seldom makes an error. He responds quickly to most of the math questions asked in class (within a second or two). However, Hank struggles with math word problems. For instance, given “Johnny had 6 apples, he ate two, and gave one to Sam, how many apples are left?”, Hank said “5”? What is the possible problem? • Hypotheses: Hank has good math computation and math fact automaticity skills (so supramarginal gyrus, temporal lobe functioning, cerebellar automaticity, and frontal retrieval of facts all good). However, he struggles with math word problems – this could be because of poor receptive language (possibly Wernicke’s Area), working memory (possibly dorsolateral), and/or fluid reasoning (right hemisphere/frontal) problems, or mental flexibility that is the problem.

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THANK YOU! QUESTIONS? COMMENTS?

Please feel free to contact me (aka, Brad :) with questions or interest in helping develop educator brain literacy!

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