Behavioural Interventions to Remediate Learning Disorders: A Technical Report 23 March 2015 George Dawson & Stephanie D'Souza Supervised by: Dr. David Moreau PhD & A/Prof. Karen Waldie PhD Centre for Brain Research and School of Psychology The University of Auckland Auckland, New Zealand Contact: [email protected] Behavioural interventions to remediate learning disorders: A technical report TABLE OF CONTENTS I Introduction ............................................................................................................ 3 II Audited Programmes .............................................................................................. 4 A Arrowsmith Programme ........................................................................................ 4 B Brain Gym ........................................................................................................... 8 C Cellfield ............................................................................................................. 17 D Cogmed Working Memory Training ........................................................................ 21 E Coloured Overlays and Lenses (including those from Irlen and The Institute of Optometry) ............................................................................................................. 30 F Danks Davis Dyslexia Tutoring .............................................................................. 34 G Davis Dyslexia .................................................................................................... 35 H Dore Programme ................................................................................................. 41 I Fast ForWord ....................................................................................................... 46 J Lexia Reading ...................................................................................................... 60 K Lumosity ............................................................................................................ 78 L Orton-Gillingham ................................................................................................. 93 M The Slingerland Approach, as used in New Zealand by The Learning Key .................. 100 N Steps .............................................................................................................. 102 O The Tomatis Method for Auditory Retraining ......................................................... 107 III Omitted Programmes .......................................................................................... 120 IV Conclusion ......................................................................................................... 124 2 Dawson, D’Souza, Moreau, Waldie – MovinCog.org I INTRODUCTION Learning disorders such as dyslexia, dyscalculia and attention deficit hyperactivity disorder (ADHD) can present significant challenges for children, parents, and educators. Combined, these disorders impair learning in as many as one in five children, with sometimes devastating repercussions for numerous aspects of their lives. Much knowledge has been gained recently by studying the neural correlates of such learning disorders, leading to the identification of specific neural networks that are altered in impaired learning (although questions remain regarding the causal links between these changes in neural activity and changes in behaviour). Quite logically, advances in the scientific understanding of these disorders have paved the way for cognitive remediation programmes aiming to alleviate behavioural symptoms by targeting their underlying mechanisms. Although we believe this endeavour should be praised, marketed programmes often lack sufficient scientific evidence to back up their claims. This is prejudicial to individuals and institutions investing time and money into interventions that may not lead to the intended results. In this report, we assess with a critical eye a selection of current popular remediation programmes. For each intervention we discuss, we provide an overview of the training tools and report on the strength of the evidence available at this time. Note that we do not have any financial involvement with these programmes, which means that there is no conflict of interest surrounding the statements reported here. Finally, we want to emphasise that none of the sections in this report are definitive. Science is a collaborative enterprise, moving forward collectively, and we make no specific predictions regarding the future of each programme. Rather, as we mentioned, we have assessed and synthesised the evidence currently available to us in order to help parents, educators and policy-makers reach better, more informed conclusions. 3 Behavioural interventions to remediate learning disorders: A technical report II AUDITED PROGRAMMES A Arrowsmith Programme Website / for more information see: http://www.arrowsmithschool.org/arrowsmithprogram/index.html What it involves: Arrowsmith offers a three to four year for-profit programme which replaces regular school tuition. It was developed by Barbara Arrowsmith-Young, author of The Woman Who Changed Her Brain. Its goal is to address the root causes of learning disabilities rather than managing their symptoms. Ostensibly the programme and its exercises are based on research in neuroscience, particularly on the principle of neuroplasticity and localisation of functions as described by A.R. Luria. The Arrowsmith programme is delivered in a school setting by specially trained teachers. Arrowsmith mandates a teacher:student ratio of one Arrowsmith teacher to approximately 10 students. The overall class size can, however, exceed 10 students, so long as the appropriate teacher:student ratio is maintained. Arrowsmith education begins with an individual online assessment process which takes approximately one day. Each student’s results are submitted to Arrowsmith, which creates an ‘Individual Learning Profile’ for the student, identifying their strengths and weaknesses. Once a student’s Individual Learning Profile has been created, he or she then spends approximately four periods per day, five days a week performing Arrowsmith cognitive exercises. These include computer, auditory and pen and paper exercises. The rest of the school day is usually devoted to more traditional English and mathematics teaching. The extent to which more traditional teaching is involved depends on curriculum regulations and individual students’ needs. Each student’s progress is tracked monthly on a web-based system, and a full year-end reassessment is carried out to update the student’s Individual Learning Profile. What claims does the company make / what does the programme target? Relatively bold claims are made in support of the Arrowsmith programme. In its programme brochure it is stated that “[u]pon completion, and with the attendant improved cognitive capacities, students are able to participate in a full academic curriculum at their appropriate grade level without the need for resource support or curriculum modification” (Arrowsmith, 2010, p. 5) Arrowsmith is not free and so details about its remediation processes are not available to the public. However, based on Arrowsmith-Young’s (2013) book The Woman Who Changed Her Brain, the programme seems to identify and target the following deficits: (1) Motor Symbol Sequencing — said to involve the premotor region of the left hemisphere of the brain, and enable us to learn motor plans to consistently and sequentially produce a set of symbols (e.g., alphabet letters or numbers). This is remedied by a tracing exercise using pen and paper, where the student is to wear an eye patch over his or her left eye apparently to stimulate the left-hemisphere 4 Dawson, D’Souza, Moreau, Waldie – MovinCog.org motor area. After remediation, the student may show improved reading tracking and potentially even an improved ability to use binocular vision cues. (2) Symbol Relations — said to involve the juncture of the occipital-parietal-temporal areas in the left hemisphere of the brain. A deficit in this area may show itself as a propensity to reverse letters (b/d, p/q) and find it difficult to read an analogue clock. Grammar (especially prepositions) may also be difficult to understand. The Arrowsmith programme seems to target this deficit with the ‘clocks’ exercise, where the student must input via a keyboard the time displayed on a computer-drawn clock, which may have many different (certainly more than three) hands. There are apparently fourteen different rules to the clocks exercise. (3) Memory for Information or Instructions — said to involve the temporal region of the left hemisphere of the brain. This deficit shows itself as difficulty in remembering and following lectures and conversations or instructions. These may have to be repeated several times before someone with this deficit can retain them. The deficit is remedied by an auditory exercise where the student must listen over and over to song lyrics until he or she can repeat them. The lyrics to be remembered get progressively more complex as the exercise continues. (4) Predicative Speech — a deficit in which means you cannot learn the rules governing sentence structure, leading to a propensity to speak and write in short sentences. This deficit may further make it difficult to anticipate the consequences of words and actions and so someone suffering from it may appear to be rude or lacking tact. It is remediated through an auditory exercise where