Top five trends of 2010 in individualized learning

1. Online School Portals- As of this month, the last North Shore School (surprising who took the longest) now has the ability for parents to know assignment grades before kids get them in class. Pros: smooth flow of information through the "assignment circle (of Doom)-see below.  Cons: the wrong people can tend to the information (read: parent anxiety alert!), and heck, who needs an assignment notebook now?

2. Response to Intervention - the transformation is complete (ly stupefying). By this point, schools are now agents of RTI ("Really Timeconsuming Interference"). Those who used to be called school psychologists are now "intervention specialists," the burden on classroom teachers is multiplied, the "diagnosis by treatment failure" model-ridiculed in medicine-is the M.O., the most amazing curricula are justified as "research based,"  and the kids who I know would benefit from some good school-based individually catered instruction are now delayed the help we all know they need.

3. Everything you need to know is now in most kids pockets - iPhones and other mobile technology are now more ubiquitous than pens/pencils in my office.  It forces a wonderful shift from teaching as dumping of information to filtering of relevance. 

4. Spell Links program - By now you should know I am not a lock-step programmatic thinking kinda guy; however, Jan Wazowicz's next project after the ubiquitous Earobics auditory processing success promises to be a player nationally as it takes language-based, theory-driven, individually-tailored genius to the realm of spelling and decoding.  Access points include Holly Shapiro's Ravinia Reading Center.

5. The spectrum is now on our collective cultural radar - autism spectrum disorders, including Aspergers (which will disappear in the new DSM-V proposed this year) are talked about the media, in heart-felt ways, making us all begin to notice the subtlety inherent in nonverbal communication.  Did ya know that contagious yawning happens less in young kids with autism? 

Just Try Harder?

I've been thinking about how often we try to solve our kids' academic difficulties with the decree to "just try harder."

First, I'm always skeptical of any solution that starts with the word "Just..." If it were a simple solution, any reasonable person would have already run across it.

Second, who are the people recruiting this decree?  In my experience, many dads, often very successful, want their kids to overcome difficulties by just trying harder.  Another recent cohort I've been hearing this from, interestingly, is kids themselves after they achieve a big breakthrough.  [I try to analyze the successes at least as much as the setbacks.]  He finally got an A on that test because, "I don't know, I just tried harder."  So, if parents and kids say so, the "just try harder" solution is correct, right?  Not really.  Because it doesn't really help on the front side of the chasm. It only works when looking back after success.

Here's my explanation of the Just Try Harder ("JTHTM"?) reasoning and why I think it's so popular:

There is a well documented phenomenon in research on children's memory for collaborative activites (e.g., Foley et al., 2002) in which children tend to over-attribute contributions to themselves.  Here's what I mean: A 4- or 5- year- old child puts a puzzle together with a parent, and afterward, an experimenter asks, "Who was the person to put this piece of the puzzle in the right spot, you or your mom?" The kid thinks back, and says, "Me.  I put it there." Kids tend to correctly say they did it when they indeed put the piece there. They also tend to say they did it when in fact review of a videotape shows that the parent and kid did it together...or even sometimes when the parent in fact put the piece there. This happens time and time again: a consistent memory error in which kids think they did more to solve a problem than they actually did.

Is this a bad thing? Actually, we consider this an "adaptive memory error," for it turns out that time after time, the kids that make this error 1) try harder on the next puzzle they do without help from parents, and 2) tend to do better on subsequent puzzle tasks.  Why fix what works? In my clinical work, we tend to like seeing kids make these types of memory errors.

So what does this have to do with parents solving their kid's academic problem with the decree to "just try harder?" Often, at first pass, we all try to solve our kid's troubles by looking back on our own experiences. Sure, why not? Worked for me, so it may work for Junior!  (It's a data set of N=1)  So we look back on our own earlier academic successes. (BTW, it turns out we really retain quite few memories from school: mostly just the really salient five that get turned into anecdotes) and we often make the same adaptive memory errors as those 4 year old puzzle builders:


We look back over our education, our 12 or 16 or more years of carefully calibrated assistance from parents, teachers, and others, and we over-attribute contributions to ourselves: "I passed that class because I stayed up all night to finish that paper" or the like.  Again, in life these are adaptive memory errors.  They cause us to put in more effort on the next challenge!  The only problem in this situation is that the memory belongs to the older generation, but the effort is supposed to belong to the younger generation.  

DSM-V

Well, the new DSM-V (Diagnostic and Statistical Manual of Mental Disorders), the bible of psychology is now drafted, as of this week.

My head is swimming, especially considering earlier blogs on semantics and labeling.

There is no more Asperger's Syndrome.  Aspies will now be considered "Autistic Spectrum Disorders."  What a weird experience, I presume: to have a name you have likely grappled with, identified with, used to find others like you, or explained time after time YANKED out from underneath you.  Now you are situated along a continuum, seen as a mild version of others.  Aspergers' is now referred to as a "personality type" and "is outside the scope of DSM, which explicitly concerns clinically-significant and impairing disorders."

There will be no more Writing Disorder.  No more Learning Disability, Not Otherwise Specified.   The process of categorizing has always felt a bit like squeezing round pegs into square holes (often for purposes of school identification or insurance reimbursement).  However, now I worry there will no longer be a hole into which to do any squeezing.  I can think of 20 kids I've seen in the last month that have a genuine writing disorder.  What do they have now?  DSM proposes the broad category "Learning Disability" for the first time.

A Reading Disorder can no longer include difficulty in reading comprehension.  Arg, we lose focus on the fact that the process of reading is making sense of text (not just pairing sounds and symbols rapidly).  I love the irony of a spelling mistake in APA making the case that reading is only decoding:

The new name for a reading disorder is "dyslexia;" a disorder of mathematics is "dyscalculia."  Turning back the clock?  The stated intention is to be more consistent with international use.  Then, one line later, the APA cites US legislation (reauthorization of IDEA) to de-emphasize the use of discrepancy in identifying a learning disability.  US legislation determines whether someone has a mental disorder?  That bill was passed so that congresspeople could get re-elected or pass their pork-barrel projects, and the DSM cites this alongside peer-reviewed academic research to justify their clinical category?

I'll blog at some other time about the various proposals to make sense of AD/HD.  That will end up being the biggest change for children in the DSM-V.

DSM-V goes into effect 2013.  They are accepting comments beginning in April.  I'll put in my two cents.

At this point, I'm reeling from the shock.  After IDEA was reauthorized, I could at least hang my hat and thinking in the DSM world.  Now these changes worry me even more.  Before I rant too much more, I should probably make sure I'm sure I'm not just over-reacting to change.  Oh look! No Worries! The new DSM has a new category for me and all those who share my concerns:  Adjustment Disorder With Mixed Anxiety and Depressed Mood

Potato, Potahto? Tomato, Tomahto?

To build on the post by Anonymous:
One of the things we struggle with in our field is terminology. Learning Disabilities? Learning Differences? Dyslexia? Specific Learning Disorders? How can we purport to know anything about learning and it's individual variations if we don't even know what to call it?

For one, we can rest assured that the choices are better today than they were more than 40 years ago. I would hate to tell a kid to their face that they had "minimal brain damage" or to explain that they were "educably handicapped" (or as my 17yr old used to say, "candilapped").  Reading disorders used to be named according to what they looked like, such as "word blindness" or to make it really fancy, put it in Latin: "Strephosymbolia" (twisted symbols). 
   
Ever since the early coinage of the term LD in the late 1960's, the field has struggled to separate itself on one hand from more general mental delays (hence, the addition of "specific") and also differentiate itself from "normal" developmental variation (hence the prefixes DISability or DYSlexia).

I do find "disability" to be a misnomer, because I spend much of my treatment hours persuading children that they ARE able, given the right strategies, practice, etc. 

In my own mind, the lack of agreed upon terminology reminds me to be humble. What medical field would still not have a name for the disease they are curing? "Hmm, should we call it Cancer, or..." The fact that we don't even have our terms straight yet tells me how early we are in our thinking. No blood tests yet, no diagnostic fMRIs, no Hippocrates to lay down the tenets of ethical treatment ("First, do no test bias").  I guess it could be encouraging that the field of Physics still hasn't quite settled on whether LIGHT (the most trusted way we could be said to know something directly) is a particle or a wave.  Sounds a little bit like our field of LD calling it one thing to a kids face and another thing to a suit-sporting table of professionals at an IEP.   In the mean time, while we muddle through our terminology differences and DSM revisions, I tap back into that humility notion and listen to the way that kids talk about their own struggles.  That's probably the best way to find out what it feels like from the inside out, and it's the best way to know whether they have recovered, or compensated, or overcome their, um, their...oh, whatever you want to call it.  

Unfettered Potential

I have to fess up to one of my educational fantasies.  Often, I’ll be working with a kid, and I imagine what learning would be like without cognitive roadblocks.  What we ALL would be like without these roadblocks, but especially them, right here and now.  

I see the seeds of some good idea that the world needs to know about, and it isn’t coming out.  The darn handwriting just doesn’t get it out fast enough before the darn monkeymind jumps on to some new thought.  Or the words weren’t accessible - just stuck right there on the tip-of-her tongue - so why try to explain it anyhow.  

I feel similar frustration trying to get needed ideas in.  A 9-year-old can give me a phenotypical run-down on the difference between Indian and African elephants, but her brain never downloaded the sound-symbol codebook to be able to read a first-grade book about them (“Huh? A Frickin’ Elephant?!”).  

What would life be like without these roadblocks, these input-output issues, these cognitive bottlenecks?  Imagine the DaVinci Flying Machine that was never made because of poor visual-spatial skills.  Or The Great American Novel never written due to waning attentional skills.  Arg. 

Often my fantasy of untapping potential drives my remediation sessions with a kid; I’m madly running through my ever-increasing key ring, fervently jamming well-used (or newly constructed) keys into quickly rusting locks.  Then quickly trying to duplicate the keys and hand them over before a session ends, or a kid wants to just do homework, or some new profound tangent pulls us away.

Assistive Technology shares this fantasy of mine.  With some skill building I’m a fan of  voice dictation software (www.macspeach.com, www.nuance.com) to bypass graphomotor weaknesses, mindmapping software (www.inspiration.com) to scaffold organizational skills, reminder systems (www.reqall.com) to aide long-term memory retrieval, text to speech scanners and pens (www.kurzweiledu.com, www.quickpen.com) for decoding weaknesses, and voice recording and uploading pens (www.livescribe.com) for note-taking assistance.  [Hmm. Maybe this is worth its own blog.]  So, problem solved?

But sometimes I am of the mind that these cognitive bottlenecks are a GOOD thing.  Perhaps they hold gifts wrapped in frustration.  

For one, the process of figuring out ones’ learning is a more powerful tool than effortlessly gliding through school and then hitting a brick wall and having no way to recover.  I worry about this when I see an 11-year-old with working memory skills in the very superior range (stronger than 98% of their same-age peers) and executive functioning/organizational skills within the borderline range (below the 9^th %ile), who rightly claims “Nah, I don’t need an assignment notebook because I remember my assignments.” [No doubt he does, but there’s no way to undo those compensatory mechanisms and learn how to use an assignment notebook in Junior Year of High School in AP Class content.]  

And does my image of unfettered potential even exist? A disembodied black box mind that effortlessly inputs information and exudes brilliance with no friction or resistance?  I am too much a believer in Whorfian thinking and know that language and culture must change our thoughts.  So a kid with an auditory processing or language disorder would be a different thinker without the bottlenecks.  And I like this kid’s mind too much to be trying to change it!

A final reason cognitive bottlenecks may ultimately serve us is that they lead us toward our proclivities.  Although extreme, consider the likes of Stephen Hawking, of Temple Grandin, of the Jill Bolte Taylors of the world.  Annie Sullivan had almost completely lost her own eyesight before learning sign language and meeting Helen.  Although clearly nowhere on the same scale of genius, personally, I have no doubt that my own frustrations coming up with that right word on the spot have led me toward expressing my truest thoughts and feelings non-linguistically through music.  I don’t know where I would be without busking, writing songs, and gigging regularly.  

Ultimately, these days I find myself reconciling my fantasies for unfettered potential (more Darwin flying machines!) and my respect for our existing neurocognitive architecture with an ever deepening faith in process over product.

I’m learning that the keys we uncover in our resilience serve us well beyond the immediate ease of showing our smarts.