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Masters in Educational Practice: Child and adolescent development 0-19

7

Neuroscience and education working together

7.3

Neuroscience and developmental disorders

It is now widely believed that learning is undertaken in a dynamic system (see Figure 1). Further advancements achieved by bringing neuroscience and education together are leading to a greater understanding of the children in our classrooms. In every classroom, each child has a unique pattern of strengths and difficulties. Their genes, and the environment they are born into and live in, affect their outcome.

Figure 1: Diagram demonstrating that outcomes emerge from interactions between the child, the environment in which learning occurs, and the manner of presentation.

Figure 1: Diagram demonstrating that outcomes emerge from interactions between the child, the environment in which learning occurs, and the manner of presentation.

'A child does not learn from a passive kaleidoscope of experiences but from the outcomes of actions that he or she has initiated.'

John Keith Brierley, author of Give Me a Child Until He Is Seven: Brain Studies and Early Childhood Education

Neuroscience and education working together have the ability to help us to understand more about how different children learn. But, we still often attempt to separate children under different ‘labels’, despite increasing evidence that overlaps in learning difficulties are the rule rather than the exception (see Figure 2 for summary). In some children, the genes they inherit combine with their environment, before and after birth, to produce symptoms that may result in the child having challenges in both their health and education. Children do not come in neat packages; despite our best efforts to categorise children by signs and symptoms, it is just not that straightforward.

 Evidence for overlapping learning difficulties
Source
Figure 2: Summary of the evidence for the occurrence of overlapping learning difficulties.
ADHD and ASD 21% of children with severe ADHD met the full criteria for Asperger’s Syndrome and 36% for ‘autistic traits’.  Fitzgerland & Corvin, 2001
Lecavalier, 2006
Fombonne, Zakarian, Bennett, Meng, & McLean-Heywood, 2006
DCD and ADHD 30–35% of children have ADHD and DCD. Salmon & Kirby, 2008
Gillberg, 2010
ADHD, DCD, Dyslexia and ASD There is extensive evidence of overlap between all four disorders. Kaplan et al, 1998
Dyslexia and ADHD Overlaps in between 35–40% of cases. Willcutt, Pennington, Olson, & DeFries, 2007 showed a shared genetic basis
SLI and DCD 60% of children with specific language impairment showed motor difficulties as well. Gaines & Missiuna, 2007
SLI and Dyslexia There is a greater risk of later dyslexia in adulthood. Pennington & Bishop, 2009

(Wood, C., Littleton, K., & Sheehy, K. (Eds.). (2006). Developmental psychology in action (1st ed.). Milton Keynes: The Open University.)

Activity

  • Do you think the diagnostic labels that we use for children in our schools today will be used in the next 20 years in the same way (e.g. Dyslexia, ADHD, ASD, etc.)?
  • How might the environment that the child is raised in affect their learning outcome?

Dyslexia

Dyslexia is a difficulty with reading and spelling skills and may be accompanied by difficulties with writing, organisation and planning. Dyslexia affects about 8 to 10 per cent of the population (Shaywitz, 1998). It is thought that reading in adults involves a network of language areas in the left hemisphere (Bar-David, Urkin, & Kozminsky, 2005). Children with developmental dyslexia display reduced activation in areas typically associated with reading in the left hemisphere.

Attention deficit hyperactivity disorder (ADHD)

Approximately 3 to 6 per cent (Robison, Sclar, Skaer, & Galin, 1999) of the school-age population is thought to suffer from ADHD. The behaviour of these children is often characterised as inattentive, impulsive and overactive. They often present a particular challenge to a classroom teacher, and to themselves. The overt activity of children with ADHD has the potential to distract teachers from understanding these learners, who are arguably made frustrated and distressed by their own behaviour.

The neuroscience of ADHD is still not clear but some agreement is beginning to emerge that individuals with ADHD exhibit neural differences in areas such as the prefrontal cortex. This region is located at the back of the frontal lobes, and thought to be involved in attention. Although our understanding of ADHD at a neurological level is still debatable, its treatment has increasingly involved the psychoactive drug methylphenidate, most commonly sold as Ritalin. In 1991, only 2,000 prescriptions for this drug were given out in the UK. By 2005, this figure had risen to 359,000, and it is currently growing by 18 per cent per year (Information Centre for Health and Social Care, 2005). There are some concerns about the long-term effects of drugs such as methylphenidate on the developing brain (e.g. Andersen, 2005) although the use of medication seems likely to endure as an important part of the solution for individuals with ADHD.

In addition to possible neurological aetiology, we know that there are many different genes related to learning difficulties. Children with complex learning difficulties in particular may have the same diagnosis but may have varying genes impacting on their difficulties. As we understand this more, we are able to recognise that genes can ‘penetrate’ (or work at different degrees) and some can have a stronger impact compared to others that increase the risk of having a difficulty.

There is growing evidence that teachers following evidence-based strategies can play an important role in improving the well-being and academic performance of students suffering from ADHD (Gureasko-Moore, Dupaul, & White, 2006). Recent successful interventions include the application of cognitive and instructional approaches to managing children’s behaviour, the inclusion of parents/carers and teachers in interventions and the training of learners themselves in self-management. This research emphasises the importance of teachers’ understanding of the disorder, its medication and management.

Dyscalculia

Dyscalculia affects a person’s ability to understand, recall or manipulate numerical information, or conceptualise numbers as abstract concepts. Some individuals may feel anxious when having to undertake any mathematics-related tasks and so may avoid situations where they have to do this.

Dyscalculia is one example of where brain imaging and educational interventions have both been used to understand the basis and importantly identify methods to remediate it (e.g. Kaufmann, Handl, & Thöny, 2003). One challenge for educators dealing with dyscalculia concerns the fact that calculation abilities often appear to be related to non-numerical skills such as visual-spatial cognition, language, working memory, etc. Thus, only a very small proportion of children with calculation difficulties exhibit a ‘pure’ dyscalculia, with most having difficulties in non-numerical domains as well.

Some examples of ‘new children’ and new conditions

With new children in an ever changing landscape, neuroscience is teaching us about the complexity of children and the way they learn, and recognising new children.

Foetal Alcohol Spectrum Disorder (FASD)

The umbrella term Foetal Alcohol Spectrum Disorder (FASD) includes:

  • Foetal Alcohol Syndrome (FAS) typically diagnosed by a paediatrician using four criteria: alcohol exposure during pregnancy; growth deficiency; certain facial characteristics; and central nervous system dysfunction or brain damage
  • partial Foetal Alcohol Syndrome (pFAS) is a term used to describe individuals who do not have all of the characteristics necessary to receive a diagnosis of FAS
  • Alcohol Related Neurodevelopmental Disorder (ARND) refers to the range of neurological impairments that can affect a child who has been exposed to alcohol in the womb.

The impact on learning for a child with FASD includes: poor mathematical ability and poor social skills.

Foetal Alcohol Syndrome (FAS) is the biggest cause of non-genetic learning difficulties in the western world. Foetal Alcohol Spectrum Disorder (FASD) describes a range of disorders caused by prenatal exposure to alcohol. It is an ‘educational’ term that refers to a variety of physical changes and neurological and/or psychometric patterns of brain damage. The brain damage can result in a range of structural, physiological, learning and behavioural disabilities.

Clarren, 1981

Premature births

With advances in medical knowledge, babies are being born and surviving at an ever earlier stage. Although some preterm babies will not have any problems, the earlier babies are born the greater the risk that they will experience difficulties. This is because the development of the brain that should have occurred in the womb has not been fully completed.

The earlier a baby is born, the higher the chances of it being born with Cerebral Palsy. The incidence of this is far greater in very premature babies and far less in those born full-term - Premature Babies and their Problems (external link)

In extreme prematurity (25 weeks), one study involving 307 children suggests that the outcome at 11 years of age include lower scores than their classmates in: cognitive ability; reading and mathematics. 13 per cent of their sample attended special schools; of those who were in mainstream schools 55 per cent required special educational needs resource provision and teachers rated 50 per cent of these children as having attainment below the average range, compared with 5 per cent of their classmates (Johnson, Wolke, Hennessy, & Marlow, 2011).

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