Some underlying causes of learning difficulties

Some underlying causes of learning difficulties

Integrated Learning Therapy (ILT) is a neurodevelopmental approach that takes note of all the factors that can interfere with a child’s ability to cope with learning and living. This means that we aim for an holistic view of the child rather than focusing on a narrow range of possible causes of learning disabilities.  As a result, we tend to almost ignore the symptoms of the disability.  We aren’t interested in treating the symptoms – we want to get to the root of the matter.

This is also why we avoid using labels.  So many children are labelled – such as ADHD, Dyslexia, Dyspraxia, OCD and so on and on.  Certainly these brain-related disorders exist but too many children are given the labels without due care and consideration of what actually may underlie the behaviours they display. Once labelled, the treatment follows the prescribed course for the label and then a child may be administered serious medications that are actually inappropriate, useless and even harmful.

So in looking for the causes, what do we find most often?

  1. Nutrition

We are what we eat – no doubt about it!  If children are showing signs of learning problems, then you need to seriously consider their diet and eliminate the major offenders: colourants, preservatives and additives. That means avoiding processed food and going back to the basics.  Buy good quality protein and combine it with fresh vegetables and/or fruits.  If your child is a picky eater, you’ll need help in resolving the diet – we are always prepared for those!

  1. Gut health

You’ve probably read about the significance of a healthy digestive system for general health and the gut’s intimate relationship with the brain.  Believe those articles because we’ve proved the connection over and over again.  Of course, gut health is related to diet and other factors but it is important enough to stand alone as a frequently encountered cause of learning problems. If you feel that your child often seems listless and unwell even though the doctor finds nothing wrong, has tummy complaints like constipation, winds and/or runny tummy and craves sweets or starchy foods, then you need to check that the problem isn’t in his or her digestive system.

  1. Environmental offenders

These include allergens, pollutants, heavy metals and parasites.  We might not find these in every child with a learning disability but the air and water in some areas of the country does contain heavy metals; certain parasites cause behaviour issues (often extreme bad moods and lack of cooperation) and pesticides certainly impact on health. In turn, health affects one’s attitude towards learning and ability to concentrate.  Allergies are also related to the immune system, which in turn is dependent on a healthy gut.  So once again, the diet, gut health and general health are interrelated.  This is one of the reasons why ILT practitioners so often exclaim ‘Nothing stands alone!’

  1. Brain development and function (neurodevelopment)

It stands to reason that if hitches occur during the time that the brain develops (in utero and during life), learning can be negatively affected. There are ways of checking a child’s neurodevelopmental status and this is especially important whenever signs of slow development, failure to reach milestones and any unusual difficulties with school-related tasks are noticed.  Sometimes early signs can be seen in movement difficulties, such as

  • Being late to crawl, stand, walk, reaching for objects; difficulty jumping, skipping, hopping, climbing; clumsiness, walking in a straight line, climbing up and down stairs,
  • Fine motor difficulties such as managing buttons, dressing independently, tying shoelaces, using eating utensils, throwing a ball, colouring between the lines.

There are many signs that can help to identify why a child, with perfectly normal intelligence, may have school difficulties.

 

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Growing a healthy gut garden

Growing a healthy gut garden

Integrated Learning Therapy places great value on a healthy digestive system.  Our knowledge about the importance of nutrition for brain health naturally evolved into a concern for the state of our clients’ guts. More specifically, for the contents of their guts.  There is little doubt that having a gut stocked with healthy bacteria and other beneficial organisms (collectively called the microbiome) puts a child at an advantage when it comes to school success.  The question is: if you suspect that gut problems are present in your child, how can you try to improve matters? How can you help him or her grow a healthy gut garden?  This article is summarized from the book ‘Follow your gut’ by Rob Knight (A TED Book published by Simon and Schuster).

As with any garden, it is necessary to nurture the existing plants by feeding them or preparing the ground for new plants by digging in nutrients.  This is where prebiotics come in.  There isn’t a universal definition for prebiotics but according to the International Scientific Association for Probiotics and Prebiotics, prebiotics are “nondigestible substances that provide a beneficial physiological effect for the host by selectively stimulating the favorable growth or activity of a limited number of indigenous bacteria.”[1]  In simpler language, prebiotics are largely soluble fibres that occur naturally in some fruits and vegetables.  They provide nutrition for the cells that line our intestines and also produce some of the benefits of natural high-fibre diets. One of the major benefits is that they stimulate the growth of health-promoting microbes.   It is logical then to assume that children who struggle to eat enough fruits and vegetables might lack these fibres and so also lack a healthy microbiome.

There are as yet no clear guidelines as to what you should do to improve matters if your child resists fibrous vegetables but at the very least, it can do no harm to provide a prebiotic supplement.

Secondly, once you’ve dug in some compost, you need to put healthy plants into your garden.  These are the probiotics that play such an important role our physical and mental health.

They are mainly bacteria that are found naturally occurring in the human gut or in fermented foods (such as yoghurt, naturally fermented sauerkraut and kimchi).  Probiotics are defined as live microorganisms that, when administered in sufficient quantities, benefit health.  Briefly, they are the ‘good’ or ‘helpful’ or ‘beneficial’ bacteria.  If you suspect that gut health is compromised by a lack of these good bacteria, or if your child has had a course of antibiotics that will effective destroy the entire crop that might have been present before an illness, you may consider trying to replace them with supplements, yoghurts, fermented foods and even suppositories.

The problem is that probiotic products have not been formally approved nor have health claims been accepted by official food and drug organisations. This means that you have to be very careful of the product you choose to buy.

There has been huge interest in probiotics in recent years – especially in view of new insights to the significance of gut health for so many different medical conditions. These range from depression to autism with a myriad of other health conditions along the way, including Crohn’s disease, constipation, insulin resistance and autoimmune diseases like Multiple Sclerosis, Rheumatoid Arthritis and even ADHD.  Several clinical trials have been done with plenty more in the pipeline.  But there is a big problem.

The problem is that currently, there’s a lot more hype than solid research to give concrete evidence to what strains of probiotics are effective for what conditions and which manufacturers can be trusted.  If you visit your Health Shop or pharmacist, you’ll see lots of bottles filled with probiotics that are advertised as guaranteed to make your garden flourish.  The downside is the lack of real evidence that any of them will work and no insight to which strains will work for you.  In addition, you won’t know whether or not the product contains any live organisms after being freeze-dried and shipped long distances to sit on a shelf.  Those in the know will tell you that microorganisms need very specific conditions to survive.

Once you try to overcome these hurdles, you will be faced with the biggest problem. This is that many people assume that any probiotic will do.  It’s like saying that you took a drug because you weren’t feeling well without being able to specify what drug or why you chose it.  Having a friend recommend a probiotic or a pharmacy assistant hand you one casually might lead to very limited results.  The best you can do is to ask your doctor or pharmacist for a brand that has some good results (randomized, controlled trial data) supporting its effectiveness. Better still, try to find one that has proved success in treating the specific problem you identify and describe to the pharmacist.

Failing that, live, unsweetened, plain yoghurt is unlikely to hurt.  If your child dislikes yoghurt, blend some fruit into it to make a smoothie.  Don’t buy the yoghurt containing fruit.  That isn’t a food – it’s a sweet dessert with no particular nutritional value.

So choosing a probiotic is not an easy thing to do.  It is, however, worthwhile persevering because from our own experience, ILT practitioners have seen notable improvements in children whose gut gardens have been tended and begin to flourish.

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[1] www.worldgastroenterology.org/assets/downloads/en/pdf/guidelines/19_probiotics_prebiotics.pdf

Thoughts on teaching handwriting

Thoughts on teaching handwriting

Education departments in some countries have expressed the opinion that there is no longer a need to teach children cursive (joined up letters) writing.  This is because there is a decreasing need to write at all thanks to the use of computers, i-pads, cell phones and other devices. We spend far more time pressing letter keys than we do with pen and paper.   So, superficially, it does make sense for learners to spend classroom time on keyboard skills once they have been taught printed letters, rather than mastering good handwriting. There are, however, some pros and cons of handwriting that need to be considered before any decision is made.

Arguments for less focus on handwriting

Many learners may benefit from not having to depend on handwriting for communication of knowledge and skills.  Those with handwriting difficulties try to avoid any written task and some even become disruptive when they have to write something down.  Indeed, Linda Silverman, a leading figure in the field of gifted child education, believes that handwriting seems to play a much more significant role in underdevelopment than has often been realized.  One of the common characteristics of underachievement is an inability to produce written work of a suitable quality to match the learner’s demonstrated (usually verbal) potential.  This leads to consequences such as inattention, avoidance, low motivation, low self-esteem, a negative attitude towards school in general and behavioural problems. As a result of this realisation, it is fairly normal these days for schools to allow a scribe to help a child with writing difficulties, and even laptop computers are allowed in classrooms.

But there is another side to this story.  Why do some children struggle with handwriting at all?  The answer lies in neurodevelopment, which is why Integrated Learning Therapy practitioners take an active interest in this subject.

When we learn to write, we rely on many developed and developing skills.  Our posture, hand grip and movement patterns are all involved and orchestrated by the motor cortex in the cerebral hemispheres concerned with voluntary movements.  Furthermore, good fine motor skill, which is needed for neat handwriting, stems from well-developed sensory and motor foundations which result in muscle and joint stability, especially in the neck, trunk and arms. Accurate tactile discrimination and hand and finger strength help to control writing instruments.  Motor planning, the coordination of the two sides of the body and the development of hand and eye dominance are also involved in laying down pre-writing skills.

While we are learning the motor skills needed for handwriting, the area of the brain called the cerebellum is involved as well.  This brain area memorises all the complex muscular actions involved in a particular skilled movement so that it can take over control of movements, leaving the higher levels of the brain free to do the actual thinking and learning.  If the cerebellum is damaged or underdeveloped then skilled movements are not easy to execute.  Coordination problems are typical signs of cerebellar irregularities so learners who cannot coordinate the movements needed for fluid, rapid writing might be suffering from inefficient cerebellar functioning.

In other words, problems with handwriting can be important signals that neurodevelopment has not progressed as it should have.  Rather than doing away with handwriting lessons it might be wiser to consider the underlying reasons for problems in this area.

Arguments in favour of cursive writing

Once the cerebellum has mastered the print form of letters, it has to learn an entirely new set of motor programmes when cursive writing is introduced.   Some schools in certain countries teach cursive from the beginning, but most prefer starting with print, because all children’s stories, reading schemes and other forms of written communication use printed script.

There are some experts who advocate the use of cursive from as early on as possible. This is because cursive has a major advantage in the fact that each word or syllable consists of one continuous line where all the elements flow together.  This means that a young learner experiences more readily the total form or shape of a given word as he or she processes the kinaesthetic feedback from the writing movements.  In this way, handwriting supports spelling which in turn contributes to literacy development.

Cursive writing facilitates speed of writing which, until things change dramatically in schools and universities, is a crucial factor of academic success.  Slow writers struggle with taking down notes in class and managing to impart knowledge during written exams.

Furthermore, cursive writing is said to be particularly helpful for learners with handwriting coordination difficulties.  Research in the area[1] shows that cursive

  • Stops reversals and inversion of letters
  • Induces greater fluency in writing which enables greater speed to be developed without loss of legibility
  • Enables more to be written in the time
  • Can improve spelling accuracy
  • Results in orderly and automatic space between letters and between words
  • Reduces the paid and difficulty experienced by pupils with coordination difficulties
  • Improves legibility of writing
  • Reinforces multisensory learning linking spelling, writing and speaking

In addition, it is known that insight and memory are enhanced by the use of multiple brain areas.  Hence the encouragement of using notes and summaries as a good study skill.  When we engage our hands to work with the brain in organising and understanding new materials, we naturally find it easier to comprehend and then recall content.

In the remedial field, it has been known for decades that the teaching of cursive writing benefitted learners with difficulties in learning and handwriting. Lack of good teaching can contribute to underachievement in schools but there seems to be some evidence that neglecting the teaching of handwriting can play a role too.

Will keyboards eradicate the problems of many underachievers or will they be somehow further disadvantaged by foregoing the benefits offered by learning handwriting – especially cursive writing?  One can only hope that further research will shed more light on this puzzling question.

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[1] Montgomery, D. 2007. Spelling, handwriting and dyslexia: Overcoming barriers to learning. London: Routledge.

ADHD behaviours and bread

ADHD behaviours and bread

Is bread really the staff of life for all people?    The answer is almost certainly that it might have been once but in our modern times, the preservatives that are used to keep it fresh for longer might be underlying the difficult behaviours associated with ADHD.

These days there is a lot written about how diet affects learning and behaviour.  Some families try to avoid certain foods – sugar and highly coloured foods are examples.  But if you have a child who is struggling with really challenging mood swings, fatigue, defiant attitudes, eczema, asthma, poor progress at school, perhaps you need to look more closely at bread.

One of the major preservatives in bread is Proprionate.  If you take this post seriously and read the labels on the breads your family eats daily, you’ll see that it is added to virtually all commercially available bread and rolls.  The official name is Calcium Proprionate and it is a mould inhibitor, also found in various cheeses. The food scientists claim that it is harmless and they base this opinion on the fact that it occurs naturally in the human body.  That may be so, but there is limited evidence as to how much is tolerated by our body and how high doses may affect the body.

Many South African families rely on bread for meals and snacks throughout the day.  Breakfast, school lunches and afternoon snacks are often based on bread.  It is an easy, relatively cheap and quick hunger satisfier.  But this high intake of bread is accompanied by a high intake of proprionate.

One person who realised the link between proprionate and a myriad of mental and health problems is Sue Dengate.  She is an Australian researcher and writer who spent years trying to understand the underlying reasons for her own children’s extreme behaviour and learning challenges.  Her efforts have resulted in her founding the FAILSAFE eating approach which is widely followed in Australia and elsewhere.  Her website is a font of knowledge about how intolerances to food and food additives – including proprionate – affect both brain and body.

For example, she mentions how some breastfed babies stopped their constant screaming when their mothers switched to preservative-free bread; how children were able to first reduce and then stop their ADHD medication after giving up preserved bread, even how high-functioning adults suffering from chronic fatigue syndrome regained their energy after excluding certain breads.

Bread preservative may not be the only additive causing problems but this post focuses on it because it is probably the additive eaten most often by people who think they are eating a healthy diet.  So many of us can cope with preservatives, colourants and flavourants but that isn’t an argument for closing our minds to the possibility that the challenging ADHD-type behaviours that we struggle with daily might be caused by or at least worsened by modern foods. The children that we’re focusing on are more vulnerable to many of the potential offenders found in our environment, including foods. The fact that other children are not affected by these things is not an excuse to ignore the possibility that one or many more potential offenders are affecting the brain, immune system and other bodily systems in an ‘ADHD’ child.

So what bread can be eaten?  I don’t have a list of breads free of Calcium Proprionate but recently found a brand at Pick ‘n Pay that was free of it.  Otherwise, ciabatta is a bread that is proprionate free.  The reason is that the preservative would kill the micro-organisms that produce the gas that form the holes in the bread.   Artisanal breads available at the increasingly popular farmer’s markets may also be free of preservatives but you would be wise to check on this before buying.  Investing in a bread making machine would be another option.

For more information about Sue Dengate’s amazing work, and full instructions as to how to follow her FAILSAFE diet, visit her website at www.fedup.com.au.

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Are some children more vulnerable to video games?

Are some children more vulnerable to video games?

It seems that even small amounts of video games can trigger a response in certain children. Most at risk are particularly sensitive – being children in homes, in foster care and even adopted children.  Such children share a symptom due to trauma that results in changes in the brain and body – namely, a ‘hair trigger’ response to perceived stress that put their little bodies into a nearly constant state of fight or flight.  This state is characterised by emotional reactivity, trouble following directions, meltdowns over small frustrations and high arousal (getting ‘revved up’ easily).

The smallest amount of time spent playing video games may trigger the stress reaction – which makes sense if you consider that such children live very close to their stress threshold. It takes far less to push them into full-blown stress mode than more relaxed peers.

Another set of children found to be particularly sensitive are those with tics or Tourette’s syndrome.  In these children, overactive areas of the brain cause involuntary motor activity. The exacerbation of symptoms caused by video games in this group was even more obvious. With some of these children, gaming increased their overall tic frequency and severity, and with others, the tics would ratchet up whenever the child actually played the game or used the computer.  Again, removal of the video games often produces significant relief.

There may be something about playing video games that puts the brain and body into overdrive, which increases both neurological and psychological symptoms .  More recently those children with ADHD symptoms are thought to react in a similar way.

Even neurotypical  children could experience less extreme but nonetheless disruptive symptoms – which means that it isn’t just highly sensitive children or those with psychiatric disorders who are vulnerable to adverse effects, but potentially any child.

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How  can you help a child develop intelligence?

How can you help a child develop intelligence?

Are you tempted to use flash cards to teach your toddler to read?  Are you considering buying computer programmes said to boost intelligence?

We are all hopeful that our children will succeed at school but to help them, we need to know how the brain develops and what kinds of learning will promote optimal development. Packaged programmes are not always the key to intelligence.

Making connections in the early years

Good brain function depends on a well-organised neural network, meaning that the brain cells have made zillions of connections and circuits are organized so that all areas of the brain function rapidly and smoothly. How does this happen?

In the first months of life, the child is in the so-called ‘sensorimotor’ period.  His brain is learning to take in bits of information from the senses and practicing to respond with bodily movements.  At this stage, the brain isn’t able to deal with much beyond physical experiences happening at a particular moment. He can’t combine information coming in from more than one sense.  For example, he can hear a motor car and see the car but won’t be able to relate sight to sound.  Only later will the sound of Mom’s car outside result in a mental picture of the car and the knowledge that it is bringing mother home.

As they grow more neural connections, toddlers begin to see the world in new ways.  The development of language and symbolic play represent the beginning of abstract through.  A child talking to Grandma on a toy telephone shows that she has a mental representation of both Grandma (out of sight) and the function of a telephone.  It is generally believed that the roots of creativity also lie at this meeting of concrete and symbolic experience giving rise to ‘pretend’ play.  Children who are good at pretending and ‘making up’ also seem to get along better socially.

Until sometime around age six or seven, children are ‘stimulus bound’.  This means that her attention is easily drawn to any new stimulus and she appears to be easily distractible (useful when you are trying to distract her from a distressing event).  Preschoolers are caught in the present, with only a vague concept of past, present and future.  They have trouble with other people’s point of view; they can’t attend to any one task or idea for more than a few seconds.

Learning to grow beyond this needs firsthand experience and interest.  Helping early intelligence to needs understanding the value of supplying a varying and interesting environment.  Novelty and opportunity to experience new situations and settings provide the means of learning to pattern information.

The key to seeing patterns

Children will benefit through lots of self-organising play activities that will allow them to make physical and mental connections.  This is more useful for healthy brain development than early tutoring.  Because brain areas that function to connect sight, sound, touch and body awareness are still developing, it is difficult for young children to combine processes from more than one modality, such as in looking at a letter and copying it, or being encouraged to simultaneously dance and sing while listening to music.

It is possible to condition babies to associate two stimuli that are presented repeatedly together (e.g. the sight and sound of a letter of the alphabet) but this learning lacks real meaning for the child and she may end up using less efficient parts of the brain to do so.  The higher levels of the brain ultimately responsible for these tasks have not yet developed enough.   If she develops a ‘habit’ of using lower brain areas for higher-level tasks (such as word recognition or reading) and of receiving instruction (from you) rather than creating patterns of meaning, she may run into big problems later on.

So drilling your child in various learning tasks results in them being good ‘technicians’ in the early grades because they have learned to deal with isolated bits of information.  However, when demands for comprehension increase, they become lost.  In higher grades, they have difficulty organizing information into more abstract ideas.  They simply cannot understand the content they are working with.

During the early years, some commonsense practices bring better results than expensive equipment.  Here are a few ideas:

  • Help your child figure out meanings and relationships in daily events; her endless ‘Why?’ questions show her need to make connections and her need for more explanation in order to do so.
  • Introduce sequencing skills – arrange objects according to size, or remembering words or events in order.
  • Talk about abstract sequences such as “If you go outside without your jacket you’ll get very cold because it’s winter”.
  • Mental patterns are built on networks of sensory connections.  Call the child’s attention to patterns in the sensory world: “What does that taste like?”  “Do these look alike?”
  • Call attention to visual patterns: “Look at the tree branches against the sky.  It looks like the tree has arms.  Let’s draw a picture of the tree”.
  • Puzzles, blocks, dominoes, kaleidoscopes are all useful materials to help visual patterning.
  • Finding something ‘wrong’ or missing in pictures links visual and intellectual skills.
  • Encourage auditory patterning with rhymes, tunes, familiar stories, and attention to sounds around the house.
  • Using tools (screws, nuts, bolts), measuring, cooking activities and gardening are all examples of activities that encourage perceptual and motor connections.
  • Practice motor patterns over and over again: using utensils and tools; cutting; catching; throwing large, soft balls are all good.
  • Self-help skills and household jobs are very important for the child to master. Give help when needed but encourage the child to do it himself even if the job isn’t done exactly the way you’d like it.
  • Give the child time to organize her own play.  Don’t hover or be too attentive.  The is one study that showed that too-frequent offerings of food and drink to toddlers was related to later poor school achievement.
  • If a child needs help mastering some motor pattern, scaffold the learning by gently guiding his body through the action sequence several times in order to lay down the neural pathway.  Dividing the action into a series of smaller activity steps is also useful.  Don’t expect young children to be able to copy complex actions that you show him.  Allow him to learn with one sense at a time (in the case of a motor behavior, his body).
  • Allow the child to make simple decisions.  Also allow them to make minor mistakes.  This is hard to do but necessary.  Children need to have experience with cause and effect. For example, “If I throw my toy down hard on the floor, it will break”.
  • Limit screen time.  Choose a daycare centre where children don’t watch much – if any – TV or videos.  Passively sitting and watching screens may lead to missing out of some of the most basic motor patterning and the attention skills and intellectual growth that goes with it.
  • Allow time for reflection and thought.  The brain needs downtime to process all the work going into its development.

Integrated Learning Therapy (ILT) strives to uncover the root causes of puzzling behaviours and learning difficulties in children. Visit the website www.ilt.co.za to learn more about this approach and find a practitioner near you to help.

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[i] With thanks to Jane M. Healy 2004. Your child’s growing mind. Broadway Books: New York