Neuroplasticity Research Offers Hope to People with Dyslexia

Your brain is plastic—but don’t worry, that’s good news. It means you can learn new things and correct brain errors throughout your lifespan—even into your old age, although it does work best during your youth. This con-cept of “neuroplasticity” is revolutionary and relatively new—and nowhere does it offer more hope than in the treatment of learning disorders such as dyslexia.

Dyslexia affects vision and hearing as well as the ability to read, write and spell. Typically found in people with normal or even superior intelligence, it can lead to many problems in school and a host of behavioral issues such as underachievement, misdiagnoses, low self esteem, social isolation, and a plethora of variations on human suffering not always visible to others. But all that’s changing.

Brain research and a growing focus on the prospect that brains can be rewired are offering promising approaches to childhood and adult learning disorders, resulting in new programs and treatments for dyslexia.

And such intervention is key because it’s estimated that approximately 10 percent of the U.S. population has dyslexia. Researchers now believe the disorder has different causes. But although it appears in various forms, dyslexia always affects reading—an important skill that children learn late compared to the age when they typically learn to talk. So why this gap?

“Reading is one of the hardest things our brains do,” said dyslexia researcher Dr. Christopher Walsh, head of the Genetics Division at Children’s Hospital in Boston. “It demands we use many different parts of our brain at once.”

In a recent study, Walsh and his team looked at patients with PNH (periventricular nodular heterotopia), a type of dyslexia caused by a rare genetic disorder. Such patients process language slowly and have difficulty reading, which Walsh discovered was most likely caused by disruptions in their brains’ “white matter.” Brain imaging showed that PNH subjects had disorganized bundles of the nerve fibers that are abundant in white matter. These brain bundles, which are usually highly efficient highways between brain cells, erratically tracked around clumps of “gray matter” deposited in the wrong places—deep into the brain’s white matter. (The brain’s gray matter is a lavish coating of neurons over the cerebral cortex that is usually thought of as the center of intelligence.) The subjects’ PNH brain disorganization meant that their nerve connections slowed down.

But why look at a brain condition as rare as PNH—a condition most people with dyslexia don’t have? Walsh defended the practical as well as the academic benefits of basic research, arguing that brain studies offer a better understanding of all the different varieties of dyslexia in the world.

“The faster we can learn what a patient’s problem is, the faster we can convert that to better treatment,” Walsh said in an interview posted on the hospital’s Web site. And by developing a clearer understanding of what the various forms of dyslexia might be, practitioners can better tailor treatments to each child’s specific needs. “The more we know about these genetic disorders, the earlier we can intervene,” Walsh said, noting that such knowledge could translate into treatments starting at birth.

A second study coming out of Children’s Hospital in Boston recently looked at another piece of the dyslexia puzzle: problems in processing sounds and difficulties in linking sounds to letters on a page. The study—published in the journal Restorative Neurology and Neuroscience in October and led by Nadine Gaab of the Cognitive Neuroscience Laboratory at Children’s in Boston—used brain-imaging and brain-training software to examine and modify the difficulties children with dyslexia have with language sounds.

Gaab believes the study’s findings could eventually help with early intervention and allow dyslexia to be diagnosed before children reach the age of reading. She also said the research suggests new ways of treating dyslexia, such as music training.

The Gaab study came about in part because of the theories and practical inventions of brain-research pioneer Paula Tallal, co-director of the Center for Molecular and Behavioral Neuroscience at Rutgers University in New Jersey. Tallal, in fact, is one of the co-developers of the brain-training software that Gaab and her colleagues used in their work.

In the 1970s, Tallal introduced the idea that children with dyslexia and reading problems could have an underlying issue with processing sounds. She helped develop software designed to rewire stuttering brains, which were increasingly seen as malleable. However, her auditory ideas had never been tested through brain imaging until Gaab came along and tried it. Gaab imaged how the brains of 9- to 12-year-old children responded to fast-moving versus slow-moving sounds, in addition to comparing the brains of normal children to those with developmental dyslexia. Although Gaab didn’t study language sounds themselves, her work is pertinent because general sound perception in infants affects later language skills by creating the brain maps used in speaking and reading.

For instance, infants with dyslexia often have trouble with faster-moving sounds. An example is the rapid “d” at the start of “Dada” or “Daddy.” Children with dyslexia don’t hear it rush past very well. Their brain map for the “d” sound and other quick sounds can be messy and out of kilter—making later reading tasks difficult.

Enter software that trains the brain. Tallal and several colleagues developed software games featuring sounds, which became part of a suite of educational computer products known as Fast ForWord (FFW) language software, developed by Scientific Learning, an Oakland, Calif., company founded by Tallal and other scientists.

Gaab’s study used FFW and included brain scans of children taken before and after they underwent the FFW training. Results showed that these sound-training exercises not only improved reading, they could literally rewire the brain—and researchers have the scanned brain images to prove it.

Preceding Gaab’s just-published work were numerous studies both in this country and around the world that compiled before-and-after data showing that all kinds of students, not just those with learning disorders, could improve their language skills through FFW training.

The FFW Web site (www.scilearn.com) lists 22 special education programs in the United States that report improved student language performance through FFW training, with educators citing improvements in phonological awareness, oral-language skills, cognitive test scores as well as reading advances.

In fact, educators are using FFW software for a whole range of students—from at-risk children, to gifted and talented students, to underserved groups such as American Indians, to children learning English as a second language—and FFW reports positive results for all of them.

In addition, FFW brain-training programs are now in use in about 40 countries. Cheryl Chia, director of Brain Revolution Pte Ltd., based in Singapore, oversees FFW programs at six Brain Revolution centers in Malaysia, Jakarta and China. In an e-mail to The Washington Diplomat, she said that Brain Revolution students typically work on FFW programs 50 minutes to 100 minutes a day, five days a week, for six to eight weeks. “We usually see improvements … in the areas of listening, attention, language, reading and comprehension,” Chia noted.

A study at a Singapore public school that examined children with auditory processing disorder (APD) before and after they went through Brain Revolution’s FFW programs confirmed that the children achieved “significant gains” in reading and phonemic-decoding ability according to standard test measures.

Other international FFW advocates report similar positive results. Catherine Ruckert, head of the Assisted Learning Center in Starnberg, Germany, is an FFW representative serving Germany and Austria. “I have been using the program for the last six years with students with learning disabilities and those with English as a second language—in total with more than 150 students in seven countries,” she told The Diplomat by e-mail.

“Research has shown that 90 percent of all learning disabilities are language based and have an auditory component. The original research conducted by professors Tallal and [Michael] Merznich showed that specific, repetitive, systematic training in the form of computer games could … rewire the language centers in the left cerebral cortex,” Ruckert explained. “FFW is actually a series of 11 interactive computer programs based on that research.”

Noting that Tallal’s early research showed 12 to 18 months’ worth of gains in language skills in a span of eight weeks, she added: “My own research … showed similar responses. Our learning-impaired [students] showed improvement in attention, processing speed, auditory memory, understanding instructions, and use of logic and reasoning. They also showed huge gains in reading comprehension and spelling.”

Ruckert has used the program to raise achievement levels among her under-performing students, “improving their quality of life,” and delighting their parents in the process. “The games are fun,” she concluded, “but make no mistake—they provide a real cerebral workout.”

FFW is not the only brain-training program that’s being scrupulously researched. A Canadian group at the University of Alberta has developed card and board games called “Prep,” which are designed to improve information processing in children with dyslexia, as well as a similar cognitive rehabilitation program called “Cogent,” which is helping young indigenous preschool students in Canada with their reading, memory and organizational skills. The programs are currently being tested in other countries, including China, Spain, Japan and India.

In fact, at India’s Allahabad University, students and faculty affiliated with a neuroscience lab are working on a computer-based cognitive retraining program called Brain Function Therapy and combining it with Prep games. Allahabad scientists intend to look at the effects of the package on both brain and behavior to help children with dyslexia.

Learning disabilities have attracted new government attention on both sides of the Atlantic. Back in Washington, on Nov. 9, Harvey Fineberg, president of the Institute of Medicine (IOM), a nonprofit that advises the U.S. government, recommended that the country create a “comprehensive disability monitoring system” that could inform policymakers. He also recommended better enforcement of the Americans with Disabilities Act, with a focus on insurance coverage for assistive technologies and services.

A number of schools in the Washington metropolitan area already provide special services for children with learning disorders and developmental dyslexia.

First among equals is the much-honored Lab School of Washington, where board members, students and staff are grieving the recent passing of the school’s leader, Sally Smith, who founded the prestigious school in 1967. Lab, which serves students ages 5 to 19, has been internationally recognized for its innovative programs for children and adults with learning disabilities. In fact, over 90 percent of Lab School students go on to college.

In Maryland, there is the Chelsea School for children with learning disabilities, located in Silver Spring, as well as the Siena School, also in Silver Spring, which was profiled in the November 2006 Education Section of The Washington Diplomat.

In Virginia, meanwhile, the Commonwealth Academy serves 61 children with learning disabilities or attention deficit disorder in grades six through 12.

Specialized schools such as these, improvements in the overall education system, and groundbreaking research are clearly changing the face of dyslexia as we know it. In fact, a recent report compiled by Julie Logan, a professor of entrepreneurship at the Cass Business School in London, found that a high proportion of dyslexics in the United States successfully run their own businesses.

According to a December article in the New York Times, Logan reported that more than a third of the entrepreneurs she had surveyed identified themselves as dyslexic—concluding that dyslexics were more likely than non-dyslexics to delegate authority, excel in oral communication and problem-solving, and were twice as likely to own two or more businesses.

She attributed this to earlier and more effective intervention by American schools, as well as to the natural strategies dyslexics develop to offset their weaknesses in written communication and organizational ability—strategies particularly well suited to small businesses. “The willingness to delegate authority gives them a significant advantage over non-dyslexic entrepreneurs,” Logan said, “who tend to view their business as their baby and like to be in total control.”

About the Author

Carolyn Cosmos is a contributing writer for The Washington Diplomat.