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Remedial training for poor readers

Recently a study by Scientists lookingat the anatomy of children’s brains during reading discovered something rather unexpected: Remedial training for poor readers results in a growth of white matter tracts in the brain, and the increase correlates with the level of improvement in sounding out words.

“This is the first evidence for an increase in white matter in response to a remedial behavioral intervention,” said lead author Marcel Just, a psychology professor at Carnegie Mellon University in Pittsburgh and director of its Center for Cognitive Brain Imaging. “It provides evidence that repeated cognitive exercises can alter the cortical connectivity of the human brain.”

The finding could have potential beyond enhancing reading ability. If a behavioral intervention can cause brain growth, benefits might be reflected in any number of brain conditions, including autism, stroke, multiple sclerosis and traumatic brain injury, experts say.

“The evidence is mounting that the brain is wired to fix itself in so many ways,” said Dr. Thomas Insel, director of the U.S. National Institute of Mental Health. “This study bridges the divide between psychology and biology in showing how the brain responds to a cognitive challenge. We need to make use of this information and figure out ways to treat neurological conditions.”

Collecting and measuring real-time images of the working brain in poor and good readers led Just and his colleagues to identify a decrease in the white matter fibers in the poor readers compared with good readers. The area of interest is in the left frontal lobe, which governs language.

The poor readers received 100 hours of training to improve their reading skills and comprehension.

The remedial intervention actually changed the anatomy of the brain, the researchers reported recently in Neuron.

They conducted brain imaging tests before and after the remediation period on children 8 to 10 years old, including 47 with weak word decoding skills and 25 who had had good reading scores.

The researchers used a test called diffusion tensor imaging, or DTI, which measures the flow of water through the white matter tracts of the brain. This provides a snapshot of the brain’s structure and can be used to compare changes over time.

They found that those with reading problems had decreased microstructural organization of the white matter in a region of the left frontal lobe.

Most of the poor readers (35 of the 47) received remedial training for six months, and the others, including 12 poor readers, had no reading intervention. At the end of the training period, when the children were rescanned, the scientists found that “the instruction resulted in a change in white matter in the very same region that showed deficiencies in white matter before the intervention,” Just said.

The changes on the brain scan correlated with improvements on some of the reading measures, he added. Scientists have never before shown that the brain’s white matter grows in response to intense but relatively brief remedial training, the team said.

No changes were detected in the white matter in those poor readers who had no remedial intervention. “This suggests that it is not a matter of development but of the intervention itself,” Just said.

“I think as the children use these circuits over and over again, the specialized glial cells [called oligodendrocytes] that construct the white matter are building up more myelin [the protective insulation of the white matter fibers] along the axons being fired,” Just explained. This makes the neural signal travel 10 times faster and delivers a more precise signal, he said.

The finding may offer hope for other neurological problems. “There are many worlds to explore,” Just said. “It is now obvious that we are not at the mercy of our biology.”

The researchers have already begun imaging the brain at work in people with autism and have found a low connectivity in white matter. They plan to provide behavioral interventions and then retest the individuals to look for growth in white matter, which they say would suggest better connectivity between neurons.

Insel expressed enthusiasm for future prospects. “This is a great place to be,” he said. “We now have the tools to understand how cognitive strategies alter the biology of the brain.”

An Article of note from Elizabeth Landau, CNN

(CNN) — People with Asperger’s syndrome would be included in the same diagnostic group as people with autism and pervasive developmental disorders, according to new guidelines under consideration by the American Psychiatric Association.

Psychiatrists are in the process of revising the guidelines, known as the Diagnostic and Statistical Manual of Mental Disorders. The manual has implications for how psychiatric drugs are developed and prescribed, what treatments get covered under insurance plans, which approach doctors take in treating their patients, and how patients view their own identities.

Anyone who has received a diagnosis from a mental health professional has most likely had his or her symptoms defined by the guidebook.

The revisions, which will be considered for the DSM’s fifth edition, due in 2013, were made public Wednesday at DSM5.org.

Scientifically, the distinction is correct; the research on people with these conditions has shown that Asperger’s is on the mild end of the spectrum of autistic disorders, said Dr. Michael First, professor of clinical psychiatry at Columbia University, who worked on the version of the DSM that is currently in use.

Of concern is that Asperger’s has been destigmatized and autism has not, he said. Over the past 15 years, communities have formed around Asperger’s, and the condition has taken on more positive tones with the notions that Albert Einstein and other intellectual luminaries may have had it.

Given that Asperger’s has become more acceptable, First favors keeping it as a diagnosis.

“This is a case where the science of the decision and social ramifications of the decision are separate,” First said.

But the DSM does not make diagnoses based on the stigma of one group over another, said Catherine Lord, director of the University of Michigan Autism and Communication Disorders Center, who is on the American Psychiatric Association committee looking at autism.

“Many people prefer to use the term Asperger’s, and we’re not saying that you can’t describe yourself that way,” she said. But the research shows “no scientific evidence that there are separate syndromes.”

Between three and six children out of every 10,000 today has an autism spectrum disorder, according to the National Institutes of Health. About two out of every 10,000 children has Asperger’s specifically, although the data are not well established, the institute said.

The new criteria require that the symptoms begin in early childhood and that deficits be measured in two areas: social interaction and communication, and the presence of repetitive behaviors and fixated interests and behaviors.

First also takes issue with “psychosis risk syndrome,” a proposed classification of the set of symptoms that sometimes precede schizophrenia.
Any new disorder added provides an opportunity for a pharmaceutical company to develop a new drug.
–Dr. Michael First, Columbia University
RELATED TOPICS

* American Psychiatric Association
* Autism Spectrum Disorders
* Diagnostic and Statistical Manual of Mental Disorders
* Eating Disorders
* Mental Health

For example, milder versions of delusions, disorganized speech and hallucinations fall under this. In First’s analysis, however, only 20 percent of people with this set of early symptoms would go on to develop schizophrenia.

That means “an unusual and unconventional adolescent who has a very rambling writing and speaking style, whose parents are concerned about the fact that their son is different, could qualify for this disorder,” he said.

This kind of diagnosis could ruin this person’s life, affecting his social life and college plans, and landing him on antipsychotic medications with strong side effects.

But Dr. Charles Raison, psychiatrist at Emory University, said there is some evidence that looking for psychosis early has tremendous benefits.

The psychiatric association’s rationale for considering psychosis risk syndrome is that psychotic illness is most effectively treated early and that intervening early may have long-lasting benefits not achievable with later therapy, the proposal said. But moving forward on putting this on the list of disorders, or in the appendix, depends on field trials.

First and Raison both lauded the association for proposing to get rid of the terms “substance abuse” and “substance dependence” and putting them under one name: addiction and related disorders, with the subheading “substance use disorders.”

Problems with thinking and memory, known as neurocognitive disorders, have been divided into “major” and “minor,” said Dr. Dan Blazer, professor of psychiatry at Duke University School of Medicine. In the past, people with “minor” impairments — for example, minor dementia — may not have been covered by insurance, and reframing the conditions in this way would include them, he said.

“Many people come seeking help because they are having some difficulty with their cognition but don’t qualify for a diagnosis currently,” said Blazer, who was part of the committee to revise the neurocognitive disorder criteria. “These are people that clearly need to be seen, and there’s a very good reason for them to be seen.”

At the same time, psychiatrists have recommended getting away from the word “dementia” because it has “outgrown its time,” Blazer said. Dementia does not accurately describe what’s going on in a person with cognitive impairment, he said.

The term will probably not disappear completely. For instance, it has not been decided whether “vascular dementia” ought to be renamed, he said.

Taking “dementia” out will probably not cause the same degree of controversy as decisions regarding autism classification because the proposed changes simply clarify what “dementia” actually means, he said.

First, however, is skeptical of this move.

“It feels to me like they’re fixing a problem that wasn’t there,” he said. “No one has ever said to me, ‘There’s a problem with the word “dementia.” ‘ ”

Blazer’s group also proposed using biological markers as guides for diagnosis. For example, several studies are ongoing to identify the signatures of Alzheimer’s disease in brain scans. No such tests are currently required by the DSM, but the revisions note that they are useful in ruling in or out certain conditions.

“We are moving toward trying to include some kind of more quantitative assessment of the severity of the condition, which will help us in this major-minor distinction,” Blazer said.

The proposed revisions also include new classifications for learning disorders. The new category “learning disabilities” will have the subcategories of dyslexia, related to reading, and dyscalculia, related to mathematics. This is a further specification of what academic skills should inform a diagnosis, Lord said.

The committees do not take insurance or drug company opportunities into account when crafting revisions to the DSM, she said. But First noted that the DSM does have these implications.

“Any new disorder added provides an opportunity for a pharmaceutical company to develop a new drug,” First said.

But Raison said the era of trying to treat an entire diagnosis is over, meaning the DSM V may have less of an impact than its predecessors in generating new drugs. As psychiatrists realize that mental illness diagnoses are sometimes vague descriptions rather than biological entities, there is a movement toward treating individual symptoms, he said.

“We’re in a bit of a backlash right now, and I think the golden age of just taking these psychiatric diagnoses as if they’re real things that exist in nature, I think those days have been winding down,” he said.

The new criteria will be available for public comment at DSM5.org until April 20. They will reviewed and refined over the next two years, during which time the American Psychiatric Association will conduct field trials to test some of the proposed revisions in real-world clinical settings.

Aspergers, the next stage in human development?

I have a staff member who genuinely believes that Aspergers is the next step in human evolution. The ability to excel in specific disciplines without the need (ability) to for social niceties is the perfect personality for the computer/digital/global is the same as local community! All one really needs are the skills which allow, or propel one to a synthesis with artificial intelligence.
Interesting idea which may not be too far off the mark, if so, then it will be a sad development. The joy of social interaction, the fun with others and the nuances of social dynamic are an essential part of what being human is all about.
It is with this goal our Social Thinking classes oriented.

Communication and Realization

Clarity of communicate with one another transcends normal social understanding.

That in and of itself should make your mind bubble!

I am not talking about just language, but actual communication! Talk, body language, and emotional language or “transpeak”!

All of us reach out to one another in the languages, or communication skills, we are raised with. I am not just speaking of English or Spanish or any other spoken language, but the languages of each family regardless of national language or local region, spoken in the home: Famlang! Famlang is also the communication unique to each family..

Words just represent ideas, but “famlang” communicates emotions and/or thoughts welded together with a desire to express our own individuality.

With that desire for individual expression within the context of local social dynamic we have the self centerpieces of family.

In that context we must yield to the solid and realization to provide for one another as individuals who chose as agents of freewill to take care of those less fortunate.

Organizational Civil Life

To avoid violence and keep society civil, government is to be a referee. Folks coming to play in the game of life, playing by the same rules. Our government is supposed to be the independent referees who call the game. Our laws are the rules of the game.

We have our representatives to create the rules and to speak for us the ensure the rules are evenly applied to all.

We have a single leader, the president, who is suppose to make sure the system of government runs smoothly and according to the rules, the CEO of the organization so to speak. And if needs be over see the strong arm (Army) and protect us.

We can appeal when we think we the rules have been applied unfairly (the courts).

How long do we, as a nation, as a people, continue to allow a minority, any minority, a subset,  by the very definition a deviation from the norm, of folks play by different rules? Allow them just because they are loud determine the direction of our nation, our values, our social interaction, our family values?

No one is really normal. We all have our specific differences and preferences. None the less when individuals and groups of people come together to form communities, organizations or even nations there are necessarily guidelines  agreed upon by all upon which we govern behavior.

It does not matter if subsets of our society have inbred differences of which they have no control, it does not matter if those deviations are choices, it matters not the intentions. What matter is the actions and behaviors. When those actions occur, then the powers (the referees) that be must determine the import of intention, action and results then make a ruling based upon just rules that apply to all evenly.

When these systems no longer function even handedly, but are allow bias and preference for whatever reason, there is no longer recourse except force.

Social Network Frustrations

The frustration of returning from being out of town for several days to find I was “down” as far as the internet goes, reminded me of just how much I now depend upon the internet for daily work and connection.

My modem died, no my router died, no my connection was some how compromised………None the less……it required me to call internet support. We will not go through just how long and drawn out, the multiple calls to different Help Centers”.

Had to buy a new one. Then the calls started again to get it working right.

I was out of my element. I could not for the life of me understand, even though we were using the same words talking about the same thing.

Our Aspergers kids are like that. We talk, they talk, or at least seem to listen and answer, but They just don’t “get it”.

Finally I spoke to “Kevin the tech guy, from Texas”, he and I could communicate! He talked me through what no one else could do! and amazingly I am on line and blogging again!!!

Did he say anything different? I don’t really think so. We just connected.

THAT IS THE ONLY WAY TO REACH OUR ASPERGER KIDS!!!

FIND THOSE WITH THE GIFT OR ABILITY TO COMMUNICATE WITH THEM. Then they will learn and build the skills to communicate and interact with others.

Thank the Lord, that we at Second Start have just such a staff!

Self Control

I read long ago that the greatest battle any one has is within themselves. Having the desire to do (or not to do) something but unable to exercise the self discpline to force thier own will over thier own lives(bodies).

The many support groups, the endless diet commercials and the jails are full of evidence this is true.

Now move that issue from a moral or ethical deliema to a physical one and we will begin to understand a bit of how our Asperger Children feel every minute of every day.