How the Neuropath Learning Process Works
Sutapa Ray, PhD

Strong cognitive skills are a pre-requisite for learning

Cognitive skills are the mental skills required to retain, recall, process and analyze information, focus and apply knowledge. These skills affect both learning and behavior because they are needed for thinking, problem solving, planning, strategizing and reacting appropriately. The single largest cause of learning struggles is weak underlying cognitive skills. Most students enrolled in special education suffer from some degree of cognitive dysfunction. When the development of brain areas involved in cognition is inadequate or delayed, we see learning disabilities arise. This can impact academic performance such as learning to read or do math. For example, most reading difficulties are a result of weak phonemic awareness, a cognitive skill that allows us to connect speech sounds. But the effects are broader and can be seen to reach into social communicative behaviors. For example, since planning and decision-making are also cognitive skills, poor development of these skills can lead to inappropriate conduct and abnormal responses as seen in children with neurodevelopmental disorders such as autism and ADHD. The good news is that cognitive functions can be developed and improved with training. These improvements can be rapid, dramatic and long lasting. Early Mind Matters is a unique 21st century tool for teachers and parents to both evaluate cognitive deficits and then correct them. Once cognitive deficiencies are identified, a customized, unique training program (EMMplus) can be developed for each child to overcome their learning disability. When the child has mastered all the activities in EMM they can then move on to our more advanced learning programs Be School Ready and Knowledge First.

How does Neuropath Learning improve cognitive function?

Neuropath Learning programs take advantage of the phenomenon of neuro-plasticity.

For a long time, it was believed that as we aged, the connections in the brain became fixed or permanent. Research has shown that the brain never stops changing through learning. Plasticity is the capacity of the brain to change with learning. Our experiences are what shape our brains. That is, changes in the brain appear to be dependent on experience. For example, stress appears to slow down the creation of new neurons in the hippocampus, whereas using particular parts of the brain appears to make those parts grow. This growth may involve the creation of new neurons, but it almost certainly involves changes that affect the connections among neurons (for instance, more synapses, synaptic strengthening, growth of dendrites and dendritic spines, etc). In fact, scientists recently found out that active cognitive training brings about visible changes in the number of receptors for the neurotransmitter dopamine in the human brain! This plasticity of the brain allows for an overall rewiring to take place that can improve cognitive functions. Since the brain is at various states of readiness, some cognitive function improvement with our programs can be observed quite rapidly while other improvements will take longer to develop with repeated and continued use. Indeed, long term stimulation studies with early intervention programs like ours have been shown to have improved cognitive outcomes.

The two key elements of cognitive function in the brain are working memory and executive function.

The term "working memory" refers to the capacity to store and manipulate information for brief periods of time, similar to a scratchpad. It provides a mental workspace that is used in many important activities in learning. Many children with learning disabilities suffer from a poor working memory. In fact, research suggests that 10% of children in regular classrooms may have a working memory problem that causes them to do worse than expected at school. Working memory is the single most important predictor of learning, much more so than IQ and all cognitive skills rely on a properly functioning working memory.

The term "executive function" describes a set of cognitive abilities that control and regulate other abilities and behaviors. Executive functions are necessary for goal-directed behavior. They include the ability to initiate and stop actions, to monitor and change behavior as needed, and to plan future behavior when faced with novel tasks and situations. Executive functions allow us to anticipate outcomes and adapt to changing situations. The ability to form concepts and think abstractly are often considered components of executive function. Early impairments in executive function may have cascading consequences for many aspects of children's development. The typical development of executive function in childhood may be crucial not only for cognitive function, but also for social, emotional and moral development. Therefore, programs like Early Mind Matters and Knowledge First that are able to train executive function can have far reaching benefits for the child's behaviors and emotions. A growing body of research demonstrates that healthy development of executive function can be fostered. The results of this research has been extremely promising and suggest that training may have direct, beneficial effects on the way in which children's brains are developing. Neural adaptation may be gradual and cumulative, however, and improvement is usually seen after frequent, repetitive skills training but the benefits have shown to be long lasting.

Cognitive training increases pre-frontal cortex activity

The part of the brain involved in executive planning and working memory is the pre-frontal cortex, whereas the part of the brain involved in learning and memory retrieval is the hippocampus. All the activities in EMM are designed to stimulate the pre-frontal cortex and require the use of the hippocampus.

Overall brain growth appears to peak at around 5 years of age after which .pruning. or elimination of synapses sets in to bring about maturation of the brain for it to function most efficiently. However, the prefrontal cortex which is the major player in cognitive function follows a slightly different developmental course. The frontal cortex is one of the last regions to reach maturity during human development. Research shows that the frontal cortex develops rapidly in early childhood, with important changes occurring at particular ages (at the end of the first year of life, between 3 and 6 years, and around puberty), and then continues to develop into adulthood. As children get older, the prefrontal cortex functions more efficiently, less prefrontal activation is needed to accomplish more executive function. Interestingly, grey matter does not reach adult levels in the prefrontal cortex until at least the end of adolescence, and myelination of this region continues into the 20s or possibly 30s. Therefore, the window of opportunity to improve cognitive functions by training is larger than previously thought and we can help older children and adults with learning disabilities.

Neuropath Learning uses a visual, right-brain approach

In order to connect, the neurons need to be stimulated through activity. All the activities in EMM and KF are designed to stimulate the parts of the brain involved in cognition. Visual stimulation with real world images is a key feature of EMM that sets it apart from other cognitive training programs. Data shows that only real world images and not cartoon images are able to activate the pre-frontal cortex. EMM and KF also emphasize visual-spatial right brain learning that is lacking in most school curriculums. Developmental learning disabilities of the right brain hemisphere are characterized by emotional and interpersonal difficulties, shyness, visuospatial disturbances and inadequate non-verbal communication skills. Similar right brain hemisphere problems are seen in children autism and ADHD. The simultaneous presentation of pictures and language in EMM and KF produces synchronization of left and right brain activation. Hemispheric synchronization is known to improve brain performance as well as lower stress and anxiety by increasing communication between left and right brain hemispheres through neural pathways.

The neuroscientific basis of the Neuropath Learning process

Our early childhood learning programs are derived from four pivotal, neuroscience-based principles: (1) intensive training exploits plasticity and cortical reorganization, (2) extensive training maximizes working memory and executive functioning thereby reducing functional deficits, (3) simultaneous stimulation with real world pictures and language allows for paired associative learning by synchronized activation of left and right brain hemispheres, and (4) salient reinforcement induces learning and long-lasting gains. These principles translate into a cognitive approach that relies on the plasticity of the central nervous system to improve learning processes through training.

What can Neuropath Learning do for children with neurodevelopmental disorders?

Deficient executive functions such as organization, planning and working memory are considered the primary cognitive deficits of Autism, ADHD and other neuro-developmental disorders even though they vary in behavioral phenotypes. Although it may be accurate to say that both autism and ADHD are associated with difficulties in the conscious self-regulation of thought, action, and emotion, they are very different disorders. It seems that each disorder is associated with problems with particular aspects of executive function. Given that these children have difficulties with executive function, our approach to train executive function and thereby reduce the likelihood of problem behaviors is almost guaranteed to have results. Research shows that simple practice of cognitive tasks with feedback on performance can improve executive function in typically developing children. One key finding was that training resulted in increases in activity in the prefrontal cortex, suggesting that training improves working memory performance by modifying the way in which participants' brains work. Our experiences with KF and EMM show cognitive training to be beneficial for children with various disorders too. This improvement is also seen on other tasks, not just the training activities in the program. Indeed, training on one fundamental aspect of executive function can lead to widespread improvements in overall performance. Even individuals with mild forms of mental retardation have benefited from cognitive training.

ADHD

Deficits in critical cognitive skills, known as executive function, can interfere with a student's ability to succeed in school. About 15% of children have some problems with executive functioning, but about 50% of children with ADHD have problems. Impaired working memory and slow processing speed are seen in ADHD. Children with ADHD also have problems with executive function which result in conduct problems from poor judgment. While hyperactivity and inattentiveness almost always respond to ADHD medications, the executive function and working memory deficits often do not. Researchers have been investigating the effectiveness of memory training and report positive results of using computer training programs with children with ADHD and with children with poor working memory. Clinical applications of this training have been very promising: in a recent study, a large sample of children with ADHD were given cognitive training and many showed considerable reductions in ADHD symptoms within a period of 5 weeks. All Neuropath Learning programs have a strong emphasis on visual-spatial memory, which is where we find the strongest link to inattention and ADHD. It has actually helped children who required medication for inattention come off their medication.

Autism

Among the sensory systems that need careful stimulation in children with Autism and Asperger's Syndrome are auditory processing skills. Most professionals and parents believe that auditory processing disorders are a core component of the attention, memory and language difficulties of these children. Intensive training with brain exercise programs have reported gains in language skills, auditory perceptual skills and auditory memory. People with autism also lack in social communication abilities like empathy, understanding actions, intentions or emotions, mainly due to poorly developed mirror neurons. But we now know that the prefrontal cortex is required in addition to the mirror neuron system for learning imitative behaviors. Research has also found children with autism exhibit impairments on executive function tasks, including nonverbal working memory. Interestingly, in autism the impairments in executive functioning and working memory appears to be due to excessive short range connectivity between neighboring neurons at the expense of long-range functional connectivity in the prefrontal cortex. Maturation of this brain region is also delayed. However, children with autism do not have global memory problems. They show good associative learning ability, verbal working memory and recognition memory. Our online learning programs that work to enhance working memory have helped autistic children learn and overcome communication problems.

Down syndrome

Mounting evidence suggests that children with Down syndrome display unique developmental characteristics in the areas of speech, language, memory and auditory processing due to delays caused by reduced cognitive skills. Research now indicates that cognitive training activities can be effective especially in the area of verbal short term memory which is one component of working memory. Our programs have been found to help auditory deficits in children with Down syndrome.

Fetal Alcohol Syndrome

Individuals with FAS exhibit executive function deficits in the areas of cognitive flexibility, planning and strategy use, verbal reasoning, some aspects of inhibition, set shifting, fluency, working memory, and, recently, on tests of emotion-related executive function. Some researchers have linked prenatal alcohol exposure to abnormalities in the development of the frontal cortex of affected individuals. One common finding is that these executive function deficits persist regardless of whether the individual has facial dysmorphology. Furthermore, executive function deficits are not simply due to a low IQ in these individuals. Some studies have shown that children with fetal alcohol spectrum disorders tend to develop multiple secondary disabilities, including school failures, trouble with the law, mental health problems and dependent living. Therefore, it is important that children with fetal alcohol spectrum disorders are identified early and receive early interventions. Research has shown cognitive training, such as verbal rehearsing and interactive math programs, to be successful at improving cognitive abilities and working memory of children with FAS, ultimately supporting academic and developmental growth of these children. These interventions have also been found to be lasting.

CAPD

A child affected by Central Auditory Processing Disorder (CAPD) can often have nearly perfect hearing, but because their brain poorly processes what they hear, a learning disability results. Information about sound encoded at the cochlea must be transmitted to the brain through a complex network of neural synapses. Researchers believe there is deficient interhemispheric transfer via the corpus callosum and lack of appropriate hemispheric lateralization in CAPD. Many of the symptoms of CAPD overlap with those of ADHD and some children suffer from both. CAPD can be the result of a variety of causes including head trauma, lead poisoning, chronic ear infections, brain development issues, or other unknown causes. No matter what the initial cause, as with the majority of other underlying learning skill deficiencies, auditory processing skills can be improved with cognitive training. Our programs take a cognitive approach to assessing this problem (EMM) and then train the brain to better process the sounds that define our world (EMM and KF).

Bipolar Disorder

Bipolar individuals react strongly to negative language/emotions because the prefrontal cortex does not effectively modulate the excessively active amygdala. What's more the dorsolateral part of the prefrontal cortex that is useful in maintaining attention and problem solving shuts down in response to negative emotions. We are mindful of this sensitivity to negative criticism and have designed all our programs to give only positive feedback. Also, a lot of our curriculum deals with social cognition including interactive social stories.

Many of the characteristics of bipolar disorder overlap with those seen in ADHD and Autism (sometimes co-morbid). Our programs provide detailed assessment of cognitive deficiencies in each child regardless of their diagnosis. We are then able to customize the most effective intervention program for each individual. We can later look for patterns, similarities and differences in the cognitive ability/disability data for children with particular disorders to design more specific interventions for each of the disorders as well as define/identify them better.

Scientific References:

  • Evaluation of early stimulation programs for enhancing brain development. Bonnier C.Acta Paediatr. 2008 Jul;97(7):853-8. Epub 2008 May 14. Review.

  • Developmental learning disabilities of the right hemisphere. Emotional, interpersonal, and cognitive components. Weintraub S, Mesulam MM. Arch Neurol. 1983 Aug;40(8):463-8.

  • The intrinsic functional organization of the brain is altered in autism. Kennedy DP, Courchesne E. Neuroimage. 2008 Feb 15;39(4):1877-85. Epub 2007 Nov 12.

  • Hyper-connectivity and hyper-plasticity in the medial prefrontal cortex in the valproic Acid animal model of autism. Rinaldi T, Perrodin C, Markram H. Front Neural Circuits. 2008;2:4. Epub 2008 Oct 29.

  • Autism spectrum disorders: developmental disconnection syndromes. Geschwind DH, Levitt P. Curr Opin Neurobiol. 2007 Feb;17(1):103-11. Epub 2007 Feb 1. Review.

  • Autism: the first firm finding = underconnectivity? Hughes JR. Epilepsy Behav. 2007 Aug;11(1):20-4. Epub 2007 May 24. Review.

  • Syntactic abilities and memory functions in young children with autism. Inge-Marie Eigsti and Loisa Bennetto. Department of Brain and Cognitive Sciences. University of Rochester.

  • Sentence comprehension in autism: thinking in pictures with decreased functional connectivity. Kana RK, Keller TA, Cherkassky VL, Minshew NJ, Just MA. Brain. 2006 Sep;129(Pt 9):2484-93. Epub 2006 Jul 10.

  • Executive dysfunction in autism. Hill EL. Trends Cogn Sci. 2004 Jan;8(1):26-32. Review.

  • Distinct neural substrates for the perception of real and virtual visual worlds. Han S, Jiang Y, Humphreys GW, Zhou T, Cai P. Neuroimage. 2005 Feb 1;24(3):928-35. Epub 2004 Nov 18.

  • Neuronal activity of human caudate nucleus and prefrontal cortex in cognitive tasks. Abdullaev YG, Bechtereva NP, Melnichuk KV. Behav Brain Res. 1998 Dec;97(1-2):159-77.

  • Clock drawing in developmental dyslexia. Eden GF, Wood FB, Stein JF. J Learn Disabil. 2003 May-Jun;36(3):216-28.

  • Individual cognitive training of reading disability improves word identification and sentence comprehension in adults with mild mental retardation. Cohen D, Plaza M, Perez-Diaz F, Lanthier O, Chauvin D, Hambourg N, Wilson AJ, Basquin M, Mazet P, Riviè JP. Res Dev Disabil. 2006 Sep-Oct;27(5):501-16. Epub 2005 Sep 28.

  • Effects of Cognitive Flexibility and Phonemic Awareness Training on Kindergarten and First-Grade Sudents. Phonemic Awareness, Cognitive Flexibility, Reading and Spelling. Krause S and Moore E. Annual meeting of the American Educational Research Association. March 1997.

  • Long-term effects of cognitive training on everyday functional outcomes in older adults. Willis SL, Tennstedt SL, Marsiske M, Ball K, Elias J, Koepke KM, Morris JN, Rebok GW, Unverzagt FW, Stoddard AM, Wright E; ACTIVE Study Group. JAMA. 2006 Dec 20;296(23):2805-14.

  • Screening for communication and cognitive disorders in infants and toddlers. Scheffler F, Vogel D, Astern R, Burgess J, Conneally T, Salerno K. Pediatr Nurs. 2007 Nov-Dec;33(6):473-80. Review.

  • Computerized training of working memory in children with ADHD--a randomized, controlled trial. Klingberg T, Fernell E, Olesen PJ, Johnson M, Gustafsson P, Dahlströ, Gillberg CG, Forssberg H, Westerberg H. J Am Acad Child Adolesc Psychiatry. 2005 Feb;44(2):177-86.

  • Memory training for children with Down syndrome. Conners FA, Rosenquist CJ, Taylor LA. Downs Syndr Res Pract. 2001 Oct;7(1):25-33.

  • Improving memory span in children with Down syndrome. Conners FA, Rosenquist CJ, Arnett L, Moore MS, Hume LE. J Intellect Disabil Res. 2008 Mar;52(Pt 3):244-55.

  • How specific are executive functioning deficits in attention deficit hyperactivity disorder and autism? Geurts HM, Vert Oosterlaan J, Roeyers H, Sergeant JA. J Child Psychol Psychiatry. 2004 May;45(4):836-54.

  • Brief report: specific executive function profiles in three neurodevelopmental disorders. Ozonoff S, Jensen J. J Autism Dev Disord. 1999 Apr;29(2):171-7.

  • The development of inhibitory control in preschool children: effects of "executive skills" training. Dowsett SM, Livesey DJ. Dev Psychobiol. 2000 Mar;36(2):161-74.

  • Reversing neurodevelopmental disorders in adults. Ehninger D, Li W, Fox K, Stryker MP, Silva AJ. Neuron. 2008 Dec 26;60(6):950-60. Review.

  • Full scenes produce more activation than close-up scenes and scene-diagnostic objects in parahippocampal and retrosplenial cortex: an fMRI study. Henderson JM, Larson CL, Zhu DC. Brain Cogn. 2008 Feb;66(1):40-9. Epub 2007 Jul 2.

  • Cortical activation to indoor versus outdoor scenes: an fMRI study. Henderson JM, Larson CL, Zhu DC. Exp Brain Res. 2007 May;179(1):75-84. Epub 2006 Nov 23.

  • Socioeconomic disparities affect prefrontal function in children. Kishiyama MM, Boyce WT, Jimenez AM, Perry LM, Knight RT. J Cogn Neurosci. 2009 Jun;21(6):1106-15.

  • fMRI investigation of working memory for faces in autism: visual coding and underconnectivity with frontal areas. Koshino H, Kana RK, Keller TA, Cherkassky VL, Minshew NJ, Just MA. Cereb Cortex. 2008 Feb;18(2):289-300. Epub 2007 May 20.

  • Rethinking Learning Disabilities. G. Reid Lyon, Jack M. Fletcher, Sally E. Shaywitz, Bennett A. Shaywitz, Joseph K. Torgesen, Frank B. Wood, Ann Schulte, and Richard Olson. RETHINKING SPECIAL EDUCATION FOR A NEW CENTURY Chapter 12; pp 259-87. Progressive Policy Institute. Thomas B. Fordham Foundation.

  • The molecular and cellular biology of enhanced cognition. Lee YS, Silva AJ. Nat Rev Neurosci. 2009 Feb;10(2):126-40. Review.

  • From creation to consolidation: a novel framework for memory processing. Robertson EM. PLoS Biol. 2009 Jan 27;7(1):e19.

  • Mirror neurons and their clinical relevance. Rizzolatti G, Fabbri-Destro M, Cattaneo L. Nat Clin Pract Neurol. 2009 Jan;5(1):24-34. Review.

  • Prefrontal involvement in imitation learning of hand actions: effects of practice and expertise. Vogt S, Buccino G, Wohlschlär AM, Canessa N, Shah NJ, Zilles K, Eickhoff SB, Freund HJ, Rizzolatti G, Fink GR. Neuroimage. 2007 Oct 1;37(4):1371-83. Epub 2007 Jul 17.

  • The new neurobiology of autism: cortex, connectivity, and neuronal organization. Minshew NJ, Williams DL. Arch Neurol. 2007 Jul;64(7):945-50. Review.

  • The locus coeruleus-noradrenergic system: modulation of behavioral state and state-dependent cognitive processes. Berridge CW, Waterhouse BD. Brain Res Brain Res Rev. 2003 Apr;42(1):33-84. Review.

  • Developmental outcomes after early prefrontal cortex damage. Eslinger PJ, Flaherty-Craig CV, Benton AL. Brain Cogn. 2004 Jun;55(1):84-103. Review.

  • Impairment of social and moral behavior related to early damage in human prefrontal cortex. Anderson SW, Bechara A, Damasio H, Tranel D, Damasio AR. Nat Neurosci. 1999 Nov;2(11):1032-7.

  • Early phonological awareness and reading skills in children with Down syndrome. Kennedy EJ, Flynn MC. Downs Syndr Res Pract. 2003 Aug;8(3):100-9.

  • Neurocognitive predictors of social and communicative developmental trajectories in preschoolers with autism spectrum disorders. Munson J, Faja S, Meltzoff A, Abbott R, Dawson G. J Int Neuropsychol Soc. 2008 Nov;14(6):956-66.

  • Decoding human brain activity during real-world experiences. Spiers HJ, Maguire EA. Trends Cogn Sci. 2007 Aug;11(8):356-65. Epub 2007 Jul 6. Review.

  • Developmental learning disabilities of the right hemisphere. Emotional, interpersonal, and cognitive components. Weintraub S, Mesulam MM. Arch Neurol. 1983 Aug;40(8):463-8.

  • Cortical activation and synchronization during sentence comprehension in high-functioning autism: evidence of underconnectivity. Just MA, Cherkassky VL, Keller TA, Minshew NJ. Brain. 2004 Aug;127(Pt 8):1811-21. Epub 2004 Jun 23.

  • Neural basis of self and other representation in autism: an FMRI study of self-face recognition. Uddin LQ, Davies MS, Scott AA, Zaidel E, Bookheimer SY, Iacoboni M, Dapretto M. PLoS ONE. 2008;3(10):e3526. Epub 2008 Oct 29.

  • The role of dominant striatum in language: a study using intraoperative electrical stimulations. Gil Robles S, Gatignol P, Capelle L, Mitchell MC, Duffau H. J Neurol Neurosurg Psychiatry. 2005 Jul;76(7):940-6.

  • Transient and sustained activity in a distributed neural system for human working memory. Courtney SM, Ungerleider LG, Keil K, Haxby JV. Nature. 1997 Apr 10;386(6625):608-11.

  • Increased prefrontal and parietal activity after training of working memory. Olesen PJ, Westerberg H, Klingberg T. Nat Neurosci. 2004 Jan;7(1):75-9. Epub 2003 Dec 14.

  • Different brain correlates for watching real and virtual hand actions. Perani D, Fazio F, Borghese NA, Tettamanti M, Ferrari S, Decety J, Gilardi MC. Neuroimage. 2001 Sep;14(3):749-58.

  • Visuo-spatial working memory span: a sensitive measure of cognitive deficits in children with ADHD. Westerberg H, Hirvikoski T, Forssberg H, Klingberg T. Child Neuropsychol. 2004 Sep;10(3):155-61.

  • It is time to take memory training seriously. Buckley S. Downs Syndr Res Pract. 2008 Oct;12(2):105-6.