Rewired to learn: the woman who changed her brain
Barbara Arrowsmith-Young became an expert on the plasticity of our grey matter the hard way – by reprogramming her own malfunctioning brain.
Speaking on the phone from Toronto before her trip to New Zealand for the Auckland Writers & Readers Festival, Arrowsmith-Young says she was thunderstruck by the soldier’s account. “I would read a sentence and it was my experience, the things he was saying he couldn’t do. Like telling the time and reading a sentence and by the time you got to the end of the sentence not being sure how that related to the beginning of the sentence. It explained something that I had, that nobody had been able to explain to me.”
It was the beginning of a remarkable journey of discovery that culminated in Arrowsmith-Young pioneering a new approach to repairing learning disabilities. It is now being used in 35 schools in the US and Canada. The approach was pieced together from two different areas of research: one on the functioning of the part of the brain in which she was deficient; the other in then-novel research on how the brain can change and grow. The result was that 30 years before most people had heard of neuroplasticity, this ferociously determined woman fought her way out of a profound learning disability by developing cognitive exercises to repair her brain.
Arrowsmith-Young knew from her first year of school in Peterborough, Ontario, that she was different. She struggled to learn as others did, she writes in The Woman Who Changed Her Brain. She couldn’t understand the difference between b and d, or between 13 and 31, and couldn’t make meaningful connections between ideas, mathematical concepts or even simple words. There was no concept in the 1950s and 1960s of learning disabilities. If you struggled, it must be because you were stupid.
This daughter of a teacher and an electrical engineering inventor persevered like fury, becoming a workaholic and developing compensatory strategies. An exceptional visual and auditory memory was her main crutch. She could regurgitate lessons or bits of information, but never truly understood the connections between different bits of information. She replayed conversations in her head hours later and deciphered their meaning. And she toiled, reading and rereading pages at home that her classmates at school had breezed through. Her marks careered from fails to 90%. By high school, when she was being asked to reason and think logically, she could do neither.
Exams held a special terror.
Social encounters were another kind of hell; she would sit at the edge of gatherings in the hope no one would try to talk with her. Pictures of her in her teens show a pensive, guarded face, framed with a dark bob. By 14, Arrowsmith-Young contemplated suicide as an escape from the emotional anguish and relentless slog of trying to keep up at school. She didn’t know, then, but her learning problems were caused by a deficiency in the left hemisphere of her brain, where spoken language, sight and kinesthetic sensations intersect. This part of the brain combines information from the outside world with that from other parts of the brain. Her sight and hearing were fine, but her brain wasn’t making much sense of the information coming in.
Despite the misery her learning difficulties were causing her, Arrowsmith-Young went on to university to do a bachelor of applied science in child studies, then after a few years at an academic post, a postgraduate qualification relating to behavioural and learning problems. She got through her studies by sleeping just four hours a night. “I used to hide out in the library and knew the routines of the guards, so I knew when I had to duck under the desk cubicle so they wouldn’t catch me and kick me out. I just needed more and more and more exposure to the material, because it was hard for me to understand it. I didn’t give up, but I drove myself into the ground physically.”
What drove her to take such a difficult path? Why not simply work in a shop? Many others might have given up, she concedes. But several forces drove her. Her parents expected all five children would go to university, and her father had always told her that as she was the only daughter, he expected her to succeed. “The other factor was the part of my brain that did work well was the prefrontal cortex, the part that thinks and drives and plans and hunts for solutions. The problem was I didn’t understand most of the things that I was trying to explore, but there was that drive.”
Her moment of grace came when she came across the work of Aleksandr Luria, a Russian neuropsychologist who wrote The Man with a Shattered World in 1972, the story of Lyova Zazetsky. Arrowsmith-Young doggedly ploughed through Luria’s other dense academic texts and concluded that if something was wrong with her brain, perhaps she could fix it. It was 1977, and studies on the frontiers of brain science had found that rats raised in enriched environments developed more complex brain connections, making them smarter. It was confirmation the brain could change and grow in response to its environment.
If the problem in her brain was in understanding the relationship between things, Arrowsmith-Young reasoned, then she needed to come up with an exercise that would develop that skill. She settled on a clock exercise, as it is only possible to tell the time by reading the relationship between the two hands of a clock. With the help of a friend, she drew up a series of flashcards with a clock face on one side and the correct time on the other side.
After three to four months of practice for up to 12 hours a day, something strange happened. “By the time I had finished the third level of difficulty, I started understanding things. I could listen to something once and understand it. I could read a page and in the first reading I could understand, whereas before I would have had to read it 50-60 times and still wouldn’t be certain I had understood it. I had never been able to understand conversations in real time. I knew that something fundamental had changed in my brain.”
Arrowsmith-Young had effectively forged new neural pathways. She continued the exercises for 10 months, and has not had to do them since. The changes are permanent; her disabilities have disappeared. Drawing on her training in education and child development, Arrowsmith-Young went on to develop cognitive exercises targeted at learning deficits in 19 different parts of the brain, and set up Arrowsmith School in Toronto in 1980. The school claims that after three to four years students can re-enter normal classes and progress without any further special help.
Canadian psychiatrist Norman Doidge was an early promoter after he referred learning-disabled clients to the school. He went on to write about the school in his best-selling book, The Brain That Changes Itself. A 2005 evaluation of 79 students in the school over three years by an associate professor of psychiatry at the University of Toronto found standard achievement test scores rose by a mean of 27%.
For the past couple of years the Arrowsmith programme has been at the centre of a tussle between the publicly funded Toronto Catholic District School Board and parents, after the board tried to cut its provision of the programme in some of its schools. The board, which was in the midst of a budget crisis, argued the programme at its schools had not had its results independently assessed, and there was no proof that it changed children’s brains. Protests by parents led to the programme being retained for now. Arrowsmith did its own research on the board’s students in 2007, based on reports from teachers, students and parents, and found that students in the Arrowsmith classes had gone on to average 79% in their high-school report cards.
On a sample of 120 disabled students, the students were picking up such skills as word recognition, arithmetic, reading comprehension and reading speed between 1.5 and 3 times as fast as their previous rate of learning. The furore was a cutback masquerading as a concern over research, says Arrowsmith-Young. “It’s really a funding cutback, but they needed to give a reason behind it. A lot of special education programmes got cut.” She met the board in April with proposals for independent evaluation, but as yet there is no fundin for the research. But she agrees there is so far no hard proof the brain gets rewired.
“It’s true in the sense that we do not have brain scans on the pupils, and it’s debatable whether these changes would even necessarily show up in a brain scan. But if you have a cluster of symptoms that seem to be related to an underlying cognitive function, and through application of specific cognitive exercises the whole cluster changes in a positive direction, there must be some underlying mechanism we are targeting and we are improving or strengthening.”
A reporter who wrote a number of stories on the dispute, Cynthia Reason of western Toronto paper the Etobicoke Guardian, told the Listener that parents were emphatic the programme worked for their kids. “All of the families of children I spoke to who were enrolled in the Toronto Catholic District School Board’s Arrowsmith programme had nothing but rave reviews and endless anecdotes about the changes in their child.” One student her school helped, writes Arrowsmith-Young, was Zachary. He had little ability to reason, so that much of the world amounted to noise. He could not understand most of what people said to him, and was reliant on his mother or a babysitter for most of his communication with the world. He couldn’t understand the rules of schoolyard games, sticking to his own rigid interpretation of the rules. He sought comfort in routines as a refuge from sensory overload.
Zachary was set the clocks exercise, as well as other cognitive exercises to address four other areas of deficit. After six months he began to change. He became more social, began to verbalise and began to slowly learn the rules of the schoolyard games. Halfway through his first year at the school, at age six, he called his father “Daddy” for the first time. His personality softened, becoming more flexible. Then there was Johanna, a 22-year-old bankteller who was impulsive and found it hard to make decisions. At school she’d had trouble developing a theme or idea in her essays, and could not separate relevant facts from trivial ones. For her, each piece of information had equal weight. As an adult she could not anticipate risk or foresee consequences. A flatmate told her a hard-luck story and she gave him all her furniture. At the bank, she was at risk of being fired because although she could learn procedures, she didn’t know which situations to apply them to. Her problems, as diagnosed by the Arrowsmith programme, were deficiencies in the prefrontal cortex, which helps to formulate and pursue goals and intentions.
Symbolic thinking is key, necessary for considering alternatives and thinking about their consequences, choosing the best strategy, and suppressing impulses and ignoring distractions. The cognitive exercises set for Johanna to strengthen her symbolic thinking were to read a series of fables of increasing complexity, and find the meaning of each fable. After several months Johanna reported she was becoming more objective and no longer reacted impulsively. As she continued to improve over the next year-and-a-half, her employer sent her to courses and promoted her to a supervisory position. In late 2010, three decades later, reports Arrowsmith-Young, Johanna is married with a family and has a flourishing business.
Arrowsmith-Young is highly critical of conventional programmes for the learning-disabled, which include heavy emphasis on developing compensatory strengths to get around the disability. “They’re all based on the premise that the learner is not modifiable or changeable. The premise of our work is we can go in and change the cognitive functioning of the learner, so the learner can learn. They don’t [need to] have the curriculum modifi ed; they don’t have to have compensations.”
And she says educationalists generally have been slow to grasp the importance of the leap forward in understanding in neuroscience of the plasticity of the brain. “Teachers have been educated that their job is to impart content, not to really impact or change the learner. “My vision would be that when students start in grade one that part of their day is devoted to doing cognitive exercises, and part of it devoted to academic content – that you go to school to exercise your brain to get it more ready to learn.” Then, ideally, by the third year students would not have learning disabilities, because those with an uneven learning profile would already have done extra work in those areas.
One such cognitive exercise would be for visual symbolic memory. Students sitting at a computer are shown one character from one of 40 languages that don’t use the Roman alphabet, from Tamil to Arabic and Burmese. They are asked to shut their eyes, visualise it and memorise it. When they are ready, they click on an icon and an array of different symbols from that language come up, and they have to identify the symbol they saw. “Eventually they get up to eight Chinese characters, and when they can memorise those characters and visually find them in a random array, all their visual-template learning has shifted. They can memorise chemical equations visually, they can learn spelling patterns, they can even remember visual-template patterns in mathematics and reading. What I believe we’re doing is stimulating the part of the brain that holds the visual images of symbols and words.”
But she says one group the cognitive exercises don’t help is children with autism. Arrowsmith has helped some children with Asperger’s, which is on the autism spectrum, but it has helped them with their learning problems rather than with Asperger’s. “That then gave them more resources to be able to cope in general.” The prospect of a new approach to learning disabilities is tantalising. Children with severe learning problems can be greatly affected by their difficulties. But Arrowsmith-Young says the one aspect of neurological wiring that can prove hardest to shift is the feelings of shame and low self-worth that those with learning disabilities grow up with. “I really believed I was not intelligent. That was the underlying fear, because starting in grade one, I struggled, and I could see other students not struggle.”
She continued to wrestle with those feelings for years after her brain began functioning normally. “The older the person is, the longer they’ve lived with a cognitive deficit, the more emotional trauma has occurred. For 26 years I thought I was very unintelligent – it doesn’t turn off overnight. It took a lot of years.”
The brain gain
Claire Shapiro left her home in New York City at age 18 to spend two years at Toronto’s Arrowsmith School to address half a dozen neurological deficits, including spatial reasoning. Despite living most of her life in New York, she was unable to navigate the subways. Cognitive exercises set included tracing pathways within a
spatial configuration until she was able to do it accurately and automatically. Now, Claire is at university and can create the mental maps necessary to get from point A to B, including finding her way from lecture to lecture.
Avital Goodman, at age seven, could not remember the city she lived in, her telephone number, her last name, her teacher’s name, the days of the week or the months of the years. Learning was a nightmare. Exercises included building her auditory memory by having her memorise very simple poems, then more di cult ones. She ended up being able to retain information heard in class and at home, and after several years returned to normal classes.