Learning difficulties are based in the mind, or more specifically in the brain, according to speech pathologist and learning difficulties specialist Devon Barnes. She has been working for the past 35 years with children who have a wide range of learning challenges.
In an discussion with learning support teacher Moya Gibb-Smith, Devon describes the challenges for parents in what she calls the "Learning Difficulties Mindfield". And gives some advice on how to sort the hype from reality when parents are trying to decide how to help their child.
What's the first thing a parent should do it they are concerned their child may have a learning difficulty? Speak to the child's teacher, says Devon.
Listen to the interview
- Learning difficulties
- Literacy difficulties
- Auditory processing
- Developmental delay
- Delayed language and articulation
- Behavioural issues
- Expressive & receptive language
- Phonological awareness
People & organisations mentioned
If you would like to read the complete podcast transcript, here it is:
Episode 103 of The Learning Capacity Podcast
Devon Barnes: 35 Years in the Learning Difficulties Mindfield
Moya Gibb - Smith: Good morning, Devon. In your many years of working with children and some adults, what have you found to be the most common learning difficulties?
Devon: Well, just to give you a little bit of background, I've been a speech pathologist now for 51 years. In my early years I worked with adults with acquired brain injuries, so people with strokes, head injuries, Parkinson's disease, cancer in the throat. So I very much was in that field for many, many years.
It's really only in the last 35 years that I have specialized in the assessment and management of children with language based learning difficulties. So we can have a disorder of oral language where the children are having difficulty with processing, what they hear, understanding what they hear difficulty of expressive language. But I also work a lot with students with literacy difficulties, dyslexia, dysgraphia. So reading and writing disabilities actually.
Moya: And is there sort of a single most common difficulty that you've encountered with the children?
More children diagnosed on autism spectrum
Devon: There wouldn't be just one single common difficulty that we see. We see a whole range of difficulties. But what I would say is over the last 10 to 15 years, we see a lot more children diagnosed on the autism spectrum. That doesn't mean that there are more children with autism. It just means we are recognizing them earlier and we are recognizing autism spectrum in those kids that maybe 20 years ago we would've just thought, that's a quirky kid. And those children now are probably getting a diagnosis that they wouldn't have then. So we've got much better at-
Devon: Exactly. And assessing those kids so that they can get the appropriate support.
Moya: And are those particular children or is there any one group of children who's more difficult to treat?
Devon: There's not one group, it really is a very individual thing. It depends on a lot of factors. One is the degree of disability. So we can see children who are nonverbal, so children with severe developmental delay, autism, all of those things who are nonverbal. Now they're not necessarily difficult to treat but they just need a different way to support them, in terms of helping them communicate both or whatever means.
Behavioural issues most difficult to treat
I guess if you say who is the most difficult to treat? It's really children with behavioural issues. And in my mind, and I know I'm right here, is that all behaviour stems from something. Not one child is born a naughty child. So you have to look at that behaviour and see what is that a symptom of because we do recognize that managing children with behavioural issues is very tricky and can be very, very difficult, and often you can't get any therapy done, because you have to manage the behaviour.
So it's really important that you understand where is that behaviour coming from? Is it coming from something like autism that hasn't been diagnosed? Is it coming from ADHD that hasn't been properly assessed or managed? Is it coming from a family dynamic? You often don't know what's going on for the child-
Moya: At home.
Devon: When you're seeing the child. And so I would say that is a big issue in terms of recognizing where that behaviour is coming from, making sure that we refer on for an appropriate assessment of that behaviour. And then we can often, when the behaviour is managed better, our therapy can be a lot more effective.
Moya: And then you can actually treat the child.
Concerned parents should talk to teacher first
Moya: So if their child is having trouble learning, if they're not getting the reading thing, if they're not keeping up with the rest of the class, or perhaps they can't follow directions, what should a parent do?
Devon: Absolutely without question, talk to the teacher. And then it'll often be the teacher that might bring up those issues. If this is something happening in the classroom and that parents haven't really noticed that there's a problem at home, it will often be the teacher who alerts the parent that there's a bit of an issue.
And so then ideally we do need for that child to be assessed. Now, that being said, that's not always possible for all families. We have parents that are very aware, and have the resources to be able to get their child assessed. Ideally it should have it in the school system.
Moya: Isn't that what a school counsellor is for?
Devon: Yes, and they do have a role in assessing the child for some things, but they can't, for example, assess the child's language. The school chap counsellor look and look at their cognitive skills, and their learning, their reading, their spelling, things like that. But if it's a language difficulty, you really need an assessment by a speech pathologist.
Some schools do employ speech pathologists. The unfortunate thing today is that in the public system, once your school age, you can't be seen by a speech pathologist in the public system.
Moya: Ah, that's interesting. Okay.
Devon: But the community health centers will now only see children up to school starting age.
Therapy, teaching, tutoring and medication
Moya: Of the children in general, are most of the problems able to be treated with medication or is it more likely that they'll receive some sort of therapy or training?
Devon: That depends on the diagnosis. So definitely if the child has been diagnosed with an attention difficulty, and I'll just point out at this time, there are two different main types of ADHD. We call it attention deficit hyperactivity disorder. And there are children who do present with the hyperactive impulsive behaviours.
But paradoxically, there's another group of children with ADHD who don't have the hyperactivity. And we call those the inattentive kids. They're like, you're absent minded professors, your daydreamers. They are the ones that often get missed because they're not misbehaving in the classroom, but they're sitting there and their little mind is wandering off and so they're not taking in the information because of their poor attention.
So if a child has been appropriately assessed and needs medication for attention, that can make a huge difference to their learning. But not all children we see do have attention difficulties. And so with those children, it's the therapy that can make all the difference.
ADHD and medication
Moya: Devon, you're talking about medication and ADHD. Well, from a personal point of view, I have a son who didn't get diagnosed with ADHD until he was 17, because he was one of the non-hyperactive types.
He's 25 now, and he says to me that he will probably be on Ritalin for the rest of his life, because he didn't get the medication when he was young. What do you think about that?
Devon: Look, it's hard to know in individual situations. And just as an aside, I have to tell you, my son, me, the expert, my son didn't get diagnosed with ADHD until he was 21. Because my son is now in his mid-40s, and 30 years ago, I didn't know what I know now.
I now absolutely now recognize that his struggles to pay attention in class, what they were, but back then I didn't know. All right. Now, that being said, it's hard to know. We do know that the appropriate medication in the right child makes a huge difference. Some kids do seem to grow out of it, and as the brain matures, they find that, after they get to 17, 18, they really don't need it anymore.
On the flip side of that, we sometimes suggest that a parent has their child assessed for ADHD. Then the parent says, "I think I've got it too." And they go and get assessed, and they go on medication at the age of 40, and find it makes a huge amount of difference.
So, I think it's a very individual thing, how long someone needs to be on medication.
Moya: Well, as my young man says now, he only takes it when he goes to work, and on the weekends he doesn't take it. He likes to be off the medication. Interesting, but, as you say, we know a lot more these days than we did then.
Devon: Absolutely. And I must ... let me just say there too, that we hear all the terrible stories on current affairs shows. Whereas the research shows that if children are appropriately assessed and medicated, their outcomes for learning, for the jobs they get, for their social life, are absolutely much, much better. If they are appropriately medicated, it is not going to turn into drug addicts.
In fact, the opposite is true. So many young people who take recreational drugs, it's a form of self-medication because they don't feel right. And so it's an absolute myth that medication for ADHD turns people into drug addicts. It's an absolute myth.
Moya: For sure.
Devon: But part of my job is trying to reassure parents that if the child needs medication, there are benefits of that. But some parents are quite adamant that they do not want their child on medication, so we have to respect that. And then we have to find other ways around that, to manage the behaviour.
Neuroscience and learning difficulties
Moya: On something different, at the moment, the field of neuroscience. There's been many, many changes in the last 20 years, the advent of the functional MRI. What is it telling us about how brains learn? And how does it apply to learning difficulties?
Devon: I think it's been quite revolutionary, in we can now see inside brains when people are doing a learning task. So we can see which parts of brains are being activated when people read, and many other things now.
But if we just think about reading, and we look at MRIs that show the brains of students who are struggling to learn to read, we see that the areas that need to light up, which are those auditory areas, and where the auditory and visual areas connect, we're seeing those don't light up, because there's no ... Those areas aren't being activated.
Moya: Aren't being activated.
Devon: Whereas, people who don't have a reading problem, we see those areas well activated. There has been some research that's also shown that that, with certain remedial programs, that we can wake up those parts of the brain.
Now that's not just with intensive computer programs like Fast ForWord, but it has been shown to wake up those areas. But it's also been shown now, in just good literacy programs. When you give a child evidence-based phonics program, and it's done intensively.
So with a good evidence-based literacy program that's done intensively and with fidelity, we could also see that that could make those changes in the brain.
The learning difficulties “mindfield” - hype vs reality
Moya: For a parent who maybe doesn't know much about the field of learning difficulties or neuroscience, but they just have a child with a problem, how do they know? How do they discriminate between the hype and the reality?
Devon: That is a very difficult question. Well, it's not a difficult question to answer, but it's one that I think a lot of people struggle with.
I talk about the learning difficulties minefield out there. There's so much now, so many programs, ideas and therapies that when you're trying to find the ones that are the most effective, that can be really difficult and parents can spend a lot of money on things which don't have research behind them and don't have a theoretical basis or have no proof that they work. I won't name those products, but they are out there.
So it's really, you know, if you go to the research, that's always going to be the guideline. Research has shown us what are the most effective ways to remediate reading. And there are many good evidence-based programs that can remediate reading.
But in my experience, I've found you can have children that participate in those programs, whether it's MultiLit, Spalding, Sounds Write, whatever it is. And we know they're all excellent programs, but there are many children that do those programs, and they do them with fidelity, who still remain...
Moya: Below par readers.
Devon: Absolutely, with poor spelling. And often those children also have language difficulties in and they have problems with memory. And so there will always be children that even with those programs still might need something extra.
Reading & writing are the written aspects of language
Moya: So Devon, you say that these children may need something extra. I think that I'd really like you to explain the connection between having a language difficulty and what the impact of that language difficulty is down the track for children.
Devon: Right? So if we think about children, pre-schoolers, they're developing their oral language, they're learning to understand what's said to them, and they're learning to articulate their needs and wants.
And we refer to that as oral language. So listening and talking. When you get to school, you've got to make the connection with those little squiggles on the page, we call them letters, map onto the sounds of language. So reading and writing are just the written aspects of language.
So if a child comes to us as a two, three year old, four year old, with delayed language and, or poor articulation, we know those children are at greater risk of developing difficulties with reading, because it's some glitch in the way their brain processes the sounds of language.
Moya: So those underlying problems will have an impact when they reach school and they're trying to learn to read. Maybe they've got a working memory problem or an auditory processing problem, or some language difficulty. What tool could you use that would address all of those issues? Or is that too obvious?
Phonemic awareness and reading difficulties
Devon: I'll come back to that in a minute, but first let me just explain what the research says about reading difficulties. The research, and there's been literally thousands of research papers over the last 20 years that show the basis of reading difficulties are difficulties in what we call phonemic awareness.
Phonemes are the speech sounds we make when we talk, when we talk, we use 44 speech sounds, phonemes. When we want to learn to read, we've got to first of all make the connection between those sounds and the letters that represent them, and then we've got to be able to manipulate those sounds in words to be able to read and spell.
We know that kids who have reading difficulties ... I describe it as they've got a fuzzy phonological system. Those kids will often have had articulation difficulties when they were pre-schoolers.
And so sometimes if you can fine tune that phonological system with something more than just a phonics program, my experience has been, that they can assimilate the phonics program much more effectively, if you fine tuned that fuzzy phonological system with a program like Fast ForWord.
Some memorable successes
Moya: Fantastic. Devon, you've been doing this for many, many years, you must have some cases that stand out. Can you tell us about one of those?
Devon: Oh, I can tell you about many. Stand out in what, Moya?
Moya: Memorable. I remember Sister Ann from St. Margaret's Hospital, when she retired, they said to her, "You must have a case that stands out in your memory." And she said, "Yes, I do. A mother giving birth at 56." And the reporter said, "Well, that's not that unusual, is it?" And she said "It was the lady’s first”. That was pretty memorable. What's your Sister Ann story?
Devon: I've got many. I guess it's those kids you teach them to read. Oh, actually, I'll tell you one story. Wonderful young man that I saw from the age of six. And I followed him through until he did the HSC at the age of 18. Highly intelligent I have to say, highly intelligent. Severely dyslexic.
We slogged away year after year and he learned to read. He always was going to be a terrible speller. His reading was never going to be fluent or fast. His reading was still laborious, because of the level of his dyslexia. After he'd done the HSC, he came in and presented me with the 50th anniversary edition of Harper Lee's “To Kill a Mockingbird”. And he wrote the most beautiful inscription. He said, "Devon, I would never have been able to read this wonderful book if you hadn't taught me how to read."
Moya: Oh, isn't that lovely?
Devon: I also have another student that I'll never forget. And she has always been a great inspiration to me. This young girl came to me, she was about 10. Now she could read, she was not dyslexic, but she had a severe oral language disorder. And so her problem was reading comprehension, so she couldn't comprehend text even though she was an excellent decoder.
And the research also tells us now, that we know about these poor comprehenders, these are the kids that can read perfectly fluently, but fail to comprehend. And we know now that that comprehension deficit is due to an oral language disorder.
Moya: I am a teacher and we used to call it word calling.
Devon: We'd say they bark at printing. And you get that in three year old children on the autism spectrum who are hyperlexic. They teach themselves to read at three, but when you test their comprehension down the track, it's pretty poor.
Anyway, this young girl was the most amazing student. She was the most dedicated. For example, we were working on vocabulary because we know children with language disorders do not assimilate vocabulary at all easily. So I would say, "Look, would you like to do this vocab sheet, take it home and do it." She would say to me, "Well give me 10, I'll do 10."
She would take home 10 vocabulary sheets and the next week they would come back and they would be all done. So we worked year in year out on her oral language. I was also helping her with written expression. Now then what we did, it just seemed too ... it was hard slog. And I used to say to myself, "If I could just get inside her brain, I know I'm not getting inside her brain."
I'd been seeing her for about four or five years when I went to a conference, where one of the developers of the Fast Word program presented their research, on their early trials showing this program was designed for children with oral language deficits. And they presented their research on these groups of children that had intervention with the program and a group that had not. And were showing great improvements in oral language.
So I think to myself, "If this program does what it says it can do, I have to know about it." So that started my search to find out more about it and eventually I trained in it and I was providing it with some of my clients, very carefully chosen clients. This young lady for lots of reasons, wasn't able to do it straight away. She did it about a few years later, I think she was in year nine or ten at that point in time.
And within weeks of doing the program we could see these enormous changes. She came to me after about week four and she said, "Devon, I now get what the teacher's saying. I now get it. I can understand what the teacher's saying."
Moya: How amazing.
Devon: And it was like, all that therapy we'd done, could now be assimilated. She went on to university. She won a prestigious scholarship. She decided to do landscape architecture. She won as I say, a scholarship to go and search the wonderful gardens in the UK, including the Vita Sackville-West gardens.
She wrote a report on that and they said it was the best report they'd ever seen. So I'll never forget her. She's now in her thirties, I went to her 21st birthday party. We still catch up for a cup of tea now and again, and I guess she has been one of my great inspirations.
Moya: Yeah. Yeah, I can imagine. Yes Devon, when I was teaching out in the country and using Fast Forward, I had similar, maybe not quite so profound results, but I saw some amazing things happen with children in my care there. And I remember one father saying to me, "The blank screen look has gone from her face." And I just thought, "Wow."
Devon: I remember too, one young boy on the autism spectrum that in the early days when the children came into the clinic to do the program, and it's the same sort of thing. And the parents said "It's like he's woken up." And after about three, four weeks during the program, he came in one day and said, "Good morning, Devon, how are you today?" He'd never done that before, ever in his life.
So somehow it wakes up those auditory and language centers.
Moya: Yeah. Very profound. Devon, it's been lovely to speak with you. Thank you.