Comments on the Levine Paris Conference

A provider of sanctuary for rare geese and other animals, a breeder of Maine coon cats, and a former busker in Harvard Yard, pediatrician Mel Levine is also a wonderful raconteur. I am primarily a visual learner, and at the beginning of the two-day Paris conference, Helping Kids Become Who They Are Meant To Be, I kept waiting for an overhead, if not a PowerPoint presentation. We were given extremely adequate handouts, but partly because Dr. Levine did not stand on the stage, but rather leaned against its edge, I thought that soon the curtains would open, and the show would begin.

However, I see now that perhaps he chose this position to connect better with his audience and put them at their ease. And that he did with great dexterity. Soon I lost the expectation of a big screen presentation as I was carried away with entertaining stories about himself and his patients, each example of which brought home a learning point, and I didn’t nod off once. It was like listening to a novel on tape.

Levine speaks not of disabilities but rather dysfunctions when describing why some students are not able to learn in the conventional classroom or without specialized support. You will find no labels in his lectures, a policy with which I completely agree. For me, an LD learner is not someone who is learning disabled, but is rather a student who learns differently. And as Dr. Levine explained, this difference is a result of glitches or detours in our neural networking system.

One of the great tragedies of our time is the existence of educational systems that are excellent for some kinds of minds, but which give scant consideration to minds endowed with other gifts. He tells us of a patient called Zander who won the State Geography Contest, but who was failing Social Studies because of a graphomotor dysfunction: his handwriting was illegible. Countries spend billions to build more prisons bursting at the seams with school failures, instead of investing their resources in teaching teachers and schools how to reach all kinds of minds. Dr. Levine has another bias that I share: all students want to succeed, in school and out. But when continually confronted with inflexible requirements and an educational philosophy that has not yet caught up with our new knowledge of how the human mind learns, young minds frequently crack against a wall that has no real purpose other than to promote failure rather than graduates.

The dysfunctions that Dr. Levine refers to are based in our brain’s neurological networking. In other words, they have a physical basis which, thanks to the increasingly sophisticated science of neural imaging, has become visible. Functional magnetic resonance imaging (or fMRI) permits researchers to see those areas of the brain engaged in increased glucose metabolism when performing such tasks as reading or recognizing rhyming. Thus they can compare the scans of “normal” readers and those for whom this task is not automatic. Some examples of neural functions are our ability to find the words we need when speaking, accuracy in reading facial expressions, and recognizing patterns or sequences in written language and mathematics.

Some of the highlights touched upon during this weekend workshop were as follows:

Day 1

1. Children need to be demystified regarding their neural dysfunction. They need to be shown where the breakdown in their neural processing occurs so they can develop techniques out of their strengths to overcome their weakness. Students often create their own best compensations when they know what to target.
2. Don’t label the kid, label the glitch. Labels are reductionist – they don’t indicate strengths. Then it can be you and the child against the dysfunction.
3. Everyone, especially children, needs to feel optimistic about the future.
4. Teach metacognition – how to think about thinking.
5. It is important to remember that neuro-developmental profiles change as we mature.
6. LD can be seen as the early specialization of the central nervous system. All minds have areas in which they can excel.
7. Let students be fidgety – it helps some of them to improve concentration. Just provide non-disruptive ways for them to be so.
8. Children need 9 hours of sleep a night. Unfortunately, these days evening is not a down time, but a primary activity time. This isn’t good as it conflicts with our biological clocks, our natural sleep/arousal states.
9. Difficulties in sleep patterns in infancy can point to attention problems beginning in the 7th grade.
10. Ability to perform tasks often varies greatly – one day they can do it, the next day not. Such persons often do well later in life if they can be self-employed.
11. Persons with attention dysfunctions are often very creative and entrepreneurial.
12. Parents and teachers should provide explicit instruction in all areas. It should not be assumed that children will automatically grasp concepts and relationships that might appear obvious.
13. At about the 5th grade, there is an explosion of decontextual material. In other words, the students now need to learn about things that they have not directly experienced in their own lives.
14. An example of an intervention: Some students have problems with their cognitive activation systems – they can’t make connections between already-learned information and new information; they need to learn how to manually switch to active processing – they must ask themselves, “Am I being active or passive right now in class? Am I able to relate something the teacher is talking about to something I already know?”
15. Some excellent literature students will have great difficulty with multiple choice tests.
16. Satisfaction Control: Our Western world is creating a culture of insatiability. We, especially our children, are all too easily bored, crave intense excitement, and want things passionately. But once these things are gotten, we are not in the least satisfied – we only want more - more innovation, more speed, more things. This attitude breeds risk-taking behavior. It also leads to relationship instability and frequent changes in employment. We need to foster behaviors that are not immediately satisfying, but which will result in long-term fulfillment and satisfaction, like good study habits and time management skills. Children need to be taught the importance of doing things that do not provide immediate gratification in favor of longer term gains.
17. Impulsivity can be a big problem. An example of an intervention here would be to teach previewing: what will be the results of my behavior? Try to visualize yourself in that situation. Learn to think about alternatives and take the time to review options. Make a list of them.
18. Parents must learn to be task masters, not just relational directors for their children.
19. All tests should be untimed.
20. As you go through adolescence, your frontal lobes slow down cognition.
21. Consider giving extra points to students who can correctly guess their grade as this reinforces good self-monitoring techniques.
22. Remove the breakdown point (e.g. poor spelling) from the project grade and schedule a time to deal with that separately with the student.
23. Memory is not a single, simple thing, nor is it imprinted in only one area of the brain. For example, it can be short term, long term or working. There are 4 types of just sequential memory – motor, non-motor, declarative and higher order. The importance of a correct assessment becomes obvious.
24. Parents need to organize their children’s space for them. They will then develop a taste for order. It might be argued that this is not a good way to teach the child independence. But is the world not interdependent?
25. Automatization should happen by high school, and it is the parents’ task, not the schools’. Many tasks should be able to occur without conscious thought, as though they were programmed, like brushing your teeth.
26. The division of labor between what is the school’s responsibility and what is the parent’s responsibility should be spelled out in writing. A contract should be drawn up, and both parties should sign it.
27. Students should be encouraged to study just before they turn off the light to go to sleep. No other activity should come between the study and the sleep.
28. All students have to learn how to deal with feelings of inadequacy.
29. Being able to forget can be as important as being able to remember. Some memories can become too cluttered. They need to be taught how to distinguish the important from the unimportant.
30. Fewer and fewer kids these days are interested in adults. Their role models have become each other, and their heroes are people like rock or sports stars.
31. A credo for children can be summed up as “avoid humiliation at all costs.” They are constantly being judged by everyone.
32. Verbal pragmatic dysfunction: inappropriate use of tone or topics; not knowing what topic to choose, not knowing when to be funny; not knowing that you need to address animals, parents, siblings and teachers differently, not knowing that a conversation is a two-way street. Interventions might include learning how to give someone a compliment or learning when and how to say thank you.
33. Some kids have social information processing breakdowns. They can’t sense if a push on the playground or in the hall was accidental or on purpose, friendly or hostile.
34. Kids need to be taught how to effectively collaborate with each other. Team working and team building is not an intuitive skill for many.
35. Children need to be taught how to relate to those in power – political acumen (sometimes also known as apple polishing).
36. There is a strong correlation between athletic prowess, physical attractiveness, and social cognition.
37. Parents and teachers need to be able to distinguish between social and behavioral problems.
38. Most kids will deny that they are having social difficulties. If they do, they don’t want advice – they want a sounding board. Help them to try and come up with their own solutions.
39. Encourage kids to collaborate with kids who are different from themselves. Two heads are better than one. I personally would pair visual and auditory learners with each other so they can learn from each others’ perspective. One can take linear notes, the other can mind-map.
40. As much, if not more, attention should be given to the bully as to the victim.
41. Children should not be made to repeat a year with the possible exception of between kindergarten and first grade.

Day 2

Major neural pathways are formed during adolescence. As this is an area of interest to me, I have researched the following information which supports what Dr. Levine was saying. There is a pertinent article by FRONTLINE Producer Sarah Spinks entitled "Adolescent Brains are a Work in Progress", and I invite you to read the section called "Changes in the Prefrontal Cortex" in her article at the following website: http://www.pbs.org/wgbh/pages/frontline/shows/teenbrain/work/adolescent.html

A. Examples of possible breakdown points in LANGUAGE:

1. Higher language functioning usually begins in early adolescence and is based on the knowledge of flexibility in language meaning. Other language parameters include such areas as receptive language (understanding spoken or written communication), expressive language (helps in long term memory storage;), concrete language (things you can perceive with your 5 senses) and abstract language (e.g. hope, loyalty, honesty). In these and other language areas, breakdowns can occur which can result in labored speech, word retrieval problems, non-elaboration and trouble forming opinions.
2. Phonology deals with the brain’s ability to distinguish between different sounds. There are 44 language sounds in the English language, but only 26 letters.
3. Phonetic awareness is the ability to first segment words and then to be able to replay the words, or put the sounds back together.
4. If you want your children to eventually study a foreign language, play records or tapes to them when they are infants as they fall asleep.
5. Morphology is the study of the smallest units of meaning in words, like prefixes and suffixes (e.g. logy means the study or the theory of)
6. Semantics deals with the actual meaning of words. It is better to know a few words well than to have a larger vocabulary you are not sure of.
7. Syntax, or the rules of a language, and the effects of word order on meaning. There are many things that depend on the order of mention strategy, like directions to a party and lab experiments. However in about 3rd grade, word math problems can no longer be solved using this tactic.
8. Discourse: when language goes beyond sentences and becomes paragraphs, texts, and lectures.
9. Metalinguistics is thinking about how language works (e.g. noticing that many adverbs end in ly, but not all of them).
10. Pragmatics: the use of language in social situations.
11. From 2nd grade onwards, parents and teachers should talk only in full sentences to their children/students, as full sentences form the basis of logical and rational thinking.
12. Children need to be taught the skills of verbal mediation or self-talk which can help them with conflict resolution (helps them to preview, to see the results of their possible responses to a perceived attack; slows them down so they don’t do the first thing that comes into their heads; in the long run, this technique helps to immunize them against depression).
13. When speaking, children and adults need to be able to put themselves in the place of their listeners.
14. They need to be taught how elaborate and how to summarize.
15. They should be able to verbally justify an opinion. Otherwise they will develop biases rather than well-thought out points of view.
16. Our current age is anti-language and pro visual/motor ecstasy.

B. HIGHER ORDER COGNITION

1. Teach conceptualization. A concept is a collection of critical features that go together under an umbrella term that sets default expectations; it helps to spare the memory; when a concept is applied to a specific, the specific doesn’t have to fulfill all the criteria under that concept; it can be rated according to the number of traits it employs; when teaching, students should be asked what the critical features of a new concept might be (e.g. what do we mean when we say a country is a democracy?). In order to insure understanding, they should also be able to tell you what the concept’s opposite might be.
2. Concepts provide a framework. They also show relationships to other areas of knowledge – they are interdisciplinary.
3. Concepts should be explicit: they may be verbal (like types of government) and non-verbal (e.g. visual, like astronomy), abstract or concrete. They may show processes, as in science (e.g. the steps that make something occur).
4. There are many levels of concept formation: none, tenuous (knows a bit about it, but not all – e.g. democracy is like America), rote (an exact repetition of what was taught, imitative (can tell it in other words), able to teach it to someone else, manipulate it (able to apply it in new ways).
5. Break downs, or dysfunctions, can occur anywhere. What you need to do is find a domain where the problem does not exist. For example, someone can have many memory problems but be able to remember lines in a play. You can then build on this strength, talent and/or affinity.
6. Many higher order cognitive functions come naturally or intuitively to some people, but need to be formally taught to others.
7. “The only way to have a good idea is to have lots of ideas.” Teach brainstorming. Write down all ideas, even the bad ones. You might need to only change one or two words to make it a great idea. Use mind-mapping for visual thinkers.
8. All young children need to spend a long time in imaginative play, not in front of a TV.

C. MANAGEMENT BY PROFILE instead of by label

Demystification

1. This can be done with the whole class or individually.
2. Together you examine where breakdowns can occur.
3. Don’t give false praise. Provide specific examples for that praise (e.g. You got 9 out of 10 right on that quiz).
4. Students love to be compared favorably with their peers. (e.g. No one else did as well).
5. Don’t praise a student for doing something well that others do easily.
6. Students should not see their teachers are paragons of perfection. Share some of your breakdown points with them.
7. When talking with an individual student about his or her breakdown points begin and end with a number – show an end to it. Never discuss more than 4 points at a time (There are 3 things that you are having problems with). Then name them (graphomotor functions, short-term memory, and expressive language). This puts a border around the difficulties and shows that their whole life isn’t wrong. Kids can’t work on something if they can’t give it a name.
8. Induce optimism into these discussions. Make a list of the student’s most notable strengths and make a list of possible careers arising from that list.
9. Establish an alliance, work together. It’s you and us (parents, teachers, and clinicians) against the glitch.
10. Don’t moralize.
11. You can start demystification as early as the 1st or 2nd grade. It’s hardest to demystify an 8th grader because they are so sure they know it all already.
12. Invite the parents to the demystification session so that all of you will be using the same vocabulary. However, parents can not do the demystification.
13. Repeat demystification more than once.

MENTAL REPRESENTATION

1. This how you set up a new idea in your mind.
2. Some examples are:

1. repeating what the teacher said from memory
2. state it in your own words/teach it to someone else
3. write it down and then elaborate on it
4. picture it in your mind
5. make a diagram or illustration of it
6. come up with some good examples of it
7. relate it to past experience

3. You need to create multiple representations of the new idea.
4. As a student progresses through school, new ideas need to be assimilated at a faster rate. However, research has shown that when an individual reaches adolescence, processing speeds slow down.

EXPERTISE

1. Every kid between 3rd and 7th grade needs to become an expert on something. It does wonders for their self-esteem.
2. This area of expertise should arise out of the child’s natural affinities – the things they really like to do or would really like to become. It is an intuitive “free pass” for learning.
3. Every parent should help their children find these out and encourage and support them in their exploration of the subject(s).
4. There is a difference between a recreational activity like bicycling and sports and an affinity. An affinity often manifests itself as a hobby, like collecting rocks or coins.
5. Schools can create cameo roles for diminished kids in school (e.g. head in-door gardener for the student who is an “expert” on or loves plants).
6. All careers involve time management, and this needs to be actively taught.
7. We all need to find a product (skill, interest) we have that is marketable.

Remember, students should practice metacognitive thinking – thinking about how they think.

You can have the onset of a learning glitch at any age. Consult Dr. Levine’s Neurodevelopmental Chart – Side B for an idea as to what processes are targeted as students move through their educational careers.

ASSESSMENT

1. They invented the tests first, and then named the dysfunction.
2. There are no tests yet for all the important life skills.
3. Look for the clinical signs, rather than test scores. How does the child present?
4. Look for reoccurring themes.
5. The diagnosis should result from the collaboration of many sources – parents and teachers as well as the pediatrician and educational psychologist.

INTERVENTIONS

1. You intervene at the breakdown points. Teacher training programs need to teach where these can occur and how to apply interventions.
2. Interventions are strategies for strengthening neurodevelopmental functions or remediating academic skills and sub skills (e.g. choose the correctly spelled word from a list).
3. Accommodations, on the other hand, are strategies used to bypass a weak function or skill (e.g. use of a spell checker).
4. Always let the kid know why you are doing something.
5. Interventions can be part of the demystification process.
6. Excellent templates for interventions and/or accommodations were provided in our handouts.
7. There is no such thing as an intervention that helps everyone.
8. Regarding questionable interventions: almost any intervention will work for 6 to 8 months. You should be wary of those that cost a lot of money and promise to work for everyone. Any intervention should be able to be verified as effective by an outside, independent agency.
9. Regarding medications: Ritalin can have a non-specific, beneficial effect. Its use needs to be carefully monitored. It can be of great help to some. Kids should have drug holidays.
10. Regarding diet: the jury is still out. However, Dr. Levine suggests that you shouldn’t eat carbohydrates unless you also eat protein at the same time.

Follow the Hippocratic Oath and first do no harm.

Never use public humiliation as a technique.

Educational mission: to teach both the hard skills like the 3 Rs and the soft skills like problem solving and reading between the lines.

The essential theme of high school education should be the teaching of study skills.
Young adults today are poorly prepared for the “real” world. There is a definite work/life unreadiness among young 20 year olds. Dr. Levine will address this topic in his new book, Ready or Not, Here Life Comes, to be released in January 2005.

If you attend a seminar or workshop such as this one, you should, within 2 weeks, follow-up at home with a discussion and/or planning group. Otherwise the effectiveness of the program is lost. Apply or teach what you have learned.

You can find out more about Dr. Levine, his philosophies and the work he has produced at http://www.allkindsofminds.org

Susan v. A.
http://studentswholearn.fawco.org
September 27, 2004

Educational Support Committee for Students with Special Challenges Students Who Learn Differently Prepared by Susan van Alsenoy, Chair Educational Support Committee Federation of American Women's Clubs Overseas (FAWCO) Copyright 1998-2000. All rights reserved. Website: http://wwwstudentswholearn.fawco.org Email: esc@fawco.org

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