Welcome!  We're Drs. Brock and Fernette Eide, authors of The Mislabeled Child. We've advocates of a brain-based understanding of children's learning differences and learning disabilities. Explore our library's pages for articles and videos on dyslexia, visual and spatial thinking, gifted and twice exceptional issues, sensory processing disorders, and temperament. 

We shouldn't think of the brain having "deficits" - because reorganization is the rule rather than the exception, and generally loss in one domain, leads to compensatory changes in the other. Auditory processing problems are accompanied by increased sensitivities in other senses - and vision is one of the most common to cause trouble.

The first breakthrough in our understanding of the yin and yang of the brain's sensory system came in research studies examining subjects who were either completely deaf or completely blind. Before there was a technology to image these events in the brain, neuroscientists had pondered what the auditory part of brain might do in a deaf person, or what the visual part of the brain might do in a blind person. Was it a specialized area of brain that would just never get the right signal? Would it just sit there? Or would it be collared into doing something else?

The answer: it got put to work by the other senses.

In this remarkable figure, you can see that the outlined area of brain (auditory cortex) has now gotten recruited to work for the visual system. That's great you might say...if you can't hear, there are so many things that can creep up on you - so increased visual vigilance can protect you from danger. Yes -that's right, but increased visual sensitivity also comes with a price. The deaf are also much more sensitivity to visual distractibility (check out the teaching tips for the deaf, including recommendations to avoid shiny jewelery)...and in milder form, but no less significant, many children with central auditory processing disorders suffer this same fate.

Visual Reorganization in the Deaf

Visual Attention to the Periphery Enhanced in Deaf

Deaf or Hard of Hearing - Teaching & Learning Supports - Trinity College Dublin

Excerpt: "The pattern of accuracy correlations suggests that girls’ linguistic judgments depended on information available to the language network regardless of the modality of word presentation, whereas accurate performance for boys depended on the modality of word presentation rather than the linguistic judgment required. These dramatic sex differences in the pattern of brain-behavior correlations reflect fundamental differences in the nature of processing required for accurate performance." Whereas girls are processing words within the brain's language networks, boys' processing is more associational and link tied to the mode in which words are presented (e.g. by sight vs. sound). The boys data is particularly interesting for the dyslexic boys we see. We've noticed that they are able to better remember sight spelling words like through if they are pictured with a doodle that reinforces the unusual part of spelling as well as its meaning.

Other interesting boys, girls learning posts:

Eide Neurolearning Blog: Visual Learning

Eide Neurolearning Blog: Slower developmental processing speed for boys

Visual overload and visual crowding are common problems in every school classroom or company work group, but the mistakes and errors that result from them are rarely recognized or traced back to their true source. It is a paradox - the more you see, the less you see, but it all makes sense if one recognizes that a child or an adult's visual working memory deskspace can become easily overloaded.

For visual scientists, visual crowding is a specific term that refers to a greater difficulty in seeing when other visual objects are present. When we look at a complex scene, for instance the picture above, it is impossible to take in all the other visual details. It's what causes some people to overload when they go to large gatherings like music concerts, Disneyland in the summertime, or a crowded Home Depot, but also children in crowded classroom, all-school assembly, writing on a scantron, or completing Mad Math Minutes.

Signs of Visual Overload

- Longer processing time, slow reading, and incomplete work on crowded worksheets

- Tantrums, irritability, and overload behaviors in crowded environments

- 'Careless' mistakes and unintentionally skipped problems on worksheets and tests

- Missed words or endings while reading, need to re-read words

Interestingly, a recent report on Visual crowding, reading, and dyslexia found that a visual crowding effect significantly contributed to slowness in word reading, and dyslexics as a group found that increased spacing between letters improved readability.

The critical spacing threshold for readability was significantly higher for dyslexics as a group compared to non-dyslexic controls, so it became easier to identify a letter away from the center if the spacing between characters were greater.

Take-home points:

- Critical print size is larger for dyslexics than controls

- Critical spacing between characters is larger for dyslexics than controls

- Reading rate improves with print size to a critical point

- Explains why many dyslexics with excellent verbal funds of knowledge still have trouble reading long words

Classroom and Test Accommodations In the classroom, more attention should be paid to print size and spacing in daily classroom (worksheets, handouts) and testing materials (as many as 1 in 5 students are dyslexic), and print size and spacing should be considered when purchasing books for students.

Large print books and reader glasses may help some students, whereas font differences (serifs like Times New Roman or hand-written fonts like Papyrus or Comic Sans often preferred) may be more important for others.

For students with narrow visual spans (see only few letters at a time), serifs or handwritten fonts may dramatically lessen the work of reading - with serifs or personalized font shapes - it is easier to perceive the overall shape of words, so that even if a reader only sees the first and last letters and general shape of the word, they can make an educated guess about what that word might be even though they are unable to see all the letters.

Many of you are probably aware of this meme from the Internet: "Aoccdrnig to a rscheearch at Cmabrigde Uinervtisy, it deosn't mttaer in waht oredr the ltteers in a wrod are, the olny iprmoetnt tihng is taht the frist and lsat ltteer be at the rghit pclae. The rset can be a toatl mses and you can sitll raed it wouthit porbelm. Tihs is bcuseae the huamn mnid deos not raed ervey lteter by istlef, but the wrod as a wlohe." Matt Davis has written more about the science and history of the discovery of this effect here.

Eide Neurolearning Blog: Blessing and burdens of vivid visual thinkers

Eide Neurolearning Blog: Video game training increases visual span

In general, auditory verbal learners attract less discussion among learning style enthusiasts because they seem to flourish in conventional classroom settings where the teachers talk and the students are supposed to listen. Strong auditory verbal learners like to processing information through a brain loop of listening-speaking-listening. They like to talk their way through information and tend to learn well with lecture, group discussions, interactive teaching, and books on tape.

Auditory verbal learners tend to have strong language skills, and may take to learning by speaking aloud, working in groups, or studying or taking notes with a tape recorder. Sometimes strong auditory learners have visual memory problems. They are such strong auditory learners because they have learned that they are better with listening. Verbal mediation can often compensate a great deal for visual problems (e.g. some with dyslexia or premature birth), but these individuals may be more prone to overload if they hav

e to 'see' by listening at the same time they are listening. Auditory imagery can be a powerful learning resource, as sounds can be associated with words, pictures, and images. Sometimes this is what children are doing when they make all sorts of noises and sounds as they think or work. We've included some articles and links on auditory imagery below. Also here's a nifty excerpt from an fMRI study of "the little voice in your head." This view is only an excerpt from the left side of the brain, an equally complicated pattern of activation is triggered on the right.

Little Voice Auditory Imagery

Learning Styles Including Auditory

Auditory Perceptual Learning

Modality-specific Auditory Imagery

Auditory Imagery and Free Recall

As it often happens, I only accidentally discovered how bad my auditory working memory was when we were playing a memory game with our kids. To my surprise, I had the worst memory span in our family (we were practicing repeating back sentences of increasing length), all this despite the fact that working memory tends to increase into adulthood.

How is it that I only really discovered it now? One answer, I think, is Compensation. How could I get by well enough to make it through medical school and Harvard, and manage my share of the household to a reasonable degree? (I confess do forget to pick up things at the market and misplace items with regularity) And I know I'm not alone. Some ADD doomsayers wouldn't think that a person like me could exist, but there are many examples of other famously feeble LWMV's who have managed to survive and thrive*, and here are a few reasons why I think that may be so.

How Do Limited Working Memory Victims Survive and Thrive?

1. Flitting Not Sitting Many successful adults with teeny tiny working memories flit about in their activities - some keep physically busy doing different things, while others keep intellectually busy in the same flitting way. Over the course of an hour, I may return to a difficult task multiple times, like a hummingbird drinking nector from different flowers. It allows me to take in as much as I can at one time, then break, then take another little sip again when I'm ready. It works for me because my long term memory is quite strong - it's just my working memory that is weak. I can remember where I was when I return to it, and this is working more productively than if I were to force myself not to switch off, but stick to a single task. I think taking in information with little interruptions also takes advantage of the novelty learning in me. Stick with something for a long time would seem like such a chore, but this way is manageable.

2. Long Term Memory is Strong If our long term working memory is strong, then a limited working memory doesn't have to be a huge handicap. Many gifted individuals with ADD may fit this pattern...how could they score so well on their IQ tests if they didn't have strong long term verbal or nonverbal memories? It's the kids and adults with both weak working and long term memories that face the greatest obstacles in school and life.

3. Successful LWMV's may be Strong Inductive or Bottom-Up Learners I have a suspicion that the LWMV is especially well-suited to the inductive learner, i.e. learners that learn best from firsthand hand experiences or personal example. Inductive learners are sometimes called bottom-up learners because they take information in from many different examples then reason back to rules based on patterns that they find. The LWMV-ADD-Inductive Learner connection may be why so many kids with attention complaints have diffuse attention and why we find they prefer to learn kinesthetically or from direct personal experiences. It seems that many of these kids seem to for a reason.

4. Many LWMVs are Strong Interest-Based Learners There does seem to be a paradox that exists for many LWMV's: if something really captivates their interest, like music or photography for Ansel Adams or a beautiful problem to an LWMV mathematician or physicist, then persistence at a task doesn't seem to be a problem. It's like getting the key that unlocks all of memory's doors, and time may seem to stop. No doubt some outsiders would call this a LWMV's hyperfocus, but it misses the point if it doesn't recognize that only certain intrinsically motivating and pleasurable activities trigger this remarkable focusing and memory-enhancing phenomenon. Anyway, some more things to think about when wrestling with decisions about what to do about limited working memory.

It is possible to survive and thrive even with itsy bitsy working memory spans. *Some famous LWMV's: Enrico Fermi often complained of a terrible memory. He took notes all the time and called his notebook his "artificial memory". From Polya's Mathematicians I Have Known, "Are mathematicians absent-minded or eccentric? I don't know, but there are infinitely many stories purporting that they are, and I shall quote a few...There is a party at (David) Hilbert's house and Frau Hilbert suddenly notices that her husband has forgotten to put on a fresh shirt...David...meekly obeys and goes upstairs. Yet he does not come back. Five minutes pass, ten minutes pass...so Frau Hilbert goes up to the bedroom and there is Hilbert in his bed. You see it was the natural sequence of things: He took off his coat, then his tie, then his shirt, and so on, and went to sleep!"

If you'd like to read more, also check out The Man of Genius. Excerpt: "Forgetfulness is another of the characters of genius. It is said that Newton once rammed his niece's finger into his pipe; when he left his room to seek for anything he usually returned without bring it..." Now obviously not everyone with the working memory of a gnat is a genius, but the point I'm making today is that it is possible to achieve a certain level of success and still seem to have only the smallest file cabinet for working memory.

BTW, if you think there's a high incidence of physicists and mathematicians in this group, you may be right. I have physicists and engineers in my family tree. Working memory limitations often run in families (but don't have to), and are seen more often in spatially-talented families, dyslexic families, etc. They may be attracted to simplicity because that's all they have room for.

Eide Neurolearning Blog: Motivation and Memory

Eide Neurolearning Blog: Passion and Flow as a Learning Strategy

Eide Neurolearning Blog: ADHD - A Different Motivation Pathway?

A child who is lame, rarely will be scolded or told to run extra laps at home, but a child with fine motor or other causes of dysgraphia is may be publicly disgraced about 'sloppy work', told to finish work at home (though it could take hours or be practically impossible), or denied recess on a regular basis to 'finish work.'

There are several types of dysgraphia, but in this post, we will discuss motor dysgraphia, or difficulty writing due to impaired fine motor or sensory-motor coordination.

A variety of dysfunctional hand grips that occur in a variety of clinical settings - but most often mild birth injury or prematurity. Though motor / sensory-motor dysgraphia is remarkably common in today's classroom (perhaps because of rising prematurity or greater survival of high risk pregnancies), teachers receive little instruction in its occurrence, and accommodations are woefully underutilized. Dysfunctional grips often have the pencil tipped forward or out of the webspace. The first three fingers are not brought together in a pinch, but rather fisted or awkwardly positioned with the sides of fingers. When children are forced to writing with very dysfunctional grasps, then pain or even repetitive stress injuries can result. Often children develop behavioral problems like task or school avoidance. Occupational therapy may help many children, but sometimes time and accommodation are essential to allow handwriting to develop to a functional level.

The first link below is to a paper describes how brain-based injury to sensory-motor systems causes individuals to press harder than normal to compensate for their loss of control. The paper concludes, "When sensory information is degraded, an increase of grip force is interpreted as a compensatory strategic increase of the safety margin to protect against unexpected load perturbations that cannot be rapidly and accurately sense ands responded by a reactive grip force increase." Children with mild neurological injury may use a very tight grasp on the pen or pencil that results in heavy pencil pressure, poor writing endurance, and hand cramping. Some teachers or administrators fear that providing a student with appropriate dysgraphia-related accommodations will result in a child "never learning to write"; however, this is not true. In fact, by denying children appropriate accommodations, these students may never be given adequate practice with higher order writing tasks like paragraph organization or redrafting, because they can't get much down on the page by hand.

Tighter grip compensates for lack of control

The Cerebellar Child    We wanted to talk specifically about cerebellar kids, because they are common sources of "mild" or soft neurological signs, but their impact on learning, activities of daily living (self-care, mood control, appetite), sensory-motor and sensory-sensory coordination, and social interaction can be tremendous. It turns out the cerebellum is particularly vulnerable to prenatal or perinatal stress, and cerebellar differences are found in groups of kids diagnosed with premature birth, mild birth injury, dyslexia, ADD / ADHD, and autism spectrum disorders. The cerebellum is sometimes referred to as the "primitive brain" because it's more along the lines of reflexive or automatic action rather than conscious thought. It used to be taught that large amounts of cerebellum could be removed (for instance because of tumor) without any significant functional deficits, but now we know that the cerebellum is involved in a lot more important cognitive functions than we were previously aware. Looking at the complex pattern of connections that pass through the cerebellum (sensory-sensory, sensory-motor, motor-motor coordination), it may come as no surprise to you that even mild cerebellar problems can produce major practical life disruptions in a child's automatic pilot (moving, balancing, speaking, or performing other skilled activities without thinking, bodily appetites and arousal, and response to danger, pain, or environmental change). Sensory processing disorder kids are often really cerebellar kids - at least from the standpoint of a neurological exam.

It's not necessarily that a child has problems all over his or her nervous system; it may be that problems have arisen in brain location that is a great relay center for sensory inputs and motor plans.

Because the cerebellum is important for triggering escape reactions in response to threat, children with even seemingly mild cerebellar problems may have trouble with quick changes in routine, and have especially volatile emotions when young and before the frontal cognitive controls have really matured.

Cerebellar cognitive affective

On the basis of IQ, gifted children are more likely to show wide discrepancies between subtest scores than non-gifted children. In one study in the Port Washington school district (Sweetland), 54.7% of gifted students showed a greater than 18 point discrepancy between their WISC-III VIQ / PIQ, compared to 17.0% of a control sample. As a result, twice-exceptionality, or giftedness with learning disabilities is more the rule in gifted populations, than the exception. Despite this frequency, twice exceptional or 2E students may find themselves struggling to fit into conventional school curriculum - too advanced for some lessons, but behind in others -as a result these kids are often in a situation in which neither their gifts nor their challenges are recognized.

Step 1: Identification of Twice Exceptionality  If we were to give one piece of advice, it would be to have a high index of suspicion for 2E. Gifted students often have many resources at their disposal to hide difficulties in sensory processing, reading and writing, and attention and organization,  so that although they may perform well enough in the classroom,  they may wear themselves down with extra work at home, become anxious or depressed, and achieve much less than their potential would predict.  Wide discrepancies may  be noted in IQ tests taken for entrance to public or private school gifted programs - but sometimes a twice exceptional student will only begin to show difficulties in the later grades as the quantity of information and work expectations increases. 

Step 2: Recognizing the Challenges  Recognizing the challenges are not always easy tasks in twice exceptional students because gifted students can use higher order strengths to compensate for lower order perceptual weaknesses or processing problems. For instance, a gifted dyslexic student may use his strong contextual filling-in ability to compensate for weaknesses in individual word reading, or a verbally-gifted student may mask his difficulty with organization and writing by getting help from friends and family. Higher order skills in reasoning and problem solving ability might help students get by with routine classroom and social scenarios, but things can fall apart if the demands are too intense (finals), or real-time multi-tasking (note-taking in a challenging class, unpredictable new social environments) is required.Wide discrepancies in subtest scores may be helpful, but some gifted students can also find away to mask their weaknesses on these. For instance, gifted students with a weakness in visual memory may still ace standardized visual memory tests because they verbally describe what they see so that the information is stored in their auditory memory. Nevertheless, this weakness in visual 'snapshot' memory is important to recognize because these students will have have trouble with visually demanding lessons (diagrams, multi-stepped math work, charts, etc.) and often note-taking in general. When we assess twice exceptional students, we make a point of asking how they arrived at answers  - because the compensatory strategies taken may reveal the sources of problems in school performance.

Step 3: Encouraging Self Understanding  We believe that self understanding should be a primary goal for helping twice exceptional students. The frustrations of 2E students are often poorly understood and underestimated because from an outside view, these kids and young adults may look successful. But the personal burdens are often significant - children who destroy their own work because they are ashamed of what their hands can produce, kids who feel like they are frauds because they don't really understand what others assume they know.  Children normally see the world and themselves in 'absolutes' - Good vs. Bad - and as a result, they struggle to accept their contradictory selves.

Step 4: School and Test-Based Accommodations - 504   Since the 2004 re-authorization of the IDEA, twice exceptional students have qualified for individual support in the form of 504 accommodations or an IEP. From Wrightslaw.com: "Twice-exceptional children are gifted children of above average abilities who have special educational needs - AD/HD, learning disabilities, Asperger Syndrome, etc. Because their giftedness can mask their special needs and their special needs can hide their giftedness, they are often labeled as "lazy" and "unmotivated".

Some schools and school districts have refused to allow qualified students with disabilities to participate in accelerated or gifted and talented programs and have required these students to give up the services designed to meet their individual needs. These practices are inconsistent with Federal law.

OCR says that if schools "condition" participation in accelerated classes or programs by qualified students with disabilities by requiring these students to forfeit their necessary special education or related aids and services, it amounts to a denial of FAPE under Part B of the IDEA and Section 504."

For more reading on Dual or Twice Exceptionality:

Twice Exceptional Pages at HoagiesGifted.org
Twice Exceptional at the NAGC
Twice Exceptional Newsletter Blog
Twice Exceptional at SENG