>
Communicating research to support the evolution of teaching

News  ·  Neurocuriosity  ·  Neuroscience & Education  ·  Evidence for the Frontline Conference  ·  The Science of Learning


THE ANNUAL LEARNUS LECTURE 2017

"DIAGNOSIS, WHICH DIAGNOSIS?"
BY PROFESSOR SUE GATHERCOLE OBE
17TH MAY 2017 AT CHURCH HOUSE, SW1


Professor Sue Gathercole opened her lecture with a summary of how many pupils have educational underachievement from 13-19 years as found in a survey running from 1948 to 2009. 17% had poor literacy and numeracy and 22% poor numeracy. She reported no significant change since 1980.

The UK is roughly in the middle of PISA 2015 lists for reading but poor in maths and science. Social Inequality still plays a significant part in underachievement and the level of socio economic status is the best predictor of these detrimental effects.

First, she went on to look at response to intervention, considering whole class inputs, small group plus parent liaison inputs, and intensive individual inputs. Intervention during the critical period in children’s education in the early years has been cited by Bowyer-Crane 2007 and Elliott and Grigorenko in 2014. It was found that the most powerful approaches were found by input in early oral language interventions together with approaches to phonological inputs.
Interestingly, this argument was supported by Professor Margaret Snowing from Oxford spoke at The Richmond Dyslexia Association in May 2017 on the very subject of phonological approaches. She described her and colleagues’ work on a project involving this intervention with nurseries to raise pupil’s readiness to benefit from education in their primary years and beyond.

A diagnostic approach across common categories, (such as ADHD, dyslexia, dyspraxia, dyscalculia, and language learning), can then be used as an aid to understand a pupil’s problems and help to guide choices of intervention input and resources.

However, Sue pointed out the prevalence of comorbidity across pupils who have many symptoms in common but also symptom variability too in those who receive a diagnosis. In addition, the routes to diagnosis can be haphazard. These limitations make research into causes and symptoms difficult and lead to confusing choices of effective treatment that can be indicated. The research developed by Sue and colleagues, at CALM (Centre for Attention Learning and Memory) in Cambridge, has found overlapping symptoms between ADHD and Low Working Memory, where 60% are male pupils. Both groups tend to have low working memory but hyperactivity distinguishes them into 4 groups:
Oppositional, Inattentive, Hyperactive or ADHD but their working memory was equivalent in all the groups. (See Frontiers in Human Neuroscience 8,976) The CALM clinic has been investigating 460 children so far, to ask, what distinguishes these children who are referred by known professionals, but not by parents, using certain chosen dimensions. The pupils mainly have a range of difficulties to include ADHD, Autism, Speech and Language difficulties. Their learning attainments, their phonological processing, their memory and their fluid intelligence are investigated.

Nothing abnormal is detected in around 30% of these pupils. The question of how they can all be grouped has been addressed through analysing their phonological skills, and their executive functions linked to attention levels. The latter seemed to be found in those with maths difficulties, especially in spatial dimensions, with the suggestion that this is linked to the abstract nature of maths which may influence a pupil’s attention levels. The question has been asked that is the brain network linked via the strength of white matter connectivity for reading ability and maths and a paper is in press from the CALM Centre’s research involving brain scans and genetic testing through saliva tests. They found that those with more efficient brain networks with multiple cognitive sub-systems, had better reading and maths levels. Working Memory Training was discussed, with evidence found that trainees benefit when they learn to do something new which would be linked to fluid cognitive abilities.

Professor Gathercole’s lecture raised important points to consider when approaching assessment of an individual pupil. There are benefits to both static assessments and dynamic assessments, either or both of which might be appropriate, in certain circumstances. She concluded by suggesting that instruction should be guided by evidence, bearing in mind that oral language and phonological abilities are modifiable in preschool pupils, whereas, it is believed that working memory is not. Finally, compensatory strategies and skills should be encouraged, as there is more than one way to learn. It was suggested at the end of this fascinating talk, that the dimensions of strengths and weaknesses should be looked at, to add to conventional diagnoses. Maybe this approach could even replace the conventional diagnoses discussed?


Jane Emerson
SENDCO Support Adviser
Member of Learnus Council