Learning Disabilities or "Careless Errors"

Neuroplasticity: Changing the playing field for SUCCESS

“Careless Errors.” How many times have teachers, supervisors or administrators spoken these words? If you would pay attention, you would be more successful. I have corrected you multiple times about this mistake and you continue to make it over and again. Why don’t you try? I am failing you. You’re fired. The judgment and the outcome are never positive. How often do we take the time to look beyond the error and try to understand why the error occurred?

A number of years ago, I had a patient who was an electrical engineer. He was in charge of multi-million dollar building projects. He was describing his frustration with employees making basic wiring errors. He was angry. He was even sad because he was going to have to fire these individuals. He described one of the individuals as hard working with a family, but the errors were at a level, the employee was a liability. I fully understood his dilemma. The liability was huge and the employee appeared “untrainable.” However, was this really the case? Why would a man come to work every day, try his best and in most respects was a great employee but in others was jeopardizing the entire company? I asked one simple question. Was the man color blind? My patient stopped his ranting. He had never thought that the person may literally be getting wires crossed because he could not see the color differences. Many people who are color blind compensate by learning to match shades of the colors they “see”, but in reality their interpretation is not reality of the color spectrum those who are not color blind see. This matching may work in some cases but it may not depending on the degree/type of color blindness that an individual possesses.

My question led to an unusual outcome. My patient called his company president and as part of the hiring process, every employee who would be installing wiring would be tested to see whether or not they were color blind. If they were color blind, accommodations could be made. In this case, the employer chose to do something radical. He chose not to assume, but to investigate further. This investigation and his actions proved invaluable for the company and all of its employees. Rather, than simply assuming the employee was incompetent or deliberately sabotaging work, he sought understanding beyond the mistake at the forefront of this dilemma.

It is all too easy in our hectic lives to attribute mistakes or work challenges to incompetence, inattention, or a plethora of other reasons. Color blindness is something that we can relatively easily assess, however, learning disabilities and/or cognitive challenges are often overlooked or minimized or the person has become so discouraged that they have accepted failure as a part of life.

In education, pediatrics or child psychiatry, learning disabilities are often under recognized and too often dismissed as “this is just the way your brain works or does not work.” Many in our education systems continue to look at the brain as having a fixed program at birth. You were designed with a good memory or a poor memory. You are great at math or it is a black hole of doom. Reading and comprehension is with ease or you are a part of the 21% of adults in the United States who are illiterate. 54% have a reading level below a 6th grade level. Perhaps, now you can begin to understand why countless people do not question the information presented by so-called “reliable” sources.

While these statistics are alarming, they document the failure of decades of education. What continues to be needed is a paradigm shift to allow widespread incorporation of neuroscience into the field of education. Please do not tell me this is expensive. I can guarantee you the entire cost of a nationwide program would probably be less than one day of savings generated by Elon Musk. Further, the cost of illiteracy is paid every day by those suffering from under achievement, addiction, prison sentences and government dependence.

What do we need to understand?

For those who struggle with developmental cognitive challenges (reading, writing, comprehension, memory, math, and telling and understanding time), it is assumed that this is just your cross to bear in life. In contrast, if at birth, you had muscle weakness that could be rapidly identified, you would be placed immediately in occupational and/or physical therapy. The goal of a pediatric specialist is to identify weaknesses early and provide prompt and targeted interventions to achieve a “normal” level of functioning. However, cognitive deficits can be more difficult to identify or can easily be dismissed by parents, health care providers and educators. With cognitive disorders, often parents are told to wait and see. I am not against observation, but it must be purposeful, not dismissive.

Dyslexia is a disorder of reading in which a person has difficulty reading words, identifying the correlation between letters and sounds, and spelling. They may reverse letters and numbers. This disorder effects approximately 20% of students, this is 4-6 students in every classroom in every school across the nation. This does not mean that these students will have difficulty with comprehension. Thus, a student may be able to comprehend all the material read to them, but are unable to read or write the material without significant effort. I mean significant effort. Imagine trying to write the alphabet in which you are unable to see the totality of letters or words. What if a letter is broken down into strokes of a pencil? The letter H is 3 strokes: two vertical and one horizontal. The letter A is 3 strokes. The letter T is 2 strokes. Thus, the child does not envision the word HAT as a totality but as 8 strokes. Now, image that every word is broken down into strokes and not letters or words. The task of learning to encode and decode words becomes insurmountable. Now, add to this challenge the importance of direction: “b vs. d”, “p vs. q” or “s vs. z”.

In 1925, Dr. Samuel Orton, harnessed his experience in working with brain injured individuals and began looking at children who were failing in school. He identified students as having “strephosymbolia,” twisted symbols. He then collaborated with educator Anna Gillingham in creating the foundational approach for treating dyslexia, the Orton-Gillingham model. The Orton-Gillingham method teaches students with dyslexia using a systematic, multi-sensory approach to learning and maintaining alphabetic-phonemic awareness. This method targets the reading center of the brain and students who were previously unable to read or spell become readers and spellers. Thus, the brain’s area of weakness was able to respond to a targeted intervention and the brain through exercise gained neuronal connections, proving the brain is not a fixed in its abilities. The brain is able to respond to targeted exercises; building new dendritic (brain cells) connections, building and reinforcing pathways and changing lives.

This method should be in every school system in the nation. Sadly, it is a challenge in even the best of school systems to identify dyslexic or other cognitively challenged students because the educational system is rigged against them. I am writing this based on 30 years of experience with children with learning disabilities. I recognize there are many good teachers, school psychologists and administrators, however, even if they are well meaning the system is designed to leave children with learning disabilities or cognitive challenges behind, despite the propaganda of “no child left behind.”

When a child is struggling in school, a parent must in writing request an assessment. The school can request an assessment but rarely will take this action. A parent or parents will make this request because a child is struggling in reading and/or math or for any number of reasons. After requesting the assessment, a meeting is held and a decision is made about whether or not the concerns are “valid” and merit testing. Testing may be completed, however, what the parent is often unaware of is that the testing completed may or may not be assessing the child’s area of weakness. Thus, if the school focuses testing on comprehension or attention and finds both intact, they will miss the fact that the child has poor phonemic awareness. They may not even test for phonemic awareness: the child’s ability to link letters and sounds. Or if the child has poor attention for the given task, the focus becomes attention as the root cause of the problem not that something else may be causing disorders of attention. Discerning which came first, the chicken or the egg, is critical. To make a comparison, if a person has an elevated heart rate, the potential reasons are numerous: exercise, fever, dehydration, anemia, thyroid disorder, hypoxia, drugs, alcohol, heart arrhythmias, fear, anxiety, panic, to name a few. We do not assume. We look at the history and the evidence before drawing a conclusion. However, when it comes to academic or cognitive challenges it is very easy to simply state inattention or “carelessness” is the root cause.

Further, when a child is giving all the proper tests in an assessment, the interpretation may not be on target. If a child scores generally above average in all testing, but in one area they are below average, all the scores will average to average. Thus, the law of averages is used to decrease the significance of the area of weakness. Thus, if three of your four limbs work well but your right forearm has poor strength, you are functioning at 87.5 percent capacity, the area of weakness does not statistically interfere with your overall capacity. Further, the school might site that even though you are right handed that you are able to type on a keyboard, therefore, this weakness does not interfere with academic success. Translation, no intervention is needed.

As a parent, if this was your child, you would be screaming saying, hold on, Johnny can’t hold a weight in their hand without pain or dropping the weight. This must be addressed. The school would reply that this may be a problem, but it is not a “school” problem. Thus, unless there is a direct link to academic outcome, unless your child fails and even then it is doubtful you will receive services.

Let’s look at this situation. Johnny is a slow reader. “Some students are just slow readers.” Johnny seems to get distracted when reading. He often looks out the window. The teacher reminds Johnny to focus on his reading. The teacher describes Johnny as very social and liked by all his peers. Johnny is a great student in math. He is artistic and a great athlete. He is just slower at reading. I am sure he will grow out of it. You could seek an evaluation to see if there is medication to help improve his attention. BAM!!! The magic pill is prescribed to shift the focus to attention and not the root cause. Johnny may have dyslexia or a disorder of visual tracking or simple can’t see the text. All of these can appear as inattention. Johnny may look away from the text because his eyes are sore and he has a headache from visual strain and needs to give his eyes a break. He may be exhausted from trying to decode the words. His eyes may jump from one line of text to another and the words do not make sense in the order he reads them. Thus, confused, he looks out the window. Assumptions can be a great starting place, but cannot be our immediate conclusion.

When I am asked to evaluate children with attentional disorders, anxiety or depression, over 90% of the time, the child has an underlying learning disorder. We falsely look at schools as a wonderful, joy filled environment in which our children learn, grow and prosper. Again, there are good teachers, however, for many children and I mean many, school is a concentration camp. I do not use those words lightly. Children who struggle cognitively are sentenced to attend a program 5 days a week, 6-8 hours a day for 13 years or longer. Thus, a student who struggles to read is told to pay attention, try harder, make your work neater. You are making “careless errors.” They may be making errors but are they truly being careless or in fact are they exhausted by all the effort it takes just to get through one hour of classroom instruction.

You already know the impact on the student who hears everyday that he is not trying hard enough. It is demoralizing. It creates anxiety and depression. These are the tip of the iceberg. Discouraged children seek escape. Drugs, alcohol and the internet are danger zones for these students.

Can these students be helped? Is there a mechanism to target specific areas of cognitive weakness? Can children and adults be helped? Can the growth of neuronal connection translate into academic or vocational success?

The answer to all of these questions is YES. Exercises do exist for those with cognitive weakness or even those seeking to improve their cognitive functioning as they age. Barbara Arrowsmith the creator of the Arrowsmith Program is no ordinary woman. Barbara suffered from multiple profound learning disabilities. You can read her life story in The Woman Who Change Her Brain. While struggling through graduate school, Barbara hypothesized that if neuroplasticity was real, if the brain had the ability to grow or expand connections, then it would be possible for areas of cognitive weakness to respond to targeted exercises. She investigated the work of Alexander Luria and then developed a series of targeted brain exercises. These exercises allowed her to move beyond her own learning disabilities. She strengthened and changed her brain. Her work led to the creation of the worldwide Arrowsmith Program and school based in Toronto, Canada.

I have had the privilege of teaching this program for the last six years. I have witnessed lives transformed. The exercises target areas of cognitive weakness. The exercises are building the foundational system upon which academic material can later be taught or taught simultaneously. Students range from late elementary school to 75 years of age. There is no age limit. The foundational exercise is Symbol Relations or fondly, “clocks.” This exercise on the surfaces appears to teach students to read an analogue clock. However, the depth of this exercise is far beyond the basic knowledge of telling time. The clocks range from 1 or 2 hands to 10. Obviously, the 10 handed clock is no ordinary clock. This exercise targets students who struggle with dyslexia, reading comprehension, understanding sarcasm, understanding the use pronouns, attention, sequencing, organization, deductive reasoning and shifting set.

Meet Sam, a rising 5th grade student. Sam was unable to read. Sam (name changed) had extensive testing from a school psychologist. The psychologist described Sam as anxious and that the anxiety was in response to the high expectation of his parents. I ask you, is it too much to expect that your 5th grade student be able to read? Sam’s anxiety was in direct response to the fact that every day he went to school and struggled to understand and manage an environment in which everything was presented in a language he could not read. Copying information from the board was a challenge because the words were just a series of letters separated by spaces. He would listen for clues from classmates or the teacher about the meaning of things or the task at hand. He tried to memorize everything spoken to compensate for what he was unable to read. At the beginning of the summer we spent with Sam, his mother place a note on his computer screen saying, “You can do this!” Sam could not read it. Sam diligently came online every day and completed the clocks exercise. Sam learned to read a two-hand clock, then a three-hand clock and eventually a four-hand clock. I don’t mean just one or two clocks in a session. He was able to master reading 25 clocks in a row in 70 seconds or less with greater than 90 percent accuracy. As a task at each level was mastered, the level of complexity was increased. After 4 weeks, Sam read the note posted on the computer by his mother for the first time. Sam not only was able to read the note but was spontaneously reading other material. Sam was growing the connections in his brain that allowed him to begin to make sense of all he had been taught but could not link together. He began to see words not letters linked together. Words became phrases and sentences. A burden had been lifted off Sam’s mind and heart. His anxiety decreased and the thought of returning to school was no longer terrifying.

Sam is one student. Sam could be you or your son or daughter. You may be struggling in your job with memory, organization, spelling, or attention. It is important to know that cognitive exercises may be a mechanism to provide you with the success you have been seeking. The Symbol Relations exercise or clocks is one of multiple exercises. Because learning issues are complex, multiple exercises may be required to help a student strengthen their neuronal network to achieve success.

There are no typical Arrowsmith students. The average student ranges from a person with dyslexia or a complex learning profile to adults desiring to improve their memory, attention or cognitive flexibility. Students have included: a college professor, a retired chiropractor, a cardiologist, a CPA, high school and college students, adults seeking to improve their cognitive functioning, and those recovering from concussion or brain fog.

Who might benefit from these exercises?

Moms and Dads: struggling with organization. You were able to manage when you were single but with young children you feel continually overwhelmed with keeping the day organized and planning for tomorrow.

Head injury: Many with post concussion injury struggle with memory, word finding, visual tracking, and attention.

Students with dyslexia, difficulty with reading comprehension, math, attention, and focus.

Students with dysgraphia: difficulty writing quickly and neatly.

Employees who struggle with attention to task, memory and organizational skills.

This program is a tool that can provide success. Remember, the causes of those who struggle cognitively are many, thus, targeted brain exercises are only one tool in the tool box, but they are powerful tools.

Student commitment can be intensive, multiple hours per day for a 6-8 week block of time or 1 hour a day (Monday- Friday) for 6-12 months or longer. Every student entering the program has a different level of challenge. If you would like to learn more about the Arrowsmith Program, please email me at drfurey.arrowsmith@gmail.com.

Our next round of classes begins, June 1, 2025.

Sheila M. Furey, MD