Clinic/education remediation with students with disabilities learning approach

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A Clinical/Educational Approach to Remediation

with Learning Disabled Students

by Robert DePaolo

Abstract

This article discusses the possible effectiveness of incorporating assertive psychotherapy methods in remediation plans for students with learning disabilities. Assertive therapy is a method typically used to alleviate anxiety but also provides other benefits such as enhanced focusing capacities, reduction in self consciousness and greater goal orientation.

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All special and regular classroom educators are faced with a conundrum when it comes to working with learning disabled students. Unlike developmental disorders, attention deficit, severe cognitive impairments, and speech and language impairments, the term learning disability lacks a clear clinical definition. For example research evidence is rapidly beginning to show that children with ADHD appear to have an under-aroused brain, typified by nor-epinephrine depletion which precludes summoning the energy to focus on tasks. (Hunt 2006). Autism is beginning to look more and more like a multi-faceted neuro-developmental disorder originating in the cerebellum (a part of the hindbrain responsible for automaticity, and other cognitive and motor/map regulatory functions (Courchesne, Courchesne et al 1988).

On the other hand the diagnostic criterion for a learning disability is mostly statistical (and hypothetical). As per the discrepancy model, a comparison is typically made between and among academic test scores, classroom performance and intellectual test scores to determine whether the differences are significant, thus warranting identification of the student as having a learning disability.

While some research on the neurology of learning disabilities suggests they have larger brains requiring a broader, more cumbersome search for information in the brain (Russell 2008), (Shaywitz, Shaywitz et al (2008) (ironically a negative factor in child development because the brain actually performs better as neural tissue is shed in child development) it is spotty. Other research on neurotransmitter functions has yielded inconsistent results. Therefore at present, no one knows what a learning disability really is.

For that reason, the move toward Response to Intervention Methods, while perhaps overly ambitious, is perfectly understandable. On the other hand, sidestepping the question of what an “LD” actually is, does little to resolve it. That has implications for educational practices and efficacious outcomes down the road.

A Generic (Clinical) Hypothesis

One way to describe a learning disability in a clinical context might involve combining elements of neurology and Information Theory – the brain being ultimately an information processing instrument. In any given classroom, irrespective of student teacher ratios, funding issues or whether or not staff are “highly qualified” there are really only three variables at work. In terms of information theory they are as follows.

1. The intended message (lesson) conveyed by the teacher

2. The presence of noise, in the form of interfering thoughts, daydreaming, physiological-based distractibility and/or competing thoughts…for example… “ I hate school“…“Why do I need to learn this stuff…” “Oh, God, I hate math.”

3. The message received by the student

Here it is argued that, whether arising from an overly large brain (which exacerbates noise interference), a negative disposition, anxiety/shyness, or self consciousness the core causative factor in a learning disability is “noise” which in various forms precludes a close correlation between the teacher’s message and the learner’s comprehension of that message. Noise equates with interference in any information system and so a learning disability can be defined clinically as one or more ongoing interference patterns arising within the brain from several possible sources that interrupt the message and compromise receipt of that message. The interference can be temporary, situation-specific (“I don’t like that teacher, he’s too intimidating”) or chronic (in the form of anxiety, self consciousness and other arousal mechanisms).

The fact that interference can have varying origins might explain why classroom performance, test scores, independent work capacities and comprehension of subject matter are variable for learning disabled students.

There is another potential factor, which is a Piagetian staple. In order for the message to be received requires prior schemes (cognitive templates) that make the teacher’s message at least partially recognizable to the student (Satterly 1987). In that context, it serves the instructor well to invoke a variation on that old saw…there is nothing new under the sun. In educational terms it would be stated slightly differently, to wit: The presentation of new information absent a frame of reference precludes effective teaching. However since most good teachers use simile, frame their lessons in terms of personal experience and use concrete examples to “break in” new topics that factor is left for another time and perhaps another article. For purposes of this article the true and most essential remedial strategy for the learning disabled student is considered to be noise reduction.

An Unorthodox, Yet Simple Solution

There is little research in the field of education regarding methods for reducing “noise.” One recent innovation was the portfolio approach which was an attempt to personalize the subject matter in such a way as to maximize student investment. One of its prime tenets was that if academics could somehow be incorporated into the self image, student motivation (a precious, yet ever-waning factor among today’s students) could be enhanced. The problem with that approach is that it assumes the student is interested in the activities that comprise the portfolio in the first place. Thus is a particularly rugged male student might view drawing pictures with a personal theme as either too “goofy,” threatening or expository. Consequently he might not warm to the task, in which his case his motivation would be dampened rather than enhanced.

Yet there is ample research within the domain of clinical psychology that does address the issue of noise, which is often equated with anxiety. The research indicates that people, including children, can overcome inhibition, self consciousness, fear and anxiety through assertive training, or assertive therapy. (Bornstein, Bellack et al 1977) (Colter & Guerra (1976).

Nuts and Bolts of Assertive Methods

The fundamental premise of assertive training is that anxiety and noise interference cannot be simultaneously activated alongside anger/arousal. (Cansier 2010) (Bower, Bower 1991). The reason is found in a process called reciprocal inhibition, which mandates that the neural circuits for aggression inhibit those for anxiety and inhibition and vice versa (Wolpe, 1958). In the clinical field this is most often applied to individuals with social phobias and anxiety disorders (Sue, D Sue, DM et al 1990), Cooley, E & Nowicki, JR (1984), Schlenker & Leary 1982). The therapist, or trainer typically begins with role playing to get the client used to expressing anger, contrariness and oppositional language in the controlled setting of the therapist’s office. Then those behaviors are whittled down, from verbal aggressive (which does not work socially and could create more problems than it solves for the client) to verbal assertiveness (which is defined as a heartfelt, high-focus set of behaviors - usually language-related - that are socially effective, yet at the same time serve to inhibit the anxiety and noise that otherwise hamstring the client in social settings.

In simple, neuro-functional terms, one cannot be in both flight and fight mode simultaneously. Flight mode is conducive to noise interference. Fight mode provides a uni-focus and blocks peripheral distractions (which is why athletes try to psych themselves up to perform better in big games).

In that context one could surmise that teaching students to be assertive learners would result in noise reduction, as well as galvanize their focus, ameliorate self-consciousness and other distractions in favor of an intense focus on the lesson at hand.

The key element, as with clinical methods, would be to find an acceptable format and style of assertive expression for students in the classroom. While each teacher and student might approach this in a unique way, there are some general guidelines that might provide grist for the mill. First, a caveat.

Not all personality types necessarily benefit from assertive training. Some required aggressive statements and posturing can, even in rehearsal, be ego-dystonic for some clients and result in heightened anxiety and possible disruption of the self image.

There are ways around this, one being the use of positive assertions (which amount to the use of positive language with “brio” – eg “I really enjoy this class and I find history unimaginably appealing due to its revelations about the present.” In addition, unlike the Response to Intervention Method, this approach would not disregard formal testing, for the following reasons: Students with low average-borderline cognitive abilities and/or significant language retrieval difficulties might become quite alienated by such a teaching method. That does not mean they can’t participate, but perhaps concrete training formats adapted to their comprehension levels could be employed to create some degree of enhanced proficiency as well.

In effect it is strongly emphatic tone rather than the specific language or the student’s disposition that elicits the assertive posture. It is powerful expression that due to the concomitant release of supportive neurotransmitters creates a constructive, quasi-fight rather than flight reaction, thus converting passive, distractible., avoidant learners into aggressive learners.

In that context the question is whether assertive/academic training implemented on a grand scale might improve academic performance and/or reduce the number of students identified with learning disabilities. Logic and prior research suggests it would, but when it comes to education the proof is always in the pudding.

Application

The next issue and the hardest to address is the “how” of this proposed methodology. What should a teacher do to create the focus/brio inherent in this personality/achievement transition?

In a counseling format it is easy to implement. It could begin with disinhibiting exercises such as

1. The client present opposing viewpoints in contrast to the counselor’s in role playing sessions.

2. The client using emphatic expression to compliment the counselor, once again in role playing, as well as practicing tonality and use of the pronoun “I.”

3. The client complaining about his lot in life fervently, then resolving to take action to work things out.

4. The client asking questions whenever there is the slightest level of ambiguity.

5. The counselor tabulating the number of questions, challenges etc to gauge self-advocative growth during the process.

Then comes the in vivo or real life application. Assignments are given to the client to behave in acceptable but self-advocative and if necessary, contrary ways in his natural environment. These are monitored by the counselor to make sure the client is not going overboard. (While assertive counselors consider themselves behaviorists, fact is they often resort to ego therapy as a means of determining whether the client has a firm enough grasp of self in society to make the right decisions and in the correct proportion vis a vis their assertive actions.

Can this be converted for educational purposes? Assertive training has been used effectively in selected educational settings (Mehrabizadi, Taghavi et al (2009). Still many of the clinical nuances would be difficult to carry out in the context of a classroom – though enlisting the aid of a school psychologist could help in that regard. Yet even a classroom teacher could use it in the context of his or her teaching style; for example with the following introduction…

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