It is unusual to find a description of what it feels like to have a cognitive impairment. Unsurprisingly, published narratives are the products of our world’s wordsmiths, but there are few published narratives by those who find it difficult to understand relationships between words. For the first 25 years of her life Barbara Arrowsmith-Young had severe difficulties in processing symbols and meanings, a semantic aphasia which caused extreme frustration with many aspects of learning, despite her phenomenal memory. Although this book is mostly about what she does in her school to help children and adults remedy their cognitive deficits, the first few chapters describe what life was like for her – a fog of misunderstanding. She could not properly understand the news, or conversations around her, let alone books or mathematical reasoning. As a teenager her frustration and loneliness almost brought her to suicide. In her twenties she stumbled, via the writings of A.R.Luria and others, on the principle of neuroplasticity, that our brains are capable of reprogramming. Luria’s The Man with a Shattered World described a man with similar deficits to her own, and she embarked on a programme of exercises to strengthen the area of the brain that Luria had identified as the culprit – the intersection of the left parietal, temporal and occipital cortices. Her exercises revolved around a consistent manipulation of the clock timings, using flash cards, asking herself repeatedly to answer questions about the relations between different arrangements of clock hands. The program required continuous stimulation with lots of repetition and then progression to more difficult questions, always concentrating on the logical connections between different times on the clock.
The changes were gradual at first, as the clock exercises became easier, but then there were surprising consequences in other areas of her life. She could understand articles much quicker, she could follow the arguments being made on current affairs programmes, and suddenly mathematics was possible and even enjoyable. A consistent and persistent attempt to rewire the weak (or scrambled) logic circuits in her brain had profound and long-lasting effects.
The story described in this book is exciting for anyone involved in education, but also thought-provoking – our education system may be failing many people. There is nothing new in the observation that cognition is made up of many different skills, relying on circuits in many parts of the brain, and neuroplasticity has become accepted. But what are the implications? While Barbara Arrowsmith-Young tells initially about her own symbol-relations deficit in the left cortex, and its consequences for learning and life, in later chapters she describes children with other different deficits, and the different programmes and exercises devised to help them strengthen the relevant parts of their brains. There are chapters devoted to children with symbolic thinking deficit (deficits in the left prefrontal cortex), profound speech disorders (left brain lesions), ‘artifactual thinking’ weakness (right prefrontal cortex lesion), prosopagnosia (problems with face and object recognition due to lesions in the left temporal and occipital cortices), number blindness (left angular gyrus and intraparietal sulcus), and so on. All of them are changeable with persistent practice of the relevant skills. Reading requires a whole set of brain areas, as does writing, and each has their own chapter with examples of how children have progressed with targeted intervention.
The effectiveness of each individual intervention is hard to judge through the teacher’s own (probably partial) account. However, the fundamental principle that some cognitive deficits can be improved by persistent use of the appropriate exercises is probably true, and could be predicted once we accept the principle of neuroplasticity. It is unfortunate that education, and support in schools and universities, for children with cognitive skill gaps, often still relies on strategies to supplement the weaknesses or using technical aids to supplement weaknesses rather than remedying them fundamentally – in the brain.
Barbara Arrowsmith-Young (2012) The Woman Who Changed Her Brain London, Square Peg
TED talk (Toronto 2013) by Barbara Arrowsmith-Young here:
https://www.youtube.com/watch?v=o0td5aw1KXA
Guardian interview (2012) here:
https://www.theguardian.com/science/2012/jun/12/barbara-arrowsmith-young-rebuilt-brain