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Ask a Neuropsychologist

We asked current classroom teachers what brain and learning questions they’d like to ask neuropsychologists and then posed their questions to the clinicians, researchers, and faculty at the Kennedy Krieger Institute Neuropsychology Department. Teachers asked questions that ranged from student mental health to issues with student attention.  Read on to see what answers neuropsychologist had for teachers.

Teacher Question: What should I know about depression in order to better support students?

Dr. Lisa Jacobson: Depression is not just a change in behavior that we can observe; it involves neurochemical changes in the brain that affect how the brain processes information. Research suggests that individuals who are depressed may process information differently and also more slowly than those who are not depressed. They may show reduced energy and greater fatigue, and also show changes in appetite and sleep quality – all of which can affect the way in which we learn, process, and remember information. In addition to being kind and supportive, providing extended time for assignments, a modified work load when possible, and multiple supports for comprehension will all benefit a student with depression. 

For more information about mental health and the developing brain, check out these resources.

Teacher Question: How long does it take for cognitive changes in the brain to translate into something concrete that I can see?

Dr. Lisa Jacobson: It depends on the changes –brain injuries such as stroke or traumatic brain injury may be evident very quickly from a change or loss of cognitive or behavioral function. Other, less dramatic changes in the brain may also be evident fairly soon, such as the neural changes underlying learning new skills (like riding a bike) or the changes in neurotransmitters and neural signaling that result in behavior indicating someone is on “high alert” or is reacting emotionally or fearfully. Think about being scared, for example –it may take only a very quick “Boo!” for your heart to start pounding and your breathing to quicken, behaviors indicating that a specific system (the limbic system, especially the amygdala) in the brain has been activated. However, many more lasting brain changes take place over a period of months to years, making those related cognitive changes evident only over a long period of time. These include development of core skills such as language or higher-level cognitive skills such as executive function. For these skills, the underlying brain changes (such as development of white matter connections between important brain regions supporting the component skills and efficiency of processing) take years to complete, so the related visible behaviors also take years to become evident.

Teacher Question: Why do I need to give directions repeatedly?

Drs. Lisa Jacobson and Mark Mahone: Our ability to listen and follow directions depends on many factors, including motivation, language comprehension skills, attention, and working memory (parts of the construct called executive function). If we aren’t motivated because the task is uninteresting, unpleasant, or overly difficult (i.e., taking out the trash or doing homework), we’re less likely to follow though quickly or completely. You can consider emotions as the gatekeeper to attention.  We pay less attention to what we care less about.

Familiarity can also influence attention. If we don’t understand the words being used or what the task involves, we’re less likely to be able to follow though, even if motivated. Furthermore, even if we are motivated and understand the task, if we aren’t paying attention at the time the directions are said, we are less likely to be able to complete the task.

Working memory involves the ability to hold multiple pieces of information in mind while using it in some way – so if the directions given are long and involve multiple steps, then even if they are paying attention and are motivated, children with reduced working memory capacity (i.e., children who can’t “hold” as much information or as many steps in mind) may fail to follow through as they have “forgotten” step 3 by the time they completed step 1.

There is also a developmental component to being able to pay attention to directions. Executive skills such as working memory develop slowly over time, but also vary with the level of demand present in the environment.Many children may show variable attention and working memory, meaning that teachers will have to repeat and simplify directions and  find other ways to support these developing skills. 

For more information about students and attention, see Dr. Mahone’s interview about the different components of attention.

Teacher Question: Why is ADHD considered a developmental disability?

Dr. Lisa Jacobson: As defined by the Centers for Disease Control (CDC), “developmental disabilities are a group of conditions due to an impairment in physical, learning, language, or behavior areas. These conditions begin during the developmental period, may impact day-to-day functioning, and usually last throughout a person’s lifetime.1” 

This specifically applies to ADHD, as this disorder begins very early in childhood –symptoms are often evident during the preschool years, although children with predominantly inattentive symptoms (and girls) may not fully exhibit their symptoms until later. The symptoms almost always persist over time, including throughout schooling and into adulthood, and are associated with substantial real life impairments, such as reduced graduation rates, reduced employment, greater social or relational difficulty, greater financial hardship, and increased risk for involvement with the legal system (e.g., Barkley et al., 2006; Gjervan et al., 2011). Like other developmental disabilities, individuals with ADHD show a pattern of specific differences in their brain development, structure, and function. Although researchers are just beginning to be able to clearly link brain differences in structure or function to observable behavioral differences, it is thought that the specific brain differences in ADHD (Castellanos et al., 2002; Shaw et al., 2007 PNAS) are evident very early in development (e.g., the brain develops differently in children with ADHD) and relate to symptom severity and expression.

References:

http://www.cdc.gov/ncbddd/adhd/data.html

https://www.cdc.gov/ncbddd/adhd/features/adhd-keyfindings-psychiatric-comorbidity-school-children.html

Barkley et al., 2006; Gjervan et al., 2011

Castellanos et al., 2002; Shaw et al., 2007 PNAS

Teacher Question: From a neuroscience perspective, is emotion really important for learning?

Drs. Lisa Jacobson and Mark Mahone: Yes and no. Too much emotion can produce an immediate contextual learning experience, but limit the ability to learn other things. For example, if you are driving and are hit by another car at an intersection, you may remember that event and the emotional reaction you experienced every time you find yourself at that specific place. This is a limbic process that involves a structure called the amygdala and its related circuitry, areas important for emotion processing. However, if we are very emotionally aroused (angry, upset, extremely sad, depressed), the brain does not attend to other information or learn as well when using other memory circuits dedicated to learning facts and remembering information. Thus, children in a classroom who are experiencing such strong emotions are likely to be less available for learning, both because they struggle to attend to the information and because they are less able to learn and retain it.

Too little emotional connection to learning won’t help stimulate student attention, focus, and motivation. But, as stated above, a strong unregulated emotional reaction will also harm learning.  We want students to sit in the middle of that spectrum. By creating a classroom environment that provides multiple ways for students to emotional engage with their learning while reducing threats and distractions, teachers can help foster learning through productive amounts of student emotional response.Additionally, teaching students coping skills and strategies to help manage their emotional reactions, supports their ability to self-regulate into the zone of optional functioning.

For more information about emotion and learning, check out how fear and anxiety can affect young children’s learning and development from the Harvard Center on The Developing Child.

Teacher Question: What impact does stress have on my students’ brains?

Dr. Lisa Jacobson: There are many research studies that have examined this question. Briefly, substantial stress results in increased heart rate, blood pressure, and levels of stress hormones in the brain and body (e.g., cortisol, among others). This results in more blood and neural signals to the periphery of the body (getting your legs ready to run away, for example) and the limbic areas of your brain, and less to the higher-order thinking areas. If you are faced with a tiger, the last thing you want to do is stop and carefully think about each of your options in depth. You want to get out of there!

In the right context and for brief periods of time, this stress reaction is adaptive (it allows us to respond to threats, run away when needed, etc.).

When children have strong support networks, including sensitive caregivers and emotionally supportive teachers and classrooms, they learn to adjust their reactions and return their reactions to a normal level each time they face stressful situations. This is part of normal physiological function. It is important to note, though, that when a student is in the midst of the stress reaction, the body and brain may perceive the situation as one of “fight or flight,” which does not make them available for effective learning and rational thought. But stress can be a chronic event, such as experiencing persistent poverty, living in unsafe conditions, living with emotionally unavailable or abusive caregivers, etc. When a developing child faces extreme levels of stress, especially when they do not experience the buffering support from caregivers or other important people in their lives that can help them learn to adjust and cope, the high level of stress and stress hormones actually changes the way the brain develops, making it less able to regulate behavior and emotions and less efficient at learning.

References:

http://developingchild.harvard.edu/resources/early-exposure-to-toxic-substances-damages-brain-architecture/

http://developingchild.harvard.edu/resources/wp3/

http://onlinelibrary.wiley.com/doi/10.1002/dev.20490/full

https://www.ncbi.nlm.nih.gov/pubmed/26105143

https://www.ncbi.nlm.nih.gov/pubmed/23339224

Teacher Question: Does emotional harm really impact the physical brain?

Dr. Lisa Jacobson: Briefly, yes. We know that both neglect, in terms of experiences of less engaged caregivers (e.g., depressed caregivers), and emotional abuse can change the way the brain develops. Children’s brains do not simply develop “automatically,” they develop in response to experiences. These experiences include connections and responses from the environment, including emotional and/or social interactions with caregivers, teachers, and others. When these interactions are either too limited/absent or too harsh, the brain struggles to develop the ability to self-regulate and manage the body’s responses and actions. This translates to fewer actual connections (synapses) between neurons, resulting in less efficient connections between brain regions and thus, less effective processing and responding. Since children’s brains develop over time, with early organization and development very important for later development, early emotional harm can have a strong effect that continues to unfold over time.

References:

http://developingchild.harvard.edu/science/deep-dives/neglect/

http://developingchild.harvard.edu/resources/persistent-fear-and-anxiety-can-affect-young-childrens-learning-and-development/

We would like to thank all of the teachers who submitted thoughtful questions about learning and the developing brain.  A special thanks to Drs. Jacobson and Mahone of the Neuoropsychology Department at Kennedy Krieger Institute for taking the time to connect with teachers and answer their questions. 

The Linking Research to Classrooms Blog hopes to continue to answer teacher questions pertaining to the cognitive and behavioral sciences as well as school law and policy.  If you have a question you’d like answered by our experts, we encourage you to contact us! 

Have a topic or question you would like to see addressed in a future Linking Research to Classrooms blog?

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