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1

2. Welcome
THOMAS BAKER, FOUNDER, HEARTSCOPE LEARNING
2

3. Today’s Goal
To change your child’s life for the long-term
1. View challenges through a wider lens
2. Consider journey from
o Childhood…
o Adolescence…
o College…
o Early adulthood
3. Address complexity and uncertainty barriers
3

4. About Me
 Research Director
 Founder
 Father of 3
 Parenting is always a challenge
4

5. About You
You are not alone:
 Students aged 6-26
 Inattention, listening or following directions
 Teacher and/or home symptoms
 More than one subject,
more than one semester
 “I know my child is bright, but …..”
5

6. We All Share The Same Long-Term Goals
Kids growing to become
 Happy
 Healthy
 Self-confident
 Self-sufficient
6

7. More Than A Test-Score
Is Not EqualTo

8. We Need A Wider Lens 8
Education

9. She’s A
Whole
Child
9
Mind Brain
Health Education

10. A Couple of Stories
 Similar situations
 Very different outcomes
 Both students from committed families
‘Super-Mom’ efforts
 Miscues (in hindsight)
Short-term ‘solutions’ assumed sufficient
Assumption ‘expert’ view considered whole-child
10

11. Wendy G
 “She’s smart, just not as quick as the other kids her age.”
 Both parents health care professionals
Meds from an early age
Accepted ‘chemical imbalance’ explanation
Accepted accommodations (504) as legal mandate
to ‘level the playing field’
11

12. Meds Weren’t Quite Enough
 Evaluated by learning specialists
Advised seek accommodations
(504 Plan)
 Mom fights for ‘rights’
12

13. What Is Wendy Thinking?
 Wendy was doing everything she was asked to do
To the best of her ability
 Each ‘failure’ is rubbed in
 Yet ‘grades’ remained fine
Expectations reduced (504)
Never revealed what she’s actually doing well
13

14. What Is Wendy Thinking?
 School struggles affect
Nuances of social relationships
Tension at home
 Self-esteem impact
Good grades, yet teasing from peers
Self-aware of differences
14

15. What about Wendy’s Mom?
 Mom is determined
 Family identity centered on academic success
 “I wont let my daughter fail”
 Homework night after night
… after night
 How much of a toll is marathon taking from Mom?
15

16. Wendy In College – On Her Own
 Lifetime of meds and accommodations
 Mom’s insistence on ‘rights’
 Evaluated by University learning specialists
Accommodations
Meds
Each ‘specialist’ comments
… then moves on.
16

17. Wendy In College – Results
 Earns 130 credit hours
Yet,
 3x failure at elementary
ed practicum
 Vicious critique from dept
chair
17

18.  “Wastes a lot of instructional time
 “Not always prepared
 “Concerns about Wendy taking over the full class
 “Not aware of surroundings and location of things
 “Not connecting the "why" you are doing things
18

19.  “Spent a lot of time with her and Wendy still is not
prepared or forgets the elements of the discussion
 “Little initiative
 “Must be hand fed everything and has difficulty thinking
on her own
 “No original ideas
19

20.  “Does not do much with the resources provided
 “False sense of success
20

21. Everyone Working At Maximum Effort
 Followed all recommendations
 Wendy maxed out
 Mom maxed out
 Yet final judgment from ‘system’
= Extinguish dream of teaching career
21

22. Case 2 – ‘Abby’
 Teacher comments began in second and third
grade
‘day dreams’
‘not organized’
22

23. Continued to Fourth Grade
Sharper teachers’ critique
 … “not paying attention’
 … ‘not able to focus’
 … ‘falling behind’
 In-class ‘friend’ appointed to remind Abby to pay
attention
 Yet no red flags on report card
23

24. Start of 5th Grade
Without parents’ knowledge
 Buzzer wrapped in sash
Timer every 3 minutes
Then,
 Abby frazzled
 Dad goes ballistic
24

25. Mom Takes Charge
 Uncomfortable with meds as only option
 Personal history
College athlete
Nuances of doctors’ motives
 Before medication commitment
Desires a deeper understanding
Pursues less-invasive options first
25

26. Abby’s Cognitive Skill Profile 26
15% 25% 35% 45% 55% 65% 75% 85% 95%
94%
0%
0%
0%
0%
0%
0%
96%
0%
79%
87%
75%
79%
84%
0%
0%
0%
0%
0%
0%
0%
0%
25%
0%
Predicted Task Score

27. Cognitive Skills Defined
 Smart =
Knowledge + Reasoning
27

28. Knowledge vs Cognitive
Cognitive Skills
 Long-Term Memory
 Working Memory
 Attention
 Decision Speed
 Auditory Processing
 Visual Processing
 Logical Reasoning
 Executive Function
Knowledge
 Classroom content
 Fractions
 Phonics
 1492
 Sports ‘playbook’
 Team formation and plays
 Competitor tendencies
 Measured by report card
28

29. Processes all stimuli we encounter
Working Memory is an essential
function in everyday life

30. Processes all stimuli we encounter
Delegates it to the different parts of
our brain that can take action
Working Memory is an essential
function in everyday life

31. Processes all stimuli we encounter
Delegates it to the different parts of our brain
that can take action
Allows us to block out unnecessary
information
Working Memory is an essential
function in everyday life

32. Processes all stimuli we encounter
Delegates it to the different parts of our brain
that can take action
Allows us to block out unnecessary information
It keeps us updated on what’s
happening
Working Memory is an essential
function in everyday life

33. Processes all stimuli we encounter
Delegates it to the different parts of our brain
that can take action
Allows us to block out unnecessary information
It keeps us updated on what’s happening –
And keeps us focused on what
matters
Working Memory is an essential
function in everyday life

34. Key For Academic Performance
10-15% of all students have
working memory deficits

35. 10-15% of all students have
working memory deficits
Students with working memory
deficits perform below average
in all areas of learning
Key For Academic Performance

36. 10-15% of all students have working
memory deficits
Students with working memory deficits
perform below average in all areas of
learning
Working Memory is crucial for
• reading comprehension,
• math,
• complex problem solving and
• test taking
Key For Academic Performance

37. Abby’s Brain Training
 4 workouts per week
 2 in-clinic … 2 at-home
 Targets
 Working memory
 Sustained attention
 Response to error feedback
 4 months - continuously monitoring
 Complexity
 Intensity
37

38. Sample BrainTraining (Mom-led) 38

39. Abby’s Results 39
15% 25% 35% 45% 55% 65% 75% 85% 95%
96%
0%
94%
0%
90%
94%
0%
94%
0%
84%
0%
87%
0%
0%
75%
0%
Predicted Task Score

40. Now High School
 Passion for theater
 Comfortable on center stage
 Defines herself by her strengths
40

41. Abby vs Wendy
 Both
supported by
Super-Mom
efforts
41
Abby Wendy
Strength-based family
philosophy
vs Brain-needs-cure
Minimize accommodations vs Maximize available
‘rights’
Authentic growth vs Pre-determined success
Cautious of expert
‘certainty’
vs Treating symptoms vs
causes
Near-ultimatum from
teachers
vs Strident parent

42. Hindsight: Neither Scenario Ideal
 Abby’s parents had earlier
warnings
 Took extreme teacher
miscue to spark action
 Wendy’s parents had insider
access to research concerns
 Especially dangers of
medication cocktails
42
 Both families
 Both took report cards at
face value
 Both relied on Super-Mom
strategy month after month
Even when clearly
ineffective

43. The Value of Case Studies
 Learning from other families
“Do not judge people by their
excellence; but by the distance
they have traveled
Henry Ward Beecher
43

44. The Value of Case Studies
“Be quick to listen,
slow to speak
and
slow to become angry... ”
James 1:19
44

45. The Value of Case Studies
 Learning from other families
I’d rather regret the things
I’ve done
than regret the things
I haven’t done.
Lucille Ball
45

46. New Cases 46
Challenge Intervention Result
Child's difficulty focusing
on a math assignment
Strattera, he won't take it.
Music, just slows him
down.
Avoidance of math,
resulting in bad grades.
Low motivation at school
and organizational skills
(6th)
daily routines and
structures, monetary
reward system for
completing and turning
in his work
It worked at first, but not
so well now. He lacks self-
confidence and
motivation.
Not being able to
complete tasks and class
work.
Sensory breaks, standing
instead of sitting, quiet
area to himself away
from other students,
rewards
Works for a week and
then back to not
completing work and
constant reminders to
stay on task.

47. Short Term Research
 “Gold Standard”
NIMH Research
1999-2001
 4 treatment
methods
 Controls added at
24 mos
 matched age,
gender, IQ, SES
 (Note inverse CIS
severity scale)
47

48. 2005 Oregon Public Health
 In a 2005 review of 2,287 studies at Oregon Health and Science
University:
 “no good quality evidence on the use of drugs to affect
outcomes relating to
 global academic performance,
 consequences of risky behaviors,
 social achievements, etc.”
Source: McDonagh, “Drug class review on pharmacologic
treatment for ADHD,” 2006.
http://www.ohsu.edu/drugeffectiveness
48

49. Long Term Research
 NIMH Research
1999-2008
 (No longer called
‘Gold Standard’
by industry
consultants)
49
Molina et al. (2009). The MTA at 8 years:
prospective follow-up of children
treated for combined-type ADHD in a
multisite study. Journal of the American
Academy of Child & Adolescent
Psychiatry, 48(5), 484-500.

50. 1,379 Canadian Youth
 14 studies that lasted a minimum of three months,
Canadian investigators concluded that
there is “little evidence for
improved academic performance”
with stimulants.
Source: R. Sachar, “Attention-deficit hyperactivity disorder,” Canadian Journal of
Psychiatry 47(2002):337-348.
50

51. UC Berkeley (2010) – 10 year
Outcomes for Females
Poor
Outcomes
12%
Positive
Outcome
88%
Non- ADHD Girls’ 10 Year
Results
Poor
Outcomes
84%
10 year
Positive
Outcome
16%
ADHD Girls’ 10 Year Results

52. 2012 European Research
 Follow-up 4.5 to 7.5 years after treatment.
 Significant symptom decline in hyperactivity/impulsivity, oppositional
and conduct disorder.
 Inattention symptoms increased but not to pre-test levels.
 Vs matched controls,
 Adolescents diagnosed with ADHD fared significantly worse on all
outcomes.
van der Oord , (2012) The adolescent outcome of children with attention deficit
hyperactivity disorder treated with methylphenidate or methylphenidate combined
with multimodal behaviour therapy: results of a naturalistic follow-up study. Clin Psychol
Psychother. 19(3):270
52

53. NIMH Conclusion
 “Results showed that, although symptoms and
impairment remained appreciably improved over
baseline levels, normalization was generally not
achieved.
 “Children still taking medication by 6 and 8 years fared
no better than their non-medicated counterparts
 despite a 41% increase in the average total daily dose,
Cont..
53

54. … NIMH Conclusion
 “We found poorer performance for the MTA group
versus [controls]
 for 91% of the variables.
 “Decisions about starting, continuing, and stopping
medication
may have to be made on
an individualized basis,
 avoiding untested assumptions
54

55. Research on Accommodations
 Required by federal law
 Routinely combined with med therapy
55

56. Research on Accommodations 56
1. Request for all accommodations to be signed by
teachers, and given a copy for home / doctor.
2. School books online or to bring home
3. Allow marking in textbook to outline important info
4. Signing of agenda daily.
5. Front of the class seating.
6. Written instructions - small step directions.
7. Does he show signs of throwing tantrums or being
frustrated in class?
8. May need to get up and move around.
9. Refocusing when needed.
10. Assistance with organization.
11. Allow extra time for work completion and processing
information.
12. May have stress ball while in class.
13. Give him option to present to small group rather than
whole group when possible.
14. Give parents notice in advance about projects when
he needs to present.
15. Teachers notes given when available. Help with
notes by peer student at other times
16. Teachers provide list of discussion questions before
reading heavy reading material when available.
17. When reading chapter books teachers to provide
audio (to be sent home) for comprehension. When
reading chapter books give chapter summaries or notes
for comprehension.
18. Provide list of vocabulary words for further
understanding. – definitions (for literal thinkers). Highlight
new vocabulary words at the beginning of a lesson.
19. Small group testing needed during state testing.
Have different subjects of tests separated or taped
together to prevent looking back at previous days test
or forward to additional tests. Have directions repeated
back to teacher to ensure that directions are
understood.
20. Teacher’s to give make up work after 2 days
absence instead of 3 days.
21. Dress out for PE in bathrooms located outside of gym.
22. The more information/assignments/material that can
be put online, the better. That helped on a few
occasions with getting homework done.
23. Maximum time of 2 hours per night for homework. If
homework exceeds 2 hours, email Academic Advisor
and teacher of the homework that will not be
completed
24. Parents and teachers to encourage class
participation.
25. Provide student with a “secret” signal to go to a
supervised designated area to cool off when needed.
26. Pair student with another student to check classwork.
27. Shorten written math assignments by using even or
odd items.
28. Use cooperative learning situations for reading.
29. List materials needed daily in class.
30. Employ a consistent format for classroom papers.
31. Read directions for tests aloud for better
understanding.
32. Maintain home – school communication via phone.
33. Sent notes home from teacher with student.
34. Shortened spelling list.
35. Modified assessments (tests read aloud).
36. Assistance with writing process.
37. Adult assistance with checking out library books at
student’s reading level to encourage reading and
promote self-confidence.
38. Assistance with putting items in backpack ensuring
all homework / paperwork gets home.
39. Provide student with advance notice when there
changes in classroom routines and procedures.
40. Allow student to use headphones to block noise.
41. Student may use work areas other than desk in the
event that numerous activities in the classroom are
overwhelming to him.
42. Counselor will provide social skills group support.
43. Have student repeat instructions.
44. Have a peer tutor program.
45. Use study guides.
46. Seat student near positive role model.
47. Provide written outline of lesson.
48. Close supervision during transition times.
49. Set up a behavior contract.
50. Use a behavior management system.
51. Use visual aids during lessons.
52. Post class expectations in visible location.
53. Compliment positive behavior and work.
54. Look for opportunities for student to take a leadership
role in class

57. Research on Accommodations
“Multiple accommodations are being recommended
without any evidence of effectiveness.
“This approach
… costs students in terms of their potential long-term outcomes,
… costs teachers' effort and time providing services unlikely to work,
… and costs districts and communities the resources used to provide
these strategies
Harrison, J. R., Bunford, N., Evans, S. W., & Owens, J. S. (2013). Educational
Accommodations for Students With Behavioral Challenges A Systematic Review of the
Literature. Review of Educational Research, 83(4), 551-597.
57

58. Lure Of False Success
 Both meds and accommodations
 Shallow and Fleeting
 Short-term supports
 Often reduce short-term symptoms
 Visible symptoms appear to change
Yet underlying problems remain
58

59. New Cases 59
Challenge Intervention Result
Child's difficulty focusing
on a math assignment
Strattera, he won't take it.
Music, just slows him
down.
Avoidance of math,
resulting in bad grades.
Low motivation at school
and organizational skills
(6th)
daily routines and
structures, monetary
reward system for
completing and turning
in his work
It worked at first, but not
so well now. He lacks self-
confidence and
motivation.
Not being able to
complete tasks and class
work.
Sensory breaks, standing
instead of sitting, quiet
area to himself away
from other students,
rewards
Works for a week and
then back to not
completing work and
constant reminders to
stay on task.

60. The Complexity Challenge
H. L. Mencken
For every complex problem
there is an answer
that is
clear,
simple …
60

61. … and wrong.
New York Evening Mail (16 November 1917);
61

62. New Evidence Often Dismissed
WSJ 7/8/13

63. Incredible Science
But highly complex
 Kids add 1200’ of connections
 On average per day!
 From birth until age 22-27
 Growth spurts
 Toddler years
 Early adolescence
 (Decline sets in late-20s….)

64. Growing Brains Connect in
Layers and Webs
 100 billion neurons
 Constant age 0-99
 Kids’ brains triple,
then double in size
Growth is in connections
(synapse)
 Brains are more unique
than fingerprints

65. New This Year Feb 11th, 2014

66. Most Students Know More About Their
Phones
 Than how to optimize their brains’ efficiency

67. Phones Are Easy to Use and
Easy to Upgrade
67
“Well, hello…. future!”

68. Brains Are Complex
… AND Require A Lifetime Contract
68

69. Mark Twain
“The secret of
getting ahead
is…
getting started.
69

70. “The secret of getting started …
is breaking your complex,
overwhelming tasks
into
small, manageable tasks
and then starting on that first one.
Mark Twain
70

71. Complexity Strategy
Phase I
Don’t Let A Burden Decay Into A Crisis
Phase II
Widen Your Lens
Phase III
Invest In Growth
Subtle yet profound
71

72. Whole
Child
Approach
72
Mind Brain
Health Education

73. Phase I
DON’T LET A BURDEN DECAY INTO A CRISIS
73

74. Don’t Let A Burden Decay Into A Crisis
1. Defuse anger – preserve relationships
2. Re-engage, even if the system is flawed
3. Change the story line
From achievement to growth
From winning to improving
From outcome to process
4. Distance yourself from barriers to 1,2 and 3
 Invite, don’t demand
5. If meds/504: proactive on benefit vs risk
74

75. Phase II
WIDEN YOUR LENS
75

76. Widen Your Lens
6. Repeat steps 1,2 and especially 3 – again and again
7. Start a Growth Outline
 Our format or yours
8. Recruit a Growth Community
 You can’t do this alone
 Remember liberating
9. Add a layer to your Growth Outline
 Once a month
 Update / expound / remap
10. Self-permission
76

77. Phase III
INVEST IN GROWTH
77

78. Invest in Growth
11. Investigate cause vs symptom
Our services
11. Growth Planning (starts at $19.95 per month)
12. Cognitive testing
13. Brain training
 Home or clinic
14. Online working memory training
15. SCOPES: evidence-based Study Skills
78

79. Growth Plan Benefits
 Learning obstacles rarely just ‘1 thing’
Mind-Brain-Health-Education factors all interact
Factors can work together to spark growth
… or work against to sabotage growth
Mind, Brain and Health factors
always greater long term impact
yet may take a back seat to ‘E’
79

80. Growth Planning Versus Medication
 Symptom-driven
 Only treats behaviors
 Only effective in short term
 Physical side-effects
 Psychological side-effects
 Delayed side-effects
 Emphasis on chronic weakness
80

81. Growth Planning Versus 504 Option
 504 only targets test scores
 Only effective if effective defined as short-term test scores
 Future performance side-effects
 Future psychological side-effects
 Implied chronic weakness
81

82. Versus Managing Homework with
Brute Force
 Only targets homework completion
 Moderately effective in short term
 Drains physical and emotional energy
 Drains parent, student and often family
 Spills over into sports, music, church, social and free play
time
82

83. Long Term Growth Planning
 Our online tools – help you develop a long term plan that
implements all short term bridges in most effective ways
possible
 Expert support via email
 $19.95 per month
 No contracts
83

84. Other Expert Services
 Upgrade to 1-1 Growth Planning
 Brain training
 parent as coach
 computer as coach
 student/parent as co-coaches
 Study Skills Coaching
 ages 13-26
 1-1 Online (Skype)
 Email Mary Jane or Tom for details
84

85. Mind
Health
Brain
Education
Mind
‘Well-Being’ Is More Important Than
 Test-scores
 Local or national
politics
85

86. 86

87. We’d Love To Join Your Team
EMAIL TOM@KCBRAIN.ORG
87

88. Thank You
88