Learning Disorders and Brain Organization (continued)

Given the importance of understanding the components of language, the following areas, which are building blocks of language, should be assessed:

Phonology How does the child hear, sequence and process sounds? Can he blend sounds into words and understand parts of words?' (For example, if we change the /p/ in pan to /f/ it makes the word fan.)

Morphology Can the child make a connection about the general use of the ending of the word? (For example: If we say 'build' and then put 'er' on it, we have 'builder.' adding er as in teacher, painter means the word refers to a person who does that particular job.)
In addition, the following aspects of language should be assessed:

Receptive language refers to the way a child listens to, takes in and understands language and is assessed by giving the child increasingly lengthy and complicated oral directions and requiring a non-verbal, pointing response. The following should be noted:

Does the child understand temporal, directional and quantitative words? (For example, in a younger child, words such as below, next to, above, half, etc.)

Is the child able to follow directions? (For example, if the teacher says take out your book, open it up to page 32, and look at the diagrams on the right side of the page).

Expressive language refers to the way a child uses language to tell what she knows.

Does the child use a wide range of vocabulary?

Does the child respond quickly or talk around the topic? A child who has trouble finding words may have concomitant problems with reading, reading comprehension, or writing.

Is the child fluent in producing language? Does she speak clearly, using full sentences, or hesitantly? Does she formulate a variety of sentence types or rely on simple sentences? Are the ideas in sequence? Is the flow of ideas logical or random?

The pragmatic aspects of language are also important.

How are the child's social skills during conversation? Does she make eye contact, wait for the other person to finish speaking before she speaks, ask a question and wait for the response? Does the child understand rules of politeness and social norms?

Metalinguistic awareness refers to the ability to take someone else's perspective. For example, when a person unfamiliar with the child's school asks him about his class routines and class requirements, can he take into account that the questioner doesn't know the teacher or the school and explain details about class procedures and rules? The ability to take the point of view of another person is important because children are constantly required to make inferences, draw conclusions and understand how someone else might think about a situation. If they're unable to do that in conversation, it is unlikely that they can do it in a more formal academic setting.

Memory Domain

This area of functioning, which is an important component of learnng, relates to how well a child learns new information and retains it over time. The questions that will be answered by an evaluation of these skills include:

Can the child

• learn and then recall both verbal and visual information?
• remember information that is presented only one time versus information that has repeated presentations?
• recall information that is well- organized versus material that is less-structured?

An evaluation tries to approximate some of the many different ways that new information is presented to children in the real world. Although there are many different aspects to memory, five important facets of learning and remembering need to be examined in a neuropsychological assessment.

Registration and short-term storage is a very short process in which a child is alert to information and keeps it in mind for a very short time. This process is related to attention and lasts about 30 seconds; after that point the information can be lost. Thus, if the child becomes distracted or is not paying attention to what she wants to remember, the new information cannot be recalled.

Working memory is a process in which a child may hold on to information for a longer period of time and has that information available to use. This process can last anywhere from 30 seconds to one hour. For example: When someone tells you their name or telephone number, that new information can be available to you for a short while after you have heard it, and it may be available to you for a longer time if it is particularly meaningful. In a classroom, working memory is important because sometimes a child must hold in mind some new information even when other things are happening. For example, a child may need to write down the homework while everyone else is packing up their bags. This child will need to recall what the teacher said so that she can write it down accurately. (Working memory, both verbal and non- verbal, plays a crucial role in executive functioning, discussed in the next section)

Consolidation is the process through which information is taken from working memory and is processed in order to form a more lasting memory. Consolidation can last from the point at which that information is registered and can go on for years. A person may take in information in the form of a picture or in the form of words; consolidation, or integration, means that the mind does something with the information, works on it and puts all the pieces of information together. Consolidation may take longer for some children than for others. For example, a child who sees a picture during the day and goes to sleep, may wake up later and remember more details about the picture than she could the day before. Her mind has been integrating and digesting the information and thinking about it even though she's not consciously aware that this is happening.

Long-term storage is the process that we typically think of when we talk about memory. Long term storage refers to how a child takes in information and stores it away in the file cabinet of his mind so that he can have access to it later. He can retrieve the information and use it in the service of new learning, he can attach new meaning to old information, or he can use that old information in a new way.

Retrieval and recognition is the process involved in getting the information out of the file drawer. It refers to information filed away (vocabulary words, stories, etc.) and to how a child gets that information out and then demonstrates knowledge of the information through drawing or speaking or writing. Retrieval and recognition are different processes: retrieval means that the child accesses learned material on her own and recognition means that an external prompt, like a verbal reminder or an image, jogs the child's memory and facilitates recollection. Typically, if a child does not easily retrieve the information well, she is likely to recognize it if given a clue.

Other Cognitive Functions

Attention

While attention is an important precursor to remembering information, and a process that helps people guide their behavior (a set of skills described below that are called executive functions), it is also a skill worth examining on its own because it is critical to learning and to success at meeting the demands of a child's environment. Attention has the following components:

Attention span is the amount of information a child can hold in mind at any given moment. (it is commonly thought that 7 things or 7 digits, as in a phone number, is the amount of information that can be held in mind)

Selective attention refers to the decision to choose to focus attention on one specific thing rather than another. When children are described as distracted, they often have difficulties in this area. Selective attention can be examined by asking children to perform simple tasks that require minimal focus such as repeating or recalling numbers, letters or sentences, or searching for visual images from an array of many pictures.

Concentration is the ability to maintain attention and work with material on which the child has focused. Concentration may require a child to hold onto information presented to her for a short time while she solves a problem using that material. This ability can be examined by asking the child to do things like mental arithmetic.

Sustained attention is the process of maintaining focused attention on one task for a longer period of time. Sometimes, one must stay focused on a task for longer than one or two minutes, and it is important to know if a child can do this, particularly when things are not stimulating. Sustained attention can be examined when children are asked to focus on a task for a long period of time, typically between 4 to 15 minutes.