Time for another post in 31 Days of Spina Bifida Awareness!
Many of the learning challenges a child with Spina Bifida may face stem from problems with executive function. Executive function is the ability to control and purposefully apply one's own mental skills. Let me explain what that means in specific ways and you will soon see why it can interfere with learning. I’ll label each executive function skill with (EF) below. These are not all the executive functions, just a representative of the main ones.
If a child cannot sustain or redirect their attention (EF) then every little distraction in the room gets them off track. Imagine sitting down to read a chapter about George Washington. The room is quiet in the beginning. Then someone nearby laughs, coughs, or a bird tweets beside an open window. A child with EF issues will turn their attention to the sound like we all would, but they won’t be able to redirect their attention back to their reading. They may look for the source of the sound only to notice a neat picture on the wall, start imagining a story behind the picture, and George Washington has been forgotten. It certainly makes reading to learn new things challenging if you cannot finish even one paragraph before becoming distracted by the environment around you.
When a child has difficulty making quick and appropriate judgment calls(EF) based upon prior knowledge or social cues then situations can easily get out of hand. They cannot easily decide what is an appropriate or inappropriate behavior or emotional response. In an elementary age child it could show in ways like excessive crying over losing a game or hitting a child who took a toy at an age when typical children understand that hitting is socially unacceptable. When presented with a situation they have no experience in navigating the student may not be able to make quick decisions on how to respond, and instead choose to do nothing.
When the ability to plan and organize activities(EF) is impaired many problems arise. Writing a report takes planning. Deciding when you will get your homework done amidst daily activities and responsibilities becomes difficult when you lack planning and organizing skills. Answering essay questions in upper level classes is hard if you cannot organize your thoughts into a logical sequence. The list goes on from there.
What about intelligence?
People with Spina bifida are generally like the rest of the population with a range of normal intelligence. However executive function issues can make even a student with above average intelligence have lower performance on the job or in the classroom. Just because you are brilliant does not mean you can harness that brilliance in a useful, meaningful way! Verbal step-by-step instruction, highlighting important reading content, using graph paper to organize and align math problems and giving background information about the text can be useful tools for student. Adults with Spina Bifida may find a planner or other reminders helpful in getting through daily activities.
So now you begin to see how these overall learning challenges will impact everything. I’ll talk about specific academic subjects in the next few days, as well as the dangers of medicating a child with amphetamines for ADD and ADHD.