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1. Welcome Back! (207) 878-1777 e-mail: infor@kaufmanpsychological.org Web: kaufmanpsychological.org

2. From Brain to Pen toPaper . . . The Neuropsychology of Writing & Best Practice InstructionalRecommendations Day 2

3. To become competent writers, students must: Become proficient in spelling, punctuation, and grammar; They must learn to write in various styles and formats (depending on the particular situation/audience); They must build strong vocabularies and deep reservoirs of background knowledge; They must learn to cope with writer’s block and develop the stamina needed to get through long and difficult assignments (writers’ resiliency); They must learn strategies (such as preparing outlines, soliciting feedback, and writing/revising multiple drafts that help them to organize their writing projects and complete them successfully.

4. The Five Stages of the Writing Process • Prewriting (brainstorming, planning, sequencing/organizing, etc.) • Drafting (writing the initial draft) • Revising (content-oriented revision/correction) • Editing (proofreading and mechanical revision/correction) • Publishing (preparation of the final draft in its final form)

5. Writing Ability & the Neurodevelopmental Functions: Spatial-Motor Comprehending the spatial relationships involved in letter/word production; coordinating small muscles of the fingers needed to form letters Attention Maintaining concentration & self-monitor work quality Memory Fluid recall of letters, rules, and ideas; simultaneous holding of all of this in working memory WRITING Executive Functioning Generating ideas & taking a stepwise approach to planning, organizing, and revising work Language Production Using words and constructing sentences correctly

6. Attention Controls Neuromotor Functions Executive Skills Memory (LTM) Language

7. Breakdowns in one or more of these processes can lead to . . Dysgraphia: A disorder of written expression – there are ‘language-based’ and ‘non-language-based’ types of dysgraphia (4 – 17% of the population, Hooper et al., 1994) A ‘shadow syndrome’ of a writing disorder: ‘Sub-clinical‘ elements of a writing disorder that make the writing process arduous/tedious (??% of the population – certainly LOTS of kids . .)

8. DA’ BRAIN: Its two hemispheres and four lobes

9. Neuropsychology of Writing II Language, Visual-Motor Functions, and Writing

10. Language The Voice of the Writing Process

11. Language-based writing problems can stem from . . . • Deficits at the word formation level (difficulties with processing phonemes, graphemes, morphemes) • Deficits at the sentence formation level (difficulties with word/phrase retrieval, syntax, or sequential elaboration) • Deficits at the paragraph/essay formation level (difficulties comprehending/recalling the manner in which sentences combine into paragraphs and beyond)

12. Left Hemisphere Language Centers

13. Language-Based Dysgraphias “It is a damn poor mind that can only think of one way to spell a word .” -- Andrew Jackson

14. Essential (and often unacknowledged) literacy acquisition facts • Learning to speak and understand others’ oral language is a natural process (basically, we’re born to do it . .) • Learning to read and write is NOTa natural process! Why???

15. Here’s why . . Literacy requires the literal REWIRING of brain circuits. That is, in order to read (and write), we must modify brain regions developed over the course of millions of years of evolution to serve oral language and object recognition so that they can function in the service of literacy.

16. Let’s look again at the brain (source: Jacob L. Driesen, Ph.D.) Receptive Language Letter-Sound Association Expressive Language Letter/Word ID Object Naming

17. Bottom line Some brains have a far harder time than most accomplishing the rewiring. We call children with such brains, ‘dyslexic.’

18. The Biggest Distinction . . Developmental Dyslexia Vs. Acquired Dyslexia AKA: Alexia or word blindness

19. Biggest Distinction within Developmental Dyslexia Auditory/Phonological Visual/Orthographic Vs.

20. Four Types of Developmental Reading Disorders (Feifer, 2011) • DysphoneticDyslexia (difficulties processing the component sounds of speech and with linking letters to sounds – inhibits the ‘sounding out’ of words) • Orthographic Dyslexia(difficulties recalling/recognizing the visual features of words; this is a particular problem with irregular words like ‘enough’ and ‘yacht’ and ‘the’) • MixedDyslexia (Impaired phonological and orthographic processing) • Comprehension Deficits (no obvious word level/mechanical reading deficits, but comprehension is impaired)

21. Subtypes of Language-Based Dysgraphias • Phonological Dysgraphia(spelling deficits associated with phonological processing deficits - students with this problem struggle with spelling by sound) • Surface (or “Orthographic”) Dysgraphia(marked difficulty with storing and/or retrieving the idiosyncratic appearance of words) • Mixed Dysgraphia(manifests itself in a combination of phonological spelling errors and orthographic errors depicting faulty sequential arrangement of letters) • Semantic/Syntactic Dysgraphia(the inability to master the rules for grammar that dictate precisely how words/phrases can be combined – writing reflects a breakdown of linguistic rules)

22. Phonological Dyslexia Difficulties processing the component sounds of speech and with linking letters to sounds – inhibits the ‘sounding out’ of words) AKA: Dysphonetic Dyslexia

23. Phonological vs. Phonemic Awareness Phonological Awareness: Syllables, Onsets & Rimes Phonemic Awareness: Grasping language at the phonemic level.

24. Phonics (AKA: The Alphabetic Principle)

25. Key neuroanatomical structures in the decoding/encoding process • We’re talking primarily about the left brain (men more than women) • Broca’s Area (brain center located in the inferior frontal gyrus associated primarily with expressive language) • Wernicke’s Area (brain center located in the parieto-temporal region associated with word analysis and receptive language) • Occipito-temporal convergence (brain center associated with the storage and recognition/recall of word forms – how they look, sound, and what they mean)

26. Broca’s Area (expressive language center – where pronunciation occurs) Superior temporal cortex (where letters and sounds of language are linked) Exec. control Pronun-ciation Letter/sound correspondence Letter/word ID Vocabulary & meaning Pre-frontal cortex (primary center of executive control and meta-cognition) Medial temporal cortex (a key ‘meaning’ center of auditory processing) Ventral occipito-temporal region (the brain’s ‘letterbox’)

27. Brain Systems for Reading(adapted from Overcoming Dyslexia, S. Shaywitz, 2003

28. Orthographic Knowledge/Competency Essential for ‘sight word’ recognition and, of course, spelling.

29. Orthographic Dyslexia AKA: Surface or ‘dyseidetic’ dyslexia Characteristics: Good grasp of phonology and phonics Difficulty recalling or grasping the visual elements and visual gestalt of words We’re talking here about a visual memory/visual integration deficit

30. Why Orthographic Dyslexia is so common in English speaking countries: English has DEEP (complex) orthography!! That is, there is not a 1:1 correspondence between all or our phonemes and all of our graphemes.

31. Subtypes of Language-Based Dysgraphias • Phonological Dysgraphia (spelling deficits associated with phonological processing deficits - students with this problem struggle with spelling by sound) • Kids with phonological dysgraphia struggle, in a nutshell, with phonological processing, and display error patterns reflecting limited comprehension of sound/symbol relationships.

32. Another language-based dysgraphia 2. Surface (or “Orthographic”) Dysgraphia (marked difficulty with storing and/or retrieving the idiosyncratic appearance of words) In other words, these kids have little difficulty spelling by sound, but struggle with phonetically irregular words containing alternative spelling patterns. “Yacht” spelled as “yat” and “enough” spelled as “enuff”

33. Test of Orthographic Competence Assesses aspects of the English writing system that are integral to proficient reading and writing. These aspects include letters, spelling, punctuation, abbreviations, and special symbols.

35. Expressive Language Difficulties & Writing • Conversational language is not the same as academic (writing) language • Word retrieval difficulties sink both oral expression and written expression • Limited elaboration ability is often a prime suspect in written language that is often ‘Joe Friday’ in orientation.

36. A failure to communicate . . . • Word retrieval difficulties sound like, “Um,” “ah,” pauses, etc (lots of “stall” words), as well as “circumlocution” (substituting a definition for a word) • Kids with elaboration difficulties sound like Joe Friday (just the facts). Very little illustrative language and connective phrases. Often use summary words such as “stuff” and “things” – writing tends to be sparse.

37. Kids with elaboration difficulties: Short-answer specialists Kaufman: Do you like to write? Kid: Nope. Kaufman: Why not? What do you dislike about it? Kid: I dunno . . . Boring Kaufman: Do you find all types of writing boring? Even story writing? Kid: I guess. Kaufman: Are there other things you dislike about writing? Kid: It’s hard. Kaufman: What’s hard about it? Kid: I dunno . . . Saying stuff.

38. Activity 3 AWorking Memory Brain Teaser! I am a small parasite. Add one letter and I am a thin piece of wood. Change one letter and I am a vertical heap. Change another letter and I am a roughly built hut. Change one final letter and I am a large fish. What was I and what did I become?

39. Activity 5 Elaboration difficulties are common among children (particularly boys). Take a moment to consider ways that you might encourage ‘non-elaborative’ kids to become at least somewhat more verbose and productive on paper. Share your thoughts with someone seated by you.

40. And then syntax problems there are . . . (huh?) • Word order is often confused • Words are placed next to each other in ways that aren’t appropriate in English (“I car washed with Dad”). • Sentences are generally poorly formed, and are hard to comprehend (sometimes even by the writer . . .)

41. When syntax goes bad:An actual newspaper quote . . • No one was injured in the blast, which was attributed to a buildup of gas by one town official.

42. Key question to ask when working a kid whose writing syntax (word order on paper) is problematic . . . Is his/her spoken syntax similarly jumbled or is it much better?

43. Matches his oral syntax: The written syntax problems are likely related to an expressive language deficit. Does not match his oral syntax: The written syntax problems are likely related to an attention or working memory deficit. If a child’s written syntax . . .

44. Wrestling with pen and paper Neuromotor Functions and the Writing Process

45. Key Point to Remember . . . Fine-Motor Functioning = Grapho-Motor Functioning Many kids with abominable handwriting draw well and have no difficulties manipulating small objects.

46. Handwriting Development: How it’s supposed to work • Luria (1973): Said that kids learn to make letters by memorizing the parts of each letter through an interaction between the muscles, eyes, and kinesthetic feedback. • With continued practice, the letter formation process becomes more automatic – a single movement (or a “kinesthetic melody”). • Kids get faster/more accurate as they get older, but not a regular intervals. • Most kids have a close approximation of their adult handwriting by Grade 6

47. Three common types of grapho-motor dysfunction(Mel Levine, Educational Care, pp. 212-213) • Motor memory dysfunctions • Grapho-motor production deficits • Motor Feedback Problems

48. Motor Memory Dysfunction • Defined: Difficulty integrating memory input with grapho-motor output (Levine: These kids lack the procedural memory needed to know how to inscribe letters dependably on demand). • Often unable to recall (fluidly enough!) the sequences of muscle movements needed to form specific letters (Can’t recall the “kinetic melodies” of letters). • The writing of these kids tends to be slow, labored, with letter sizes varying widely and spacing being inconsistent. • Kids with this issue prefer manuscript (printing) to cursive!!

49. Grapho-Motor Production Deficits • Defined: Difficulty transmitting/executing specific muscle assignments to the finger while writing • Levine: These kids show poor grapho-motor coordination(they lack grapho-motor fluidity), use heavy pressure, and write slowly • There’s a poor balance often between the muscles balancing the pencil and those moving it • These kids generally use ‘thumb over’ pencil grips and/or elongated fingers • These kids often show a co-morbid speech/language (articulation) impairments; Levine: They endure the same kind of trouble assigning mouth movements in speech as they do assignment finger movements in writing.

50. Motor Feedback Problems • Defined: Difficulties getting (or comprehending) feedback from the fingers with regard to the pencil’s exact location as letters are being formed • Also known as “finger agnosia” • Levine: Affected students may compensate by keeping their eyes very close to the page in attempt to visual monitor the pencil point, since their fingers are failing to report back. • Kids with this condition usually rely on their larger muscles (wrist and arm) to write, as they have more of a sense as to what these muscles are up to