by Bob Doman

The key to understanding and improving global function in children and adults with Down syndrome is determining and developing their cognitive function.

Whether we are looking at a two-year-old or an adult with Down syndrome, their level of function, their ability to learn, think, and communicate is a reflection of their cognitive level. 

Cognition is the mental function that permits us to process information, to acquire knowledge, to understand, think, and communicate. Cognition is not reading, math, or specific knowledge per se; it involves the neurodevelopmental pieces that comprise auditory and visual short-term memory, working memory, and eventually executive function. 

Cognition, or intelligence, is partially a reflection of what we were born with, but primarily it is something that develops. Anything that develops can be developed, impacted, improved. Unfortunately addressing cognition, how we process and manipulate what we see and hear, is missing almost universally from all education. For children with developmental issues, this leads to inappropriate, untargeted* input, low and unrealistic expectations, and poor outcomes.

Case in point

I recently received a report from a school outlining their curriculum for a twelve-year-old child with Down syndrome. Her curriculum includes the following:

• Science – forces and magnets
• Geography – comparing Australia, Greenland, and Africa, including significant historical events
• History – Stone age to Iron age
• Reading – creating and writing sentences about what they did over the weekend
• Math – shapes, positions, directions, statistics
• Computing – the pros and cons for social media advertising
• and a project to research, create, and launch a campaign to encourage others to be healthy.

Sounds wonderful—what a great opportunity for this child. This curriculum would be appropriate for perhaps a typical or gifted child, and even a few children with Down syndrome who have been given the opportunity to develop typical or better processing skills and who had a commensurate educational foundation. Unfortunately, the child in this classroom is functioning at the cognitive development level of a two-going-on-three-year-old. She is just putting two to three words together, learning to feed and dress herself, and developing the ability to process two to three step directions. She’s not twelve, she is two going on three. This is perhaps an extreme example, but it’s real! However, it would not be at all unusual for a twelve-year-old, but functional two to three, to be taught phonics and printing and other inappropriate things, based on their functional level. Would you think it appropriate to teach a typical two-year-old phonics and printing? How successful would you be, and how much of a waste of their time would it be? And what about all the things that would have been appropriate for them? The point is that when targeting the needs of children, it is their level of function, their cognitive level, their ability to process information and their complexity of thought that should determine what is appropriate and targeted.

Children develop when we provide them with what is targeted and appropriate for them. This targeted input is what develops their global function, helps build cognition, and leads to good outcomes. Where they are is more a reflection of their processing level than their chronological age. You don’t try to teach algebra to a child who can’t add.

Looking at a child with Down syndrome primarily through the lens of their chronological age does them a great disservice and results in inappropriate, ineffective education and therapies, and poor outcomes. Such historic failures have resulted in a poor perception of potential. The foundation of all development is neuroplasticity, and the first fundamental rule of neuroplasticity is to provide the child with input that is targeted to them.

We have been fortunate to have worked with many thousands of children and adults with Down syndrome, and in the case of many individuals, we have worked with them for decades. We have seen what is possible if we, along with the family, work with an understanding of the whole child and work diligently to build cognition. Without exception, those who develop processing abilities in the “normal” range can become the adults who have good jobs, drive, have good social relationships, and enjoy good lives. After these years and thousands of individuals with Down syndrome, we have never seen one reach these high global functional levels without having developed the commensurate level of cognition. 

Optimally we start working on processing and cognition virtually from birth; and the sooner we start the process, the more we begin funneling in the pieces that help produce global knowledge and functional intelligence. Years lost are gone. Can we start working on this function later? Absolutely. Addressing the foundational pieces of cognition, short-term memory, working memory, and executive function even starting with adults can produce dramatic change; but time lost is time lost in teaching that brain how to learn and think and filling that brain with the knowledge and experience that builds full lives.

Developmental and educational priority number one is developing the ability to learn and think—cognition/processing power. 

To learn more about processing power, watch our video below

Reprinted by permission of The NACD Foundation, Volume 37 No. 2 , 2024 ©NACD

The post Down Syndrome & Cognition appeared first on NACD International | The National Association for Child Development.

“All great change in America starts at the dinner table.” 

— Ronald Reagan

If your children are infants, toddlers, of school age, or adults, or somewhere in between, family meals can be incredibly important. Whether our motivation is teaching a skill (such as eating or participating in meal preparation) or fostering family dynamics (such as communicating about the day, participating in discussions, building independent thinking), family meals may not just be the most important meals of the day, but the most important times of the day, or even their lives.

We are all aware that times have changed and that all the changes have not been for the better. Some of the more significant changes involve family, perception of family, and perhaps even the definition of family. There are many family traditions that are being lost in our fast-paced consumption-driven society. One very important piece that has been lost in many families is simply family meals. As a society and for the sake of our children, we need to revisit what has been the norm virtually throughout human history and has been lost to a great extent over just the last 50 years.

In many homes today, family meals are becoming more and more something that is part of family history or perhaps something reserved for special Sundays and holidays. For most families, breakfast is something you grab on the way out the door or something that gets shoved into children before they start the day. Today, rather than someone taking time to prepare a healthy breakfast meal for the family, most people grab the home equivalent of fast food. How about lunch? Lunch is rarely something that is done as a family. Everyone is off doing school, work, or whatever. In most families the best shot at getting the family together for a real meal is dinner. Let’s look at some of the problems being caused by the loss of family meals, as well as the benefits that we can derive from this old foundational family institution.

Over the past number of decades, I have observed an increase in several issues negatively affecting virtually all children that can be associated with missing family meals.

Just last night I had a family dinner with my son, Laird, his lovely wife Sadie, and my grandchildren, 5-year-old Arielle and just-turned-two Lachlan. Lachlan sat across the table and as he typically does, he kept an eye on me throughout the meal. The degree to which he observed me became obvious when he carefully nudged a piece of carrot to the edge of his plate, then onto the table with his fork. I had not had a chance to comment before he looked up at me and did an amazing job of imitating my head tilt and disapproving expression, which resulted in my smiling at him in spite of the fact that I knew I shouldn’t do it. (Lachlan fits “too cute for his own good.”) This was followed by my tilting my head and making different expressions that Lachlan mimicked beautifully. This went on for about 90 seconds, following which he picked the piece of carrot up and put it back on his plate. The degree to which children observe us and learn from us when we are in close proximity is greatly underestimated. Rarely throughout a typical day do these opportunities present themselves as they do during a family meal.

Although at two Lachlan has yet to learn that experimentation has its limits at the dinner table, there are many things he has learned from eating meals with his family and observing, things that many children who are fed by themselves or eat by themselves often do not learn until much later, and some of which are sadly never learned.

Optimally a family meal entails having the whole family together—Mom, Dad and all the kids. The only thing that generally beats this is when the extended family is included, as this grandfather can attest. Although we realistically can’t always, or even often, create the ideal, the closer we can come to it, the better. A parent, or a parent and a sibling, having a meal with a child is preferable to the child just eating alone or being fed, while the parent or caregiver simply attends to getting the food into the child. Part of this equation is delineating between eating as in consuming food vs. sharing a meal together, a learning experience. Eating is a process by which you get food from your hand, a utensil, or some container to your stomach, generally as quickly and as unceremoniously as possible. Having a meal together, sharing a meal, is often the most educational part of the day for children and parents alike. I grew up in the ’50s outside of Philadelphia. In the ’50s most mothers’ job was the family—period. Moms had time to cook and to sit down and share good meals with their family. Sunday dinners and extended family dinners often meant coats and ties for the guys and dresses for the girls. These meals were treated as significant events, even if they were frequent. I recall as a child learning early on that at a meal you talked. There was no TV, you didn’t read at the table, and an effort was made to include everyone in some form or level of discussion. Everyone participated or received some attention. I was in a restaurant recently and was shocked by a large family that was seated near us. You might not define eating at home as “dining,” although one would hope to approximate that as often as possible; but if a family goes to a restaurant and makes that financial and time investment, you might hope that the experience would approximate “dining.” On this particular evening while I was dining with my family, I noticed the large family next to us that consisted of both parents and six children who ranged from about six to sixteen. All sat the entire time staring at their phones. It would have been bad enough if they had answered calls, but not a word was spoken. Throughout the entire time they were in the restaurant, the only words spoken were to the waitress who took their orders. This was not a family sharing a meal together; it was an opportunity missed and lost, and sadly a statement about this family and many others.

Let’s look at our children of various ages and families at different stages and explore the significance of the family meal.

• Part 1 Infants and Toddlers
• Part 2 Three to Five Years
• Part 3 Five to Eighteen +

Part 1

Infants and Toddlers

Learning to chew, self-feeding, eating a variety of nutritional foods, auditory processing and language development

Learning to chew

As part of our program at NACD, which entails working with the whole child, we have families post many videos of their children on our NACD Portal. These videos provide our staff with vital information and insights that help us educate the family and assist in the child’s development. Observing many parents spoon feeding their little ones is often a bit of a painful experience. In these instances, it is very apparent that the obvious goal is to get the food from the bowl to the child’s stomach as quickly as possible. To accomplish this goal, the parent is often using an amazingly large spoon. Not only do we observe food being shoveled into the child’s mouth, but the rate at which the food is shoved in is such that the child has no opportunity to learn how to use their tongue to manipulate the food in the mouth. Learning how to use the tongue is a significant component of a child learning to chew and to speak. In order for the child to progress from purees, to chewable foods, to self-feeding, they need to learn how to chew. Chewing is a very important part of digestion, and children who do not chew well often have digestive issues and constipation. In addition, chewing is the first big piece of oral motor development that establishes the foundation for good articulation. If Johnny was being fed while some of the family was eating, it would be a much slower process with a significantly different goal. The goal would be to assist the child in eating, teaching them how to eat, and interacting, not simply filling their stomach. The children who are fed as previously described often are very slow to learn how to chew because they are not only being deprived of the opportunity to learn how, but deprived of the opportunity to observe Mom, Dad, and big sister chew.

Expanding taste, accepting a variety of foods

A side effect of delayed chewing is the slow introduction of a variety of identifiable foods. Pureed foods all tend to look and feel the same in the mouth and are often all mixed so that the child cannot differentiate between specific flavors and odors. It’s experiencing a wide variety of food, textures, tastes, and smells that develops the acceptance of a wide range of food and teaches the child not only to eat, but enjoy a variety of nutritional foods. Guess what else the child who is fed alone misses? The opportunity to observe what other people eat and enjoy. The nature of the beast is to want what others have; and observing what other family members have and then being offered the same thing contributes to the child’s trying and enjoying different foods and textures. The child who is fed and eats alone is deprived of these very important opportunities that can lead to picky eaters and lifelong rejection of many nutritious foods. The first tastes that a child perceives are sweet and salty. Delaying the introduction of other tastes often leads to the child rejecting the more nutritious foods and craving sweet and salty food.

Self-feeding

As we move from baby to infant to toddler, we want to be teaching the child how to feed themselves, moving from finger foods to utensils. Self-feeding is a very important step toward independence. The more independent a child becomes, the more the child initiates doing more things on their own; and nothing is perhaps more significant to independence than feeding oneself. The longer a child (or adult for that matter) is dependent, the harder it is to foster independence, initiation, change, and progress. The more the child initiates, the faster their global development. There are many other pieces to this, including the child who eats alone and is trained to need a distraction for meals, such as a screen or toys.

Moving along in the child’s development, eating with the family teaches many important things, from how to eat appropriately with utensils, to table manners, to simply sitting at the table until the meal is finished. Children learn how to be civilized from adults who are and who model appropriate behaviors. Eating with your child is an important modeling and teaching opportunity.

Family meals often present one of the most important opportunities for the child to observe and learn. Young children learn visually, by observing. If a child is eating alone and not sitting next to family members who are feeding themselves, they do not even have a mental picture of someone feeding themselves. As a result, they are slow to initiate self-feeding and are content to continue being fed. Conversely, the child who closely observes people eating with utensils learns how to eat with utensils.

One disturbing thing that children who are learning to self-feed, but who are eating by themselves, commonly learn is to throw food or drinks and plates and whatever is within reach. Why not, if they do not have sufficient modeling to show them how to eat and act appropriately or do not have the opportunity to simply observe and interact with other members of the family during a meal? If they are eating with someone else and happen to throw something, someone is there to give them immediate feedback. 

Processing, receptive and expressive language

Young children learn by being in close approximation to other people and observing. They also tend to observe some more than others. The family meal affords them the opportunity to focus and learn from specific family members. The family meal is an ideal time for the child to observe, listen, and begin to understand and process language and produce sounds and language themselves. Auditory processing (the ability to process a word, then phrases, then sentences) is of paramount importance to the development of cognitive function. The child at a family meal is a relatively captive audience who can observe and listen to what is being said and learn.

One of the keys to development is neuroplasticity. The child’s brain develops from specific input being provided with sufficient frequency, intensity, and duration. Children need consistent opportunities to observe, interact, and learn.

Part 2

Three to Five Years

Table manners, expanding taste, attention, processing and language development, chores, responsibility and independence

We often think the goal of meals is simply to eat, to get nourishment; but as already discussed, there are many associated pieces that are extremely important. At each stage of the child’s development, there are important developmental pieces that relate to, and are aided by, family meals.

Table manners—taming the beast

It’s often easy to spot a child who typically eats alone: their table manners are horrific, and it takes longer to clean up the table and the floor after a meal than it was for the child to consume it. Teaching a child appropriate table manners requires first and foremost modeling appropriate table manners and then providing the child with appropriate instruction and feedback. The more often someone else is present and demonstrating appropriate table manners, the more quality input the child receives, and the faster they learn what they should do and how to do it.

Expanding taste—nutrition

Children who eat meals alone tend to learn to want the same things at every meal. Breakfast and even lunch is often the same every day. It is often easy for parents, once they discover what the child will eat for breakfast and lunch, to give the child the same thing every day; and unfortunately the child learns to want the same thing. So they both establish a pattern that neither is motivated to change. Eating the same thing daily is not nutritious, particularly if we look at what the children typically get for breakfast and lunch. Often the only opportunity the child has to learn about different foods is at dinner, assuming that the child is eating with the rest of the family. Healthy foods are rarely a child’s preferred foods, which again tend to be sweet and salty foods, which are often followed by grains. Gluten is becoming of greater concern in regard to allergies and intolerances. Children eating cereals, breads, and pastas often become addicted to these foods and reject what they should be eating. The taste for a variety of foods needs to be developed for the child to not only learn to eat, but enjoy the variety of meats, fruits, and vegetables that contribute to a healthy diet. The greater variety of foods we can introduce, and the earlier, often the better.

One good example of children learning to eat more sophisticated foods if exposed to them from an early age is what I observed in southern California in the ’80s. The first couple of times I saw this I was honestly a bit shocked; but it occurred so often that it became almost the norm in southern California. The snack food of choice of these families for their children under five and often as young as eighteen months was sushi. And the kids loved it! It was a great demonstration of how rapidly taste can be developed if given the opportunity.

Processing—cognition

Young children, when seated at a table with family members, attend to those family members. If they are not offered distractions like the TV, iPads, crayons and toys, they pay attention to what the other members of the family are doing and saying. Hopefully the family members try to engage these little ones during the meal. This process of attending without distractions helps build the child’s processing and attention span, which is a key to learning.

Perhaps the most important thing that drives the development of receptive and expressive language, cognition, and global development is the development of sequential processing. Building sequential processing develops short-term memory, then working memory and executive function, the pieces that determine our level of function even more so than innate intelligence. The primary thing that pushes processing is specific targeted auditory and visual input. One of the things that most children do well is let you know whether what you are saying to them, showing them, or doing with them is targeted to them or not. The test is their attention to it. If you are hitting the nail on the head, the child attends; if not, they don’t. Children sitting at a table with family members can be relied on to give the rest of the family feedback as to whether they are being included or not. The children tend to shape the family’s behavior. The more targeted the input, particularly from a family member, the faster the development of these vital processing abilities that will influence how the child ultimately learns, thinks, and functions.

Language development

Teaching a foreign language is not an easy task. It’s important for parents to understand that any language is a foreign language to a child learning their first language. The best way to teach any language is through immersion. Immersion simply means that you are living with the language and learning from your observations and involvement and out of need. Throughout the course of the day, the child has an opportunity to observe and interact and start to learn the language; but throughout most of the day there are many things going on, and it’s difficult to isolate words and their meanings. The family meal gives the child an excellent opportunity to isolate, observe, model, and learn to understand and then use language. It’s not a shock that one of the first words that a child learns is “more” and that one of their first word combinations is “Mom more,” followed by the phrase “Mom more please,” to using full sentences. The family meal should be a focal time in the day for relevant talk that contributes to the child learning the structure of the language and developing their own receptive language abilities. The language function of most children in this age group is a direct reflection of the targeted interaction between the child, parents, and siblings who naturally expand their use of language to fit the child they are speaking to. No one is better suited to this job than the people who know the child best; and no time may be better suited to this development than the family meal.

Chores, responsibility, and independence

I have written several articles talking about the importance of teaching a child to do, be responsible for, and to own chores. Most parents grossly underestimate their child’s capabilities and the global importance of their children learning to be capable, contributing, and independent and “owning” chores. The best initial chores to teach a child to own are those that are associated with specific events that occur daily. The first such event is simply getting up in the morning, but following that are meals, and again, particularly family meals. It is important to separate “helping” from “owning” a chore or job. Many children learn to follow specific helping directions and prompts even before the age of three and can be helpers. This period between three and five years, however, is an ideal time to teach your child not only how to do chores, but to own them. In response to the questions asking what chores children have, I often hear such things as “Johnny takes his dish to the sink.” My response to that is often, “If Johnny is capable of taking his dish to the sink, why not everyone else’s, and how about him completely cleaning the table?” Sadly, the parents’ response to that is often that Johnny eats alone, and if not, the parents do not even perceive that Johnny could do it if taught. They totally miss the understanding of the huge benefits Johnny would derive from doing it.

Unless children learn otherwise, they are egocentric, believing that the world revolves around them. Unfortunately, egocentric children can become narcissist adults. At three or even before, most children are ready to learn and own jobs and to learn that they can contribute; and they will learn to welcome and seek other ways to serve and contribute.

Ownership of a chore or job means that the child owns a particular task and preferably that they alone do it, so if they don’t do it, it doesn’t get done, which creates a problem. One of the first meal-associated jobs is teaching the child how to put silverware away from the dishwasher. Most children enjoy doing this job and can see that they are contributing and like it. Other meal—associated jobs that children in the 3-5 year range can do includes setting the table, cleaning the table, cleaning the floor under the table (even three year olds can learn to use a dust buster well), moving into washing dishes, loading, and unloading a dishwasher and even initial food preparation. Family meals can provide consistent opportunities for children to learn that they can be capable, contributing, members of the family. The earlier our children learn to happily and competently contribute, the sooner they start on the path of learning to be responsible, altruistic and selfless, self-reliant, contributing members of the family and society. Learning to be responsible with definitive chores helps children understand intention, which generalizes to other things including academics.

The more our children learn to do independently, particularly things that go beyond their own needs, the more they perceive what they could do, and the more things they initiate doing on their own, creating attributes that will serve them well in everything they do.

Part 3

Five Years to Eighteen Years +

Language development and social skills, processing (short-term memory, working memory and executive function), communication between parents and children, education, learning family values and history, learning critical thought and expression, becoming highly capable.

Theoretically a child moving from five years through adolescence to eighteen year of age is taking a young child and creating an adult. Unfortunately, there are not many eighteen-year-olds who we can confidently consider adults today; and that number appears to be shrinking every year. If you have a child five years of age, it’s not too early to remind you that your job is to put together the pieces to turn that child into a functional adult, who is equipped to go off to college or trade school by themselves, seek full time employment, start a business, join the military, or explore other adult options. These years pass at an amazing speed, and the target needs to be kept within the sights. This job requires putting together a lot of pieces. At NACD we know the need to work with the whole individual and the need to have someone at the helm steering the ship. No one knows a child as well as the parent. Teachers, relatives, coaches, clergy, and friends do not know as many pieces of the child as do actively involved parents. I have built several houses which have all come out well. Each one required my vision and design, the help of an architect, an engineer, a head contractor, and sub-contractors. The vision for the houses were mine, and I needed and used the various folks to help put the projects/visions together; but the houses were my babies and from concept to completion they were my responsibility. If they had not turned out as I envisioned, it was my fault and no one else’s. Building a house, even a large, complex house, is nothing compared to helping to assist a child in becoming a happy, successful, capable adult. And the need for attention to detail and ongoing participation cannot be overstated. One needs not to look too hard at society in general to see and hopefully understand the need to have actively involved parents steering the ship.

Language development and social skills

One of the most important jobs as parents is simply to talk to our children. In our busy lives meals are often the best, if not the only, regular opportunities parents have to get and hold the attention of their five-to eighteen-year-old and speak with them. A parent innately knows how to speak to a specific child. You innately use sentences of a length they can process and language they can understand. You have a pretty good idea as to what your child knows and doesn’t know, so you know if they have a frame of reference for a topic or not. A parent with the knowledge of their whole child is better suited to provide this invaluable input than anyone else. We call this targeted input. This targeted input and verbal interaction creates the building blocks of language and much more. If we are verbally interacting with our children throughout the day, it is often language that is directing them to do something or stop doing something; and although there may be opportunities throughout the day, particularly for families who are home educating their children, to really talk and communicate, the family meal can and should be perceived as a daily unique opportunity to have Dad, siblings, and even extended family participate. Language development occurs most rapidly when verbal interaction is of interest to the child, meaning you are talking about things your child has a frame of reference for, knowledge and interest in, and when the actual language being used is targeted to them. Parents almost universally use language that their children can understand and process, and constantly, even though they are rarely aware of it, they use language that is always just a notch above their child’s, which helps develop their language skills. This targeted interaction can be tremendously more efficient in building the child’s language structure and vocabulary than most group classroom instruction or interaction between children. Such group or child-to-child interaction is either not targeted to an individual or, as in the case of verbal interaction between children, they are modeling sentence structure and language that is not developmentally advantageous and perhaps not even acceptable. Children often speak to each other in abbreviated code, economizing on words and using vocabulary that Webster would scratch his head over. That’s not exactly conducive to proper language development.

Verbal interaction during a family meal is also an opportunity for parents to model and guide their children in proper table manners and acceptable ways to have a discussion, to agree or disagree appropriately. We all have many patterns of behavior that affect virtually all aspects of our lives. Children interacting with other children without the benefit of quality targeted parental modeling and feedback can lead to negative patterns of behavior, which can be difficult to modify or develop.

Processing (short-term memory, working memory, and executive function)

A major key to global development and function is processing power. Most children today have better visual than auditory processing power as a reflection of opportunity or lack of such. Children generally develop visual processing before auditory simply because until they can understand language, they learn and understand their world based on what they see.

As children develop, we need to provide as much targeted auditory language input as possible to balance these critical pieces. Ultimately, auditory processing is the more significant piece relative to cognitive development. Auditory processing facilitates thinking in words, and as it develops, so does the complexity of thought, language, maturity, behavior, attention span, and so on. The importance of auditory processing cannot be overstated. And what builds auditory processing? Targeted language input. Targeted language input is that which builds auditory processing. I believe that over the past decades as we have seen the increase in mothers working outside of the home, we have seen a corresponding increase in attention disorders, which are largely a reflection of auditory processing issues. You attend to what you can process, and the more and better you can process, the longer you attend. Parents talking to children is hugely important to the development of processing and its associated pieces. To learn more about processing, please read the associated article.

Communication between parents and children

If you are aware of a problem, have a misunderstanding or a question or just feel out of touch with someone you work with or a friend, your first thought should be to talk about it.

As important as it is to establish this relationship and open and maintain the avenues of communication, this often does not exist between many parents and their children. Ongoing, regular family meals do, again, provide rather special opportunities to establish this open communication. Parents can throughout the course of busy daily interaction with their children throw out questions in an attempt to find out what is happening with their children, but often this is not sufficient to facilitate good responses and open good lines of communication. As a case in point, ask the majority of kids upon their return from school about what they did at school and most parents get the same response—“nothing.”

Family meals can be used to open these critical lines of communication. If families simply talk during meals, the meal becomes this regular time to talk and communicate, and a question like “What did you do at school today?” is much more likely to produce a very different answer and open the door to further exploration, teaching the child how to express feelings and problems and to share their lives with their siblings and parents.

Education 

Most parents miss the boat when it comes to taking advantage of their unique position in helping, if not taking the lead, in their child’s education.

To understand how significant the parent’s role can be in education, let’s start by separating “what was taught” from “what was learned.” Schools and most curriculums are packed full of tons of “stuff,” and we tend to confuse all of this “stuff” that was “taught” with what was learned. If you learned something, you know it. If you don’t know it, you didn’t learn it. Pick a subject, any subject, from the explorers, to anatomy and physiology, trigonometry, astronomy, chemistry, or whatever you were “taught” and today write down everything you remember about that subject. This might not take long. Some of these things you might have been “taught” for years, and what do you remember? Perhaps not much, and certainly the more years that have passed since you were “taught” these things, the less you remember. But what you remember is very important and significant.

We tend to remember the more important pieces, the pieces that were reviewed over time, that were practical, interesting, or relevant to you—knowledge and information that helps you make connections between what you learned and understanding your life and the world today. These gems should be shared with your children, before, during and after they have been “taught” these things as part of their curriculum. “Did you know that…”. “Would you believe…” “That reminds me of…” are all phrases you can use at these family meals to introduce subjects; and over the course of a few meals, you can plant seeds, create interest and relevance, or even provide an entire foundation so that when these gems are part of your child’s curriculum they have more relevance and significance; and perhaps because of your meal discussions, your children will learn more of what is “taught.”

Talking at meals is different for your child than when you are sitting down to “teach.” Topics at dinner are presented in a more relaxed manner and are felt to be more like sharing than “teaching.” For this reason they are generally more welcome and have a greater impact. Another great benefit of sharing your knowledge at meals is that you get to pick and choose the topics. There is nothing wrong and everything right about first teaching your children about your interests, interests that you hope would be shared by your children and lead to lifelong shared interests and sources for ongoing interaction between you and your children. It’s often more important for your child to learn about your family business, your favorite sport, or any other of your interests and things that bring you joy and that you can possibly share with them for the rest of your lives than many of the subjects taught in school.

Family values and history

I recently had two visits from family members who I haven’t seen for many years. I live in Utah and most of my family still lives in the greater Philadelphia area where I’m from. It was great seeing them and reconnecting. A lot of our time together was spent sharing memories and getting confirmation of our joint recollections. The foundation of many of our memories came from recollections of extended family meals that generally occurred around holidays. These events were always opportunities to explore family history and values and to connect as a family. Family history offers perspective, perspective that is often missing from our lives. One of my visitors was a cousin whom I was very close to as a child and who I haven’t seen for about forty years. His short visit offered an opportunity to get him and his wife together with my extended Utah family and explore family history together over dinner. As it happened, my cousin, a recently retired judge, had done some searching and discovered that both our fathers had lived as children with their parents and grandfather in a very modest 700 square foot row home in Philadelphia. His father became a physical therapist and mine a physician. Both were innovators, and their service made great contributions to the treatment of brain injured children and others, and all from their very humble beginnings. Our families’ histories are rarely documented, and if not for the verbal communication of our families’ legacies that often only gets communicated at family meals, most of it gets lost; and our children and grandchildren are deprived of the history and perspective that helps give meaning to their lives and has the power to influence their futures.

Learning critical thought and expression

We want to create a safe welcoming environment around our family meals that produces a safe place for the exchange of ideas and views. Today more than ever, our children are exposed and often bombarded with a plethora of opinions and views that they have difficulty sifting through. Without a safe place to communicate what they have heard and a forum to openly discuss these views, they are often left with simply accepting what they hear at face value and following the latest and loudest voice.

Family meals can provide our children with the forum they need to safely talk about what they have seen and heard and learn how to speak of it and, with help, to critically evaluate it, form their own opinions, and learn how to appropriately express those opinions. Through healthy discourse with people they love and trust, they can also learn how to respect and value other opinions and learn not to be threatened by differing opinions. As parents, at family meals we need to understand that we are models, and how we react and what we say, and how we say it will teach our children how to think critically and express their views and listen to others. Often our softly spoken, non-confrontive words provide the food for thought that our children can later digest.

Becoming highly capable

Several years ago, I was a keynote speaker at the Washington State Conference on the Gifted and Talented and had the opportunity to help the educators see the correlation between cognitive processing and creating higher functioning students. At that conference they were using a new term, replacing “gifted and talented” with the term “highly capable.” I liked the term and have since redefined it and now use it more globally to mean essentially an individual who knows how to function in their world independently and competently. As I see it, helping our children become highly capable adults means that we are teaching them from an early age how to be independent in all aspects of their daily lives, understand responsibility, and develop qualities that will permit them to be confident, capable, and successful adults.

Relative to the discussion at hand of family meals, we can start the process of creating highly capable adults when our children are 5 years old. Hopefully by 18 we have succeeded in helping our child well down the road of becoming highly capable. As mentioned in the previous 3–5-year section, we can start teaching chores that the children own associated with meals. As we proceed in the development of our children, we want to continue to build on this by progressively adding to these pieces. By the time our children are 18, they should know how to plan meals, shop intelligently, understand budgets, prepare meals from A-Z, and clean-up and much more; but we can use the family meals as the foundation.

I had one of our NACD graduates who chose to go off to start her college career in England from her home in the U.S. An 18-year-old with the guts to go off to college in another country says something about confidence and capability. Shortly after beginning life in her new dorm, she made a discovery that most of the other students were lost. They had kitchens in the dorms, but the other students didn’t know how to cook or even buy food for that matter and couldn’t budget. The result was that they ate out and burned through their monthly allowance halfway through the month and had to beg Mom and Dad to send more money. As our highly capable young lady discovered, these other students also didn’t know how to clean or take care of their rooms or wash and iron their clothes. They also didn’t know how to be responsible for organizing their time, getting up in the morning on time, studying, and doing class assignments. She ended up holding classes for her dorm-mates to teach them how to take care of themselves and how to become more capable. Learning the pieces involved, learning to be responsible for all these pieces surrounding planning and seeing a meal accomplished from concept to fruition can be a significant piece that fosters the confidence and independence that can help turn a helpless child into a highly capable adult. Independence produces initiation, which in turn creates the impetus to learn more and assume more and more responsibilities.

Use family meals as the foundation to start building an adult. Do not underestimate what your children are capable of doing if given the opportunity and the responsibility. They will rise to your level of expectation.

Adults

The fabric that largely defines and holds our society together is the family. The fabric that is the family is woven together, built, and reinforced by the threads of our ongoing connection and interactions as a family. This connection needs to be reinforced and built upon on a regular basis. Sadly, for many, the connection between family members often only consists of short calls or text messages. The need for real connection is perhaps greater today than ever before, as we all shift though the bombardment of media that on a daily basis questions and even attacks many of the basic tenets that have formed the foundations of our beliefs.

Speak with most any adult about their close family times and recollections growing up and they will often speak of family meals, particularly meals with the extended family.

Speak with seniors and you will discover that past family meals are memories that last when others have long faded away. You will also discover that if such family meals are now available with children, grandchildren, and extended family that these events don’t just keep them connected to family, but to themselves.

Our sense of self, our identity, who we are and continue to be is woven into the fabric of the family.

The family meal is the foundation upon which our family is built and upon which we learn to know and maintain ourselves.

What’s for dinner?

Family Conversations App

If you’re looking for questions to get the conversation started, we built something for that: Family Conversations

Reprinted by permission of The NACD Foundation, Volume 35 No. 3 , 2022 ©NACD

The post The Most Important Meal of the Day is Not Breakfast, It’s the Meal(s) the Family Has Together appeared first on NACD International | The National Association for Child Development.

Processing and Its Relationship to Cognition, Maturity, and Global Function

What every parent needs to understand about processing:
It’s not about chronological age, it’s processing power.

by Bob Doman

Whether your child is “typical,” has learning or attention issues or special needs, you need to understand your child’s processing level and its global significance.

Knowing and understanding your child’s processing provides you with some important insights into how they take in information and learn and think much better than does their chronological age. This information provides you with vital information that can help you be proactive and help them achieve their innate potential.

The term processing power is generally reserved for and applied to computers and their ability to manipulate data and the speed with which they can do so. People understand that the more processing power their computer has, the better. What most people do not understand is the significance of human processing and its relevance to child development and global human function.

At NACD we have been working with the development of human processing power and have developed software and hundreds of activities to assist in this development for more than 40 years, working with tens of thousands of children and adults.

We view human processing as the ability to take in and to manipulate visual and auditory information, to learn and manipulate information, and to think. These functions are also the neurological pieces that underlie our maturity and behavior and which in turn provide us with the means to develop the mental ability to do such things as plan, prioritize, develop self-control, organize, and more–cognitive function.

The more associated pieces of information we can process, the more we take in of what there is to see and hear, the more we learn, and the higher our level of cognition. What different individuals process varies significantly, as does their perception of the world and their ability to think and function. None of us see, hear, or process the world the same way or think alike; but the stronger our processing power, the better equipped we are to learn and think, understand our world, and function in it.

Processing power develops in children. It changes, and what changes can be developed at any point in our lives.

Neuroplasticity is the mechanism by which the brain develops and changes. Everything we put into our brains and everything we think, feel, and use our brains for to some degree physically changes our brains and its function for better or worse. Our processing power impacts the quality and quantity of data we take in and our ability to manipulate and think.

The more we learn and know, the more meaning and significance what we perceive has, which in turn affects the relevance to our brains, and thus in turn affects what we take in and process. The world that is perceived is the world as seen and heard through our ability to process it and its relative significance. And the more of those pieces we can manipulate together, the greater our complexity of thought and ability to think.

Psychologists use the terms short-term memory, working memory, and executive function, rather than processing power, but processing power really says it better. The term “memory” doesn’t really describe, and to some degree distorts and minimizes, the neurological mechanism and significance of our processing power.

When we first start working with a child, and at NACD that means the whole child, we begin with basic functions, which include simply their ability to see, hear, feel, taste, and smell. These are things that are often taken for granted. In some cases, there are specific factors affecting these functions, ranging from actual injuries to the brain, to genetics, to more common problems such as middle ear fluid, degrees of hearing loss, to a wide variety of issues affecting vision, etc. But the reality is that all of these sensory functions need to develop or be developed in every child because they affect the child’s ability to process input, process the world. The brain needs to learn how to process and interpret this sensory information. If the child cannot perceive this sensory information, they need to be provided with the means with which to develop these functions or, to use another computer term, garbage in-garbage out. You first must see, hear, feel, taste, and smell properly. Most children on the autism spectrum, and to varying degrees children with other developmental problems, have issues that negatively impact the brain’s ability to learn how to process even basic sensory information appropriately. These sensory issues need to be addressed in order to develop processing power and further overall development.

Measuring Processing Power

Processing power can be gauged by looking at auditory and visual sequential processing.

For most children and adults functioning above the level of the average five-year-old, sequential processing can be tested by measuring what is referred to as a digit span. To test someone’s auditory digit span (the measure of how much the individual takes in from what they hear), you would simply say a sequence of numbers slowly (1 second intervals) in a monotone voice and have them repeat the sequence. Do not repeat the sequence if they miss it; give a different sequence of numbers. Start with 3 random numbers (using numbers from 0-9, do not repeat a number until you have surpassed a sequence of ten numbers), and give longer sequences until they can no longer repeat the sequence. The highest sequence they can get correct is their auditory digit span.

Following the same method, you can also test their reverse auditory digit span, presenting the numbers in the same way, but asking the participant to repeat the numbers backwards. The highest number of digits they can repeat backwards is their reverse auditory digit span.

Likewise, you can also test the visual digit span. Following a similar procedure, clearly write a series of large font numbers starting with a sequence of three numbers on a card or whiteboard; then show the participant the sequence and have them immediately read it aloud, without letting them review it. Immediately remove the card and have them repeat the sequence. As with the auditory test, continue until they can no longer repeat the sequence. Repeat this process again, but after having read the sequence from left to right, ask them to repeat the sequence backwards to ascertain their reverse visual digit span.

Some children younger than five who are familiar with numbers and can identify them easily can be tested with digit spans. Children can be tested prior to this by asking them to repeat a series of names of familiar objects, such as “spoon, table, ball” for auditory sequencing, or visually showing them a sequence of pictures and having them name them as you point to them and then removing them and having the child name the objects in order. Some children will be able to understand (“process”) a reverse sequence when they can do a forward sequence of 4; but many will not be able to until they can do a sequence of 5 digits forward.

Younger children can be crudely tested by having them follow a sequence of directions such as “Touch nose, ear,” or asking them to find this and that.

Forward digit spans are generally referred to as a representation of short-term memory, and reverse digit spans as a representation of working memory. But for now simply see these numbers as a representation of processing power.

At NACD we have tested the processing power of tens of thousands of individuals, and in some cases tested and followed some individuals for decades. Digit spans themselves are used as a testable number, but the primary processing power gauge is the individual’s actual function– their ability to understand and use language, their problem solving, behavior, and maturity. For younger children there are some very direct correlations between functions such as language and behavior and sequential processing.

When most children are in the processing range of 1-2 (with typical children this generally correlates with being 8 months to 24 months of age), they are relatively easy to please, generally happy unless they have a basic need such as being hungry, needing to sleep, or needing a diaper change. At this level of processing power the first random words begin popping out. As the child moves to stronger 2s, the behavior tends to begin to get more difficult and we often get tantrums–terrible two behaviors–but the child also starts using meaningful words and 2-word combinations. As we work into sequential processing power of 3, we start seeing what we refer to as “lock and block” behavior, which means that if the child perceives a request as something fun, typical, and nonthreatening, they will comply; but asking them to do something that is atypical or that they sense as strange or threatening in some way will often result in them just staring at you and refusing to comply. Behavior is to a significant degree a reflection of the child’s complexity of thought–processing power. At this stage the language moves into phrases of three to four words, and as the child moves toward processing a 4 they start using sentences and can be bargained /reasoned with. All these changes are reflections of the child’s ability to process (understand) and to think with greater and greater complexity. As processing power increases from here, so does the ability to process more and more of what is said and what is seen, and to think with greater and greater complexity. Other factors begin to figure into the equation, such as the individual’s ability to think conceptually (in words) and to visualize (think in pictures).

Processing power is what ultimately permits the individual to develop higher level mental function and associated maturity. The term “executive function” is used to describe these higher levels of function, which include things such as the ability to adapt, plan, self-regulate and control, time management, and organization. These functions only exist to the degree that our processing power permits.

To understand any child and many adults it’s not about chronological age, it’s Processing Power.

Whether we are trying to understand a special needs child, a “typical” child, or even an adult for that matter, one of our best insights as to how they function and thus what we should expect from them and what to do to help them improve is understanding their processing power. The degree to which we can identify their level of function, the greater our ability to target their needs.

The sad reality is that most educators have no idea as to a child’s processing ability and thus have limited ways at best to appropriately target their needs. For example, a special education teacher and an occupational therapist may be trying to get a six-year-old child with Down syndrome to write or cut with scissors with very minimal or no success because the six-year-old child has the processing power of a typical 2-year-old. Would you work hard to get a two-year-old to write or use scissors? Not if you had any sense. There are a lot of much more appropriate things to be teaching a child at this level, not the least of which is how to process more.

If you had a typically functioning four or five-year-old, would you be surprised if compared to a much older child they had a short attention span, were a bit distractible, and were still immature? No! Now if you had an eight, nine, or ten-year-old child, or even older, who had a short attention span and was distractible and immature, would you just jump to the conclusion that they had ADHD? Sadly, this is the label that is given to most of these children, even though they still have the processing power of a four or five-year-old and their attention span, distractibility, and maturity are in fact appropriate for where their processing is. Solution: raise their processing power! If you had a four-year-old whom you wanted to sit and attend in a third or fourth grade classroom, how would you do that? You would probably have to drug them. Would you do that, or would you wait until they were older and had developed the processing power needed?

What about the sixteen-year-old who is struggling in school, can’t get himself out of bed in the morning, is irresponsible, socially inept, and who wants to get a driver’s license? If you were to test his processing and were to discover that he had all these issues because he had the processing power of a five-year-old, would you want him to have a driver’s license? Do him and the world a favor and don’t put him behind the wheel of a car until you’ve raised his processing power to the point that he could develop some real executive function and make good decisions.

Typically, processing develops rapidly from infancy to about nine years of age, (see https://www.nacd.org/short-term-and-working-memory-clinical-insights) and then very slowly develops a bit from nine years until into the twenties. After the twenties, without intervention of some form, or exceptional use and demands, it starts a slow decline. Sadly, the processing level of most seven-year-olds is close to most young adults.

If you look at the change in global development between an infant and an average seven-year-old, it is quite spectacular. That tremendous change is not due to the child getting older; it’s due to the opportunities they have received and the resulting increase in their processing power. If you see children with high global function, you are generally looking at a child with superior processing. There does not appear to be any limit as to how far processing can develop given the targeted input to do it.

What develops changes, what changes can be developed.

Until the educators and psychologists and particularly the academics understand that the foundational pieces that permit us all to function can be developed, very few will ever come close to achieving their innate potential.

It’s a tragedy that our potential as individuals and as a world population remain untapped and that children and adults are labeled and denied the opportunity to achieve their innate potential. “Typical” or “average” is not a reflection of the potential anyone was born with, it’s a reflection of limited opportunity. We can all do better and function at higher levels if given the opportunity.

Developing processing power is something that should be an integral part of every child’s day.

Parents need to educate themselves, become active participants, and become the force that helps their children become all that they can be.

Related Apps/Software

NACD has developed many activities to develop processing power. Programs that are accessible to the general public include:

Simply Smarter

Cognition Coach – Toddlers

Cognition Coach – Preschool

Related Graphs

The Simply Smarter Project

Construct of Thought and Memory

Reprinted by permission of The NACD Foundation, Volume 35 No.1, 2022 ©NACD

Related Articles

https://www.nacd.org/the-effect-of-the-simply-smarter-program-on-short-term-memory-working-memory-and-academic-competency-for-elementary-students/

https://www.nacd.org/nacd-makes-adults-smarter-too/

https://www.nacd.org/vol-2-working-memory-training-physically-changes-brain-better-fmri-neuroimaging-study-finds/

https://www.nacd.org/nacdwasatch-peak-academy-school-model-program/

The post Processing Power: What Every Parent Needs to Know appeared first on NACD International | The National Association for Child Development.

Most of us have no idea what creatures of habit and patterns we are, nor how stuck we can be in these behavior patterns. I have three dogs that keep reminding me of what a creature of habit I am. If I’m watching TV in the evening and pick up the TV remote, my dogs notice; and if I turn off the TV, they all jump up ready to go. Which way they go is determined by the direction of my first step when I stand up. In the morning if I pick up my cup from the coffee machine and if I turn left, my dogs run down to my office. If I turn right, they go about their business because there are too many options as to what I might do. You probably put the same foot into your pant leg first most every day. The point is that we humans create hundreds of behavior patterns, most of which we are oblivious to.

When dealing with children, particularly children with developmental issues, the connection between the child and the parents and caregivers is amazing. This connection leads to each learning each other’s patterns. Patterns can become ruts, ruts that both parent and child can get stuck in.

One very common pattern or rut that creates problems involves what children will eat. In a very significant percentage of children who come to us, ranging from severely involved children to those who are gifted, a common problem is picky eaters. Back in the early ‘70s when we created a program specifically for children with autism, I worked with a teenage girl who had eaten no food other than apples for virtually her entire life. To compound the mystery of this child, she also had pica—she would put most anything in her mouth and eat it. This included everything from dirt to bugs and her dog’s feces from the yard, but not food. The issue with her eating a greater variety of foods was obviously not an issue with taste or smell, although this can be an issue for many children, particularly those on the spectrum. It was simply a matter of an established pattern, a habit. It should be noted that food cravings that come from eating a lot of some specific foods can also be a contributing issue. Kids are not simple.

In a previous article (Independence and the Developmentally Challenged Child) I discussed how important and vital independence is for the overall development of the child or young adult. The child’s and the parent’s patterns and habits often have a very negative impact on the development of independence.

An example of a common pattern that slows down the development of independence in many children is helping them dress themselves. Most parents who assist their child in dressing and undressing assist in virtually the exact same way every time, and the child participates, or does not participate, in exactly the same way. As an example: Mom approaches Johnny with a T-shirt. Johnny sees it and waits for Mom to put it over his head, at which point he lifts his arms and she helps put his arms in the sleeves. Then she pulls the shirt down. Every day they follow the same pattern. If Mom doesn’t do something to change her pattern, the odds are great that Johnny doesn’t either; and Johnny’s development of independence in dressing himself goes nowhere. Parents need to become acutely aware of the hundreds of such patterns, habits that have been created by them and their children, and consciously work to break them.

It’s helpful when trying to grasp the significance of patterns to see how differently children perform with different people and in different places. Children who work with their parents, caregivers, therapists, and teachers are often going to react and perform differently with each person, or in each place, because patterns and habits are created together and are often person and place specific. Each adult establishes a new pattern, and to some extent the physical space helps establish a new mental picture and a new pattern as well. Most children on the spectrum are strong visualizers, creating mental pictures and videos associated with many aspects of their lives. For these visualizers anything that changes their picture (or habit) can lead to them becoming upset, with the net result being that family members and caregivers avoid upsetting the apple cart and work hard to maintain and reinforce the habits.

One of the most devastating and pervasive problems associated with patterns negatively impacting many of our children with developmental issues is prompt dependency. Prompt dependence is actually taught through creating a patten by which the child is prompted, generally verbally through virtually every step of what they are being instructed to do. Some children, after years of such instruction, develop such a strong pattern that they will do almost nothing without a prompt, requiring someone to guide them through most everything they do, creating greater dependency and stifling independence.

Referring back to the picky eater problem, parents often discover that their child will eat foods at the grandparent’s house that they won’t eat at home, or in a restaurant, or even outside. This is because a new place helps change the pattern.

The teenage girl with autism I met had her eating problem largely resolved within the week she and her family spent with us. Guess what we did to fix it? Almost nothing. The child had spent her whole life at home, eating by herself in the same kitchen at the same table and given the same food—apples—because her family been convinced that she wouldn’t eat anything else, and had established a very strong behavior pattern. When the family flew across the county, stayed in a hotel and at our offices, and ate at restaurants together, they broke the pattern. My little suggestion was to not have any apples nor bring apples to the restaurant and to simply order her the same food the parents were eating and tell her they didn’t have apples. She ate the food and within the week established a new behavior pattern, which was to eat what the family ate.

Patterns and habits affect all of our lives to amazing degrees. Having healthy diets for most people means establishing a new behavior pattern or habit. Exercising regularly for most people requires establishing a new behavior pattern or habit. Many people realize how difficult it can be to break an old pattern and create a new one and realize it doesn’t just happen. You have to very consciously work to create that new behavior pattern; and the longer a pattern exists, the tougher it is to change it, whether it is a good or a bad habit.

Typically developing children are neurologically changing rapidly, and that neurological change pushes them to do new things; and in the process it tends to break many previously established patterns of behavior. Typical children and their parents can certainly fall victim to habits. But when you slow down the developmental process, life tends to become just a series of pattens that essentially rule the child and the family’s life and can significantly and often dramatically inhibit change, development, and expectations. These patterns can affect all areas of development and function. An example is children learning patterns of communication. If whining works to get attention, and Mom interprets that as the child wanting something and becomes trained to start offering the child options until the whining stops, then the odds are good that the child will maintain that pattern of communication even though they neurologically are ready to start verbally communicating. In a similar vein there are children who develop a functional vocabulary of only a few words, who may go years without expanding that vocabulary. It becomes their pattern, and if the expectation is that it’s all he or she can do, then it becomes the perception of what can be, and it is accepted. A child who has a vocabulary of three words is demonstrating that they have the cognitive ability and the oral motor ability to think in words and produce words, why not ten words or twenty words or a thousand words?

If a child lacks mobility, the ability to move either through crawling, creeping, or walking to get to something, and learns to simply lay on the floor and space out, cry for attention, or whine until someone brings something to them, then often these become patterns and the child has no perception that they could move to go somewhere or get something. These children may have the cognitive and physical pieces that would permit them to move, but they are stuck in a pattern.

Looking at pieces of the child in isolation makes it very difficult at best to determine what is a reflection of the child being stuck in a pattern vs. what can, could, and should be. The perception of what can be is then easily limited to what has been, and doors are closed not based on the innate potential of the child, but rather on what patterns have been and are in place.

If, however, we view the “whole child,” the gestalt of the child, we can then see what could be and what pieces need to be put together to break the habits or patterns and move forward.

For example, one vital piece of the “whole child” is cognitive function. If we have understanding, auditory sequential processing, that says the child mentally has the ability to use language functionally and put two or three words together, as well as adequate oral motor skills for speech, but they only use a few words, then we know we have a child who today could be speaking much more, if not for being stuck in a pattern. If, however, we have the cognition, but not the needed oral motor function, then we know we need to work on the oral motor function hard, as well as working behaviorally to create the internal need to communicate. Conversely, if the child has sufficient oral motor function, but not the cognitive function, then the primary focus becomes the cognition.

Looking at a child as their isolated pieces and not understanding their patterns and habits can produce misdirected efforts and priorities, and more often than not turn the focus toward alternatives that lead to poor, low, or limited expectations that can negatively impact the child’s ultimate potential.

Not understanding the “whole child” or the impact of patterns can lead to pursuit of poor alternatives. For the child with limited language, the alternative may be an augmentative communication device that for the vast majority of children fails. If full mobility is deemed to be improbable, then putting the necessary developmental pieces together gets scrapped, and the therapy gets directed toward a child who will spend the rest of their life in a wheelchair. Or a child with unresolved behavior issues ends up being medicated, rather than having his pieces put together and patterns broken.

Habits and patterns impact all of our lives. For our children with developmental problems, these habits and patterns, both theirs and ours, can have devastating consequences. Every child needs to be viewed through the lens of the “whole child” and seen as a creature of habit if we are going to begin to provide them with a real opportunity to realize their innate potential.

Lack of function needs not and should not be viewed as a prognosis or predictor of potential.

Reprinted by permission of The NACD Foundation, Volume 34 No.5, 2021 ©NACD

The post How Patterns of Behavior Affect Your Developmentally Challenged Child appeared first on NACD International | The National Association for Child Development.

These COVID-19 Coronavirus times have certainly turned many of our worlds upside down. We now virtually have a world full of homeschoolers; more parents are at home with their children than at any time in the history of the world. Exceptional times and exceptional circumstances can also result in exceptional opportunities. Many of us are rediscovering and redefining basic things like family, work, school, and our relationship to institutions and society. I would like to talk with you about redefining potential and intellect and how while you are all at home, you have the potential to change the lives of every member of the family.

I would like to share a personal story. I grew up in a family of pioneers in human development. My father, a physician, and my uncle, a physical therapist in the ‘50s, worked with brain injured children and discovered that with the proper stimulation, healthy parts of the brain could learn to carry out the functions of damaged areas of the brain. This was ground breaking work that was originally seen as heretical, but is now after decades universally accepted. Changing perceptions is not an easy task, as I can certainly attest to after fifty years of trying to do it.

When I started studying psychology in the sixties, I had a tremendous advantage over others studying and working in the field. I came to understand that all development was possible through this amazing mechanism called neuroplasticity. If you understood neuroplasticity, development was no longer such a great mystery. The brain changed and developed as a reflection of specific stimulation, not because it just got older. Armed with this understanding, I looked at the brain as dynamic, changing, and most significantly, as changeable.

One area of early interest for me was learning and memory. At that time it was just beginning to be understood that there were various components of memory. Memory was being broken down into short-term memory, working memory, and long-term memory. The focus was on testing it and looking for correlations between these pieces and how people learned and functioned. At that time and for decades, the worlds of psychology and education did not have a perception that you could actually help develop or change memory; and even today, they are not really working to do that. My perception, based on an understanding of neuroplasticity, was that these components of memory didn’t just pop up as adult abilities, but they developed; and what developed changed; and what changed was changeable. I set out to understand all of these pieces and to find ways to change, develop, and accelerate that development.

Decades later I am proud to say that we have developed a great understanding of all of these foundational pieces that we now lump together and refer to as “processing.” Armed with this knowledge and the tools we have developed, we have helped change many thousands of lives. Improving these pieces of auditory and visual short-term memory and working memory is quite simply making people smarter. From our first software that ran on a Commodore Pet computer with a cassette drive in the early eighties, to the Brain Builder software in the nineties, to the present online Simply Smarter program and many dozens of one-to-one activities, we are working to change lives. From brain damaged individuals to those on the autism spectrum, to those with learning and attention issues, to typical children and adults, we can build all of these foundational pieces of memory that literally have the potential to make everyone smarter.

At NACD we work with “whole children,” designing home based comprehensive programs that address everything from a child’s sleep and behavior to how they walk and do algebra, including innovative comprehensive homeschool/home-based educational programs. But there is something that in one way or another is on every child’s program, and that is processing activities.

We are fortunate that we can work via Skype with any family in the world who has Internet access and give them the tools designed to develop and improve their brains. Today everyone doesn’t need to come to NACD to work on their processing. You can take advantage of this expertise and go online and in about fifteen minutes a day put together the pieces that can help you and your children work to become smarter. The tool that is available to you is our Simply Smarter program, a tool that your children can use all by themselves!

Let me help you understand what this all really is and what it can mean for you and your family.

What is “smart?” Can you define it? Do you think you would like your kids to be smarter? How about you?

You can define “smart,” possibly, but even more so, you probably know it when you see it. Smart has to do with being present, being aware, being able to take in and process a lot of information, being able to manipulate that information, think with complexity, put ideas together, focus, and communicate.

Smart doesn’t necessarily mean knowing that the capitol Nevada is Carson City, or that Sir Walter Raleigh was beheaded, or that the First World War ended on November 11, 1918, or what your bile duct does, or that “or” is a conjunction. But smart does mean that you are more likely to find such things interesting and you can learn them more easily than most. Knowing “stuff” doesn’t make you smart. (You are going to actually forget most “stuff” unless you are smart enough to make associations and connections between “stuff” and use it.) And smarter also means that it’s easier to understand and learn everything.

What is the foundation of “smart?”

The foundation of smart is the ability to process and take in a lot of information that you see and hear and to manipulate that information and think.

The more you can process and take in what there is to be heard, the stronger your auditory short-term memory. Your auditory short-term memory provides the fuel for the development of your auditory working memory, which is how many pieces or words you can hold together and manipulate, which equals your complexity of thought, or “smart.” How many pieces of visual information you process from what you see, whether from observation of your world or from reading, relates to your visual short-term memory; and as with auditory processing, your visual short-term memory provides the pieces you use to create your visual working memory and visual-spatial abilities. These fundamental, foundational pieces ultimately determine how much information you take in and use, which translates to how much knowledge you gain and your complexity of thought. All this equals “smart.”

How does processing “smart” develop?

Processing develops primarily from birth to about seven years. The rate and degree it develops is a reflection of the targeted stimulation and opportunities that you receive. In general the more quality one-to-one interaction between a child and an involved adult, the faster and the further it develops. The more enriching the environment, the faster and the further it develops. With specific targeted input designed to build processing skills, processing not only can be accelerated, it can be developed to superior levels.

When does the development of processing abilities stop?

Without specific intervention, the development of processing abilities almost comes to a halt at about seven years of age. From seven into our twenties, it typically develops perhaps another ten to fifteen percent; and after our twenties, without specific intervention it goes into a slow decline. You can continue to learn more, but your ability to do so declines, as does your ability to manipulate the information. As you continue to learn, you can become wiser, but not necessarily smarter, unless you are stretching your processing through complex cognitive activities or actively working to preserve or develop it.

How can you build processing ability and get smarter?

Everyone, from infant to geriatric, with input that is targeted to them, can incrementally build and improve processing ability and get smarter. We at NACD have been developing methodologies and improving processing abilities for the full spectrum of children and adults for over forty years. NACD designs specific processing programs for families who are members of NACD and who wish to utilize comprehensive developmental and educational programs designed so that they can be implemented in the home by parents and caregivers. But as mentioned earlier, NACD also has developed a very comprehensive targeted program for all children five years old and older and for adults up to and including seniors—Simply Smarter.

What is Simply Smarter?

The Simply Smarter program is a dynamic online system that constantly develops and modifies itself, adapting to the individual user to help produce maximum change. Specific activities work progressively to address focus, attention, intensity, auditory and visual short-term and working memory, visualization, conceptualization, and visual-spatial abilities, all of the pieces that help make everyone learn, think, and function better. The program first assesses your baseline and then builds from there, tracking and graphing progress. It has the capability of adjusting from basic levels of a child to levels of incredible function.

What can you do with children under five?

Children at or functioning under five years of age generally need specific one-on-one activities that are designed as part of NACD’s individualized programs. But in addition children from toddlers to five years old can use NACD’s Cognition Coach apps to build processing skills.

How long does it take to get smarter?

With motivation and consistent use, measurable changes can occur in a couple of weeks; and with continued use of Simply Smarter, virtually unlimited improvements are possible. Over the course of the present lockdown, you have the potential to produce a significant change.

Who has used Simply Smarter and what have the results been?

The range of those who have used NACD’s processing activities and Simply Smarter is as broad as the population. NACD’s Simply Smarter and other processing programs have been used by thousands of typical and gifted children and adults, those with learning and attention issues, as well as those with significant developmental issues such as autism spectrum disorder, Down syndrome, and brain injuries. Most everyone working on our comprehensive home based programs not only knows about processing, but is actively working on processing every day and understands the correlation between their child’s processing and global function and abilities. We have seen exceptional changes along the path of many thousands of children’s development and are continually heartened as we see their potential being redefined. Processing is a huge key to success and potential.

Please take this opportunity to change your child’s life trajectory. My mission in life has been to help change the perception of potential and to help develop the tools to do it. Today with more parents and children at home than ever before, I see this as a unique chance to change many lives and potentially change the perception of what can be.

To read an incredible testimonial from a couple about Simply Smarter and see what incredible things even a child can do, please read the following article and watch the video.

Reprinted by permission of The NACD Foundation, Volume 33 No. 4, 2020 ©NACD

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Today’s spotlight is on a fine young man who I have known since 1996. Yes, that is correct, 1996. I have been with NACD long enough now to have several adults that I have seen since they were infants, Nicolas Cooke being one of them. When I think of individuals that I have the greatest amount of admiration for, Nicolas is certainly on that list. Born with Down syndrome, Nicolas has been seeing us since he was an infant. Over the years I have been so proud of how he shines. Nicolas has developed into a wise, responsible, hardworking, strong young man of excellent character.

Nicolas has done very well in developing physical excellence and participated in his first triathlon at age eight. Nicolas’s mom, Linda, is a swim coach, and knowing the importance of physical exercise, she had Nicolas swimming at an early age. I remember the two of us reminiscing that he went from crawling, creeping, and walking right into a child who could compete alongside typical peers in a triathlon. Today, at age 24, Nicolas is involved in bodybuilding and martial arts and has been featured in a piece by a local gym where he works out.

Nicolas is very active in his community and his church. He has participated in a theater group and is a favorite within the children’s ministry, where he dresses up like Shaggy Dog and teaches children about God. At church Nicolas not only works in the children’s ministry, but he is also on the worship team and can be caught from time to time playing his guitar. One of Nicolas’s additional stomping grounds is at a local horse barn where he works part time. Linda says that Nicolas is on quite a few “speed dials” when it comes to needing help with various projects. Each morning, while Mom works and coaches, Nicolas is very diligent in his responsibilities, cooking, cleaning the home and pool and focusing on his education. Nicolas also assists in caring for his invalid father who suffers from a debilitating, degenerative neurological disorder. Being the youngest of nine children, Nicolas now has eight nieces and nephews that he loves to read to, play with, and supervise.

Linda knew that working on appropriate behavior and manners and teaching him to have a strong work ethic were crucial in helping him to be a highly capable adult. She and I can look back on his “stubborn years,” being thankful that she always kept firm boundaries in preparing him to be an individual that other people would seek spending time with.

In talking one day with Linda, she commented on the fact that Nicolas can clean her house better than anyone she could ever hire. His attention to detail and making sure each and every job is well done is a real asset. At the time Mom said, “I bet he could even be hired out and do a better job than any other cleaning company,” and then her eyes lit up. At the next evaluation I was pleased to hear that Nicolas already had a few clients.

It is a pleasure to work with so many wonderful families through NACD; and I am so blessed to be able to follow a number of our NACD kids and watch them become such fabulous adults. Nicolas is a man who makes each and every life he touches that much better.

Reprinted by permission NACD Newsletter, February 2020 ©NACD

Read the full article about Nicolas here: https://www.easttexasmatters.com/news/local-news/adaptive-athletes-shine-at-east-texas-gym/

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by Bob Doman

I have introduced you to Coco previously here and here. Coco is now almost five and a half. For those of you who are new to Coco, he was born with a brain injury/cerebral palsy, with a very broad range of issues and a terrible prognosis. Previously I talked about the development of Coco’s processing abilities, which as you will see in the accompanying video, have not only continued to develop, but are now truly exceptional. Coco’s story is much more than a story of superior processing. Coco’s story is one of parents creating a vision of what they felt could be, then working with incredible focus, intensity, and intention to achieve it.

Coco’s father, Razvan, understanding how important these first years are to his son’s future, has put his career aside and moved his family to a new country, with a new language, which offered greater acceptance and future opportunities for his son and focused on the vision. None of this has been easy for the family. They have had to lower their lifestyle, and mom had to go back to school and start a new career and work on weekdays, while dad works on weekends. A year and a half ago, their second child arrived. Baby Ellen (named after my sister, their NACD coach), not to be neglected, has been on a program of her own and is doing great.

The Manole family “gets it.” They have a vision. Recently the doctors, therapists, and social workers who oversee special needs children in the area requested a meeting with the Manoles, who had declined any of their services. Based on communications with the family, the physician, out of concern for Coco, requested the meeting. Having the child’s medical records, the doctor was concerned because Coco was not receiving any of their services, and he felt that the expectations expressed by the Manoles for Coco were unrealistic. One of the sore points was the Manole’s vision that Coco would someday walk. The doctor found such an expectation as unrealistic under the “best” of circumstances, but certainly delusional if Coco was not even receiving the therapies, services, and assistance they were offering.

So the Manoles met with the official team and introduced them to Coco and his program. The net result of the meeting was that the team got the vision and now share the vision that unconventional parents, doing an unconventional program, not only could, but would if they continued do as they were, turn a vision into a reality.

The Manoles communicate with us very regularly (at times daily) and supply us with very regular program implementation videos. This level of communication and interaction has permitted us to continually modify program and program implementation in order to keep us targeted and thus to take the best advantage of neuroplasticity.

Coco’s dad, Razvan, is a man after my own heart—impatient. He’s not going to wait and see what the future will bring for his son. He’s going to create it.

Please watch Coco’s new video below. You will want to see what digit spans of 22 look like!

Reprinted by permission of The NACD Foundation, Volume 33 No. 1, 2020 ©NACD

Here is Coco’s reaction to seeing the article about him!

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In my last article I mentioned that working memory is another factor to consider when looking at anxiety in our children. Bob Doman, founder and director of NACD, has been at the forefront of understanding working memory and its impact on global function since the early ‘80s. It is a big deal. It is not just big, but huge, gargantuan, as it is the foundation that permits us to think. It not only permits us to think, but it also plays a role in our ability to regulate our emotions. Let’s spend some time on working memory, defining its role in our ability to handle stress.

Let’s first review how the brain works in a simple way. Information comes into the brain through our senses. If our sensory channels are functioning normally, the information gets perceived correctly, then it gets processed through our short-term memory. Our working memory is what allows us to think about this information along with taking information that we already know out of long-term memory. For example, if I am sitting in a class and I am listening to a lecture, I am taking in what that teacher says, hearing the information, processing what they are saying, and using my working memory to think about what I already know about that topic, how what they say impacts what I already know, what client comes to mind when I think of what the teacher is saying, etc. I am visualizing, conceptualizing, and developing an opinion or my own thoughts about that particular topic and how it may or may not benefit my work.

According to Bob Doman, “Working memory is the foundation for global neurological maturity and function. It essentially encompasses most of what we think of as ‘thinking.’”

“The NACD model of cognitive function recognizes various components of thinking and learning. Of all of these functions, working memory, including executive function, encompasses the areas that impact simple and complex behavior regulation and problem solving the most. The development of various parts of executive function appears to be a good indicator of future academic success, as well as future life success. Mathematics, reading, and critical thinking are all affected by how well various components of executive function develop and work. Not only do these neurological functions impact academics, but NACD and researchers also find that they impact social skills, job skills, and the skills needed for a child or adult to navigate daily life independently. Time management, time awareness, goal setting and planning, organizational skills, social awareness, financial planning, running a household, writing a research paper, writing a paragraph, and forming thoughts into conversation are all functions that depend on this higher cognitive level referred to as working memory and executive function.” (Doman, 2016)

So what does all this have to do with anxiety? When we think of our kids, anxiety can creep up when they have too much information coming in through their senses, but not enough short-term and working memory to manipulate the information. Have you ever seen a World History textbook? If you have a smart kid who wants to do well in school, but doesn’t have well developed short-term and working memory abilities, they are very likely to get anxious just looking at the book. The pieces that allow them to manage their time with material, organize their studying, and plan how to work through the material are not where they need to be in order for that child to be successful. Now if we have that same kid with five or six classes, with similar amounts of material, imagine how much more anxiety can develop.

Many of the anxious children on our caseload, who may be pre-adolescent age and are struggling with school to the point of shutting down, have poor working memory and conceptual thought. They simply don’t have the ability, YET, to be able to perhaps even process the information coming into their brain, let alone manipulate it and problem solve, think and reason through all that is being presented to them. Let’s also take into consideration what is happening with their bodies during this time frame. They become so overloaded they shut down. With our kids that have good short-term memory but poor working memory, rather than solve a problem that they are facing, sometimes these children may ruminate on the problem itself. Rumination is simply rehashing a problem in their head over and over without having the working memory that permits them to organize their thoughts and reach a conclusion, therefore creating increased anxiety. The more developed a person’s working memory is, the more likely they are able to solve and reason through their problems.

The more a child can reason, the less likely they are to get stressed and shut down. If we look at a neurotypical 3-4-year-old, they are just learning how to reason and problem solve. If they encounter something that is stressful to them, they don’t have the working memory to process the situation and are likely to dart or hide behind their mom versus using conceptual thought to reason as to how best to approach something. The same can be true for a child who is 12 years old but has the working memory of a 3-4-year-old. The same behavior happens, only it looks more problematic because it is an immature behavioral response for a child at that age.

We also have very bright individuals on our caseload who are also anxious because of their incessant need to be the best, to be perfect, to be the straight A student. When does academic pressure, measuring kids, too much testing, and narrow competition get recognized as potentially one of the greatest causes to mental health issues in our kids? Stay tuned to next month’s article.

Reprinted by permission of The NACD Foundation, Volume 32 No. 9, 2019 ©NACD

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A lot of folks, particularly in the USA, have a hard time describing where in the world Romania is or are able to tell you much of anything about Romania (which unfortunately speaks to our educational system); but ask about Transylvania and everyone’s interest perks up and they conjure up visions of Dracula.

This last month I spent almost two weeks in the mountains of Transylvania with about 200 of our NACD family members from five different countries. We were practically under the shadow of Bran Castle, or what is widely known as Dracula’s castle.

This event was made possible through the efforts of many folks, but particularly little Tudor’s mom, Andreea Dumitru, and Teodora Pop, our NACD Romanian Coordinator.

Andreea’s efforts resulted in the advertising company Blitz TV sponsoring the event and arranging for free rooms and breakfasts for all of the families at the Cheile Gradistei Resort. Without this help many of the families would not have been able to participate.

There were two primary reasons for orchestrating the Transylvania Experience. The first was to provide a venue for an in-person evaluation for the children in the region, particularly Romania and Bulgaria, and the second was to provide an opportunity for the families to spend time together. To varying degrees families with children with developmental and genetic issues find it difficult to integrate their children into many, if not most, social situations. Getting to spend time with other families with similar issues who understand, permitting them to share support, encouragement, and to just be able to relax, accept, and socialize was a great unique experience. Sadly, Romania and the surrounding countries are often not very accepting of many of our children; so it was particularly important to hold this event in Romania.

Our Romania chapter, which includes many Bulgarian families, is certainly our most proactive NACD chapter, doing everything they can to support each other and to educate other families in their countries about the hope that NACD offers. Our families travel from around the country to participate and share their NACD experience at every possible event that they think might help another family learn about the hope for their children. They understand that NACD’s family-centered approach means that any family in any place in the world is only a call, an email, or a Skype visit away from their coach and evaluator on any day and that they can help their children irrespective of what may or may not exist in their area.

The feedback from the event from the families was outstanding, and everyone wants to repeat it next year, even with the understanding that we may not have funding assistance. At the families request, I have happily committed to coming back again next year (I didn’t have a chance to visit the castle on this trip, so I need another visit to Transylvania) and we will hopefully return to the same spot and show off and share the children’s progress and help generate some new memories to add to those we created this year.

Personally, it was a bit demanding. It took twenty-two hours to get there, arriving in the evening and starting the evaluations first thing the next morning; but it was truly a marvelous experience. These are incredible families! Being able to relax and interact with the families and share meals and a little down time outside of the evaluation process was extremely rewarding. Perhaps some of my greatest memories are of watching the children with issues and all of the typical siblings interacting together as naturally as if they had know each other forever. The typical siblings were amazing to watch. They instinctively knew how and when to help and how to communicate with or just be with a new special needs child they had just met minutes before. Speaking of communication, the majority of the parents spoke English and often an additional language or two, as did the children. I loved all the “Hi Bob”s I heard from so many of the kids who were just learning to talk as they walked in for their evaluations.

We have some hope that other NACD chapters and groups around the country and the world will come together and do more to help build their regional community of NACD families.

Lesson to be learned: We do better as part of a community that shares a common approach, common ambitions, and a belief that the primary responsibility for our children and the best people to help our children are we, the parents. We can make a difference and change the lives and futures of our children.

As always it is an honor and a privilege to be involved with such incredible families and children.

For more photos and a daily journal of Bob’s trip, please visit our Facebook page!

Testimonials from our Romania Attendees

TEODORA POP

I also wanted to write a few words about this experience, but it is so hard to write about everything in a couple of phrases.

For me it was an amazing and different and new experience, even though I am with NACD for 2 years and a half now and I´ve been before to Bucharest to help Bob with translations. This time I also took part in the organisation of the event and it was amazing. Meeting families for the first time, seeing other again and listening to everyone´s story, sharing opinions and advises and being there with Bob during the eval was a HUGE learning experience for me. I am confident that my decision to stay in Romania and dedicate myself to this cause and to the NACD families in Romania was the correct and the best one! I am honored and humbled working with the NACD staff and with all of you here in the Romanian chapter!!!

IOANA GRECU

The experience in Cheile Gradistei was beautiful and full of emotions. We waited eagerly for this moment. We couldn’t wait to meet Bob Doman, and the impression of him is a great one. We feel that he is a very good person and very involved in what he is doing. The kindness with which he is looking at the children makes you trust that what he is saying is good for the little ones. The parents are great, full of hope and positive. We left the place trusting in the NACD program and trusting in ourselves as a family that we took the best decision when we joined the program. The landscape helped us to relax and to spend some family quality time. Even though we had to leave earlier than scheduled, the presence of the other kids and parents made the days feel very short and filled with great moments. Thank you for everything!

IOANA RASPOPA

I need to say that we are grateful for a great weekend. Yes it was beautiful, but meeting with Bob (this time Matei was OK and awake comparing to last year) was a huge reinforcement for us. We also got really useful information from Teo and from other parents that gave us courage to push for more changes for Matei.

RALUCA BUSUIOC

You know what the experience at Cheile Gradistei makes me think at? We are thought that from the 3: frequency, intensity and duration, the most important is the intensity. So this experience was not as much duration as is was high intensity! Exactly like in the NACD activities: high intensity, so that you will want more!!! So that it will be forever in your mind and in your heart!

FELICIA TUSLUC

It was a great experience, both because of meeting people with which we share the same vision of recovery and of the joy in our children’s eyes enjoying the fresh air with us and other children like them. Meeting Bob face to face again revived our hope and trust in the complexity of the program and in our capacity to obtain great results.

PAULA SERBAN

For me this experience was revealing! I saw my child with different eyes and my soul was filled with hope. Meeting the other parents was as important, feeling their support and full understanding. To be able to talk with people that totally understand was something that I wished for for a long time. Besides the NACD family it is very difficult to find so much understanding and good advice. Now I feel that I have recharged ‘my batteries’ and we can keep going with so much hope. Thank you so much NACD!

RALUCA MANEA

It was wonderful seeing Bob again and getting to meet old friends that we have known merely in the on line. The children had a great time and loved to make new friends. It was a great time of connecting and reconnecting.

ALEXANDRA ANGHELINA

For us it was a first on multiple levels. Our first evaluation, first time meeting Bob Doman, first contact with a community of this type, first time seeing how a program looks like. So far we are loving everything that we discovered. We start this road filled with trust and extremely motivated to learn how to implement the program correctly.
The experience of meeting other NACD families was a great and interesting one. I can only bow in front of all this people that I got the chance to meet. They are an example worth following.

Thank you so much for this experience. And we cannot wait to see you all next year!

ANGELA HLATCA

For us, the Hlatca family, this year evaluation was another reason for hope and joy: after one year of vacation we finally were able to start the program again. We were happy to see Mr. Bob Doman again and he encouraged us and gave us new hopes for Tudor. This year´s location was a very beautiful one and we felt great there. The evenings were the best, having the opportunity to meet new NACD families and spend time together, to share experiences and to enjoy our beautiful children with which we played a lot. Mr. Bob Doman spent some time with us in the evenings and he is such a warm and very friendly person. A big thank you also for those who organised this very successful event!

Reprinted by permission NACD Newsletter, July 2019 ©NACD

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Back in May we introduced you to Coco Manole, the incredible little boy who was developing really fantastic processing abilities. This little brain injured/cerebral palsy four-year-old had developed astonishing digit spans of 10 forward and 9 reverse, which is absolutely phenomenal. Very few adults have short term and working memory at this level. Well, that was then and this is now. He was just getting started.

Just for the sake of perspective, shortly after starting program in July of 2016, Coco was just learning to process very simple one-step directions, such as “touch your nose” and was unable to follow a two-step direction. He was also only was able to say three words and understood no English.

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Video: One Step Directions

Coco today, not yet even having reached his fifth birthday, is doing much better. Coco’s improved processing has helped him in every aspect of his development. Developing motor skills for a brain injured/cerebral palsy child, from creeping on the hands and knees, to manipulating the hands to pick up food to feed oneself is much easier when they can take direction and think through and mentally manage all of the little pieces required to start learning and performing these apparently simple functions. The difference in developing motor skills in a child with good cognitive abilities vs. one with lower cognitive function is no different than trying to teach quantum mechanics to an individual with strong working memory compared to one without.

Coco is now amazing all of us with his extraordinary processing abilities. His forward digit span is now an amazing 16! His auditory reverse is now an unimaginable 13, and after just a couple of months since starting on visual digit spans, his visual digit span is already a 13!

Video: Auditory Forward 16

Video: Auditory Reverse 13

Video: Visual Digit Span 13

I hope that everyone will be inspired by little Coco. Although the majority of his day and program is dedicated to developing his motor function, we are certainly not ignoring his academic/intellectual development. Coco reads close to 500 words in Romania and English and enjoys reading books in spite of his visual issues, which we are addressing and improving as well. He understands addition and subtraction and identifies and labels literally thousands of items in some detail and is very conversational. In July when I met with the family in London for Coco’s evaluation, I had the privilege of having dinner with the family. Coco was not only totally tuned into our conversations, but was a polite active participant who could have served as a model for some college students I know. He is also perhaps the sweetest and most compassionate child you will ever meet and is doing great as a big brother to his little sister, Ellen.

I firmly believe that we all have the potential to function at incredible levels and our ability to fulfill this potential is only limited by our vision, our commitment, and our knowledge.

Lack of function is not a prognosis of what can be.

Congratulations, team Manole! You are an inspiration for us all.

Reprinted by permission of The NACD Foundation, Volume 32 No. 7, 2019 ©NACD

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