Signs of dyslexia may be present in the brain from birth

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Some 5 to 17 percent of all children have developmental dyslexia, or unexplained reading difficulty. When a parent has dyslexia, the odds jump to 50 percent.

Typically, though, dyslexia isn’t diagnosed until the end of second grade or as late as third grade, when interventions are less effective and self-esteem has already suffered.

“It’s a diagnosis that requires failure,” said Nadine Gaab, Harvard Medical School associate professor of pediatrics in the Laboratories of Cognitive Neuroscience at Boston Children’s Hospital.

A new study in the journal Cerebral Cortex led by Gaab and lab members Nicolas Langer and Barbara Peysakhovich has found that the writing is on the wall as early as infancy—if only there were a way to read it and intervene before the academic, social and emotional damage is done.

In 2012, the Gaab Lab showed that pre-readers with a family history of dyslexia (average age 5½) have differences in the left hemisphere of their brains, according to magnetic resonance imaging (MRI).

“The first day they step in a kindergarten classroom, they are already less well-equipped to learn to read,” Gaab said.

Some researchers have proposed that the difference reflects being raised by a dyslexic parent—perhaps, for example, being read to less. But could the difference be innate?

To answer this question, Gaab and colleagues performed advanced MRI brain imaging on 14 infants with a family history of dyslexia and 18 infants of similar age with no such family history.

Since infants need to be completely still inside the scanner, this required an elaborate protocol, developed with the help of Ellen Grant, HMS associate professor of radiology and director of the Fetal-Neonatal Neuroimaging and Developmental Science Center at Boston Children’s.

Parents brought their babies in for scanning before their best naptime, early enough that they wouldn’t fall asleep in the car, and settled them in a space that was intended to mimic the babies’ home sleep environment. Time was built in to allow babies to get used to the sound of the MRI machine.

Once parents got their babies off to sleep, Gaab’s team carefully slid the infants into the scanner. This strategy worked about 70 percent of the time.

The MRI scan included an advanced technique called diffusion tensor imaging (DTI). It measures the flow of water molecules along the brain’s fiber tracts, and gives a good indication of how the fibers are structured and oriented and how well information is flowing in the brain.

As reported in the new study, the scan found alterations in a particular structure called the arcuate fasciculus, a bundle of fibers that connects the posterior cortex, which is involved in mapping sounds and word/letter recognition, with the frontal cortex, which integrates and comprehends this information.

The arcuate fasciculus in a child with a family history of dyslexia (L) versus no family history (R), as seen on DTI. Image: Nicolas Langer and Barbara PeysakhovichDetailed segmentation of the images revealed that fibers in certain areas of the arcuate fasciculus were consistently less organized.

People who have suffered damage to the arcuate fasciculus are known to have problems with expressive and receptive language and with phonological processing—the ability to manipulate the sounds of a language, a critical part of learning to read. In infants with familial dyslexia, inherited genes may interfere with the prenatal development of the arcuate fasciculus, said Gaab, impairing its structural integrity.

“The street could be full of potholes, or it could be the street is narrow or has a really crappy surface, or there might be a lot of intersections where you have to stop,” she said.

But biology isn’t necessarily destiny. Research shows that with early interventions, 50 to 90 percent of children with dyslexia can become good readers, said Gaab. There are even studies indicating that the interventions lead to normalization of white matter pathways in the brain’s left hemisphere.

But while public health studies support early intervention for dyslexia, many schools shy away from screening, lacking the resources to test and intervene.

“We hope this study will help show that kids should get interventions before kindergarten,” said Gaab. “We’re not saying you should scan every kindergartner, but if you have a strong family history, you could potentially have a five-minute DTI scan to see if you are at risk.”

Adapted from a post on Vector, the clinical and research innovation blog at Boston Children’s.

Source hms.harvard.edu

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Coaching psychology explained

Why do clients use coaching psychology services?

Using 'self-help' approaches to personal and professional development can be risky. Sometimes the right kind of help provided at the right time can be life changing. Coaching psychology is a service that people access when they feel that professional support in building a happier, more successful or satisfying life would be of value to them.

How do coaching psychologists support clients?

Contrary to the stereotypical portrayal of psychologists in the popular media, coaching psychologists do not judge, impose or assume that they are the 'expert' in what the client needs to do in life, and they do not give 'advice'. Good coaching psychology is about using the art and science of psychology in practical down to earth ways to support clients in creating their own success at work and in life.

It is worth bearing in mind that most of the tools and techniques currently applied by practicing coaching psychologists have been drawn from the domains of clinical, counselling and organisational/occupational psychology and are predominantly cognitive behavioural in nature. There are, however, many ways of applying psychology to deliver the type of services that coaching psychologists offer.

One of the ways coaching psychologists support clients is by helping them set out their own path for personal success in life and at work and not by providing a specific set of answers or 'paradigm' to work with.

Coaching Psychologists will also constructively challenge the beliefs and assumptions clients make that prevent them either from reaching their full potential or find a different path to follow in support of building a happier, more successful or satisfying life.

Understanding and accepting the choices that are made in life can be fundamental to a client's ultimate success within their personal journey. Coaching psychology supports future happiness, satisfaction and success through compassionate exploration of the choices people have made to inform better decision making practices in the 'here and now'.

Sometimes coaching psychologists use specific, focused techniques with long and scary sounding names which can be daunting for people who are not from an academic or scientific background. A good Coaching Psychologist will ensure that when specific techniques are used, that they do not get in the way of the developmental process. Rather than using professional jargon the techniques used by Coaching Psychologists are explained in clear every day language and explanations generally cover what specific techniques are being used and why. Coaching Psychologists are able to offer a simple explanation of scientific evidence for applying specific approaches in language that clients can understand.

Psychotherapeutic techniques are also sometimes applied by Coaching Psychologists within coaching relationships. The exploration of serious issues such as unresolved childhood abuse or coping with either psychiatric injury or disability can be dealt with in positive life affirming ways. Using psychological approaches in ways that are not 'clinical' or 'medically' focussed has significant scope for supporting people with mild to moderate mental health issues in the wider community.

Some Coaching Psychologists are able to skilfully weave clinical or psychotherapeutic approaches into their coaching work and address the complex boundary issue by making sure this approach is agreed up front with the client at the beginning of the coaching relationship.

Other coaching psychologists will not deal with these issues and will not apply either clinical or psychotherapeutic techniques within a coaching relationship, preferring instead to on-refer clients to another service provider to address issues of a mental health or psychiatric nature in another setting. This is done to manage the boundaries between different types of service that have been contracted.

The client's needs, wishes and best interests are always paramount in considering the structure of coaching psychology services and explicit client permission is needed if issues of this nature are to be addressed within a coaching relationship.

A coaching psychology programme is complete when the client feels able to lay down their own path to happiness, satisfaction or success without needing our ongoing support. There is no set time frame for this because each client is different and has unique needs. Clients are always welcome to re-engage with services at times of particular stress or where big decisions are being made and additional support is felt to be useful. Coaching Psychologists aim for appropriate use of services and are ever mindful of the potential for clients to become dependent on the positive, life affirming support they receive from us rather than developing and accessing these supports from their social and professional networks.

The ultimate goal of a coaching psychology service is to provide a focused service in support of clients in developing insight and skill in tapping their own inner resources.

One of the ways coaching psychologists achieve this goal is by supporting clients to get in touch with their inner resources in the uniquely personal ways that make sense to them.

How is coaching psychology different from other types of psychological service?

There are many sub-domains of psychology which is often confusing both for clients and psychologists alike. The many names for the services psychologists deliver in society essentially cover the same kinds of services delivered in different contexts and which draw upon different combinations of evidence based tools, techniques and practices. At the end of the day, coaching psychologists are not really different at all from other types of psychologists. What all psychologists have in common is that we use both the art and the science of psychology to provide compassionate services for clients who come to us for support in leading happier, more successful or satisfying lives.

What this means is that a coaching psychologist can be usefully defined as a helping professional who applies the art and science of psychology to support clients in leading happier, more successful or satisfying lives within a coaching relationship. If you are a psychologist and take this broad and positive approach to your work then in my view you can legitimately call yourself a coaching psychologist irrespective of what domain you practice in or what specific tools and techniques you use in support of your practice.

A final thought

Perhaps the one defining feature of those of us who call ourselves 'coaching psychologists' both now and in the future is that we have broken free of the limitations imposed on us by the way the profession of psychology has been artificially subdivided into 'silos' within the various professional bodies that we all belong to around the world.

What could ultimately define us as Coaching Psychologists is the creativity and courage to apply psychological arts and sciences in ways that are as unique and individual as the clients we support.

Specific Phobias

New places, high bridges, old elevators may make all of us a bit uneasy or even frightened. We might try to avoid things that make us uncomfortable, but most people generally manage to control their fears and carry out daily activities without incident.

But people with specific phobias, or strong irrational fear reactions, work hard to avoid common places, situations, or objects even though they know there's no threat or danger. The fear may not make any sense, but they feel powerless to stop it.

People who experience these seemingly excessive and unreasonable fears in the presence of or in anticipation of a specific object, place, or situation have a specific phobia.

Having phobias can disrupt daily routines, limit work efficiency, reduce self-esteem, and place a strain on relationships because people will do whatever they can to avoid the uncomfortable and often-terrifying feelings of phobic anxiety.

While some phobias develop in childhood, most seem to arise unexpectedly, usually during adolescence or early adulthood. Their onset is usually sudden, and they may occur in situations that previously did not cause any discomfort or anxiety.

Specific phobias commonly focus on animals, insects, germs, heights, thunder, driving, public transportation, flying, dental or medical procedures, and elevators.

Although people with phobias realize that their fear is irrational, even thinking about it can often cause extreme anxiety.

Depression

Most people feel anxious or depressed at times. Losing a loved one, getting fired from a job, going through a divorce, and other difficult situations can lead a person to feel sad, lonely, scared, nervous, or anxious. These feelings are normal reactions to life's stressors.

But some people experience these feelings daily or nearly daily for no apparent reason, making it difficult to carry on with normal, everyday functioning. These people may have an anxiety disorder, depression, or both.

It is not uncommon for someone with an anxiety disorder to also suffer from depression or vice versa. Nearly one-half of those diagnosed with depression are also diagnosed with an anxiety disorder. The good news is that these disorders are both treatable, separately and together.

Read on to find out more about the co-occurrence of anxiety and depression and how they can be treated.

Depression

Depression is a condition in which a person feels discouraged, sad, hopeless, unmotivated, or disinterested in life in general. When these feelings last for a short period of time, it may be a case of "the blues."

But when such feelings last for more than two weeks and when the feelings interfere with daily activities such as taking care of family, spending time with friends, or going to work or school, it's likely a major depressive episode.

Major depression is a treatable illness that affects the way a person thinks, feels, behaves, and functions. At any point in time, 3 to 5 percent of people suffer from major depression; the lifetime risk is about 17 percent.

Types of Depression

Three main types of depressive disorders—major depression, persistent depressive disorder, and bipolar disorder—can occur with any of the anxiety disorders.

Major depression involves at least five of these symptoms for a two-week period. Such an episode is disabling and will interfere with the ability to work, study, eat, and sleep. Major depressive episodes may occur once or twice in a lifetime, or they may re-occur frequently. They may also take place spontaneously, during or after the death of a loved one, a romantic breakup, a medical illness, or other life event.

Some people with major depression may feel that life is not worth living and some will attempt to end their lives.

Persistent depressive disorder, or PDD, (formerly called dysthymia) is a form of depression that usually continues for at least two years. Although it is less severe than major depression, It involves the same symptoms as major depression, mainly low energy, poor appetite or overeating, and insomnia or oversleeping. It can manifest as stress, irritability, and mild anhedonia, which is the inability to derive pleasure from most activities.

People with PDD might be thought of as always seeing the glass as half empty.

Bipolar disorder, once called manic-depression, is characterized by a mood cycle that shifts from severe highs (mania) or mild highs (hypomania) to severe lows (depression).

During the manic phase, a person may experience abnormal or excessive elation, irritability, a decreased need for sleep, grandiose notions, increased talking, racing thoughts, increased sexual desire, markedly increased energy, poor judgment, and inappropriate social behavior.

During the depressive phase, a person experiences the same symptoms as would a sufferer of major depression. Mood swings from manic to depressive are often gradual, although occasionally they can occur abruptly.

Depression and Anxiety Disorders: Not the Same

Depression and anxiety disorders are different, but people with depression often experience symptoms similar to those of an anxiety disorder, such as nervousness, irritability, and problems sleeping and concentrating. But each disorder has its own causes and its own emotional and behavioral symptoms.

Many people who develop depression have a history of an anxiety disorder earlier in life. There is no evidence one disorder causes the other, but there is clear evidence that many people suffer from both disorders.

A major depressive episode may include these symptoms:

A major depressive episode may include these symptoms:

• Persistent sad, anxious or "empty" mood
• Feelings of hopelessness, pessimism
• Feelings of guilt, worthlessness, helplessness
• Loss of interest or pleasure in hobbies and activities, including sex
• Decreased energy, fatigue, feeling "slowed down"
• Difficulty concentrating, remembering, making decisions
• Insomnia, early-morning awakening, or oversleeping
• Low appetite and weight loss or overeating and weight gain
• Thoughts of death or suicide, suicide attempts
• Restlessness, irritability
• Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders and pain for which no other cause can be diagnosed.