cognitive & socio-emotional resilience in children with ... · 10/14/2016 · cognitive &...

Cognitive&Socio-EmotionalResilienceinChildrenwithDyslexia

FumikoHoeftMDPhD

[email protected] |@fumikohoeftUCSFDept ofPsychiatry|WeillInstituteforNeurosciences|YaleHaskinsLabs

R01HD078351(Hoeft,UCSF)R01HD086168(Hoeft/Pugh,UCSF/Haskins)R01HD065794(Pugh,Haskins)P01HD001994(Rueckl,Haskins/UConn)R01MH104438(Nordahl,UCDavis/MIND)R01MH103371(Amaral,UCDavis/MIND)

FUNDING

Liebe Patterson

Dennis&ShannonWong– DSEA‘88FoundationToney&PotterFamily

NSF1540854SL-CN(Gazzaley/Uncapher,UCSF)

TheHelpGroupSummit10.14.2016

Whyiseachchildsodifferent?Howcanweensuresuccessineachchild?

TAIGA“INFORMATIONSEEKER”

KAITO“STORYMAN”“3DMAN”

Empathic

Spiderman- Halloween

Analytic

Red/Whitebloodcell- Halloween

Avoidsreading Avidreader

JackHorner,apaleontologistfromJurassicPark/World

NOWTechnicalAdvisorofJurassicPark(=Dr.AlanGrant)MacArthurGeniusAward(‘86)Romer-SimpsonMedal(’13)

THENSeverelydyslexicGraduatedhighschoolwithD---Failedcollege7timesNevergraduatedGPA0.06(Honorarydoctorate,’06)

Importanceofresilience

Importanceofenvironment&community

Importanceoflookingatanindividualasawhole(includingliteracy butalsoothercognitiveandsocio-emotionalaspects) 3

Resilience

Theabilitytoadapttostressorsintheenvironment(adversity)by“bending”but

not“breaking”(Karatsoreos &McEwenF1000PrimeReports2013)

Socio-emotionalresilience Cognitiveresilience

Outline• IMPORTANCEOFANINTEGRATIVEAPPROACH

- Reading&dyslexiaarecomplex.- Multiplefactorsimpactdyslexia&success.

• THENEWNEUROSCIENCEOFDYSLEXIA

• COGNITIVERESILIENCE

• SOCIO-EMOTIONALRESILIENCE

• CONCLUSION

IntegrativeApproach|NewNeuroscience|CognitiveResilience|Socio-EmotionalResilience|Conclusion

CostofDyslexia

Risks

Dyslexia

POOROUTCOME: ReadingComprehension,EducationalAttainment,PsychosocialAdjustment

DLPFC

ORTHOGRAPHIC

PHONOLOGICAL

IFGopPreCG

SMGpSTG

FusiGITG

InsuladStr

PPC

SUSCEPTABILITYGENES


CostofDyslexia

Developingdyslexia 50%withfamilyhistory,(vs.7%inlowrisk)

Costtoindividual >£100klessearning($150k)Costto(UK)society >£1bn/year($1.5bn)HighSchooldropout 2.5xPrisonpopulation 32-46%(notelowIQandnotSLD!)Anxietydisorder 2.0x(5.0xseveretestanxiety)Depression 2.0xSubstanceabuse 2.7xADHD 4.5x

Pennington&Lefly.ChildDevelop2001;Cosden JLD2001;Wilsonetal.JLD2009;ForesightMentalCapitalandWellbeingProject.2008;DuPaul etal.JLD2012;


ResilienceModelofLD:PromotingResilience&OptimizingLDOutcome

Risks

Dyslexia

PoorFunctionalOutcome• PoorReadingComprehension• NegativePsychosocialAdjustment

Haft,Myers,Hoeft.Curr Opin Beh Sci 2016

StephanieHaft

Socio-EmotionalProtect.F.

INTERNAL• Growthmindset• Hopefulthinking• Senseofcoherence• Locusofcontrol• SelfdeterminationFAMILY• Familycohesion• Maternalaffect• Strongparental

attachment• Parentalsupport&

understandingofRDPEER/SCHOOL• Peerrelationships• Mentorshipby

teachers• Teachersupport• Smallclass-size

CognitiveProtectiveFactors

• Orallanguageskills• Motorskills• Task-focusedbehavior• Executivefunctions• Interpersonal

relationships

LessSevereDyslexia

• Morphologicalawareness• Vocabulary• Verbalreasoning• Executivefunctions• Grammar

PositiveOutcome


ImportanceofanIntegrativeApproachtoMaximizingChildren’sLearningPotential

Maximizing children’s learning potential

NEUROBIOLOGY

EXTERNALENVIRONMENT

INTERNALENVIRONMENT

STEREOTYPETHREATMOTIVATION&MINDSETRESILIENCE&GRIT

Weaknesses vs. Relativestrengths

Risk vs. Protectivefactors

Vulnerability vs. Resilience







• CONCLUSION


MultipleFactorsContributetoDyslexia

RiskGene2

RiskGene3

RiskGene1

ProtectiveGene1

ProtectiveGene2

DyslexiaRisk

Pennington.Cognition2006.Penningtonetal.JAbnorm Psychol 2012.– Multipledeficitmodel

Environment1

Environment2

Diathesis-stressmodel: Rosenthaled.“TheGenain Quadruplets”‘64Liabilitythresholdmodel: Gottesman &Shields.PNAS‘67


TheNeuroscienceofDyslexia– TraditionalViewFocusonWeaknesses,Risks&Vulnerability

phonologicalprocessing

(visual/selective)attention

cognitiveimplicitprocedurallearning

short-termmemory

informationprocessing

RELATIVEWEAKNESSES

d


TheNeuroscienceofDyslexia– TraditionalViewFocusonWeaknesses,Risks&Vulnerability

Occipito-Temporal(OT)Orthographicprocessing

Temporo-Parietal(TP)Phonologicalprocessing

POORREADERS&DYSLEXIA.Reducedefficiencyinbrainnetworksrelatedtospeech&visualaspectsofreading.Shaywitz etal.NEJM’98;Hoeftetal.JNeurosci ‘06.Hoeftetal.PNAS‘07


charactertraits,socio-emotional

Grit,Resilience,Mindset,Empathy

TheNeuroscienceofDyslexia– EmergingViewFocusAlsoonStrengths,ProtectiveFactors&Resilience

visuo-spatialHolistic,3d

cognitiveexplicitmemorycomprehension

IQ,reasoning,orallanguage…

RELATIVESTRENGTHS phonologicalprocessing

(visual/selective)attention

cognitiveimplicitprocedurallearning

short-termmemory

informationprocessing

RELATIVEWEAKNESSES

d


TheNeuroscienceofDyslexia– EmergingViewFocusAlsoonStrengths,ProtectiveFactors&Resilience

Occipito-Temporal(OT)Orthographicprocessing

Temporo-Parietal(TP)Phonologicalprocessing

PROTECTIVEFACTORS&RESILIENCEWhichbrainsystems???


Strengths,ProtectiveFactors&Resilience:Coincidence,CompensatoryorMeanttobe?

• Coincidence Bryden MP.Laterality’87

• Compensatory Lansdell HJ.CompPhysio Psychol ‘69,LevyJ.Nature’69

• Causal Kosslyn SM.Psychol Rev’87,Cai

etal.PNAS’13Evolutionaryadvantage Geschwind N.AnnalsofDyslexia‘84

http://www.theoryofhealth.com

www.quora.com

https://flipboard.com/@shannybasar/superhumans-dt0otb7iz


IntegrativeApproachtoDyslexiaResearch

msec

years

Learning

Cognition

Reading,Math

Perception

Socio-emotional

Preconception

Prenatal

Postnatal

Child

Adult

AdolescentDE

VELO

PMEN

TALSTAG

E

GeneNeurochemistry

Physiology

Neuroanatomy

Behavior


EEG

MRI

EEG/MEG

DTIfMRI

NIRS

TMS/tDCS

MEG

Genetics

Brainelectricalactivity Brainstructure&function

Brainstimulation

IntegrativeApproachtoDyslexiaResearch


OurWork@.

resilience

motivation/grit/mindset/stereotype

threatcharactertraits

growthchart

biomarker

earlyidentification

i-Screener

intervention/Prevention

UCSF Dyslexia CenterDEPARTMENTS:PsychiatryNeurologyOtolaryngologyPediatricsRadiology

PARTNER SCHOOL:The Charles Armstrong School

UCSF Dyslexia CenterSandler Neurosciences Center

675 Nelson Rising Lane, Suite 190San Francisco, California 94158

[email protected]

UCSF Dyslexia Center

Leading the way from basic neuroscience research to the classroom: individualized and strength-based approach

Collaborating with experts in�� Oral & written language�� Emotional processing including

reactivity & empathy�� Executive functioning & reasoning style�� Visuospatial processing�� Motor speech�� Structural & functional MRI imaging�� ADHD & anxiety�� Socio-emotional health & resilience�� Effects of dyslexia on aging

mechanism

prenatalenvironm

ent

genetics

brainimagingrisk

learning

compensatoryfactors

environment

LD/dyslexia

autism

bilingual

protectivefactors

underserved

UNESCO

US/CADept of

Ed

community schoolsmuseums

WhiteHouse

brainLENS

Mechanismofreading&learning

Earlyschoolreadiness&risk

Community

Socio-emotional,Charactertraits







• CONCLUSION


ResilienceModelofLD:COGNITIVERESILIENCE

Risks

Dyslexia





relationships

LessSevereDyslexia


PositiveOutcome


COGNITIVERESILIENCEResilientDyslexics

RESILIENTREADERS:Thosewithgoodcomprehensiondespitepoordecoding.

Thosewithdecodingdifficultiesrelymoreoncontextualinformationtobeabletoreadsuccessfully.INTERACTIVECOMPENSATORYMODELOFDYSLEXIA(Stanovich,1980)

Implicationsforintervention.

SmadarPatael PhD

LaurieCuttingPhD


COGNITIVERESILIENCEBrainMechanism?

RESILIENTREADERS

POORREADERS

TYPICALREADERS

Expectedpatternrelatedto:RESILIENCE

DECODING

COMPREHENSION

Decoding

Comprehension

TYPICALREADERS

GoodcomprehensionbutgooddecodingalsoPOOR

READERSPoordecodingbutalsopoordecoding

RESILIENTREADERS


COGNITIVERESILIENCELeftDorsolateralPrefrontalCortex(DLPFC)

Resilient > Poor readersResilient > Typical readers

RESILIENT READERS

POOR READERS

TYPICAL READERS

RESILIENCE

DECODING

COMPREHENSION


COGNITIVERESILIENCENotjustdyslexicsbutanyonecanhaveit.

R²=0.12409

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1

-40 -20 0 20 40

PrefrontalVolum

e

CognitiveResilience

10-16yochildrenwith&withoutpoordecoding


COGNITIVERESILIENCEChickenoregg?ShowsignsBEFOREreadingfailure.

R²=0.12409

R²=0.14004

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1

-40 -20 0 20 40

PrefrontalVolum

e

CognitiveResilience

Prereading kids’leftDLPFCpredictsfuture‘resilience’


COGNITIVERESILIENCERoleofDLPFCNetwork?

-2

0

2

4

6work

working1backmemorywm

2backload

encodedmaintenance

oddball

salient

shifting

attention

distractorcues

congruentexecutive

rulerehearsalconflictincongruentmonitoringrules

verbalverb

visuospatial

spatially

dyslexia

reading

readers

phonologyphonological

phoneticsemanticsemantically

nounsnoun

1000FunctionalConnectome.Neurosynth.org

Relatedtolearning,attention,&cognitiveflexibility

Fronto-parietalnetwork


COGNITIVERESILIENCEFronto-parietalnetwork“flexiblelearninghub”.

Dynamically changes how it connects to other key networks based on current goals.

Critical for learning new skills and building mental rules.

Allows immediate & flexible transfer of skills.

Coleetal.NatNeuroscience’13


COGNITIVERESILIENCE?OtherFrontalMechanisms

Phonological

Orthographic

Articulatory

Hoeftetal.PNAS’07; HancockRichlan Hoeft.Neurosci Beh RevHoeftetal.PNAS‘11

RoelandHancockPhD

LeftFronto-StriatalNetwork– ArticulationRightInferiorFrontal&Fronto-ParietalWhiteMatter– Predictoutcome


COGNITIVERESILIENCE:Summary

Prefrontal&fronto-parietalnetwork

Cognitiveflexibility,learningnetwork

Importanceofpromotingactivitiestoenhancecognitiveflexibility&self-regulationearly







• CONCLUSION


ResilienceModelofLD:SOCIO-EMOTIONALRESILIENCE

Risks

Dyslexia








PositiveOutcome


SOCIO-EMOTIONALRESILIENCECharactertraitscriticalforsuccess

Selfdiscipline,morepredictivethanIQ(2x)&aboveandbeyondachievementitself

(Duckworth&Seligman,Psychol Sci ‘05)

2x

Above&beyondIQ&achievement


SOCIO-EMOTIONALRESILIENCEBrainmechanisms

VTA

GROWTHMIND-SET:Beliefthatabilityiseffortbased

GROWTHMINDSET

COGNITIVEREAPPRAISAL(Dohertyetal.Science‘04)

INTRINSICMOTIVATION(Muyrayama etal.PNAS’10)

VTA

GRIT:Perseverancetowardalongtermgoal

GRIT

PERSISTENCE(Gusnard etal.PNAS‘03)

FUTUREREWARD(Dohertyetal.Science’04)

Myersetal.SCAN2016

Multipletargets– Multipleroutestoenhancelearning

ChelseaMyers


SOCIO-EMOTIONALRESILIENCEStereotypethreatmayputindividualsatrisk

“Stereotypethreatisbeingatriskofconfirming,asself-characteristic,anegativestereotypeaboutone’s

group.”–SteeleandAronson(1995)

“Whitemencan’tjump.” “Womenarenotgoodatmath.”

reducingstereotypethreat.org,Whistlingvivaldi byClaudeSteele

“AfricanAmericanshavelowerintelligencethantheirwhitepeers.”


SOCIO-EMOTIONALRESILIENCEStereotypethreatMAYexistinLDs

Whymightindividualswithlearningdisabilities(includingdyslexics,butalsoADHDetc)experiencestereotypethreat?

• Groupidentification- lowachievement• Awareofstereotype(KellyandNorwich,2004;Rashkind etal.,2006)• Negativeacademicself-concept(Zeleke,2004)• Lowself-esteem,negativeaffect,anxiety,and

depressionwhenfacedwithperformance-avoidancegoals(thedesiretoperformlesspoorlythanothers)(Sideridis,2007;Aquino,2011)


SOCIO-EMOTIONALRESILIENCEAnIntegratedProcessModelofStereotypeThreat

ConceptofAbilityDomain

ConceptofGroup

ConceptofSelf

“Iamagirl…”

“IthinkIamgoodatmath…”

“Girlsarebadatmath(andmathisimportanttome)…”

Forbesetal.,2008

Discordanceleadstostereotypethreat

ReducedattentionStress&AnxietyFear&ThreatReducedlearning&memory,&performance

Everyoneisprone.


SOCIO-EMOTIONALRESILIENCEBrainmechanismofstereotypethreat?

Women&under-performanceinmath

Krendl etal.Psychol Sci 2008

LackofimprovementinmathperformanceovertimeunderST(interaction:p<.005)

Stereotypethreatimpactskeycognitivenetworksandemotion-relatednetworksnegatively

LackofMATHrelatedactivationunderST

IncreaseinEMOTIONalresponseunderST

NoSTgroup STgroup NoSTgroup STgroup


SOCIO-EMOTIONALRESILIENCEBuildingResilienceAgainstStereotypeThreat

• Reframingthetask(e.g.Quinn&Spencer,2001)

• De-emphasizingthreatenedsocialidentities(e.g.Stricker andWard,2004)

• Rolemodels(e.g.Blantonetal.,2000)

• Externalattributionsfordifficulty(e.g.Goodetal,2003)

• Self-affirmations(e.g.Schimel etal.,2004)

• Growthmindset(e.g.Aronsonetal.,2002)


SOCIO-EMOTIONALRESILIENCEStrength-basedapproachmaybuildresilience

r =.42

Poorerthereading,betterthevisuo-spatial(configural)abilities(vonKárolyi etal.,‘01;‘03).

Read

ingAb

ility

Visuo-SpatialDifficulty

Diehl…Hoeft…Pugh.NeuroImage ‘14


Visuo-spatialprocessingshowyin-yangrelationshipwithreading

KenPugh

SOCIO-EMOTIONALRESILIENCEMentoringmaybuildresilience

Scores

26.7%***P<0.0001

12.5%~*P=0.05

2.5

3

3.5

4

4.5

5

Responsetofailure

Depression SelfEsteem

Fall Spring

Displaymorepositiveemotionsandeffort-basedstrategiesinthefaceoffailure.

IMPROVEMENTIN:

SELFESTEEM(12%)GRIT(value)(8-36%)GROWTHMINDSET(14%)LDIDENTITY(comfort,bond,importance)(24-52%)READINGSELF-CONCEPT(19%)etc…

N=48


SOCIO-EMOTIONALRESILIENCEMentoringmaybuildresilience

-100

-50

0

50

100

150

1.5 2 2.5 3 3.5

Self-Esteem

(FalltoSprin

g%increase)

Mentee-RatedMentorshipQuality(1-lowto3-high) N=39

R２=0.13(r=0.36)P=0.025


SOCIO-EMOTIONALRESILIENCE:Summary

• Stereotypethreat&fixedmindsetcouldbepotentialmechanismsunderlyingunderperformanceinthosewithlearningchallenges.

• Otherssuchasanxiety,motivationandreducedgritlikelyinteractwithstereotypethreatandfixedmindset,andresultinfurtherunderperformance.

Dyslexia StereotypeThreat

AttentionPFresources Fixed

mindset

Reducedgrit

Reducedacademicachievement

Reducedmotivation

Anxiety







• CONCLUSION


CONCLUSION:PromotingResilience

Risks

Dyslexia










relationships

LessSevereDyslexia


PositiveOutcome

COGNITIVETRAINING

SOCIO-EMOTIONALLEARNING(mentoring)

LITERACYINTER-VENTIONS


CONCLUSION:PromotingResilience

• Cognitivecontrol,self-regulation– Cognitivereappraisal&positivereframing,Promotesgrit

• Strengthbasedapproach– Confidence,Optimism

• Growthmindset– Activecoping(senseofcontrol),Optimism

• Socialsupport,rolemodel,mentoring– Connectiontocommunity

• Reducestereotypethreat– Optimizelearningenvironment&enhancedperformance

• Stressinnoculation (exposuretotolerablelevelsofstress&challenges)

Charney.NatRevNeurosci 2009;KenGinsberghttp://www.fosteringresilience.com/7cs.phpIntegrativeApproach|NewNeuroscience|CognitiveResilience|Socio-EmotionalResilience|Conclusion

BayAreaUCSF(NCWhite,RHendren,KLeWinn,LPasch,MGorno-Tempini,BMiller);UCBerkeley(SBunge);UCDavis(YUchikoshi,DAmaral,CWuNordahl);UofSF(GLeung);USA/CanadaBostonCollege(JBlack);GeorgiaStateU(RMorris);HarvardU,BostonChildren’sHospital(LProck Albers);MIT(JGabrieli);UofBritishColumbia(LSiegel);UofMichigan(IKovelman,RMarks);VanderbiltU(LCutting);

YaleU,HaskinsLabs,UConn(KPugh,JReuckl;EGrigorenko);AsiaBeijingNormalU,China(HShu);HebrewU,Israel(RFrost);KeioU,Tokyo,Japan(BYamagata,MMimura);Nat’lCntrl U,InstofCogNeurosci,Taiwan(DWu,OTseng)UHongKong,China(CMcBride);EuropeBCBL,Spain(MCarreiras);UCollegeLondon,UK(CHulme);UofJyvaskyla,Finland(HLyytinen,PLeppannen,URichardson);UofSalzburg,Austria(FRichlan);

[email protected] |@fumikohoeft |brainlens.org

R01HD078351(Hoeft,UCSF)R01HD086168(Hoeft/Pugh,UCSF/Haskins)R01HD044073 (Cutting,Vanderbilt)R01HD065794(Pugh,Haskins)P01HD001994(Rueckl,Haskins/UConn)R01MH104438(Nordahl,UCDavis/MIND)R01MH103371(Amaral,UCDavis/MIND)

AcademicSenateAwardDyslexiaCenter(CharlesSchwab,KellyGorman&SteveCarnevale,FloraFamilyFndtn,BatteryPowered,Thomas&EvaFongFamilyFndtn,Lori&RaydePole,Dan&StaceyCaseFamilyFndtn)

FUNDING

Liebe Patterson

Dennis&ShannonWong– DSEA‘88FoundationToney&PotterFamily

NSF1540854SL-CN(Gazzaley/Uncapher,UCSF)

PARTNERS


Thankyou…

POSTDOC&RESEARCHASSISTANTWANTED!


cognitive & socio-emotional resilience in children with ... · 10/14/2016 · cognitive &...

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