Alternatives to labelling

Considering all the controversy around labelling, it is not surprising that new models have emerged that provide alternative frameworks for assessing the needs of learners with SEN.

2.4.3.1. Response to Intervention models

Some schools try to circumvent the processes of diagnosis and labelling by relying and focusing more on teaching and learning. An example of such an alternative is the three-tier approach of the Response to Intervention (RtI) model (Fuchs, Mock, Morgan & Young, 2003, p. 159). In RtI, learners are provided quality instruction and their progress is monitored. Those who do not respond appropriately are provided additional assistance and their progress is again monitored. Those who continue to not respond are thereafter considered for special education services.

58 2.4.3.2 Functional brain mapping

Perry and his co-workers (Perry & Pollard, 1998; Perry, 2006; Perry & Hambrick, 2008; Perry, 2009) have made brain imaging accessible to special education, in the form of a tool called the functional brain map. The tool is connected to a questionnaire that when completed produces a visual representation, showing which areas of the brain are underserved by neurological input. His work, like the IQ test, contributes to the invisible- visible shift by making what was previously invisible — brain structures and functions — visual and visible to educators. Since the brain map forms part of the learner's psycho-educational profile, I discuss its principles in more depth.

i) It fits within the Neurosequential Model of Therapeutics

The brain map developed from within the Neurosequential Model of Therapeutics (NMT). Perry and his co-workers developed NMT as a framework to explain the effect of trauma on children. They describe NMT as a developmentally sensitive, neurobiologically informed approach to clinical work, and not as a specific therapeutic technique or intervention. More recently, Perry and his team have been working on adapting NMT to school environments as The Neurosequential

Model of Education (NME). Although it is primary a model for trauma,

Perry states that it could also be used for children with developmental delays; however, the time period for restructuring may take longer for a developmentally delayed child than for a trauma child. The

framework has five core principles which are as follows:

● The brain consists of interconnected systems: NMT sees the brain as multi-systemic, involving different systems that interact and are interconnected. Four main anatomically distinct regions are

59 and cortex. Various parts of the systems of the brain mediate

different functions, for example, the cortex mediates thinking while the brainstem/midbrain mediates states of arousal.

● The brain is organised in a hierarchy: Most of the brain's

organisation takes place in the first four years of life. The brain is organised sequentially in a specific hierarchy. The least complex features are located in the brainstem at the bottom, and the most complex are found in the cortex at the top. During development, the brain organises from the bottom to the top, meaning that the lower parts of the brain develop earliest.

● The brain's development is influenced by neuro signals:

Monoamine neural systems (i.e. norepinephrine, dopamine, and serotonin) are very important in the brain. These project throughout all brain regions from the bottom up and have the unique capacity to communicate across multiple regions simultaneously and therefore provide an organizing and orchestrating role. As noted above, the organization of higher parts of the brain depends upon input from the lower parts of the brain. If the incoming neural activity in these monoamine systems are regulated, synchronous, patterned, and of "normal" intensity, the higher areas of the brain will organize in healthier ways. If incoming neural activity is extreme, dysregulated, and asynchronous, the higher areas will organize to reflect these abnormal patterns. Consequently, when these monoamine neurotransmitter systems are impaired they can result in a cascade of dysfunction from the lower regions (where these system originate) all the way up to areas higher in the brain. Put differently, when neurosystems in the brain are compromised and become abnormally organised, they lead to dysfunction.

60 ● The age of the experience affects brain organisation: This model

takes the history of the learner very seriously in so far as it tries to relate dysfunctional symptoms to the nature, timing, pattern, and duration of the developmental experience. For example, the very same traumatic experience will impact an 18-month-old child differently than a 5-year-old.

● The brain stores memory: NMT sees the brain as a historic organ. Structural and chemical changes in neurons allow for the storage of information or memory. As noted above, various parts of the brain mediate different functions. In addition, they also store information that is specific to the function of that part. This allows for different types of memory (cognitive — such as names and phone numbers; motor — such as typing or bike riding; or, affective – such as nostalgia). The brain stores information in a use- dependent fashion. The more a neurobiological system is "activated", the more that state (and functions associated with that state) will be built in. If these states persist, they will become traits.

Consequently, the more frequently a pattern of neural activation occurs, the stronger will become its internal representation. The internal representation functions as a processing template through which all new experience is filtered. In the developing brain, memory states organise neural systems, which then become traits. A child will develop an atypical or abnormal pattern of neural activation when important neural systems are being over-activated during sensitive periods of developments.

ii) It is an assessment tool

Perry and his colleagues (Perry & Hambrick, 2008) state that the map is an oversimplification of the complexity of brain regions, yet it is useful to practitioners as an assessment/progression tool. It

61 provides an approximation of the developmental/functional status of the child's key functions, helps establish the strengths and

vulnerabilities of the child, and helps determine the starting point and nature of enrichment and therapeutic activities most likely to meet the child's specific needs. When used with the NMT

philosophy, this functional map helps to document progress and to create a developmentally sensitive sequence to enrichment,

educational, and therapeutic work.

iii) It is matched with specific interventions or therapeutic techniques

The NMT process helps match the nature and timing of specific therapeutic techniques to the developmental stage, brain region, and neural networks mediating the neuropsychiatric problems. Since the brain is organised in a hierarchical fashion, interventions have to start at the bottom and work upwards from there (Perry & Pollard, 1998). The idea is therefore to start with the lowest part of the brain related to the undeveloped/abnormal functions and to move sequentially up the brain as improvements are seen. This means that the first step in therapeutic success is brainstem regulation. A variety of patterning, repetitive somatosensory activities are advised as a way of reaching the brain stem. It is important to reach the brainstem in order to confront issues of self-regulation including arousal, impulsivity, and

hyperactivity. Examples of such somatosensory activities include music, yoga, rhythmic breathing, drumming, and therapeutic massage. Once self-regulation shows improvement, the focus then has to shift to the limbic area to deal with relational-related problems. This can be done with play and arts therapies. After relationship skills have been established, a verbal and insight oriented approach can be adopted to work with the cortex areas of the brain. In short, brain function is strengthened through starting with repetitive rhythmic somatosensory experiences, then working towards establishing relationship skills, and

62 lastly by strengthening reasoning.

iv) It has several advantages

The brain map tries to follow biological markers rather than social category constructions. Its use in education is not as clear as an x-ray of a broken bone would be to a radiologist or a doctor, but,

nonetheless, I do feel that as educators we should start engaging with it to gauge its potential in practice. It is positive in that it:

 bypasses the act of labelling and diagnosing

 it is comprehensive and holistic

 it promotes growth, not stagnancy or fixed-ability

 it provides data that can be used to discuss the learner and inform classroom practices, making it suitable as a type of evidence-based practice

 it provides a well-rounded reference point of what to expect in terms of the learner's functions relative to home and school

v) It has challenges

The body is a physical organ and we have come a long way in

understanding its mechanisms. Likewise, the brain is a physical organ that we are beginning to grapple with through neuroscience, but the real relationship between the brain and the mind still eludes us. The jump from the physical to the mental and the biological to the symbolic is not clear nor necessarily linear, yet Perry's work reminds us that brain functions influence all functioning — emotional, physiological, behavioural, and cognitive. We are still looking for clarity on whether intellectually disabled learners are just slower learners who need more time to learn or whether they actually learn differently. The brain map indicates that learners with SEN present with different brain structures and brain functions. Furthermore, the NMT philosophy suggests that

63 learners with SEN do not just need more time but that they need very specific intervention, and in a specific sequence, depending on which area of the brain is under-activated. To emphasise, learners with SEN are developmentally different. Carlson (2010, p. 38-39) reminds us that schools that accept the notion that intelligence is dynamic, in this instance through restoring brain function, have to then assume far more complex roles than those who ignore the development of intelligence itself in favour of knowledge accumulation.

2.4.3.3. Dynamic Assessments

I have already discussed the rationale of using dynamic assessment (DA) as part of this study in Chapter 1. For completeness sake, I reiterate that DAs have proved particularly beneficial for learners with SEN (Gillies, 2014). DA is an umbrella term for types of formative assessment aimed at assessing the learning potential of learners (Feuerstein et al., 2010; Le Beer, 2011). To illustrate DA, Vygotsky (1935/2011, p. 203-204) worked with two learners who were both 10 years old and who both had standardised test results that showed that they had the mental age of 8 years. He worked with one of the learners and together they solved problems that corresponded to the norm of 9- year-old children. Thereafter, he worked with the other learner and together they solved problems that corresponded to the norm of 12-year-old children. His conclusion was that the two children were not intellectually equal, as was suggested by standardised testing, in that the second learner had a higher learning potential compared to the first.

DA blends instruction with assessment, learning, and intervention.

Consequently, DA forms a contrast to standardised testing, where the learners have to perform independently and are generally assessed by the assigning of a score to the product that they have produced independently of the examiner. One of the important goals of DA is to formulate recommendations for the development of learners' cognitive and learning functions via targeted cognitive intervention, based on the belief that these functions are flexible

64 rather than fixed (Kozulin, 2014, p. 569; Feuerstein et al., 2010). Moreover, Kozulin (2014, p. 556) also points out the strong relation between Response to Intervention (RtI) and DA. The higher a learner's potential to learn, the more likely that learner is to benefit from second tier intervention. On the other hand, a learner with a very low learning potential will most likely benefit more by remaining in or transferring to a SEN unit.