Managing working memory loads in the classroom and the importance of broader cognitive dimensions that impede learning Dr Joni Holmes Head of the Centre for Attention, Learning and Memory MRC Cognition and Brain Sciences Unit, University of Cambridge International Thinking Skills Conference, 12th June 2018

Overview Introduction to working memory Working memory and learning Characteristics of children with working memory problems Supporting children with working memory difficulties CALM: Importance of other cognitive abilities for learning

Introduction to memory

Different kinds of memory Procedural memory Learned skills Lasts: lifetime, once skill is established Examples: writing, riding a bike

Different kinds of memory Semantic memory Facts, knowledge Lasts: a lifetime, if used sufficiently frequently Example: knowing that Paris is the capital of France

Different kinds of memory Autobiographical memory Stored facts and significant events from your life Lasts: a lifetime Examples: first day at school, your wedding day

Different kinds of memory Episodic memory Records details of particular experiences Lasts: up to several days Examples: Remembering breakfast this morning, or where you parked the car

Different kinds of memory Working memory Store information over the short-term Lasts: seconds only Example: following instructions such as “When you pass the church on the left, turn immediately right and take the second left”

Working memory: Key features Capacity to hold material in mind and manipulate as necessary for brief period Mental workspace Limited in capacity Catastrophic loss

Working memory: Development Working memory ability increases steadily with age between 4 and 14 years Huge differences in working memory ability between children of the same age

Mean scores on working memory test as a function of age, with 10th & 90th centiles

Mean scores on working memory test as a function of age, with 10th & 90th centiles

WM and Developmental Disorders Deficits in WM are a common feature in many acquired and genetic developmental disorders of learning ADHD (Martinussen & Tannock, 2006) Reading difficulties (Swanson, 2003) Mathematical difficulties (Geary et al., 2004) Specific Language Impairment (Archibald & Gathercole, 2007) Dyslexia (Jeffries & Everatt, 2003, 2004) Down syndrome (Jarrold, Baddeley & Hewes, 1999) Williams syndrome (Jarrold, Baddeley, Hewes & Phillips, 2001)

Working memory and learning

Links between working memory and learning in school Working memory ability is associated with: Baseline assessments Key stages 1, 2 and 3 Learning difficulties

Baseline assessments Assessed within 6 weeks of school entry Working memory skills were strongly associated baseline assessments of reading writing mathematics Excellent predictor of KS1 maths and English levels in Yr 2 (Gathercole et al., 2003; Alloway et al., 2005)

Key Stage 2 Mean working memory scores as a function of English and maths attainment groups - data from 11-year olds (Gathercole et al., 2004) Note. KS3 also (Jarvis & Gathercole, 2003)

Characteristics of children with poor working memory Poor academic progress More than 80% of children with poor working memory fail to achieve expected levels of attainment in both reading and maths

Characteristics of children with poor working memory Poor academic progress Reserved in groups (normal social integration) Ross (6 years) is a reserved and quiet child who tends not to volunteer responses and rarely answers direct questions, particularly in the whole-class situation. He is sometimes becomes more vocal when working in small groups although he isn’t necessarily discussing the task in hand. Although have friends and are not socially impaired

Characteristics of children with poor working memory Poor academic progress Reserved in groups Difficulties in following instructions “Put your sheets on the green table, arrow cards in the packet, put your pencil away and come and sit on the carpet.” John (6 years) moved his sheets as requested, but failed to do anything else. When he realized that the rest of the class was seated on the carpet, he went and joined them, leaving his arrow cards and pencil on the table.

Characteristics of children with poor working memory Poor academic progress, particularly in reading and maths Reserved in groups Difficulties in following instructions Problems when activities involve processing and storage Ruby’s teacher wrote sequences of numbers on the white board that had some numbers missing. She read aloud the numbers, and asked the class what numbers had been missed out. In each case, there was more than one number missing. Ruby was unable to name the missing numbers.

Characteristics of children with poor working memory Poor academic progress, particularly in reading and maths Reserved in groups Difficulties in following instructions Problems combining processing with storage Place-keeping difficulties When the teacher wrote on the board Monday 11th November and, underneath, The Market, which was the title of the piece of work, Nathan lost his place in the laborious attempt to copy the words down letter by letter, writing moNemarket.

Characteristics of children with poor working memory Poor academic progress, particularly in reading and maths Normal social integration Reserved in groups Difficulties in following instructions Problems combining processing with storage Place-keeping difficulties Short attention span and distractibility “he’s in a world of his own” “he doesn’t listen to a word I say” “she’s always day-dreaming” “with him, it’s in one ear and out of the other” Teachers often describe children with poor working memory as having short attention spans and fail to recognise memory problem. Note distinction here between low wm and ADHD – low wm don’t have the same hyperactive behaviours

Characteristics of children with poor working memory Poor academic progress, particularly in reading and maths Normal social integration Reserved in groups Difficulties in following instructions Problems combining processing with storage Place-keeping difficulties Short attention span and distractibility Adam (5 years) struggles to maintain attention, particularly during whole-class teaching when the pupils join together on the carpet. Hence, he sits directly in front of the teacher and is frequently prompted to sit correctly and to pay attention as he regularly fidgets, looks around the classroom and distracts other children near him.

ADHD: DSM-IV symptoms of inattention At least 6 of the following: Often does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities Often has trouble keeping attention on tasks or play activities Often does not seem to listen when spoken to directly Often does not follow instructions and fails to finish schoolwork, chores, or duties in the workplace Often has trouble organizing activities Often avoids, dislikes, or doesn't want to do things that take a lot of mental effort for a long period of time Often loses things needed for tasks and activities Is often easily distracted Is often forgetful in daily activities

Symptoms displayed by children with poor working memory (in red) Often does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities Often has trouble keeping attention on tasks or play activities Often does not seem to listen when spoken to directly Often does not follow instructions and fails to finish schoolwork, chores, or duties in the workplace Often has trouble organizing activities Often avoids, dislikes, or doesn't want to do things that take a lot of mental effort for a long period of time Often loses things needed for tasks and activities Is often easily distracted Is often forgetful in daily activities Gathercole & Alloway (2008), Gathercole, Alloway, Elliott, Kirkwood , Holmes & Hilton (2008)

ADHD: DSM-IV symptoms of hyperactivity/ impulsivity At least 6 of the following: Often fidgets with hands or feet or squirms in seat Often gets up from seat when remaining in seat is expected Often runs about or climbs when and where it is not appropriate (adolescents or adults may feel very restless) Often has trouble playing or enjoying leisure activities quietly Is often "on the go" or often acts as if "driven by a motor" Often talks excessively Often blurts out answers before questions have been finished Often has trouble waiting one's turn Often interrupts or intrudes on others (e.g., butts into conversations or games)

Comparing children with ADHD and low working memory Executive function … cognitively same, and mention equivalent impairments in reading and maths in both groups too age-typical deficit range Holmes et al (2014)

Teacher ratings of behaviour Comparing children with ADHD and low working memory Teacher ratings of behaviour age-typical elevated Behaviourally different, BUT Holmes et al (2014)

Characteristics of children with poor working memory SUMMARY: Poor academic progress, particularly in reading and maths Normal social integration Reserved in groups Difficulties in following instructions Problems combining processing with storage Place-keeping difficulties Short attention span and distractibility, but not hyperactive/impulsive

Why do children with poor WM struggle to learn? Learning is a step-by-step process, based on successes in individual learning activities. Children with WM impairments often fail in the classroom because the WM loads of each activity are excessive for them. WM failure leads to inattentive behaviour, simply because the child forgets what s/he is doing. This leads to frequent lost learning opportunities, and consequently slow rates of learning

Supporting children with working memory problems

Intervention 2 approaches Classroom-based support Working memory training

1. Classroom-based support Reduce WM overload Elements of good teaching practice Be aware of the warning signs of WM failure Monitor the child Reduce amount of information to be stored Reduce difficulty of processing Be prepared to re-present important information Encourage the use of memory aids Help the child to use strategies

1. Classroom-based support: Evaluation Teachers say: relatively easy to implement as they can work with existing curriculum activities enabled them to understand that many task failures are due to forgetting the child benefits from working within own capacity, with greater rates of task success For more information: Gathercole SE & Alloway TP (2008). Working memory and learning: A practical guide for teachers. Sage Publishing Elliott, J., Gathercole, S.E., Alloway, T.P., Holmes, J., & Kirkwood, H. (2010). An Evaluation of a Classroom-Based Intervention to Help Overcome Working Memory Difficulties and Improve Long-Term Academic Achievement. Journal of Cognitive Education and Psychology, 9, 227-250

2. Working memory training Computerised memory training program Game-style environment designed to train working memory Train on working memory tasks for 25 sessions over a 6-8 week period Adaptive: individual works at span level

WM training highlights Improvements on untrained working memory tasks

WM training highlights Enduring changes in brain activity Functional activity in fronto-parietal networks (Klingberg, 2010) Connectivity of attentional and sensory processing networks (Astle et al., 2015, 2016)

WM training highlights No reliable benefits of training for: reading maths attentional symptoms of ADHD IQ To be effective may need more than training alone Embedded in everyday learning activities that place demands on WM (Holmes & Dunning, 2017) Practice in applying newly developed strategies

Importance of broader cognitive dimensions for learning

Causes of learning difficulties Previous studies diagnostic group (ADHD, SLI) clinical /community samples strict inclusion criteria focus on one cognitive domain (e.g. WM) Limitations Diagnostic group: captures only 3% of struggling learners Or apply strict inclusion criteria to derive “pure” samples of children (e.g. reading only problems exclude children with low IQ, or comorbid conditions like maths problems) Problems Assumes children with same diagnosis have similar symptoms, whereas in reality we know there is high symptom variability within groups Assumes groups are distinct, but in reality common symptoms occur across diagnosis Fails to capture majority of struggling learners and does not accommodate cooccuring problems, which are common 50% of those with reading diffs have SLI or maths problems. Less is known about cooccurence of SLI and maths but in one study half of a sample of children with SLI had procedural counting problems (Donlan, Cowan, Newton & Lloyd, 2007) Common: complex, co-occurring

Assessed cognition, learning, brain structure, genes Centre for Attention, Learning & Memory established in September 2014 (750 children to date) Recruited children experiencing difficulties: from schools, educational psychologists, mental health services, clinical psychologists, paediatricians, speech and language therapists Assessed cognition, learning, brain structure, genes Asked: (diagnoses aside) What dimensions of cognition, learning, behaviour & brain structure distinguish these children? WM is one of many cognitive abilities linked to learning – recently broadened our scope to look at other cognitive abilities in broad sample of poor learners

Domains LEARNING Risks & causal factors C O G N Attention I T Behaviour BRAIN GENES Executive functions, attention, communication, mental health Structural MRI, diffusion-weighted imaging, resting-state Saliva Short term and working memory Risks & causal factors LEARNING Attention Episodic memory Executive functions Phonological processing Processing speed Nonverbal reasoning

CAMHS & Paediatrics: n= 228 (55) Education n=447 (156) CAMHS & Paediatrics n=256 (61) SLT n=36 (15) Referred to CALM n=739 (232) Current sample n=650 (203) Education: n=390 (134) CAMHS & Paediatrics: n= 228 (55) SLT: n=32 (14)

Dimensions so far ….. Cognition Behaviour Learning Phonological Literacy, language Executive/ spatial (incl WM) Inattention Maths Hyperactivity* Social/ pragmatic communication ? *Hawkins et al. (2015): dimension of hyperactivity and social pragmatic communication problems within and beyond ADHD, Brain Sciences, 6, 50

Summary Poor working memory places a child at high risk of poor academic progress Both classroom management and intensive training may be able to help ….. … but more research is needed to develop interventions that can improve everyday functioning and classroom learning Need to consider other cognitive abiltiies too

Thank you Further questions, email: joni.holmes@mrc-cbu.cam.ac.uk Information about the clinic: http://calm.mrc-cbu.cam.ac.uk/