The Pyramid Concept of Educating Children

PACE training provided a developmental schema that has proved very useful as a way of making organizational sense out of all the therapies out there.

Basically, PACE taught us a model that views development as a pyramid. The lowest and foundational layer of the pyramid is genetics, which we cannot alter. The layer that builds on this is sensory/motor development. This includes gross and fine motor, auditory processing, visual processing, and integration of these senses (sensory integration).

The next layer up is development of cognitive skills -- things such as pattern recognition, attention skills (ability to sustain attention, ability to focus in the presence of distractions, ability to divide attention and multi-task), sequencing skills (both auditory and visual), short-term memory (both auditory and visual), working memory, etc.

The peak of the pyramid -- actually, the smallest portion of the pyramid -- is academic learning.

Each layer of the pyramid is dependent on what is underneath.
Acquisition of cognitive skills comes easily when all of the sensory/motor skills are fully developed, and academic learning comes easily when all of the cognitive skills are highly developed.

When there is a problem in one of the underlying layers, however, all the layers above are adversely affected. It's like taking a chunk out of the pyramid! Anything above that area will be unstable. The lower down the chunk is in the pyramid, the bigger the chunk, and the more chunks that are missing, the more severely are the upper layers adversely affected. If you were to actually build a pyramid out of bricks and then start removing bricks, pretty soon you would find you could support only a much smaller peak than when you started.

For a diagnosed language-based learning disability, a good first step would be to evaluate and/or remediate every major area of sensory level development. Since language-based problems are often associated with auditory processing disorders, it would be a good idea to get an APD evaluation from an audiologist who specializes in this area.
Since sensory integration problems often result from auditory processing problems, it would be a good idea to also get an occupational therapy evaluation.

Both of the above evaluations are usually covered by medical insurance, and private evaluations are usually more comprehensive than the evaluations done in school. To ensure insurance coverage, the easiest procedure is usually to first find the best specialist and then call their office to ask. They deal with insurance all the time and are often the best way to learn exactly what you need to do to make sure your insurance covers the evaluation.

If sensory level problems are found, I would make that type of therapy the first priority. Aside from professional therapy sessions, there are often many things you can do at home. Sound therapy options, for example, include The Listening Program and FastForWord If there are sensory integration problems, aside from working with an OT (and a good one can recommend many home activities), you can supplement with Dance Dance Revolution and Snowboarding games. Since auditory processing and sensory integration problems can interfere with both vestibular development and vision, it's a good idea to remediate auditory and SI problems prior to vision therapy, or at least to start remediation in those areas before starting VT. Vestibular problems always need lots of bodywork, which is why some children with vision problems don't do well with VT until occupational therapy activities are incorporated.

Once sensory level development deficits have been reduced as much as possible, the next step is a cognitive training program (usually Audiblox or PACE). These programs are very efficient at developing cognitive skills quickly, which always lag if there has been any sensory level developmental delay. These programs can bring a child up to age level cognitive skills within a few months – provided severe sensory level problems are not limiting cognitive skills development.

Once cognitive skills acquisition has been optimized, the very last step in remediation is a good academic program. Unfortunately, schools have only an academic mandate. That is why many children in special ed at school make abysmal progress.

If I had followed the advice of the professionals we consulted, I'm sure my daughter would have been permanently learning disabled.

Professionals have blinders on, and are deeply knowledgeable only about their specific area. That's why a teacher can say a child will learn to read when she's ready (even though she's desperately interested in being able to read on the level of her peers). That's why an ophthalmologist not only describes vision therapy as a scam, but also doesn't know enough to refer a mother to an orthoptician. That's why a speech pathologist can recommend FastForWord for a child who does not have an auditory processing disorder.

The above are all examples of professional advice I was given. My daughter did not make progress until I took matters into my own hands. I decided to try Reading Reflex at home even though the teacher said to wait, I decided to evaluate the results of a developmental vision evaluation first-hand instead of taking our ophthalmologist’s word for it, and decided to try PACE because all we had to lose was a discrete amount of money. Without all three of those programs, my daughter -- who was reading at a preschool level at age 8 -- would not now be reading fluently at a 9th grade level (at age 13). It was just plain dumb luck on our part that we stumbled across each of these approaches at the right time. With hindsight, it's much more clear why we happened to be successful.

Not all problems can be fully remediated. However, most problems can be substantially reduced with appropriate interventions. The problem is in deciding what interventions are appropriate for a specific child. In my experience, the person capable of making the best decision is the parent. The parent sees the whole child, observes the child closely, and currently has the ability to research extensively on the Internet specific problems and specific therapies.

Medical doctors are no better than other professionals. Medical doctors, even pediatricians, are schooled in physical disorders and diseases. They get minimal or no training in developmental disorders. Pediatric neurologists are trained to diagnose and treat diseases and physical trauma; very few have specialized training in developmental pediatrics.

Over the years I have had opportunities to see children with problems whose parents took various routes to help them. Always, the parents who took a bottom-up approach to remediation (sensory first, then cognitive, then academics or some reasonable accommodation of that order), and who did their own research and made their own decisions, got the best results. Those who relied solely on "professional" advice always seemed to spend a lot of money and see few results.