Monthly Archive

A Cognitive Development Primer for Parents

1st January, 2008

By: Max Stanley Chartrand, Ph.D. 
Research in Communicative Disorders
and Glenys Anne Chartrand AdDipOT
Occupational Rehabilitation
This article is reprinted here with the express permission of Dr. Max Stanley Chartrand of DigiCare® Hearing Research & Rehabilitation. The original article appeared on his no longer available Website.
Today, there exist several critical misconceptions relative to the development and potential of children. We call these misconceptions the ‘elephants in the living room’. They’re so obvious that they tend to be invisible to a vast army of practitioners and parents in search of answers to perplexing problems. This brief treatise will attempt to expose and clarify the ‘elephants’ that lie in plain view of all, and in the process, provide the reader with solid and time-proven solutions that are available to everyone to resolve what up to now have seemed to be insurmountable challenges.
One of those misconceptions is that children vary significantly in intelligence potential. Another is that once they do exhibit signs of learning or cognitive disability that they will always remain so. Both assumptions are wrong on their face. For instance, studies show that from individual to individual, race to race, and other genetic factors there is no more than a +/- 10 point spread in the range of IQ normality. In fact, performance is so disengaged to actual IQ scores that they are almost irrelevant to how far a child can go in life. Furthermore, all children can increase their Intelligence Quotient (IQ) throughout their entire lives simply by doing the things that foster good mental and cognitive health.
The other assumption, that ‘=’once cognitively disabled always cognitively disabled’ does not hold true against the reality of the dynamic and plastic neurological system of the human body. Indeed, children can and often do overcome almost every cognitive developmental obstacle in their path. Most so-called ‘learning disabilities’ are simply delays in development that seem magically to disappear later when no one is paying attention. A good example of this is the statistics in stuttering, which is comprised of about 92% boys. But, looking at that same population later, we finds that <10% of that group are still stuttering into adulthood.
In fact, statistics repeatedly show that 85-90% of all children who suffer from learning, cognitive, and communicative disabilities are boys. Girls, as a rule, make up about 10-15% of that population. Why is that?
First of all, females are born with corpus collosums—the connective tissue between the two hemispheres—approximately 30% larger and more developed than males. So, during about a 7-10 year maturation period—without any extraneous causes for delay—males are already playing ‘catch-up’. On a level playing field, males usually catch up cognitively with females by the teen years. On that same level playing field in later school years, the two sexes split off into parallel areas of cognitive superiority, such as spatial vs fine motor performance, and cognitive reasoning vs linguistic bias.
This explains why more than 90% of cases identified with ADD and ADHD are boys. Taking the straight line of correlation (in cognitive development vs behavior patterns) from the U.S. public school system into the U.S. penal system, where the vast majority of inmates are illiterate, we find that 96% of those imprisoned are males. Hence, although boys and girls are about equally exposed to injury, disease, allergy, and plugged Eustachian tubes (causing chronic ear infections), boys end up exhibiting the lion’s share of developmental setbacks. Girls, with superior auditory, communicative, vocabulary and cognitive head starts, rarely exhibit the same developmental, behavioral setbacks as do boys.
‘This expose is not intended to point fingers or stir resentment, but to call all thinking persons to action, today. Our goal is to help every child avoid the sad results of mainstream ignorance and unintended neglect.’
As these children grow older, and are expected to perform at the same level, the boys most behind tend to mask their lack of grade-level performance with behavioral distractions. Unchecked, this trend escalates into early school expulsions and dropouts, illegal driving, lower-echelon work and eventually standing on the outside of society itself. The data on these trends should garner the attention of every thinking parent and professional, rather than to be swept under the rug as so much ‘sexist’ data.
In the beginning: Chronic infant ear infections
A prevalent trend in pediatrics that has caught almost the entire medical community unawares is the continual increase in allergies among pre-school and school-age children. In the 0-3 age range this manifests itself most readily in the continual rise in cases of middle ear infection (OME). But the truth is that the vast majority of these cases began as allergy cases. This explains why several recent studies show treatment regimens without antibiotics about as effective (or, rather, ineffective) as the treatment with antibiotics. Streptococus and/or nuemococus areus, the most common bacterial causes of children’s ear infections, are actually secondary conditions. The primary condition is unrelenting, unresolved inhalant allergy as a result of:

  • Dust mites and mold spores at home
  • Seasonal plant pollens
  • Common foods (i.e., yeast, dairy and wheat products)
  • High-sugar, high-salt diets
  • Caffeinated drinks
  • Second-hand smoke
  • Silicate dust in high winds
  • Iron-additives in infant formulae (boys)

For infant males, commercial formulae with added iron can dramatically increase allergy response as it later shortens their lives. Yet every federal government-sponsored infant program requires high iron supplementation in covered formulas! Popular caffeinated drinks exacerbate the problem further by adding hyperactivity and anxiety. High-sugar and over-processed foods, along with a host of nutritional deficiencies, keep the child in a perpetual allergic state, hampering behavioral self-control as it slows cognitive development.
We need to keep in mind that most childhood ear infection episodes are not accompanied with pain; hence, most go undetected. The child, in most cases, can go months, or even years, with a 20-30dB loss of hearing sensitivity without complaint. We estimate that only about 10% of OME cases are even reported, because those that involve pain, swelling, and crying tend to be the only ones to receive adult attention. Furthermore, studies have proven that a mild, long-term 16dB loss of hearing acuity can put a child as much as one grade level behind their peers. So, the longer and greater the hearing loss, the further they may fall behind their peers in:

  • Speech/language development
  • Development of central auditory functions
  • Attentional/squelch abilities
  • Vocabulary size
  • Cognitive skills (reasoning, logic)
  • Reading skills (aka ‘dyslexia’)
  • Spatial skills
  • Fine motor skills
  • Limbic system (aka anxiety, depression, ADD/H)
  • Socialization, bonding and participation
  • Sense of security, confidence

Moreover, even the child who suffered OME during ages 0-3, but later recovered by the time they reached school, can be significantly setback in their developmental track. Since males start with a disadvantage, they tend to stand above the ‘norm’ in learning disabilities, and hence, comprise almost all of those held back a year at the first grade level. Following those same children into later grades, we too often find them still behind even their new peer-group. The worse cases find males in 8th grade that read at 3rd grade level.
In an youth (ages 16-21) education/penal system project in which one of the authors participated during the 1980s, this was exactly the case: More than 95% of court-ordered enrollees were male, their average dropout grade was the 8th grade, and their average reading level was 3rd grade. The goal of the program was simply to help them pass the GED examination, an ominous task for young men who could barely write their names legibly. In every case that could be documented, they suffered from repeated episodes of OME during infancy. Most received no treatment at all, other than for pain.
For this reason, the authors stress the importance of documentation in school records and regular hearing tests throughout childhood years. Yet only 15% of the 16,500 school districts have an audiologist on staff. Of those that do, the audiologists are kept busy with a tiny portion of the children needing their attention. Most school kids go from elementary through high school without one single properly administered test in a sound-treated environment.
At the same time, billions of taxpayer dollars are spent annually on special education, as enrollments and the categories that define eligibility expand at an exponential rate!
(Note: Of course, there are other trends that increase the incidence of bonafide learning disabilities: increases in drug abuse and use of tobacco by mothers, declining infant mortality rates due to medical advances, and progress in earlier intervention of childhood problems. But the authors contend that the vast majority of those identified with learning disabilities are simply developmental delays due to OME, allergy, nutritional imbalances, and un-/under-treated hearing loss).
Call to Action: Solutions at our fingertips
The following section will discuss some of the action items that can be implemented everywhere at very low cost to help the largest number of children. It is interesting that a ponderous body of data supporting these recommendations has been with us for some time, but has been virtually ignored by mainstream practice, and by public educators in general. Hence, when parents find out about these “elephants in the living room” they are often quite upset with their medical care, educational staff, and themselves for not doing something sooner.
This expose is not intended to point fingers or stir resentment, but to call all thinking persons to action, today. For every day of delay causes thousands of children to graduate from their childhood years with the yoke of unrealized potential and a lessened outlook on life and happiness. Our goal is to help every child avoid the sad result of mainstream ignorance and unintended neglect.
‘To improve math and science performance and to outgrow a host of learning disabilities) we encourage mandatory music instruction as part of the core curriculum for K-8.’
With the above in mind, we will now enumerate some of the solutions in order of their importance, and hope that every person who has it in their power to implement them will have the courage to do so.
I. Hearing health equates with cognitive health
The first step in every child’s case, before any other kind of testing, should be a complete hearing evaluation, including detailed hearing health history. The hearing history should show whether and how extensively the child suffered from repeated middle ear infections during the critical years of 0-3, and beyond.
If the hearing test shows a loss of 16dB PTA or more, remedial action should be considered. In most cases, there may be an ongoing inhalant allergy. The milder cases may be treated with a mild decongestant (such as Children’s Sudafed) or non-narcotic antihistamine (such as Allegra or Clairton appropriate to body weight) taken daily in the morning only as prophylaxis. Retesting of hearing thresholds can ascertain if the desired result is being achieved.
More serious cases may require the insertion of Pressure Equalization (PE) tubes by an otolaryngologist. These will usually stay in place up to about 2-3 years, and maintain hearing levels in spite of allergic interference. In some stubborn cases, both of the above approaches may be necessary.
In cases where thresholds exceed 25dB PTA, hearing aids should be considered when medical treatment would not improve hearing thresholds any further. A mild hearing loss can be devastating to the developing child, especially in social, attentional and speech development.
Scarring of eardrum tissue or adhesive otitis residue on the tympanic membrane (eardrum) as viewed through video otoscopy can cause a loss of up to 20-25dB in a child. Technically, such losses are not cause for hearing aid recommendation, but yet we know there can be significant developmental delay if not addressed. In such cases, FM Classroom Soundfield is a definite answer.
The school’s health history records should identify those students who fit the above profile, and alert appropriate staff to support the educational/developmental needs of each student. Staff that should generally be alerted as to at-risk children are:

  • Audiologists
  • Special educators
  • Speech/language pathologists
  • Educational Audiologists
  • School Counselors
  • School Nursing Staff
  • Home Room Teachers

From what we now know as a result of extensive and conclusive research, FM Classroom Soundfield should be utilized in every classroom for grades 1-8 in all schools. Data from the landmark 1978 MARRS Project is quite supportive of this recommendation. The cost of equipment can be expensive (>$2,000 per room) or inexpensive (>$130 per classroom), depending upon equipment utilized and who installs it. But the results in increased student performance, behavioral control, and teacher effectiveness is undeniable. School districts that are serious about raising student performance will install these systems. The FM Classroom Soundfield System consists of:

  1. A wireless FM mic and transmitter worn by the teacher
    [* An FM receiver connected to
  2. 2 or more small speakers located in the back or sides of the classroom.

The object is to ‘equalize’ the teacher’s voice throughout the room, so that those sitting in the back have the same acoustic advantage as those sitting in the front. Participation and academic performance gains among ALL students also rise, while those who’ve ‘fallen between the cracks’ are helped, too. Following is a list of those who are especially helped by FM Classroom Soundfield:

  • Students with hearing impairment at all levels (about 14% according to one recent study)
  • Students with attentional problems (about 35% of boys and 5% of girls on average)
  • Mainstreamed students with learning disabilities (especially dyslexia)
  • Students with behavioral/socialization problems
  • Teachers who must raise their voice often to keep class attention and control
  • Schools that are serious about raising test scores of their general student body

II. Closed Caption: ‘Reading while watching TV’
Since 1993, the Americans with Disabilities Act (ADA) has required that all televisions sold in the U.S. are equipped with closed caption (CC). CC places the text visually onto the screen. The ADA has also mandated that all videos and television broadcasts feature closed caption. It seems the public schools in the U.S. have been the slowest segment of society to follow the spirit and letter of the ADA in cases of hearing impairment. In effect, every videotape or film production shown in the school should have CC turned on, since so many of the children with impairments have fallen between the cracks of the system.
We urge parents to request that closed captioning be utilized in all such school presentations. Furthermore, we urge all parents to require that their children who have any degree of reading problems to watch TV at home with the closed caption. This may take some talking to get the non-impaired members of the family to agree. But the rewards in improved reading skills can be phenomenal. Also, children who come from homes where English is a second language benefit from regular use of closed caption.
Furthermore, please be aware that not everyone complies with the ADA. There are still numerous programs (mostly older reruns) that fail to provide closed caption. And movie theatres have almost universally ignored the auditory implications of ADA (and OSHA, too, as they often exceed safe sound levels to impress their teen-age audiences. At typical 90-95dB SPL sound levels, theaters should be passing out earmuffs at the door!).
III. The universal antidote: Music
One correlation in education that stands out as a HUGE ‘elephant in the living room’ is that as U.S. schools have all but eliminated or dumbed-down music programs as core curriculum over the past 30 years that U.S. math and science scores have plummeted simultaneously. The schools can give math and science ’til the students are blue in the face, and they will never approach, the aggregate level of performance of their Japanese and Taiwanese counterparts. The reason is that development of musical skills provides the neurological building blocks so necessary for cognitive skill development.
Music is also the antidote for a host of disabilities, including central auditory procession disorder (CAPD), dyslexia, socialization problems, ADD/H, interhemispheric discontinuity, and a host of other ‘learning disabilities’. Studies on this are conclusive, piled high for all to see—if they will only look. Tons of impeccable research has been laid at the doorstep of the U.S. Department of Education, only to be discarded before it can reach the local school districts and parents who need it the most.
For that reason, we strongly encourage mandatory music instruction as part of the core curriculum for K-8. From grades 9-12, it may be elective, as that is the age for specialization. But for younger ages, keyboarding, band or string instruments, or vocal music should be the experience of every school child. As a result:

  1. A host of learning disabilities and behavioral problems will dramatically improve
  2. Overall student performance in tests of cognitive ability will rise
  3. Funds for myriad remedial courses and ineffective special education programs can go to something that actually produces solid results
  4. (Note: Most special education programs are badly needed, but have expanded to include many, many children who simply need tasks and counseling to ‘catch up in their development’).
  5. Juvenile delinquency and dropout rates will plummet
    Students will go on to more technical careers in far greater numbers

Until your school institutes music as core curriculum, however, we suggest that you start every child by the time they are 8 or 9 years old with weekly music lessons. Piano is the best instrument for cognitive development, and can even accommodate children down to age 5 or 6. Practicing daily at home for at least 25 minutes per day will yield unbelievable dividends!
IV. Soccer as the universal sport
Regardless of your favorite sport, soccer has been shown to extend the greatest opportunity to the largest number of children for superior spatial and cognitive development. It is the school sport of choice in every nation that outstrips our youth in math and science. It has the least limitation on physical size, and participants can start as young as 4 and go all the way through college.
We mention this here, because we see a huge groundswell of parents promoting soccer in the U.S., while the public schools exert an enormous amount of effort keeping soccer out of the schools. Of course, the primary reason for the opposition is that it competes with other more ‘popular’ sports. But if our goal is really to give the largest number of children the greatest opportunity to grow and develop, we will pursue the steadily increasing trend of bringing soccer into our public schools.
V. Good health: Foundation for good development
No treatise on the subject of development would be complete without bringing in the foundation for good health: proper diet, appropriate exercise and restful sleep. American children, as a rule, are culturally lacking in all three of these areas! They go to bed too late, go to school malnourished, and rarely exercise, causing alarming rates of obesity. The richest nation on Earth resides among the most neglectful of good health practices.
Under separate cover we will provide more insight into the nutritional aspects. But suffice to say here that we, as parents, need to:

  1. Eliminate or reduce those foods that cause allergies in our children
  2. Remove or reduce caffeinated drinks from our children’s diet
  3. Go all out to stop children from smoking and drinking alcohol (we need be better examples!)
  4. (4) Provide essential nutritional supplements (calcium w/ vitamin D, for instance would go far in building stronger bones and bodies)
  5. Increase water intake for better hydration of the body, fewer allergies, and better kidney/urinary tract function

Add to the above recommendations, to a set an age-appropriate bedtime so that the child has a chance to ‘wind-down’ before nodding off to sleep. Contrary to popular belief, teenagers need MORE sleep than pre-teens. A student that is well rested, and who has a high-protein (NOT high carbohydrate) breakfast before going to school will far outperform the students who come tired, strung-out, and half-starved. Feeding the body is feeding the brain, especially when Omega-3 oils are included.
Proper Exercise is another area that must be covered in another venue in more detail. If your school does not mandate physical education, and your child leads a sedentary lifestyle, it is recommended that they take dance, swim, martial arts, or other forms of regular weekly instruction. Furthermore, it is highly recommended that students join the community soccer league, since few public schools now offer soccer. In other words, you can take charge of your child’s physical program, instead of waiting for the school system to do it for you. The benefits will last your children into old age, with longer and healthier lifespans, greater resistance to disease, and will lead them much closer to reaching their optimum potential.
Featured Organization: DigiCare®
Our thanks to Max Stanley Chartrand and Glenys Anne Chartrand for allowing us to reprint their article.
Dr. Chartrand is Associate Professor of Behavioral Medicine at Northcentral University and President of DigiCare Hearing Research & Rehabilitation, Colorado City, CO. He lectures and writes extensively on health and psychology topics.
Mrs. Chartrand serves as Director of Rehabilitation and is a recognized expert in occupational and geriatric rehabilitation from New Zealand. She also gives lectures and publishes on topics of auditory rehabilitation, nutrition and stress management. She is Registered with the National Board of Certification in Occupational Therapy in the United States and in New Zealand, and also is Board Certificated in Hearing Instrument Sciences.

PediaStaff hires pediatric and school-based professionals nationwide for contract assignments of 2 to 12 months. We also help clinics, hospitals, schools, and home health agencies to find and hire these professionals directly. We work with Speech-Language Pathologists, Occupational and Physical Therapists, School Psychologists, and others in pediatric therapy and education.


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