COGNITIVE ENHANCEMENT:

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1 COGNITIVE ENHANCEMENT: Keeping Our Brains Fit and Healthy Debbie Gilmore Executive Director, Arrowsmith Program Established in Toronto, 1978 In over 100 public and private schools throughout Canada, USA, Australia, New Zealand, Malaysia, Thailand, South Korea and Spain

2 TOPICS FOR TODAY Neuroplasticity Barbara Arrowsmith Young her work Cognitive function Cognitive lens Cognitive reserve Cognitive enhancement

3 Neuro=Brain NEUROPLASTICITY Plasticity=Modifiable The brain's ability to change both its physical structure and its functional organization, to form new neural connections throughout life

4 PRE-NEUROPLASTIC PARADIGM

5 PRE-NEUROPLASTIC PARADIGM The Brain Unchangeable Hard-wired Function can not be altered if damaged or limited Ageing Brain Brain maturation at approx. age 11 or 12 Slow decline No process to improve function Live with it

6 NEUROPLASTICITY GIVES HOPE

7 THE BRAIN CAN BE MODIFIED Change cognitive capacity to learn Strengthen specific cognitive functions in neural networks

8 Our brain is a lifelong resource that we can use to take control of our lives, our version of the world and how we operate within it.

9 BARBARA ARROWSMITH YOUNG

10 Somatosensory Cortex (Registers location of sensation) Juncture Temporal/Parietal/Occipital (Association Area of Association Areas) Parietal Lobe (Spatial Reasoning)

11 ALEXANDER LURIA Identification of Function Mapped out the brain and proposed that the brain is made up of specialized cognitive areas that carry out very specific cognitive functions. These areas work together in neural networks to carry out complex tasks.

12 Lyova Zazetsky and A.R. Luria

13 MARK ROSENZWEIG Stimulation of Function The brain can change at a physiological level thus creating better learners. Stimulated (Enriched) rats improved performance on mazes (better learners) increased levels of neurotransmitters more glia cells enlarged capillaries (better blood supply) No Special Stimulation Toys for Stimulation (Enriched) more dendrite branching (more synaptic connections)

14 IMPLICATIONS OF THEIR RESEARCH Not only is the brain made of very specific cognitive areas but these areas can be targeted, stimulated and strengthened

15 ARROWSMITH PROGRAM Designed by Barbara Arrowsmith Young to address her own cognitive deficits by utilizing the research of Luria and Rosenzweig The Arrowsmith Program is a suite of cognitive programs comprised of intensive and graduated cognitive exercises that are designed to strengthen a series of cognitive functions. It is a facilitator-led program. The teacher has specialized training by Arrowsmith Program. The 19 cognitive functions addressed by the Arrowsmith Program are those involved in reading, writing, auditory memory, non-verbal learning, reasoning, executive functioning, numeracy, visual memory and spatial awareness. Programs are designed to address an individual s unique profile no one size fits all

16 COGNITIVE FUNCTION Cognitive functions are the characteristic function or job of a region of the brain or network of regions

17 CONTINUUM OF FUNCTION Very Severe Average Superior

18 EXAMPLES OF COGNITIVE FUNCTIONS capacity to read non-verbal cues necessary for navigating social interactions visual memory functions necessary to learn reading and spelling patterns executive functions necessary for thinking, planning and problem solving capacity for grasping relationships auditory memory functions involved in retaining information capacity for quantification required for time scheduling and budgeting ability to learn motor patterns necessary for writing capacity to recognize faces spatial reasoning

19 UNIQUE COGNITIVE PROFILE Every individual has a unique learning profile due to his or her combination of cognitive strengths and deficits Cognitive deficits combine to create various academic and social learning problems The Arrowsmith Cognitive Profile Questionnaire is available on

20 Brain Activity while Reading Out Loud (Lassen et. al. 1978) Example of a Functional system (neural network) as postulated by A. R. Luria

21 COGNITIVE LENS Think about the person who: Is socially awkward or rude Cannot see another person s point of view Is rigid and needs routine Can t tidy their room Can t see a specific item in the fridge or their closet Can t use a map or find their way to a familiar place

22 CONDITIONS FOR NEUROPLASTIC CHANGE Active Engagement Effortful Processing Novelty / Task Complexity

23 HARNESSING NEUROPLASTICITY Reduce Negative Factors Increase Positive Factors Chronic Stress Prolonged Anxiety Chronic Pain Sleep Deprivation I can t ; I don t Self- challenge - Active Sustained Engagement - Effortful Processing - Novelty and Complexity - Reward/Performance Feedback Exercise Growth Mindset Mindfulness various factors can contribute to loss of synapses, shrinkage or retraction of dendrites (de-branching), and pruning of axons, thereby reducing communication in those areas (Kays et al., 2012)

24 CHANGE SUSTAINED OVER TIME To ensure the change in functioning is sustained and not just practice effect or short-term temporary wiring change we need to: Keep our brains active over the lifespan Integrate and use the cognitive gains resulting from mental training Reduce factors that lead to negative neuroplastic change Increase factors that lead to positive neuroplastic change

25 CHANGE SUSTAINED OVER TIME If one wants only a temporary trick, it can be induced quickly; if one wants it to last, it must be induced gradually, allowing for harder neuroplastic change. Regardless of the source, a sustained change in a pattern of neural activity is a necessary trigger for neuroplasticity. Lillard & Erisir (2011) Donald Hebb s principle: neurons that fire together wire together. In other words, all of the brain s activities that occur together (fire together), strengthen their connections and inter-connections (wire together) The more they fire together, the stronger the connections.

26 COGNITIVE RESERVE Cognitive reserve refers to the ability to optimize or maximize performance through differential recruitment of brain networks and/or alternative cognitive strategies. The brain can change the way it operates and thus make added resources available to cope with challenges. This concept holds out the promise of interventions that could slow cognitive ageing or reduce the risk of dementia.

27 COGNITIVE RESERVE Cognitive reserve is not fixed it can change across the lifespan depending on exposure and behaviours. Therefore changes in lifestyle, even later in life, might impart reserve against age-related cognitive decline or dementia. The exact recipe is still unknown. The generic recommendation is to maintain educational and mentally stimulating activities throughout life.

28 COGNITIVE RESERVE Yaakov Stern (2012, Columbia University) found that: Lifetime exposures including educational and occupational attainment and leisure activities in late life, can increase cognitive reserve Those who engaged in more leisure activities had 38% less risk of developing dementia The protective effect of higher cognitive reserve decreased risk of developing dementia by 46% Experiences at all stages of life, even late in life, can impart cognitive reserve. The findings support the possibility that it may be possible to intervene even later in life in order to impart reserve, slow age-related cognitive decline and prolong healthy ageing.

29 COGNITIVE ENHANCEMENT The adult brain has the plasticity switch mostly turned off. Change is only permitted for those things that have captured the brain s attention, and only when the brain itself judges that change to be beneficial for it.

30 CONDITIONS FOR NEUROPLASTIC CHANGE Active Engagement Effortful Processing Novelty / Task Complexity

31 COGNITIVE ENHANCEMENT How do we turn the plasticity switch to on? When : we pay attention or focus on a task or goal we are rewarded or punished or when it expects a reward or punishment the brain positively evaluates performance in a goal-directed behaviour the brain is surprised by something new or unexpected

32 COGNITIVE ENHANCEMENT When task achievement is of no consequence, or when experiences are unimportant or strictly routine, the brain does not release the chemicals the modulatory neurotransmitters to turn on the plasticity switch.

33 COGNITIVE ENHANCEMENT What types of activities are beneficial? Cognitive stimulation Exercise Social stimulation

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35 COGNITIVE STIMULATION Take on a new activity and acquire new skills and abilities Develop a habit of working on the level at which you make steady, measurable progress Count every indication of progress as success Reward yourself for growing achievements Work on a demanding level which will improve abilities faster

36 COGNITIVE STIMULATION Exercises that are satisfying and rewarding Activities that encompass new learning and that demand you pay attention to the details of what you see or hear or feel or smell Activities that involve complex planning or performance challenges Skills that can never really be mastered

37 EXERCISE Physical fitness is a major contributor to brain fitness. Its aerobic values have a direct, positive physiological impact on the brain.

38 SOCIAL STIMULATION Visiting or being visited by relatives and friends Go to movies or restaurants or sporting events Doing unpaid community volunteer work Playing cards or games or bingo Going to a club, centre, classes, church

39 LANGUAGE, MEMORY AND VISION Engage in activities that will focus on language, memory and vision. During ageing, nearly every aspect of the brain s operation and accuracy slows down and deteriorates. BE CONSCIOUS

40 MORE BRAIN FOOD Mindfulness Gratitude Sleep health Good diet

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