The really upbeat meme that needs to be understood is that learning disabilities are not lifelong at all. Whatever effort it takes, they can be overcome.
That really is good enough. That means that an investment will produce a useful employable human being. Failure and default institutionalization is not an option to tolerate.
I also argue that education itself needs to adopt this approach. It is my contention that all students can become math friendly. It takes persistent practice and patience. Breakthroughs then occur. The same methods surely enhance memory methods as well. Why do we have so called photographic memories and is there a way forward with this? What i am saying is that we need to lift the bar for all students and use these methods to refine ability.
.
Eight Revolutionary Ideas Rooted in The Arrowsmith Program
Posted on July 24, 2019
Download the article here.
By: Howard Eaton, Ed.M., Director, Eaton Arrowsmith Schools
http://www.eatonarrowsmith.com/eight-revolutionary-ideas-rooted-in-the-arrowsmith-program/
I sit in my home office this early July morning, listening to the
sprinkler outside provide water to the vegetable garden. My computer is
on, with the screen reflecting a blank Word document. I want to share my
thoughts, ideas, beliefs on special education, neuroscience and the
Arrowsmith Program. I will go for a walk after, taking my dog, Hector,
who has been a loyal family friend for the last twelve years. This is
almost the same number of years I have been engaged in the Arrowsmith
Program. To be exact, it has been fifteen years. During this time the
Arrowsmith Program has been my primary career focus. It has been my
privilege to learn from a remarkable pioneer in Educational
Neuroscience, Barbara Arrowsmith-Young.
The following words highlight what I know Barbara Arrowsmith-Young
has brought to the field of Learning Disabilities and Neuroscience.
These are revolutionary, paradigm shifting ideas that I hope will one
day be common place in public schools around the world; that indeed
children and adults of all socioeconomic backgrounds, who are struggling
in school, will have open and free access to cognitive intervention
solutions like the Arrowsmith Program. These are the top eight
revolutionary ideas rooted in the Arrowsmith Program that we must all
understand and when possible, should be shared with parents, educators,
psychologists, psychiatrists, medical doctors, speech-language
specialists and all those involved in the well-being of children and
adults who struggle to learn.
#1) Not Lifelong
Just now I went to search for the latest definition for learning
disabilities on the Learning Disabilities Association of Canada (LDAC)
website. I had last seen it in 2002. I wanted to know whether the 2002
definition was still on the site, or if the definition had changed based
on insights from research. It was updated in 2015, but one aspect of
the definition remained the same. It still stated that “learning
disabilities are lifelong”[i].
What really grabbed my attention when the LDAC web page appeared on
my screen was the ad above the text on the official definition of
learning disabilities. It is (at this moment in time) an advertisement
for the Arrowsmith Program. An intervention program that knows learning
disabilities are not lifelong.
The irony of all this really outlines where we are at in the field of
Learning Disabilities. It is a time of change – as slow as it is.
Thousands, upon thousands of educators still believe that learning
disabilities are lifelong. It is easy to understand this as the official
definition for learning disabilities, as both Canada and the United
States highlight this notion. Textbooks on learning disabilities that
are used to train educators still state that learning disabilities are
lifelong.
The research on the Arrowsmith Program is highlighting the fact that
this is not true; that the underlying cause of learning disabilities,
weaknesses in neurological functioning, can be improved. If you have
time, review the decades of research undertaken on the Arrowsmith
Program.[ii]
Research conducted in 2018 and 2019 is showing that the Arrowsmith
Program improves functional connectivity between large-scale brain
networks with related improvements in cognitive abilities. These brain
networks are associated with processing speed and cognitive efficiency.[iii] [iv]
The concept that the brain can change (neuroplasticity) is not new.
This is not an idea developed by Barbara Arrowsmith-Young alone over the
last half-century. The knowledge of brain plasticity has existed for
many decades.[v]
The challenge in education or educational policy-making is that the old
ideas are hard to replace. Educational law and policy on learning
disabilities are built on the pre-existing idea that the brain is fixed,
and that if you have a neurological based disability, it’s for life.
How long will it take for learning disability definitions to change, to remove the word lifelong, and replace it with less certain statements of permanence? Might we add a sentence to these official definitions like: “learning
disabilities can be caused by persistent neurological dysfunctions and
might be remediated through an intensive cognitive intervention program”?
This is a real challenge for the field. What I do know is that the
current definition is creating a false narrative about the potential of
children, and even adults with learning disabilities. The current
definition is limiting their potential to improve cognitive capacities.
More importantly, it is telling school administrators, teachers,
children and their parents that your brain cannot change.
#2) Bridging the Gap: Neuroscience and Education
The Arrowsmith Program is building an important bridge between
neuroscience and education. This is important as most teachers (90%)
believe that knowledge of the brain is important when designing
educational programs.[vi]
Barbara Arrowsmith-Young is one of the first pioneers in a developing discipline called Educational Neuroscience.[vii] Dr. Norman Doidge, author of The Brain That Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science,
wrote an entire chapter on Barbara as it is quite a remarkable
narrative of overcoming severe learning challenges. He highlights the
fact that Barbara studied concepts in neuroscience while at graduate
school and then, ingeniously found a way to translate them into an
educational program focused on improving cognitive capacities for
children and adults with learning disabilities. In Barbara’s book, The Woman Who Changed Her Brain: How I Left My Learning Disability Behind and Other Stories of Cognitive Transformation, Dr. Doidge’s foreword noted that “Barbara’s own story…is truly heroic, on par with the achievements of Helen Keller.”
In short, Barbara Arrowsmith-Young brought neuroscientific insight
into educational practice for children and adults with learning
disabilities. She was one of the first to begin to bridge this gap, and
it is a critical gap to continue to fill. These two fields of study have
a difficult time communicating with each other at colleges and
universities around the world. It is getting better, and Barbara,
through the Arrowsmith Program, is playing a significant role in making
this happen. Neuroscientists and educators at universities around the
world are now studying the Arrowsmith Program. Faculties of medicine and
education at several top universities are researching the Arrowsmith
Program to discover how both could work together to improve educational
outcomes of children.[viii]
There is a long way to go to fortify the bridge between the two fields
of study, as problems related to a common language and research literacy
exist.[ix]
What is great to see is the Arrowsmith Program is providing these two
research fields, and their scientists, a shared language and experience.
#3) Cognitive Assessment to Cognitive Intervention Model for Learning Disabilities
I taught at the Faculty of Education, at University of British
Columbia, as a Sessional Instructor. This was back in 2000-2005, prior
to my full awareness and engagement in the Arrowsmith Program.
Each year I was asked to teach a course on Learning Disabilities to
students in the teacher education programs. The textbook I chose for the
course was widely used and praised by academics in the field of
Learning Disabilities. The textbook focused on definition, assessment,
intervention, and future possibilities for the field. There was, of
course, no mentioning of brain plasticity or neuroplasticity. It was all
about lifelong problems, bypassing weaknesses, finding accommodations,
the importance of technology, and essentially how to help children with
learning disabilities survive school.
There was one chapter in the textbook that interested me the most. It
was the chapter on assessment of learning disabilities. This was
because I had my own psycho-educational assessment practice at the time.
I would work with psychologists to conduct comprehensive assessments,
and with that data make educational recommendations for parents,
teachers and school administrators. I was known in Vancouver for writing
good reports with practical recommendations.
A challenge I had at the time was that many of my recommendations
were not implemented in schools. My assessments were used to designate
the child as having a learning disability for funding purposes, write up
an Individualized Education Plan (IEP), and then placed in some filing
cabinet. Yes, there were teachers that read the assessment, placed
recommendations in the IEP and did a monthly review. They were amazing; positive development happened for that child as a result, because we found ways to work around their neurological weaknesses.
What was missing in the assessment world was a connection between
neurological or cognitive deficits, and the intervention given to the
child. If we found a cognitive weakness, say in processing speed or
working memory, we did not give an intervention for it; instead, we
wrote down a way to avoid that problem in school. We would write in the
report that the child should be given extra time on tests or the ability
to use a keyboard because their written output was too slow with
paper-pencil tasks. There was no intervention, but rather avoidance of
the underlying cause of the learning disability. The reason for this was
obvious at the time to me. These neurological weaknesses were
permanent.
The Arrowsmith Program is the first, and to my knowledge, the only
comprehensive assessment-to-intervention program in the world addressing
a wide range of cognitive capacities. Thus, unlike a school-based
psycho-educational assessment that uncovers a weakness in auditory
working memory, and then recommends that teachers write down what they
say on the white board, the Arrowsmith Program assessment will identify
this cognitive weakness and then implement a cognitive capacity
improvement program to strengthen auditory working memory. Again, it is
the only comprehensive cognitive assessment to cognitive intervention program that can also be implemented in a classroom setting.
#4 Individualized Cognitive Intervention: Progress Measured in Real-Time with Real-Time Feedback
The Arrowsmith Program Assessment was created to help teachers,
parents and children understand the underlying cognitive capacities that
are responsible for learning. As well, an individualized Arrowsmith
report is provided to identify one’s unique and specific combination of
cognitive strengths and weaknesses. Many parents note the report is so
comprehensive that they now understand why their child is struggling
both academically and socially.
Prior to being engaged in the Arrowsmith Program, I conducted
thousands of psycho-educational assessments. My goal was to get a
measure of intelligence, discover other cognitive capabilities, along
with areas of academic achievement in reading, writing and math. My team
needed to determine if the child’s potential to learn (IQ score) was in
any way not showing up on measures of achievement. By reporting to the
parent whether the child’s intelligence was average or above average,
the children will do better in areas of achievement and in school-based
subject matters. The reason their child was struggling in school was
because they were not getting the proper instructional format, such as
extra time on tests, or the teacher was not writing down information
they were saying on the board. This was not the child’s fault; the
school and the teachers had to do better.
Well, I can go down that road, complain about schools and how we
poorly deliver curriculum to children with learning disabilities.
Teachers can argue back that they do not have the time or resources to
help all the children with learning difficulties, each with their own
unique cognitive weakness, in their classroom. Yes, we can all agree to
that point. So, what do we do? I suggest we look at the Arrowsmith
Program as a solution. The Toronto Catholic District School Board
(TCDSB) adopted the Arrowsmith Program for years in multiple schools and
had remarkable outcome data. Again, I recommend you to look at this
research and see just how many children did not require in-school
resource room support after receiving the Arrowsmith Program.[x]
These children with learning disabilities, many receiving intensive
resource room time, were able to go into the regular classroom setting
without extensive assistance due to improved cognitive capacities after
their targeted cognitive intervention designed around their Arrowsmith
cognitive assessment.
I like this quote from Ed Batista, “make feedback normal [and] not a
performance review.” I don’t know a lot about Ed, but I love that quote
because it relates to schools, education and working with children and
adults with learning disabilities. Everyone should embrace feedback, but
oftentimes we are fearful of it. This is especially the case for those
with learning disabilities, because it has often beem negative.
The Arrowsmith Program is designed around normalizing feedback,
making it immediate, seeing feedback as a way to grow your potential to
learn and to set new goals in your program. Barbara Arrowsmith-Young was
aware, having had a learning disability herself, that a program that
worked on one’s cognitive weaknesses would be challenging. Thus, she
needed to design the delivery of the program in a way that would inspire
one to move forward through a challenging task. She worked to develop a
program that would incrementally challenge a child on a specific
cognitive task, give the right feedback to reinforce success when
necessary, and move them to mastery level of that cognitive task over
time. Once achieved, a higher level of cognitive challenge would be
presented to that child.
The Arrowsmith Program is now extremely effective with feedback for
both the student and teacher through technology advancement. Today,
teachers using the Arrowsmith Program walk around the classroom with
tablets that display each child’s cognitive program and level of
engagement on their cognitive intervention program at that moment in
time. Each child can see in real-time how they are doing when engaged in
the programs. Thus, teacher-student interaction is high, feedback is
constant, and their progress is measured by the second.
Teachers are motivated by the desire to make a difference in the
lives of their students. Arrowsmith allows teachers to realize this goal
when working with students with learning disabilities. Too many
students with these disabilities are not engaged in school and leaving
before graduating or graduate with minimal course requirements. Today,
research supports this finding as related to dropout rates for those
with LD[xi] and/or ADHD[xii]. This needs to change. We need to give these students a reason to engage in school.
#5) Connections Between Neuroscientific Research and Academic Success: The Importance of Working Memory
Achievement remediation may not be the most critical school-based
intervention need for children with learning disabilities. Why would
that be the case? Does one not need to read, write or understand math
concepts? Of course, that is a real need, but what is important to
recognize is that one needs underlying cognitive capacities to acquire
those achievement skills. For example, the brain needs to have
neurological abilities with verbal and visual-spatial working memory to
achieve in mathematics.[xiii]
Working memory is a part of short-term memory and allows us to hold
information temporarily for processing. It is important for holding
information, reasoning through information, and expressing information. A
weakness in working memory capacity can be extremely problematic for a
child or an adult.
Today, there is a significant body of research that has informed
psychologists and neuroscientists, and less so educators, that working
memory can be improved, and with this improvement, can help children
succeed in areas of achievement.[xiv]
As well, research is showing that working memory skills are more
important than one’s IQ score in predicting academic attainment.[xv]
Thus, at times, there may be a real need for cognitive capacity
intervention before achievement intervention. This can be observed in
non-responders to math or reading intervention programs.
I have seen hundreds of children with learning disabilities not
benefiting from reading or math programs. These programs are delivered
by excellent tutors or teachers, and yet that child’s progress in
reading and math is very slow. These tutors and teachers are puzzled, as
they have had other children advance very quickly with them over the
years. Why is there a discrepancy in their levels of progress? The
answer lies in the underlying cognitive capacity profiles of those
children. Some have more severe verbal working memory deficits. They may
also have more severe visual-spatial working memory deficits. As a
result, they will each respond differently to the achievement
intervention, say in mathematics.
A problem arises when the parent or teacher continues to try the math
intervention without success. The child begins to feel utterly useless,
a failure and disappointment. We are trying to provide the child’s
brain with sensory information they cannot process, memorize and
therefore, understand.
Neuroscience research is now showing that we can improve these
cognitive capacities and should do so before introducing achievement
skills. The Arrowsmith Program Assessment can identify these cognitive
capacity weaknesses. Then the Arrowsmith Program provides the cognitive
intervention to improve these weaknesses. It is imperative that we put
children in educational experiences they can manage neurologically. In
cases where they can’t manage, we now have the knowledge to strengthen
the underlying cognitive capacities so that they can.
#6) Teachers Can Directly Improve Cognitive Capacities of Students and Not Work Around Weaknesses in Brain Functioning
I have been writing a book on the 150 Australian families that moved
to Vancouver, British Columbia, Canada to have their children enroll in
the Arrowsmith Program from 2010 to 2019. There are fewer each year now
since 23 schools in Australia adopted the Arrowsmith Program during that
time. As part of my research for the book I decided to interview some
of the schools in Australia that adopted the program. I wanted to see
how the recently trained Arrowsmith Program teachers were doing, moving
from the regular resource room model of intervention for children with
learning difficulties to a more cognitive intervention model.
What these Australian teachers said was quite profound. One teacher in Melbourne said, “I
would never go back to a resource room model. I can’t imagine it. I can
now improve the child’s brain, and not have to work around their
weaknesses. No, no, can’t imagine it.” Another from Sydney noted, “it is so rewarding to provide this program to my students. I am giving them more hope, [and] more control over their lives.”
This is a revolutionary change in teacher education and teacher skill
development. The Arrowsmith Program is educating teachers from around
the world on brain functioning, how the brain changes, learns, and how
to best develop neurological abilities. The Arrowsmith Program is
allowing them to directly improve the quality of life of children not
just in school, but for the rest of their lives.
The teacher is no longer feeling as if they are just trying to get
the child through school. No longer do teachers feel like they are doing
the work for the child. Instead, they are coaching children to do tasks
they never imagined they could accomplish, let alone even focus on for
just a few minutes.
#7) Students Are Finally in Control of Their Success and Developing Self-Awareness
I have had many meetings with parents and their children who are
struggling in school. I often hear the parent state how much they are
doing to help their child with homework. Whether it is to remind them to
do homework or assist them as they work through a school-based project,
they are spending hours repeating elementary school or high school with
their child. I will also hear the child say that they go to a special
education classroom or resource room to get extra help as they often did
not understand the teacher in the classroom. The child will say to me,
“Ms. Williams is really nice, and helps me a lot. She does things for me
like writing out my answers or reading things I don’t understand.”
Essentially, what I described above is not highly unusual for
families with children with learning disabilities. It is worrisome when
this is teaching the child that external forces, chance, luck and adults
are controlling their lives. It also teaches that life can be
unpredictable, as there is someone there to help you, and at other
times, not. There is a lot of research since 1966 about the locus of
control.[xvi]
The finding of data is that the more external the locus of control is
in a child, the more negative the outcomes for academic achievement,
personality, and social adjustment. In fact, findings show that maternal
prenatal external locus of control accompanies reduced mathematical and
science abilities in children.[xvii]
During pregnancy, the more the mothers feel that life is about luck or
fate, the more the likelihood of the external locus of control showing
up in their children. It is uncertain whether the father influences
their children, however, I would bet it is not good either.
The Arrowsmith Program provides an educational platform that teaches
both the child and parent that success is based on their effort, their
ability to set goals and to achieve them over time. The Arrowsmith
Program teacher does not provide answers, reduce workload, or ask
parents to re-teach concepts at home. The parent is not in the
educational environment, other than to encourage and cheer their child
onto success. Slowly, over time, the child can begin to build an
internal locus of control. Children or adults with an internal locus of
control realize that their success is dependent on their own engagement
in life. You are not successful in the Arrowsmith Program because of
luck or fate, but rather it comes from determination, resilience and
responsibility.
This development of an internal locus of control can then lead to a
better sense of self-awareness. Here the impact of the Arrowsmith
Program gets very interesting to me. This is one of the most
revolutionary concepts that Barbara Arrowsmith-Young is introducing to
the field of Learning Disabilities. I will take this one step at a time,
as it is important to be clear on this concept.
First, the Arrowsmith Program does provide a child or an adult with
the opportunity to see the control of their lives coming from the
internal mind, and not external forces influencing their lives (i.e.,
teachers explaining or parents helping). This is where it all begins, in
the self-discovery stage¾that what I do and the amount of effort put
into a task, will shape who I am.
Second, the Arrowsmith Program provides the child or adult with
cognitive programs that builds self-awareness. That is, there are parts
of our brain, like the parietal temporal occipital association area[xviii],
that allow our minds to develop meaning from the world around us.
Self-awareness is hard to achieve without developing the meaning of the
world around us. These parts of our brain need to be developed and
challenged.
Barbara Arrowsmith-Young developed a cognitive program called Symbol
Relations. Over time, the task progressively gets more challenging.
Brain imaging shows that children who do this task engages parts of the
brain responsible for reasoning, or cause-and-effect problem solving. In
just a 6-week summer intensive program, research showed that three
large-scale brain networks responsible for self-awareness show improved
connectivity.
Finally, let’s bring this all together; the relationship between the
ability to have an internal locus of control and its development in
children and adults. The Arrowsmith Program first begins to develop this
approach to life by how the individual engages in the tasks and second,
the program itself builds neurological functions that allow that
individual to better understand themselves as related to the world
around them. The combined effect is life changing for that child or
adult. It is not uncommon for an adult engaged in the Arrowsmith Program
to state, “I no longer live in a fog. I live in real-time. I know what I can do, and how I can achieve it.” If this is not a statement of self-awareness, I am not sure what one would be.
#8) Learning Disability Narrative Change
The Arrowsmith Program is changing the current learning disability
narrative. It is very difficult to change the narrative of a field of
study. It is usually accomplished in small steps, over many decades.
This is the case for the impact of the Arrowsmith Program over the last
forty years.
The current narrative in the field of learning disabilities, is as
stated above, that these are lifelong disabilities. That the brain is
fixed, and that children and adults with these difficulties must be
understood as needing strategies, technology or other specialized
instruction to work around their neurological weaknesses. Yet, they are
smart as well, with average to above average intelligence. Some become
famous like Albert Einstein, Thomas Edison, and more recent names like
Jay Leno, Paul Orfalea, Charles Schwab, Cher, Whoopi Goldberg, Richard
Branson. And even more recent names like Orlando Bloom, Keira Knightley,
Michael Phelps and Daniel Radcliffe.
So, there is the narrative. You have a lifelong disability that you
need to find ways to work around your weaknesses, and if you do so, you
can quite possibly be successful like those famous people. I used to
embrace this narrative whole-heartedly. It was all I knew.
The Arrowsmith Program is slowly revolutionizing this narrative. It
is important that we do, because what we have is not working in schools
today. Dropout rates are still too high.[xix] Depression and anxiety[xx] in those with learning disabilities is too high. Suicide rates are higher in this population and particularly with women.[xxi] Economically having a learning disability is not good.[xxii]
The narrative from the Arrowsmith Program is clear. If you have a
learning disability you can improve your cognitive weaknesses. These are
not lifelong neurological deficits. YOU oversee your success, not
others. You can develop a better sense of self-awareness. You have more
possibilities in life for career choices. You do not need to look up to
famous people with learning disabilities to feel good about yourself and
accept your fate. You can achieve so much more. As Barbara
Arrowsmith-Young states, “It is through cognitive transformation that we
help unlock each individual’s gifts, allowing them to dare to dream.”
Howard Eaton, Ed.M.
Director/Founder
Eaton Arrowsmith School
[i] https://www.ldac-acta.ca/official-definition-of-learning-disabilities/
[ii] https://arrowsmithschool.org/research/
[iii]
Jagger-Rickels, A. C., & Rose, G. M. (2018) ‘Exploring the
Relationship Between Improvement in an Intensive Learning Intervention
and Changes in Resting state Functional Connectivity’, paper presented
to Sixth Biennial Conference on Brain Connectivity in Montreal, 26-28
September, presented 27 September 2018.
[iv]
Jagger-Rickels, A. C., Rose, G. M., & Kibby, M. Y. (2019) ‘Effect
of Comorbid Learning and Neurodevelopmental Disorders on Resting-state
Functional and Effective Connectivity in Adolescents’, poster presented
to Cognitive Neuroscience Society Annual Conference in San Francisco,
23-26 March, viewed 26-28 March 2019.
[v] https://en.wikipedia.org/wiki/Neuroplasticity
[vi]
Pickering, S. J., and Howard-Jones, P. A. (2007) Educators’ views of
the role of Neuroscience in Education: A study of UK and International
perspectives, Mind, Brain and Education, 1(3).
[vii] https://en.wikipedia.org/wiki/Educational_neuroscience
[viii] https://support.ubc.ca/projects/new-frontier-education-science-arrowsmith-young-collaborative-neuroscience-education/
[ix]
Devonshire, I. M., and Dommett, E. J. (2010). Neuroscience: Viable
Applications in Education? The Neuroscientist, 16 (4), 349-365.
[x] https://arrowsmithschool.org/wp-content/uploads/2016/12/tcdsb-report.pdf
[xi] https://www.seattletimes.com/education-lab/report-washingtons-dropout-rate-is-high-for-students-with-learning-disabilities/
[xii]
Fried, R., Petty, C., Faraone, S. V., Hyder, L. L., Day, H., and
Biederman, J. (2016) Is ADHD a risk factor for high school dropout? A
controlled study. Journal of Attention Disorders, 20 (5), 383-389.
[xiii]
Van de Weijer-Bergsma, E., Kroesbergen, E. H., and Van Luit, J. E. H.
(2015) Verbal and visual-spatial working memory and mathematical ability
in different domains throughout primary school. Memory & Cognition,
43 (3), 367-378
[xiv]
Soderqvist, S., and Nutley, S. B. (2015) Working memory training is
associated with long term attainments in math and reading. Frontiers in
Psychology, 6: 1711
[xv]
Alloway, T. P., and Alloway, R. G. (2010) Investigating the predictive
roles of working memory and IQ in academic attainment. Journal of
Experimental Child Psychology, 106 (1), 20-29
[xvi]
Rotter, J. (1966). Generalized expectancies for internal versus
external control of reinforcement. Psychology Monogram, 80, 1-28.
[xvii]
Golding, J., Gregory, S., Ellis, G., Nunes, T., Bryant, P., Iles-Caven,
Y., and Nowicki, S. (2019) Maternal prenatal external locus of control
and reduced mathematical and science abilities in their offspring: A
longitudinal birth cohort study. Frontier in Psychology, 10: 194.
[xviii] https://en.wikipedia.org/wiki/Parietal-temporal-occipital
[xix] https://thejournal.com/articles/2017/05/17/students-with-learning-and-attention-issues-three-times-more-likely-to-drop-out.aspx
[xx]
Nelson, J. M., and Harwood, H. (2010) Learning disabilities and
anxiety: A meta-analysis. Journal of Learning Disabilities, 1 (44),
3-17.
[xxi] https://www.additudemag.com/study-people-with-learning-disabilities-more-likely-to-attempt-suicide/
[xxii] http://www.ldao.ca/introduction-to-ldsadhd/articles/about-lds/learning-disabilities-statistics/
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