The Birth of Neuroplasticity Interventions: A Twenty Year Perspective

Abstract

Fast ForWord® was the first, computer/Internet delivered, neuroplasticity-based training program ever developed to enhance neural performance. It grew out of over 25 years of basic and clinical research in two distinct scientific disciplines.


One utilized behavioral, electrophysiological and neuroimaging methods to study individual differences in language development and the etiology of developmental language-based learning disabilities (including Specific Language Impairment, Autism and Dyslexia).

The other utilized neurophysiological and behavioral methods in animals to study neuroplasticity, that is, changes at the cellular level driven by behavioral training techniques.

This chapter reviews (1) how these two lines of research were integrated to form the scientific basis of Fast ForWord® and (2) the steps taken to translate and instantiate our collaborative laboratory research into clinical and classroom interventionsthat could be scaled up for broad distribution around the world, while remaining efficient, effective and enduring. In 1996, Scientific Learning Corporation (SLC) was co-founded by four research scientists (Paula Tallal, Michael Merzenich, William Jenkins and Steve Miller).

To date, nearly three million children in 55 countries have received Fast ForWord® interventions. On any given school day approximately 100,000 children log in to train on one of twelve Fast ForWord®Language, Literacy or Reading programs. More recently, Fast ForWord® language and reading programs are being used increasingly as an effective method for improving English as a second language (ESL), including success for ESL children whose first language is non-alphabetic.

Introduction

When we began our collaboration in 1993, the now rapidly growing fields of “cognitive neurotherapeutics” and “neuroeducation” did not exist, nor did the concept of using neuroplasticity-based training to improve “brain fitness”. The methods we developed, and subsequently were the basis of over 50 patents, were the first to use video gaming technologies with the explicit goal of improving human performance.

Research on Language Development and Disorders

The most basic unit of any language is the phoneme, the smallest unit of sound that can change the meaning of a word. For alphabetic languages, in order to learn how to read and become a proficient reader the child must become aware that words can be segmented into smaller units of sound (phonemes) and it is these sounds that the letters represent. This is referred to as phonological awareness. Phonemes are the basic building blocks for spoken language, as well as for alphabetic written languages.

Research on Neuroplasticity-Based Training

Neurophysiologists have mapped the features of the sensory world at the single cell level. This research has shown that within each sensory modality the features that represent the physical world come to be mapped at the cellular level in a highly organized fashion.

The Birth of Fast ForWord®: Translating Theory into Practice

Considering the amount of speech directed to the infant, it is easy to understand how important speech is in shaping the auditory cortex during critical periods of human development.

Designing Neuroplasticity-Based Training Games

For our first study we designed and developed a series of verbal training exercises ranging from speech discrimination to grammatical comprehension, disguised as “games”. Some of these games were implemented on computers, while trained professionals using tape-recorded stimuli presented others.

The First Laboratory Studies: Rutgers Summer Camps 1994–1995

Our initial laboratory studies were conducted with children who each met the criteria for language learning impairment (LLI). Two groups matched on age, IQ and language skills were quasi-randomly assigned to receive the same language intervention program.

Scaling Up: The “Neurotherapeutic Revolution”

  • Fast ForWord® Language v1
  • First Multi-site Clinical Field Trial (1996–1997)
It is one thing to obtain results in well-controlled studies in a research laboratory under the direct supervision of skilled research scientists. It is quite another to demonstrate that efficacy can be achieve in “real-world” clinics and classrooms where children most commonly receive intervention. Soon after founding Scientific Learning Corporation (SLC) our first goal was to convert the games used in our laboratory studies into a fully computerized training program (Fast ForWord® Language v1), and then to conduct large-scale field trials in clinical and educational settings to assess its “real-world” efficacy.

Independent Agency Evaluations of Fast ForWord®

Studies on the effectiveness of educational and/or clinical interventions are inherently difficult, in part because of the many skill sets and multidisciplinary collaborations required to conduct these studies in “real- world” clinics and school settings. Before introducing a new method, curriculum or product, schools have to answer a practical question: does the new approach leads to better outcomes for their students than whatever intervention strategies they currently have in place? In translating research from the laboratory to classrooms, we have found that most school administrators and curriculum directors are only willing to make important decisions for their school after they have conducted their own, internal, independent study.

Cognitive Neurotherapeutics: The Challenges of Translation

The biggest challenge we have faced along our journey to translate our laboratory research into real world settings has been negotiating the torturous path between the world of our scientific colleagues, as compared to the very different world of K-12 educators and clinicians who make the decisions about whether our products will be offered to the children who could benefit from them. Nowhere have these different worlds collided more directly than when it comes to assessing and reporting the efficacy of Fast ForWord® products.

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