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Hemispheric Asymmetry and LDby Carin Smit, Director
Synapse Africa Neuro-Nutritional Institute, Gauteng, South Africa
as published in Discoveries, Spring 2000, Vol. 18, No. 2

Remedial teaching has for years narrowly focused on the symptoms of conditions such as ADHD, and dyslexia, attempting to address them by means of behavior modification, repetition, or compensations, utilizing a student’s strengths. This approach has had mixed results. Some students respond well while others seem to “outgrow” their deficits. However, a significant number of students remain heavily dependent on outside help both in and outside the classroom. Some were mainstreamed, and for a while we thought we had managed to redeem their futures only to find an unhealthy number filtering back into remedial situations or becoming school dropouts. What can we do with these children, who test with average and even above average IQ scores, but who never seem to quite “get there”?

Neuro-Cognitive Reconstructive Therapy™ approaches learning disabilities from a premise that a true learning disability is intrinsic to the student and is not caused by a student’s environment or by the educational system. Therefore, changing the system (i.e. accommodations, tutors, etc.) will not change the learning disability.

A true learning disability, a deficit due to central nervous system dysfunction, can only be truly remediated by addressing the cognitive and perceptual deficits within the individual.

Hemispheric Asymmetry and LD

The normal human brain is structured for optimal learning through asymmetry – that is, the two sides of the brain look and act differently. The left hemisphere is well suited to logical, sequential, organizational types of tasks while the right is at its best with more creative, conceptual duties. Competitive hemispheric function is a result of two hemispheres that are too alike in structure and function. Where a child’s genetic predisposition brings about greater symmetry, the effect is often lack of concentration. Other tell-tale signs of hemispheric competition are stuttering, dysfluency, dyspraxias and various visual-motor integration deficits. The percentage of those with bilateral language deficits is approximately 9 – 11%, the same percentage of students who struggle with attentional and learning deficits.

The most severe impairments stem from language control in the wrong hemisphere, such as when language and speech is controlled in the right instead of the left hemisphere. This condition frequently leads to the most resistant forms of dyslexia, as the language dominance is in a hemisphere ill suited to language function. The right hemisphere is not logical, cannot sequence, isn’t analytical and cannot think in time – all critical skills for effective language control. Statistics reveal that approximately 4 – 9% of the population has language controlled in the right hemisphere, a close correlation to the percentage of those considered to be severely learning disabled.

Brain Plasticity

If it is true that learning disabilities are intrinsic and that such brain structures are not conductive to learning, how then can these students learn? Previously it was thought that neurological loss was permanent. However, the latest research in neurocognition, shows that the brain is essentially plastic at any age. Replacement tissue for damaged neurons can grow in the brain. A rethinking has emerged based on the work of scientists like Dr. Ira Black, Department of Neuroscience and Cell Biology at the Robert Wood Johnson Medical School, Piscataway, NJ. She and other scientists have set out to find out what makes the brain plastic. Their work focuses on the “trophic” factor, or the amazing survival potential of every cell of the human body, including the brain. Dr. Black maintains that the unique ability of the brain to survive against great odds can be attributed to the brain’s flexibility, altering structures and functions in response to its environment over time. The development of new thinking patterns may arise simply because the brain has been intensively challenged to form novel organizations.

Taking Time For Change

Change is possible and that is how this population of at-risk children will learn. However, time is essential. So often parents and teachers have heard it said “Johnny has reached his potential, he has reached a ceiling…” or “He is too old for this kind of intervention.” Gazzaniga et al. (1995) state that the plasticity of the brain is enhanced from one millisecond to the next, building a grid, which is read by the nervous system as quasi-permanent if used often enough to maintain that grid. Weak and faulty memory banks can be rebuilt and strengthened. These changes take place over days and weeks. The more acute the stimulus, the more permanent are the changes in the neural structure.

Research also shows that such plasticity follows a person throughout life. Kaas (Gazzaniga, 1995) states that changes in damaged cortical perceptual and perceptual-motor maps can be affected even in adults, within minutes, hours, days or weeks. Black explains that growth factors play a uniquely unifying role in the brains of adults as well as children, in the sense that they integrate experience (input from the outside world) with impulse activity and synaptic pathways, thus becoming more and more plastic and enabling neural architecture to change – regardless of the age of the person. The brain left unmediated will gravitate toward less plasticity. Conversely, the brain which is challenged and stimulated will grow toward greater plasticity.

If the above research holds a caveat for educators and parents, it is this: It is inexcusable for anyone who knows change is possible to allow students to struggle and become frozen in a disability, maintaining that they are beyond help or have “reached their ceiling”.

The key for all mediators of learning is to understand that we need to be kind yet insistent, applying respectful pressure to those deficit areas in perception and cognition, pushing against the old dysfunctional neurology, until new, functional patterns emerge. The process is tedious, often painstaking, as it may feel as if we are trying to impress prints in wet sand. However, the process yields remarkable results. Patience is needed as molecules change cells, that in turn change transmitters, which change synapses, affecting change in circuits that govern perceptions, that govern memory banks, that feed thoughts and conceptualizations and ultimately change thinking patterns from dysfunctional to functional.

What is Neuro-Coginitive Reconstructive Therapy?

Neuro-Cognitive Reconstructive Therapy™ is an intervention which addresses the lack of cerebral asymmetry and/or other perceptual deficits by presenting the brain with tasks that require logical, analytical and sequential processing, the aim being to establish language control in the left hemisphere. Such processing involves multi-modal integration, meaning that both hemispheres and multiple modality centers must work together. Interactive language between therapist and student is the basis for the process since the location and dominance of the language centers are important aspects of optimal brain function.

Further benefits of Neuro-Cognitive Reconstructive Therapy™ are improved attention, visual-motor and sensory integration, memory, and processing speed, more efficient thinking and decreased impulsivity. These outcomes are achieved through two one-on-one 80 minute sessions per week. Each therapy session consists of a variety of techniques customized to address specific deficits and develop flexibility of thinking. The techniques require high multi-modality integration (visual, auditory, tactile, kinesthetic) and are part of every student’s program. These and other techniques are implemented in a program of progressive challenge, constantly mediating the student to his highest potential.

The belief in deficit stimulation was an idea ahead of its time in the 1960’s as an organization in the USA, NILD’s Educational Therapy™ was being developed. Yet today it is receiving continual confirmation through research, particularly in the neurological sciences. Pushing deficit areas in perception and cognition remains a key to seeing the brain miraculously restructure itself and rewire its faulty circuits. Change is possible, and Neuro-Cognitive Reconstructive Therapy™ is a powerful agent of that change!


Black, I. B. (1995) Trophic Interactions and Brain Plasticity. The Cognitive Neurosciences, pgs. 8-19, Gazzaniga, M.S., Ed. MIT Press: Cambridge, MA

Gazzaniga, M.S. (1995) The Cognitive Neurosciences. MIT Press: Cambridge, MA