Academic Interventions and Treatments

At Possibilities, we have always provided an integrated and scientifically-sound approach—from the assessments we administer to the treatments we provide. We recognize that Attention Deficit Disorders, like ADD and ADHD, are complicated and usually have other challenges that go along with them, like Learning Disabilities in reading, writing and math. We make diagnoses as a Multidisciplinary Team because we are committed to a comprehensive approach that relies on multi-expert knowledge. And, of course, our experts rely on science to make accurate diagnoses, too!

Beyond assessments for ADHD and Learning Disabilities, we provide treatments for a range of concerns. When it comes to learning, we offer interventions to address specific academic challenges. A comprehensive approach—supported by evidence—also guides our treatments. Here are some common questions about our academic interventions, and our responses to provide you with more information.

How do you determine what academic treatment my child might need?

If you’ve started with a Signature Assessment at Possibilities, then our Team has already examined a full range of skills related to learning including attention, executive functioning, working memory, short- and long-term memory and processing speed. Since our Signature Assessment also examines academic skills in depth—in reading, writing, spelling and math—we’ll have a detailed profile that determines where to start and how to prioritize areas for academic treatment.

Can my child receive academic interventions through Possibilities if we received a Psychoeducational Assessment somewhere else?

Yes, you can. We will require some background information to get us started, including a copy of the Psychoeducational Assessment report, to help us formulate a personalized Treatment Plan.

What programs do you use?

We offer programs from the Direct Instruction (DI) curriculum. DI programs are comprehensive, intensive, repetitive and evidence-based. We administer these programs in reading, writing, spelling and math. DI interventions are also available to promote language skills for children who have difficulty understanding and expressing speech. Because language is such an important part of learning, we offer these DI language programs, too. We also use additional, systematic programs to support our DI work, like Step Up to Writing, depending on your child’s needs.

Do you offer brain training exercises or neurofeedback to boost learning?

No, we don’t. Currently the research evidence is not strong enough for us to offer these approaches. What is clear from research in the neuroscience of learning is this: the brain must do exactly what is hard for it to do in order to make specific gains. So, to improve reading, the brain must read. To improve writing, the brain must write. To improve spelling, the brain must spell. To improve math, the brain must calculate. General programs that exercise the brain don’t take this approach to improve academic skills—but Direct Instruction programs do.

What makes Direct Instruction so special?

Direct Instruction programs have been designed and updated with decades of data supporting their effectiveness. Information is presented to the brain consistently—in organized and structured lessons—with the right amount of repetition to help emerging skills “stick.” Students do not move forward in DI lessons until the skills they have learned earlier are learned very well. This approach ensures a solid footing going forward, so strong skills can build even stronger ones.

Are Direct instruction programs effective with students who have ADHD?

Yes! Direct Instruction programs are structured with lots of built-in review. They also require quick and spirited responses quite often! Instructors trained in DI are very skilled at engaging students in lively back-and-forth interactions that build practice into each lesson. For some children, though, significant challenges with focus can make even the most structured and fast-paced lessons difficult to manage. In ADHD, research shows that the best treatments are integrated—which means functioning improves the most when there are different treatments combined and working together. For some students, ADHD medication that brings neurotransmitters to optimal levels helps the brain become better focussed and more effective at learning.

What if my child has trouble with many academic skills?

A focused and repetitive approach is critical for success with Direct Instruction. So, we don’t introduce too many separate programs at once. Our Treatment Plan for your child will specify what programs we think should be started first, when new programs should be introduced, and how programs can be coordinated effectively if we are combining multiple interventions like reading and math.

When you say DI programs are “intensive,” what do you mean?

Research shows that Direct Instruction programs work best when they are delivered frequently and consistently. When there are long-standing learning difficulties, despite extra help at school, the brain needs more input to see patterns that can help it perform better academically. DI Reading Programs require at least two days every week since frequent exposure to letters, words and blends is necessary to help change brain circuits for decoding.

What do you mean by changing brain circuits for reading?

Challenges decoding—which means sounding out words—have been linked to a specific brain circuit. Students who struggle to read in Grade 2, and in later grades after that, may have a Learning Disability that affects how they sound out words. This particular Learning Disability is called Dyslexia. But the good news is that sounding out skills can be boosted significantly with specific, evidence-based programs like Direct Instruction.

Strong readers typically activate a circuit in the left hemisphere of the brain when they sound out words. This left-sided circuit is impressive. It can read just about anything—even fake words like panderastoric—because it is super skilled at decoding! But struggling readers typically show activation in the right side of the brain, much more than the left. This alternate route is a problem, because the right-sided circuit isn’t designed for sounding out. Instead, it makes a whole lot of guesses. So panderastoric might be read as panda, though it’s trying its best! Programs like Direct Instruction can turn down the volume of the right-sided circuit and boost the activity of the left-sided one, priming the brain for reading. When this physical switch in brain functioning happens, it’s turned on for life, and reading improves dramatically.

What does the brain look like when reading circuits are changed with academic treatment?

The brain images below are from a 10-year old student with severe reading difficulties. Brain activation while sounding out words is indicated by the white patches. Red and green circles have been added to mark the size and location of these areas more clearly. Before reading intervention, the brain’s right hemisphere was more active than the left—a pattern typical in Dyslexia. After intervention, the left hemisphere became more active and the right hemisphere stepped back. The result? Sounding out words became easier and more accurate! You can read more about changing brain circuits for reading with scientifically-supported treatments in Sally Shaywitz’s excellent book, Overcoming Dyslexia.

When is the best time to start tutoring with programs like these?

You are going to hear different answers to this question, depending on who you ask. Some clinicians and educators suggest waiting to assess for learning challenges, at least until Grade 3. They argue that all students learn at a different pace, and that it’s best to see how learning settles before assuming something is not developing as expected. We do not share this perspective at Possibilities. Given our training in neuropsychiatry and neuropsychology, we will always approach diagnoses and treatments from a brain-based perspective. Brain science —filled with images like the picture above—shows that the best time to change a brain circuit for reading is before Grade 3, not after it. And research from psychologist Dr. Keith Stanovich makes it very clear that gaps in skills widen the longer you wait, making it harder to create change with tutoring later on.

Is it too late to improve academic skills if a student is in late elementary or high school?

No! Generally when it comes to any interventions, the sooner you treat when you begin to see problems, the better. However, some students work really hard to earn high grades, or they are bright enough to do well, until work becomes unmanageable. Then challenges become more obvious. Getting a comprehensive assessment that looks at attention, learning and mental health can be helpful to pinpoint the reasons for learning difficulties at any age. Then a tailored Treatment Plan can be made. Dr. Shaywitz, author of Overcoming Dyslexia, says it’s never too late to teach a brain to read. Even adults can benefit from solid programs that develop skills in systematic ways.

Are these academic tutoring programs covered by OHIP?

OHIP does not cover educational treatments. However, our academic interventions may be covered by private insurance plans. If psychology oversight is required for insurance coverage, a Psychologist can collaborate with your child’s Direct Instruction tutor in developing and supervising the academic Treatment Plan.