What’s up with Memory?

“It is an important part of what makes us truly human, and yet it is one of the most elusive and misunderstood of human attributes.”

http://www.human-memory.net/

What is memory?

I loved this website, and thought I would read it, share some parts of it, and think of how to apply it to our population of children who are deafblind.  Memory is something that is much more complex than we can begin to imagine.  To simplify things, it has been compared to a super-computer, or a complex filing cabinet.  It would have been simpler if memory was located in one place in the brain; but it isn’t.  It involves a process that occurs all over the brain (Distributed Processing) in patterns that we really cannot fully comprehend and is reflected in our body’s sensory and other systems. So, it might be better to imagine a really complex web of intrinsically connected threads that “symbolize the various elements of a memory that join at nodes or intersection points” (http://www.human-memory.net/) to create a whole memory.  Since memory is distributed, when there is damage to one or more parts of the brain, some memory is retained in the undamaged or less damaged areas.  Let us look at some basic memory information and think about deafblindness and its impact on memory.

Types of memory:

These three can be thought of as levels where one leads to the next:

Sensory memory  —  Short term memory — Long term memory

You need all three to have a really well-established memory of something.  Because it completes the “storing” process, this will also give us some idea why long term memories usually persist when short-term memory fails.  It is then reasonable to think if a child has a memory that is established in this way, we should try to connect other memories to it – so the “new” memory is added to and strengthened. Concepts are broadened in this way as part of the process.

• Sensory Memory. Our memories differ because of the way in which we receive input for them. So visual input from an event for one person will result in primarily a visual memory; while for another person who cannot see, the input from the same event may have been auditory.  So the memory is auditory.  These are two very different memories – but for the same event.  For our children who are deafblind:
  • How are they getting the information to store? Using a sensory integration inventory, or a functional assessment of the senses is important.  Occupational Therapists will have suggestions for this.
  • Which sensory system is functioning the best?
  • To “jumpstart” your quest – here’s a sampling of Sensory Inventories:
    • From the University of Iowa: http://www.uihealthcare.org/uploadedFiles/UIHealthcare/Content/Services/Center_for_Disabilities_and_Development/UCEDD/Self-Advocacy/Behavioral_Support(1)/sensoryinventory.pdf
    • From OT Innovations: http://www.ot-innovations.com/clinical-practice/sensory-modulation/sensory-assessments-for-adolescents-adults/
    • And then there’s Texas School for the Blind and visually Impaired – Learning Media Assessment: http://tsbvi.edu/publications/1037-learning-meadia-assessment-a-resource-guide-for-teachers-2nd-ed Want an overview of the LMA?  Check our earlier article: http://www.oregondb.org/news/Summer1-2014.pdf

• What might all the pieces be? It would be important to note if more than one sense is involved.  What would the combined input look like?  These sensations, often stored as “emotionally” connected memories are sometimes known as “Bodily Emotional Traces”.  See the section in this blog under ‘Is there a language of deafblindness’: http://www.deafblindinformation.org.au/congenital-deafblindness/for-professionals/communication/
• Want to learn more and practice noticing these?  Go to Open Hands Open Access (OHOA) module 7 on www.nationaldb.org .  Click on the link to the OHOA modules and register so that you can take a look.  No cost for doing this!
• And here’s one more site that has an interesting section with a diagram of body maps connected with various emotions (Fig.2.) : http://www.pnas.org/content/111/2/646.full
• Look at this study — which connects emotional and physical pain:  https://www.psychologytoday.com/blog/body-sense/201204/emotional-and-physical-pain-activate-similar-brain-regions

Are there implications for our children who are deafblind?  When a person’s body “lights up” in a specific way to an emotion, the body-brain connection provides that emotional piece that only serves to strengthen what the child is learning.  If all remembered emotions were positive – this would be so beneficial.  But this is not always what happens.  Perhaps if we knew or could guess what the less than-positive ones were, we could work on connecting them to more positive activities and memories.  For example, a child who had been a premature baby has emotional memories connected to heel sticks (for blood-draws).  This child may not even consciously remember this, but the pain and emotional upset connected with them may remain, hovering in the background in his memory.  He may react poorly to massage when someone touches his foot and heel – even though there is no actual pain – and display emotional distress.  Even though infant-child massage dictates starting with the feet and legs, perhaps for this child starting from a less vulnerable place on the child’s body will help to relax the child.  Doing the heels last may, in time, help transfer the emotions from negative to positive. https://www.psychologytoday.com/blog/body-sense/201204/emotional-and-physical-pain-activate-similar-brain-regions

• Short term memory – also known as “working memory”. See the ‘video-watch’ section of our newsletter: http://www.oregondb.org/news/Fall2014.pdf   I love that the website I am looking at calls short-term memory the brain’s “post-it” note.  It is not meant to stay and is more for instant and quick recall – unless it is processed and stored. http://www.human-memory.net/types_short.html  .   The same article gives a couple of good examples.  If you are reading a sentence, your short term memory has to keep track of the earlier part of the sentence so that the whole sentence can then be put together for meaning.  I picked this example because so many of our children cannot keep too much information in short term memory.  For example, they may hear and understand the first part of the sentence and lose the rest, or only make note of the tail end of the statement.  SO – wouldn’t it help to (a) shorten sentences – or even use phrases; (b) Look for comprehension (and storage of this) before moving on, and (c) Practice recall really soon after – and repeat, repeat, repeat?  It is also helpful to figure out if we need to use one-step, two-step – or more – directions with a specific child.  Too many steps all at once, and you may lose the child’s attention and muddy his comprehension. Since the pre-frontal cortex (front of the head) is thought to be the main part involved in short-term memory, damage to this area of the brain results in poor working memory – and this will disrupt the process of memories being stored to be retrieved.
  • What are some possible factors/techniques to help our children so that a short-term memory is stored in long-term memory?
    • Make sure the child is attending – and is relaxed.
    • Simplify what it is that needs remembering.
    • Repeat, repeat, repeat.
    • Attach it to a context.
    • Connect it to something that is of interest to the child and so provide motivation.
    • Try using Mnemonics with some children. Music mnemonics are interesting….  http://learningassistance.com/2006/january/mnemonics.html .  Remember “knuckle mnemonics”?  https://commons.wikimedia.org/wiki/File:Knucklemnemonic.jpg .  If you are a creative person, you can perhaps create some “touch mnemonics”, based on the “likes” and preferences of a child, that might help “anchor” ideas and concepts.\
    • Link to “old” and established memories – and provide cues (visual, auditory, or other sensory).
    • If a child is able to speak or sign—have them repeat, using words or signs – and not just passively listening to or heeding your message.
    • Use “chaining” (an Applied Behavior technique)– both backward and forward – depending on what it is. It could be simple instructions, or a routine:
      • http://special-ism.com/last-is-first-in-backward-chaining/
      • http://www.learningsolutionsmag.com/articles/325/last-things-first-the-power-of-backward-chaining .
    • Remember – reduce distractions because they will possibly erase the short-term memory and you will have to start over.
    • Be aware that each child will differ in “memory span” – i.e., how many things in a row can be recalled. Miller’s Law suggests that the “magic number” is 7+ or -2.  For our children who are deafblind and have additional severe disabilities, this will be less. The human memory website also reminds us that memory span can differ between cultures.  For example, “..English-speakers can typically hold seven digits in short-term memory; Chinese speakers can typically remember ten digits.”  The reason?  “Chinese number words are all single syllables, whereas English are not.”
    • “Chunking” or putting together in a group is one technique – the ideal being 3; but this may or may not be possible to use with a specific child. It’s okay if you only do ONE thing a time – a chunk of one!

In short – grab an important idea or concept from short-term memory – and find a way to help it stay!

• Long term memory

No one yet knows enough details about long-term memory.  It is possible that we never forget anything that gets stored there – but that it is the recall process that may be affected and may make it appear like we have forgotten.  In the elderly, long-term memories often seem to come out of nowhere – and even seem more vivid than before.  So they WERE somewhere – buried in the brain – resurrected by some association that seems random.

You need short-term memories to create long-term memories, but this can only happen when there is a process of CONSOLIDATION, stabilizing a memory “trace”:

• “Rehearsal” — Repeat, repeat, repeat!   Make it “routine”. Literally – a synapse increases in strength as an increasing number of signals are transmitted between neurons. “As such a neuronal pathway, or neural network, is traversed over and over again, an enduring pattern is engraved and neural messages are more likely to flow along such familiar paths of least resistance.”  http://www.human-memory.net/processes_consolidation.html .  If a new experience “adds” to an existing memory, the brain may “re-wire”.  In order to sustain this rewiring, the body produces new proteins to actually rebuild the synapses in the new shape – the “new” memory! If that does not happen, the memory will weaken over time.  It is important to continue to practice the “new” additions along with the old so they meld together.  So, again – simply repeat, repeat, repeat.  Be aware that sometimes, instead of adding something to an existing memory network, the new information causes interference and can be disruptive to the older memory—and end up being confusing for a child.  Perhaps for our children who are deafblind/multi-disabled it may help to let some time pass before adding the “new”.
• And here’s something to keep in mind – SLEEP (slow-wave or deep sleep) is critical during the first few hours. Even daytime naps can help!  “Studies have shown that information is transferred between the hippocampus and the cerebral cortex during deep sleep” and it is essential for the process of consolidation.  This fact makes me wonder whether a child who cat-naps (e.g., a child with CVI) may be resting in order to consolidate something he saw or experienced.  We DO know that after a cat-nap, a child with the diagnosis of cortical visual impairment is usually more alert and ready to learn once more.
• Associations that are meaningful – Make it functional. Doing this causes us to create a network of meaning – and therefore probably a stronger neural network.
• Reading out loud – or even whispering or mouthing – helps with memory. We know this.  Most of us have actually done this.  I know I still do this when I am preparing for a presentation or a discussion.  The auditory connects to the visual and are better together. So if a child can read, or use another sense (e.g., vision-touch, sound-touch) – it will help consolidate a memory too.

The WHAT and HOW of long term memory:

Long term memory includes memories that reveal WHAT happened (episodic memory) – events, and facts.  These are sometimes in the form of a series of events that form the whole story, reflecting on something that actually involved the individual– “autobiographical events – times, places, associated emotions and other contextual knowledge”. http://www.human-memory.net/types_episodic.html .  So – it is really important to relate back to a SERIES, step by step perhaps instead of just one little piece out of context.  We could do this by creating little booklets that represent the whole story or the whole routine – and go from page one to the next and onwards until the end.  One can make a good case for a type of forward and backward chaining here too – with stress on a series.

Memory also includes other types of memories.  For example, Semantic memory, which is an extension of episodic memory and contains some of the HOW as well.  It is “a more structured record of facts, meanings, concepts, knowledge about the external world” – and this is knowledge separate from the personal type of knowledge or may have started out by being personal and now can be categorized as “simple knowledge” – hard facts.   It is abstract – and connected to symbolic language.

For example, a child who is deafblind may recall early experiences in a hospital – brightness, loud sounds, voices of medical personnel, the smell of disinfectant in the room or on the bedclothes – and the procedures that happen to him/her. In the background, there may also have been music or the rhythm of a specific piece of medical equipment.  All these are episodic – and may be played again and again in the child’s brain.  All these pieces, as they occur, are distributed in the brain to various areas –vision, hearing, smell, etc) but the hippocampus puts them all together into one “episode”.  Any ONE of these pieces could trigger the entire episode.  That is possibly why a child may startle or fuss suddenly – because a “trigger” brought up the whole hospital experience.  I remember traveling in a car en route to the Children’s Museum in Portland – with one of our children who is deafblind, his brother, and his mother.  As we got close to Portland, he became very fussy and made loud complaining sounds.  And suddenly as we rounded a curve on the freeway, this changed – to a big smile and happy sounds.  I had no idea why – until his mother said, “We just went by the ramp to the hospital”!  Aha!  A combination of blurry vision and muscle memory told him this.

Sometimes personal “episodic” memories and general knowledge “semantic” memories combine into an “autobiographical” memory.  The website page has an interesting sidebar that says that autobiographical memory may be linked to handedness.  It states that for someone who uses both hands (mixed handedness), autobiographical memory seems to be stronger.  They think this may be a reflection of better communication between the brain’s two hemispheres, and a better functioning corpus callosum.  So it is worth noticing if a child is right-  or left-handed, or ambidextrous.

Also relating to long-term memory is what the article calls “temporal direction” http://www.human-memory.net/types_retrospective.html .  We all look BACK to past episodes and occurrences (Retrospective Memory).  But, connected to this is what we know we have to remember in the future (Prospective memory) – or “remembering to remember”.  For instance, when we have to use cues to trigger a retrospective memory that will also help us recall what we will be doing or looking at.  A child who is deafblind definitely needs cues (as we all do!!).  Thoughts bounce between the two.  If a child has a routine of dropping off the attendance sheets in the main office at school, he already has the routine in retrospective memory.  However, he may still need those cues – to know when he is halfway to the office (humming sound or sound of water splashing from the water fountain), at the office door (cue pasted on the door jamb, or a change from floor to carpet).  It is the reason why we make lists too.  I know one youth who was deafblind who would make up his grocery list in the order of the various aisles in the store.  He used his past knowledge of WHERE to project where he needed to be in the store.

And, before concluding this blog, I’d like to share a few additional sites on memory:

http://www.brainhq.com/brain-resources/memory/types-of-memory/long-term-memory     I enjoyed reading this article on long-term memory with some really simple points to remember.  Long term memory:

• Can last for a few days or a few years
• May not be of equal strength — some are more memorable than others; some need prompting/reminding
• It is dynamic. We revise, add, and even blend one memory with another (therefore not always reliable!)
• You can consciously or unconsciously remember something — riding a bike is the latter
• Different “forms” of memory mix and mingle
• If the brain of a person does not or cannot record sensory information clearly, memory recall is better
• Sharpening the process of what you take in through your senses will improve memory — Does this sound familiar — “Practice, practice, practice”?

And I like the “memory mythbusters” in this article: https://elearningindustry.com/memory-types-facts-and-myths .  Read the short article!  Here are “thought ticklers” from it:

• There are no everlasting memories
• Memory is not infinite
• Encoding will not reinforce our memory
• Don’t study before you sleep
• Memory decays with age
• The people that learn faster are those that hardly forget
• There is no easy way to memorize

This site has 10 memory myths: http://www.memory-improvement-tips.com/memory-myths.html?utm_campaign=elearningindustry.com&utm_source=/memory-types-facts-and-myths&utm_medium=link

This article on working memory – which it calls the “search engine” of the mind, is excellent too: http://www.cogmed.com/about-working-memory?utm_campaign=elearningindustry.com&utm_source=/memory-types-facts-and-myths&utm_medium=link

Another article on working memory from which we can derive some information for our children who are deafblind: https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/executive-functioning-issues/5-ways-kids-use-working-memory-to-learn?utm_campaign=elearningindustry.com&utm_source=/memory-types-facts-and-myths&utm_medium=link

This link lists 12 interesting facts about human memory – and the first one states that the human brain starts remembering –FROM THE WOMB:  http://www.theceugroup.com/12-surprising-human-memory-facts/    You can also learn some amazing “memory” facts about Alexander the Great, Mozart, Winston Churchill, and Bill Gates!

Take a look.  Happy reading!

 

Proprioception

Big word.  Significant sensory phenomenon.  It is related to what we call the “Sense of Touch”.  Strangely enough, we are mostly unaware of this sense — but we would be at a tremendous disadvantage if it was damaged or not functioning as it should.  We use it all the time in so many ways — reaching out for something, placing our fingers on a keyboard and then tapping on the keys, bringing food to our mouth, climbing stairs, going up or down a slope/ramp, and so on.  It is the body’s internal way of informing us of where we are in space.  It is also the way our body connects touch with our motor functions.

Read more about proprioceptive dysfunction in books by A. Jean Ayres or Carol Stock Kranowitz (e.g., The Out-of-Sync-Child) and what they call the “position sense”. The receptors for this sense are internal — inside our muscles, joints, ligaments, tendons, and connective tissue.  In the field of deafblindness, we often refer to “distance” (vision, hearing) senses, and “contact” (touch, taste, smell) senses.  The proprioceptive sense is our “deep” sense.  Why is it important to know about this sense?  If it is not functioning in a child, it means that the child cannot experience the world in the same way as most of us do.  And it shows up mainly in what people consider “behaviors”.  So what we may think of as just plain “klutzy”, may be a dysfunction.  What might we look for?

• A child who takes a really long time to perform an action — although you can “see the wheels turning”.  His brain and body parts are not working in-sync with each other — and it is a lot harder to do tasks we take for granted.
• Directions become a puzzle — how does one move forward or backward?  Right and left are just words and actions may not match up.  In fact, it may seem like a child is deliberately going in the wrong direction with his foot, hand, body.
•  A child who reaches for something — and knocks it over because the action was done too fast, with too much pressure.  Or something slips out of his grasp because he cannot figure out how hard he should grip it — even if his hands have the strength to grip hard.  Maybe he bangs too hard on his drum, or holds your hand really tight and cannot seem to “let go”.
• A child who cannot seem to maintain posture, slumps, leans on his arms when at a table, leans one way or the other, and may often lose balance. He has an especially difficult time on stairs or ramps — and finds it impossible to ride an escalator.
• A child who flails around and is very fearful if you lift his feet off the floor.
• A child who is strong enough to walk, but does so only if he is able to be in contact with something — furniture, railings, even a wall.
• Some children who appear ambidextrous, but may actually be struggling with figuring out which one works better — and for what activity.

Here’s an article that has a long list of behaviors: http://www.cherringtonsawers.com/tactile-vestibular-and-proprioceptive-senses.html

And then — Read this article for some ideas on some things you can do to help:  http://www.sensory-processing-disorder.com/heavy-work-activities.html  The article ends with a long list of ideas!

Creating resistance seems to help — weighted items (blankets, lap blankets, vests, shoes, hats, spoons and other utensils) could be useful.  Stretchy, but close-fitted clothes sometimes help (e.g., spandex tights, a fitting undershirt).  Thera bands or body sox may be fun too.

For some children, they can sometimes “get their act together” if they are allowed to “re-group” in some way.  A child may lie down (usually, on his back).  He may cross his legs to weight one with the other.  He may also cross his arms over his chest.

Enough said for now.  But do try to imagine how you would function if your proprioceptive sense was not!  It might give you some clues on what a child in your care (or an adult you know!) might be going through.

 

Touch differs?

Have you ever thought about how touch differs from your other senses in the information it provides?  A good way to find out is to blindfold yourself and try and do some selected tasks, or even walk a selected route.  If you do, you will soon find out!  Many people tend to think that when someone loses their vision, their touch just “takes over”.  Even with all we know now about the plasticity of the brain, we still cannot expect an apple to become an orange!  Working in  the field of visual impairment and deafblindness, we need to think through everything we are expecting of the children and youth we work with.  So — we MUST think of how touch differs, especially how it differs from vision.

It is what we call a “contact” sense.  You cannot touch something from a distance – like you can see or hear something at a distance. Arm’s length. Let’s say you are under blindfold and are confronted with your desk at work.  You have some idea of where everything is located because (hopefully!) you remember where things usually are on the desk.   But here are some things to consider:

• You do not get an OVERALL view of your desk.  So you cannot pounce on that pen when you need it, or make a beeline for a book that you know you left on your desk yesterday.  You have to move your hands around to locate them.  And even when you do find your pen or the book, you are really only concentrating on those items and not on the rest of the desk.  You have just lost some of the environmental “context”.  So, keeping this in mind, what is one important thing to remember to do? Organize your desk very carefully so that you know where things are in relation to one another.  And then leave a note on your desk saying, “Do not mess with my desk!”
• To reiterate – you are provided with little or no CONTEXT. If there’s a mug of coffee balanced on the book you are looking for, you might just find the mug, but not the book below it.  Or you may just knock the coffee all over your book!

When you look around you, images are stored so rapidly that you are not even aware of the tremendous number of eye movements and brain connections it takes in that split second to give you an overview of your surroundings.  Imagine you are in a garden — even a small one — and you want to know what is around you — but you are unable to see.  You need to use touch.

• You know very soon that touch does not give you the same rapid overview.  It is not a QUICK sense when you need to explore. Of course, the “defensive” side of touch is quick — as when you touch something hot.
• It may take you a long time to explore what you can with your hands – or your feet.  You also realize that you may be feeling with other parts of your body.  After all, the sense of touch is more than just in your hands!  It is THE LARGEST SENSE because it is from head to toe!  To make things more complicated, not all areas of this large sense act the same way.  Some are more sensitive than others.  Certainly that is one of the reasons most people who read braille by touch do so by using their finger-pads rather than their elbow or the backs of their hands!  I knew one child who read better with his thumb; and another who read with the sides of his hands – but that was because their finger-pads did not function the way most finger-pads do.
• You will also discover that there are things you cannot reach and some you cannot touch – like that tall sequoia tree or the tiger at the zoo!  So for touch to work, it MUST BE WITHIN REACH.  Consider — when you cannot reach something and you cannot see it, you may never really develop a concept for it, unless you have a visual memory of it.  For example, try describing Mount Everest to a person who has been blind from birth.  There are also things we can “see” visually that are not “real”.  For example, try describing  “horizon” in tactile terms.  Having miniatures doesn’t work very well either.  When you touch a miniature sequoia tree, Mt. Everest, or the Eiffel Tower, your sense of touch does not give you the same information that your eyes would.
• When looking at a painting on a wall in front of us, our eyes make a large number of movements between parts of the picture as they take everything in.  We are not even conscious that are eyes are moving around, very rapidly, so we can “see” the whole picture and maybe recognize that its the Mona Lisa – because we see the whole thing.  Touch cannot do this.  We can look at a famous statue — and recognize it instantly.  Think of the large statue of President Lincoln at the Lincoln Memorial.  It is LARGE — but our eyes can scan it rapidly and our brain can confirm what we are seeing.  Imagine – if it was possible — how long it might take to go over the statue via touch!  And then, when we are done, it may still not be recognizable at all — too much to scan via touch, too many details, too much to put together!  It will just not make sense.
• This applies to reading too.  Reading print and reading braille are two very different experiences.  When you read print, your eyes, very rapidly, scan ahead.  If they didn’t — you would be reading only one letter at a time, and not seeing the whole word or a section of a line.  The eyes make stops as they scan a line of print – each stop-move is counted as a “saccade”.  For a beginning reader, there are many stops.  For a speed-reader, there may be only two or three stops per line.  Now think of braille.  It is read with the pads of the fingers (usually!), one or two fingers taking the lead, while the others help keep track of what is on the line, and when to change to the next line.  A person new to braille will look at only one letter at a time — and a more experienced person will scan the whole word.  This is where the similarity to print-reading ends. Really good braille readers do not have to stop and start.  They can just read continuously, except perhaps for a brief interval to change to the next line – or, deliberately, to rest.  This is even more so for those who are using what is called “refreshable braille”.  Maybe this can explain why one expends more energy when reading braille, than if reading a print version of the same document.

When you scan the environment with your eyes, you take in not just color in all its variations, and detail of the things you see — but this also includes what I will call “tactile” visuals.  For example, you can look at surfaces and objects and estimate whether rough or smooth, hard or soft – even without touching them.  This is because your eyes and brain create a loop of information where your eyes borrow information and add it on to what the actual visual is.  With touch, this type of interface between touch and the visual does not happen.

• You don’t feel the color.  There has been some research done to figure out if some people can actually “feel” the color – and, who knows, this may be possible!  But, in general, if I touch an apple, I cannot tell you if it red, green or yellow.
• You may not know the “detail” of the color either — streaky, all-red, spotted?
• Touch is usually the sense that CONFIRMS what you see.  I see something that looks really heavy and rough (like a large rock in a garden), but it is only when I touch it or pick it up that I know it is really only a pseudo-rock – and light.  It is also much smoother than I originally thought.

These are only some thoughts about touch.  More to come!  To repeat myself — just be aware that touch does not automatically take over all the functions of vision because HOW they function differs.

Next blog or blogs (depends on how much I meander!!):

The importance of light touch.

Touch and the “social” sphere.

Extensiveness of touch.

Variety in touch.

 

 

Welcome

This is my first blog on here.  So hopefully it will make some sense to folks who are going to read it.  I am not “down under”, but this koala was so cute, I decided to use him in this first blog.