title: Cognitive tutoring induces widespread neuroplasticity and remediates brain function in children with mathematical learning disabilities.
abstract: Competency with numbers is essential in today's society; yet, up to 20% of children exhibit moderate to severe mathematical learning disabilities (MLD). Behavioural intervention can be effective, but the neurobiological mechanisms underlying successful intervention are unknown. Here we demonstrate that eight weeks of 1:1 cognitive tutoring not only remediates poor performance in children with MLD, but also induces widespread changes in brain activity. Neuroplasticity manifests as normalization of aberrant functional responses in a distributed network of parietal, prefrontal and ventral temporal-occipital areas that support successful numerical problem solving, and is correlated with performance gains. Remarkably, machine learning algorithms show that brain activity patterns in children with MLD are significantly discriminable from neurotypical peers before, but not after, tutoring, suggesting that behavioural gains are not due to compensatory mechanisms. Our study identifies functional brain mechanisms underlying effective intervention in children with MLD and provides novel metrics for assessing response to intervention.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California 94305, USA.
authors.forename: Teresa
authors.initials: T
authors.lastname: Iuculano
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California 94305, USA.
authors.forename: Miriam
authors.initials: M
authors.lastname: Rosenberg-Lee
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California 94305, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Richardson
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California 94305, USA.
authors.forename: Caitlin
authors.initials: C
authors.lastname: Tenison
authors.affiliation: Department of Special Education, Vanderbilt University, Nashville, Tennessee 37203, USA.
authors.forename: Lynn
authors.initials: L
authors.lastname: Fuchs
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California 94305, USA.
authors.forename: Kaustubh
authors.initials: K
authors.lastname: Supekar
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California 94305, USA.|Department of Neurology and Neurological Sciences, Stanford University, Stanford, California 94305, USA.|Stanford Neurosciences Institute, Stanford, California 94305, USA.
authors.forename: Vinod
authors.initials: V
authors.lastname: Menon
mesh_terms: D001921:Brain / Q000503:physiopathology*; D002648:Child; D003071:Cognition; D005260:Female; D006801:Humans; D007858:Learning; D007859:Learning Disabilities / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy; D008297:Male; D008433:Mathematics; D009473:Neuronal Plasticity; D011340:Problem Solving