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CEC-King-1

VIEWS: 14 PAGES: 32

  • pg 1
									                                                                     James King

IS/The MKM Visual
Memory Technique
Children with learning disabilities may be described as:
  children who have a disorder in one or more. of the basic psychological
  processes involved in understanding or in using language, spoken or
  written, which disorder may manifest itself in imperfect ability to listen,
  think, speak, read, write; spell, or do mathematical calculations. Such
  disorders include such cOAditions as perceptual handicaps, dyslexia, and
  developmental aphasia, but does not include children who have learning
  problems which are primarily the result of visual, hearing, or motor
  handicaps, or mental retardation, of emotional disturbance or of
  environmental disadvantage (1).

Over the years, this definition has been useful. especially in
identifying children for federal programs. Before this definition was
coined, consider the frustration that a parent might have had in talking
to a legislator:
Parent: I have a child who is not doing well in school. He needs help.
Legislator: We fund all sorts of programs. What seems to be the
problem?
Parent: He's having trouble learning to read, write, and spell.
Legislator: We have excellent programs for the mentally retarded.
Parent: He's not retarded. The psychologist says that he is well within
the normal range, but he has trouble seeing and hearing.
Legislator: We have excellent programs for the blind and deaf.
Parent: Well, the doctors say that he has 20/20 visual acuity and he
passes all hearing tests. He just seems so clumsy in everything he
attempts that now it's getting harder and harder for him to try
anything.

Paper presented at the Second Annual Meeting of the College of OPtometrists in Vision
Development. October 7. 1972
                                                                               363
Legislator: Y-Ou mean that he has motor problems but he's not
cerebral palsied; he has eyes but he doesn't see; he has ears but he
doesn't hear; and he can't read but he's not retarded. Just what kind of
child do you have?
At least with this definition the parent can now answer:
Parent: J guess he just doesn't have the ability to Jearn easily.
Legislator: Is your son the only one like this?
Parent: In talking to my son's teacher and other parents there are
apparently an awful lot of kids with similar problems. In fact from what
I've read, anywhere from 3 to 40 percent of the school-age population
have some learning disabilities.

Legislator: What happens to these kids?

Parent: Sometimes they get put in special education. But most special
education programs are geared for children that are mentally
retarded, emotionally disturbed, or cerebral palsied-and these
children are none of these.
Legislator: What happens to them then?

Parent: Once a child gets in special education he most likely will stay
there throughout his academic life; however, the environment isoften
not stimulating and the constant association with children that are
frankly retarded or emotionally disturbed is not conducive to his
learning. He may drop out, get pushed out, become delinquent or
become generally hard to employ.

Legislator: Are all of these children destined to fail?
Parent: Some children ultimately solve many of their problems
themselves. Most parents, however, have a long wait, waiting for their
children to "outgrow it." Many children simply trudge through school
barely surviving from day to day.
Legislator: What other alternatives are there?
Parent: Well, in some schools, there are teachers that have special
training in recognizing and working with these kinds of kids. These
learning disability specialists give classroom teachers some ideas
they can use and also work with small groups of children for a few
hours a day or several times a week. This gives the child some
individual attention and still keeps hi m with his classmates for most of
the actiVities.


364
Legislator: Anything else?
Parent: There are private schools springing up all over the country.
Some of them are good, some not so good, and most are rather
expensive. At least they offer an alternative for those that can afford
them.
Legislator: As a practical point, I would find it hard to convince my
fellow legislators to fund special programs for 40 percent of the
children. Isn't it possible that some of the problems are due to poor
teaching in the first place?
Parent: There are children with learning disabilities and there are
teachers with teaching disabilities. One problem is that many
teachers are not prepared in their education to cope with these
children. In many teachers' colleges, learning disability courses are
not required and may be offered only at the graduate level. But
sometimes, even with excellent teachers some children can't seem to
learn.
Legislator: But why can't they seem to learn?
Parent: Answer that question and you've really got something! The
least you can do is recognize that these children exist. We don't care
what percentage figure you use: 3-6-10-15 percent-we'll accept
anything for a start. Fund model programs that identify these children
early in the game and provide intensive remedial care. Then find out
what programs work best on what kind of kids and then tell everyone
else about it.
While it is an awkward definition and few professionals are
completely satisfied with it. it does attempt to describe a type of child
that was not cared for under any other programs. It excludes the blind,
the deaf, the cerebral palsied, the mentally retarded, the emotionally
disturbed, and the environmentally disadvantaged. Unfortunately,
children do not come nicely packaged and labeled, and most children
with learning disabilities have multiple handicaps.
If this is an honest evaluation, then the most obvious would be a team
approach involving those professions that are knowledgeable in child
development and learning. The problem in most team approaches,
however, is that the various professions often let their egos get in the
way of the child and instead of an interdisciplinary pooling of
knowledge, there is merely a pooling of biases.


                                                                    365
    Ideally, a well-oiled efficient team might consist of. but not necessarily
~
    be limited to, education, psychology, medicine, speech therapy, and
-
i
    optometry. Perhaps we should develop some model for the
    development of language and see how some of these professions
    might view a child. I think that it is safe to say that children learn
    through many modes-visual, auditory, kinesthetic, and tactual-but
    the two most important modes for reading are vision and audition.
    The following model for the development              of   language   was
    developed by Wold (2) (see Fig. 1).
    At the base of the triangle we find an S which represents
    Seeing, in the broadest sense. This assumes the presence of an
    eye, an end organ capable of receiving light impulses,
    transducing and transmitting them to the brain. If a child is
    deficient at this level he falls into the category of the visually
    impaired or blind.
    The H represents Hearing, in the broadest sense. This assumes
    an end organ, the ear, capable of receiving vibrations of sound
    and transmitting those impulses to the brain. If a child is
    deficient at this level, the problem is classified as hearing-impaired or
    deaf.
    The next level is the perceptual level, visual perception (VP) and
    auditory perception (AP). Defining the term "perception" is a trap that
    I'm going to avoid. The model merely shows that the perceptual level is
    an intermediate stage between a raw sensation and concept
    formation.
    After a child has had several percepts and can relate current percepts
    to prior percepts, the concepts of memory are developed: Visual
    Memory (VM) and Auditory Memory (AM).
    However, where most problems arise is when the child is exposed to
    arbitrary visual symbols that make up letters representing sounds that
    join to form words representing concepts and ideas. The child has to
    learn to process these symbols by a visual symbol-processing (VSP)
    and an auditory symbol-processing (ASP) mechanism.
    Now, if all of these processes are developed one upon the other and
    are integrated one with the other, the result is the development of
    language (L) which includes reading (r), writing (w), and spelling (s).



    366

                                 r Ls

                         VSP
                        VM                   AM
                    VP                          AP
                    s                              H
                    Figure 1.

If we use this model we can see how a child could be examined at the
(5) or (VP) level by an ophthalmologist or optometrist and come out
with a report like "There is nothing wrong with his eyes-he has
20/20 visual acuity."
A report from the speech therapist might read "He has normal
hearing" and the otologist would agree that "The ears are free from
disease."
A parent may note the child's good memory (VM): "Why, he can goto
a ball game and come home and tell me exactly what happened." Or
(AM): "He can hear a song or a commercial once or twice and repeat it
faithfully."
It is understandable how one might see "holes" in some of the higher
visual perceptual areas and assume that these deficiencies may be the
sole cause of the learning disability-or, one might see an auditory
def.iciency and assume that training in audition is the answer.
In fact, some remedial strategies are dependent on whether the child
is deemed to be a visual learner or an auditory learner. The rationale
goes like this: "Children learn in different ways. Some children are
highly visual and others are highly auditory. Visual children should be
taught reading by a look-say method, while auditory children should
be taught by a phonics technique."
I have visited schools that have carried this to an extreme. They had all
their problem children divided into two groups, the visual and the
auditory. Sometimes the training was directed toward· the strong
mode to the near total neglect of the other mode.


                                                                     367
                  Visual         Auditory        Visual          Auditory


      High

      Low     I    X        (

                           (1)
                                    X       I       x
                                                          (2)

                                                                    x




      High

      Low
              I I  X                X       I      x                x
                           (3)                            (4)
      Figure 2.

If you were to go into an average second grade you would find several
combinations of visual and auditory attributes. That is, some children
would be high in the visual area and low in the auditory, some would
be high in the auditory and low in the visual, others would be high in
both visual and auditory and still others would be low in both visual
and auditory; see Figure 2.

Groups 1 and 2 would probably show some learning problems. Group
3 would include the very good students, while Group 4 would be at the
very bottom of the pile, perhaps borderline retarded.
If good readers are generally strong in both visual and auditory skills,
perhaps we should gear our therapy so as to guide the not-so-good
reader in that direction. Perhaps we should worry less about "is this
child a visual or auditory learner" and more about "how can we help
the child develop visual-auditory integration at the symbolic leveL"
What are the relationships between vision and audition and reading
and learning? It is not uncommon for an optometrist to have a child
referred to him for a visual examination whose sole symptom is poor
school achievement. The optometrist may complete his exam and find
on the surface nothing of major significance. A characteristic report
might be:
  Uncorrected distant visual acuity was 20/20 with each eye. Eye movement
  ability was fair. No muscle paralysis was present. Near visual acuity was
  20/20 with each eye. A slight tendency for the eyes toturn in (esophoria) at

368
  the reading distance was noted. Color vision was normal. The eyes
  appeared healthy and free from disease.
The referring teacher may question:
  How can I with just a paper and a pencil and a casual observation detect
  major visual perceptual problems with this child and you, doctor, with your
  years of training, fancy office, and expensive equipment, can't seem to?
A referral to the school psychologist is often less than productive.
After several hours of testing the report may read:
   His 10 appears to be within the normal range, but he seems to have a
   reading problem. It is suggested that an individualized instructional
   program be prescribed to remediate the problem.
There was a time. years ago, when I solved these problems by
completely ignoring them. I was trained to expect that large amounts
of uncorrected farsightedness, astigmatism, amblyopia (lazy eye),
strabismus (crossed' eyes), and!or anisometropia (difference in
correction between the two eyes) might be related to learning
problems. After all, if a child can't see the blackboard, howcould he be
expected to do well in school? Through lens application alone, I have
shared the joy of s'uccess with parent and child on numerous
occasions. I have observed complete changes in personality almost
overnight.
 But I have other experiences to account for.
• I found that many uncorrected nearsighted children were doing
especially well in school. The only reason that they were referred was
because they couldn't read the school nurse's eye chart.
• I observed many children with lazy eyes and crossed eyes that were
excellent readers.
• I examined children with moderate and even large amounts of
farsightedness and astigmatism that were able to achieve quite well.
• I observed children with very poor eye movements that were able to
cope, while some children with relatively smooth eye movements
were unable to read well. A child's tolerance to stress can vary greatly.
• I observed the dilemma of children who passed the school nurse's
Snellen testing, yet were often in the poorest reading group.
Even when I expanded my diagnostic procedures, I was unable to see
much connection between the child's reading ability and my visual
findings. I finally concluded that either there was very little
relationship between vision and reading, or the testing I was doing
was either too gross in nature or inappropriate in design.


                                                                        369
THE EVE AND LEARNING DISABILITIES
A newcomer to the field will soon find that there are various schools of
thought as to the relationship between vision and learning. Most
ophathalmologists (specialists in eye disease and surgery) and some
optometrists (vision specialists) see virtually no relationship while a
small but growing number of optometrists have broadened their
knowledge and have become more sensitive to the visual needs of
children. They offer in their practices a specialty called visual therapy.
But let's get back to Wold's model of the development of language and
discuss those visual traits that we feel to be most related to learning,
specifically: (1) near binocular performance, (2) form perception,
(3) directional concepts, (4) reading and writing posture, and
(5) memory.

Near Binocular Performance
Our research has suggested that many children with reading
problems have problems in using their two eyes together as a team at
the reading distance. We developed a very critical near-point reading
test called the MKM Monocular and Binocular Reading Test (3). This is
a set of six cards designed for use in a stereoscope at the near position.
The child reads 110 basic sight words with his right eye alone, with his
left eye alone, and with both eyes together. Time and errors are noted
on a score sheet. Figure 3 shows howthe words are presented. Figure
4 shows a score sheet.
If a child cannot read these words at all, it could show a lack of basic
sight-word inventory or inadequate decoding ability. The MKM
Binocular Preschool Test (4) may be of value in such cases. This test
uses objects instead of words (see Fig. 5).
A binocular problem may be present if:
(a) A child reads significantly better with one eye than the other. A
difference in time of 20 percent is considered significant.
(b) A child reads significantly better with each eye alone than he does
with both eyes together.
(c) The words "float around," "overlap," or "run into each other"
excessively.
(d) One eye intermittently or completely suppresses on the binocular
card.
By suppression, we mean that one eye seems to inhibit the
performance of the other so that the inhibited eye tends to "turn itself
off." Crossed eyes and lazy eyes characteristically are suppressed. But

370
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children with reading problems may show suppression only under the
critical near-point stress of reading. They often pass screening tests
like the stereo-fly, the Keystone visual skills tests, and the Spache
binocular reading test and still fail the MKM binocular reading test.
With over ten years of experience we have found:
(1) Good readers generally read equally well with either eye and do
not suppress on the binocular card.
(2) Average to fair readers show some instability on the binocular
portion and show some suppressions.
(3) Poor readers show a great amount of binocular instability with
double vision or complete suppression.
We do not say that the binocular instability and suppressions are
necessarily the causes of learning disability. But we think perhaps that
the suppression and binocular instability may be related to a more
central cortical inhibition. If poor binocular performance is a
significant area of concern then it follows that therapy techniques
geared to improve binocular performance might be of value.

Practically speaking we find two effective approaches:
(1) Lens therapy-A great improvement in binocular performance can
often be noted with the proper lens application for reading. Often this
is through the application of relatively small amounts of plus power
(plus .500 to plus 1.500) over and above the optimum lens
requirements for distance seeing. This is most conveniently
prescribed in a bifocal form and is called a "Iearning lens."
(2) Antisuppression therapy-If the eyes cannot be made to work
together as a team with lenses alone, sometimes antisuppression
techniques are required. The most effective instruments that we use


372
include the Otwell Electronic Orthopter and the Translid binocular
interaction trainer as well as conventional rotations, stereoscopic,
polaroid, and anaglyphic techniques.
I can appreciate a parent's confusion. An optometrist may recommend
learning lenses with perhaps only a slight farsighted correction for
distance and a slightly stronger lens power in its reading portion, yet
an ophthalmologist can say, "There is nothing wrong with his eyes."
When this happens to us we simply ask the parent: "Did the
ophthalmologist examine how the two eyes worked together under
the binocular stress of the reading act?" That is a loaded question
because ophthalmologists typically do not.
Form Perception
Geometric Form reproduction. If a child has difficulty with copying
basic geometric forms, for example, cross, circle, square, triangle,
divided rectangle, diamond, he will undoubtedly have difficulty
copying letters. Template training for such children is helpful so that
they can learn to match the motor patterns to the visual patterns. The
test we use is the Perceptual Form Test (5). The templates that we use
are produced by the Circle Printing Company (6). Template training
can encourage visual-motor integration,but template training alone
does not generally develop reading ability.
Form boards. If a child has difficulty in seeing the relationship between
the forms and the form board, he will probably have difficulty
recognizing similarities and differences between letters and words.
The following is a classic          demonstration    of   figure-ground
relationships (see Fig. 6).

We wonder if some children have a problem in organizing printed
words on a page as to what is the word and what is the page. If a figure­
ground (foreground-background) relationship is not apparent it may
appear as a nonsensical mish-mash of black and white. We have a
basic premise that vision is learned and that some children have not
learned how to use their vision effectively; see Figure 7.
Form boards are available from Childcare, Inc. (7). Cow pictures may
be ordered through any member ofthe Optometric Extension Program
(8).

Directional Concepts
One of the most common symptoms of children with learning
disabilities is their tendency to reverse letters, numbers. and words.

                                                                     373
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  .;'.
Most children tend to reverse letters, numbers, and words in the early
stages of learning to read and write. However, we feel that if reversals
persist beyond the second half of first grade, the child should be
watched very closely. Parents are often told, "He'll outgrow it," "He's a
'slow bloomer';" or "He's immature."
Perhaps Wold's model could be expanded to include another triangle,
superimposed on the first, to suggest a three-dimensional figure. This
triangle would have at its base K (Kinesthetic) and T (Tactual); see
Figure 8.
We view the kinesthetic and tactual senses to be important in more of
a supportive role in the development of language. Gross motor
training alone, however, will not necessarily develop reading ability.
Studies have shown that children who spend "X" hours in creeping, or
in walking on the walking rail, or in balancing on the balance board,
generally show no significant improvement in reading as compared to
a control group. However, we feel that it is not fair to conclude, as
some have done, that perceptual-motor training is of no value. We
view it as an important component in a very complex model. Our
experience suggests that there are specific procedures that help
children solve their directional confusion problems.
These relate to motor activities which teach the concept of laterality
(an internal awareness of right and left), directionality (an ability to use
the concepts of right and left in visual space), midline, center of
gravity, balance, rhythm, body image, spatial awareness, and eye­
hand coordination.
Procedures for these activities have been described by Kephart,
Getman, Belgau, MKM. and many others.

Directional concepts really become important when we consider how
similar many letters and numbers are. For example, if I show you a
cup, and then turn it upside down, rotate it from side to side, and then
throw it to the floor, it always remains a cup-a broken cup perhaps
but still a cup.
A child entering school comes from this consistent kind of world. A cup
is a cup, a chair is a chair, a table isa table. In school he is told that one
form, such as "b," can have several different names and can represent
several different sounds depending upon how it's viewed (b, d, p, q).
Further. it can be made to look like a whole lot of other letters with just
a few small changes; see Figure 9.

                                                                         375
                                              r
                                             wLs




                             s                     H


                                         T
                             Figure 8.




                 bh'1nur

                 Figure 9.



A child who cannot discriminate between small differences and has
directional confusion problems will have difficulty in learning the
code. So many words look so much alike:
on - no/was - saw/but - put/where - there/who - how/help - play

To experience the sensation of directional confusion, try a brief
experiment. Place a writing pad on your forehead and hold it there
with your nondominant hand. Take a pen with your writing hand and
print the word "was" on the pad. Next print the numbers 1 through 5 in
a similar manner. See if you wrote any of the letters or numbers in
"mirror form." Try this on a friend and note the effort that often goes
into making the letter s or the number 3. Some children have difficulty
remembering which way those letters go too. Many children tend to
grow into this problem rather than out of it, unless they receive very
special help.
 Reading and Writing Posture
A child operating under visual stress often tends to move his face very
close to his work. Often he will lay his head on his arm with one eye
much closer to the book than the other. When he writes, he may tend
to hold his pencil exceptionally tightly, sometimes so tightly that his
knuckles turn white.

376
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Figure lOa. Low chair, flat table. without learning lenses
When a child attempts to read or write, he will generally position himself so that the
plane of his face is nearly parallel to the plane of the task. In this figure, the chair
shoulder is elevated and the visual working distance approximates the length of the
pencil. Curved spine. visual stress. near sightedness. Also. notice the adverse shadow
effects.


We recommend reading and writing on a 20 0 sloping surface.
According to the research of Dr. D. B. Harmon, this angle allows the
child to align the plane of his face with the plane of the task with a
minimum of stress. Good lighting. a 20 0 sloping surface, and the
proper lenses for near work help create an atmosphere conducive to
learning (see Figs. 10a and 10b).

We also find that children are seldom taught how to hold their pencils
properly. The child gets the most feedback when he grips the pencil
with the thumb, index finger, and middle finger. When these fingers
are put together they form a triangle, but most pencils are round. A
round peg doesn't fit into a triangular hole comfortably. This problem
can be solved by using a pencil gripper with a round center hole to
accommodate the pencil and a triangular outer surface to
accommodate the fingers. The writer's hump that is so common on the
middle finger of the writing hand has been known to diminish or
disappear when the pencil gripper is used (see Fig. 11).
Memory
Many children with learning disabilities have difficulty remembering
how to spell or pronounce words from one time to the next. They may
say the word correctly in one sentence and then respond as if they
have never seen the word before when they encounter it a few lines
later. They may study all week long for a spelling test and dofairlywell


                                                                                   377
                                                                 /
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                                                                             " .;        ~~.   ,-':,'-"

                                                                           ..




  Figure 1Ob. Proper chair, MKM Port,A-Desk, with learning lenses
  In this figure, a sloping surface (MKM Port-A-Desk) has been provided. Now the child
. can pursue his task under relatively stress free conditions.




                mkm
                port-a-desk                                          ..
                                                                     :.
                Side View




only to miss many of the same words when used in a written
assignment and misspell most of the words in the six-weeks spelling
test.
The study of memory is fascinating. We find that there are many kinds
of memory. There is long-term memory and short-term memory. All of
the senses leave memory traces. There is visual memory, auditory
memory, memory for touch and taste, for smell and movement. There
is rote memory, the memory of repetition, and logical memory,
whereby things or events are remembered by their logical relationship
to each other.



378
                ~-




              The greatest invention

                since the pencil ...

        HOYLE PENCIL GRIPPERS

       Figure 11.


Memory has been recognized as an important aspect of learning for
some time. Cicero said, "Memory is the receptacle and sheath of all
knowledge." Apparently no one really understands the mechanism of
memory. The basis of memory may be electrical. chemical or both­
but whatever the process, memory can be improved. Devices for
aiding memory are called mnemonics after Mnemosyne, the Greek
goddess of memory.
Education frequently requires rote memory of names, dates, places
and facts. Some schools are giving the child the opportunity to explore
concepts and discover logical relationships for themselves.
Information so discovered is more easily remembered. Few schools
are systematically teaching children how to remember. In our
research we found no reading system that presented the elements of
language in an easily remembered form, which led us to develop the
MKM Visual Memory Reading System (9).
Some of the more commonly mentioned cues to reading include
configuration, context, phonetic analysis, and structural analysis.
CONFIGURATION. A number of aids are helpful in decoding:
(1) The first part of the word is more helpful in decoding than the last
part.


                                                                    379
(2) The top half of the word is more helpful in decoding than the
bottom half.
(3) Small nonphonetic words of similar shape and length are likely to
be confused.
The technique of having a child trace around a word would appear to
be of limited va lue. For exa mple, the teacher might stress the form of
the word "bed," have the child trace it. a nd note that "it looks just like a
little bed" (see Fig. 12).

It's understandable that the child may respond "bed" when the word is
actually bid, bud, bad, bit, bat. but, bet, etc.
(4) Configuration is helpful in distinguishing words of different form
and length, for example: bed from bathroom or kitchen or elephant.


                                  r8ec1l

                                  Figure 12.



   ~ia], rBua),        [BaaL ~, [i?o1], [B-dtl, M,

[Bea]          ~pm]                     ~ reTee~anJJ
CONTEXT. Configuration cues are much more valuable when used in
conjunction with context. For example, it may be difficult to decode the
following form from configuration clues alone:


                                  ~
But the possibilities would be increased when the cue is used in a
sentence:
The pilot got into his I     un     I

                             or

The Boy Scouts rubbed two sticks together to build their         ~
PHONETIC ANALYSIS relates to the study of speech equivalents of
printed symbols, and their use in pronouncing printed words. It relates
to the visual symbol-processing and auditory symbol-processing

380
levels of Wold's model. The integration of visual symbols that
represent speech sounds is helpful in attacking unfamiliar words.
Some people will say that English is not a phonetic language, that
there are so many irregular words that stressing phonics is
nonproductive. However, English is consistent between sound and
symbol about 85 percent of the time, if the reader knows a few basic
principles.
Some children with learning disabilities have never figured out that
letters represent speech sounds.
STRUCTURAL ANALYSIS. In analyzing an unfamiliar word it is helpful
to be able to break it into syllables and recognize roots, prefixes, and
suffixes. Children who have difficulty seeing relationships of parts to
wholes often have difficulty in developing proficiency in structural
analysis.

THE MKM READING SYSTEMS

Mnemonic devices enable the mind to "chunk" several concepts

together into one artificial whole. The concepts may be connected

through a word, a rhyme, or a picture.

Common examples of this type of chunking include:

HOMES-a key word which suggests the names of the Great Lakes

(Huron, Ontario. Michigan, Erie, Superior).

Every Good Boy Does Fine-the names of the lines on a music staff

(E, G, B, 0, F).

30 days has September, April, June, and November-for

remembering the number of days in the month.

The absurdity of the rhyme or picture is of no disadvantage since it

makes memorization easier.

Children with learning disabilities often have difficulties in visual

sequential memory and auditory sequential memory. They have

difficulty storing and/or retrieving abstract concepts.

We felt that if we could identify specific phonetic and linguistic

concepts, and then create a mnemonic device to make these concepts

more easily remembered, perhaps we could help the child develop the

visual and auditory integrative skills that would help him decode and

encode words.



                                                                    381
We started this task in earnest in 1961 and first published the MKM
Visual Memory Technique in 1963. We have been testing,
researching, expanding, and modifying it in our office and in selected
schools ever since.
We have had the privilege of being optometric consultants to many
schools and have been associated with several extremely effective
a nd successful projects:
• Project CARE (Creative Academic Remedial Education), Cambrian
School District, San Jose, California, A three-year Title I project,
involving many Mexican-American children in a multidisciplinary
approach. The MKM technique was the foundation language program.
• The Meadowbrook Visual Memory Project, the Meadowbrook
Elementary School, Corpus Christi, Texas. Meadowbrook was recently
(1973) designated as a model school for individualizing reading. The
MKM Reading Systems is a key element.
• We have also seen these principles work in a South Dakota Indian
Reservation School and a Chicago inner city school. We were pleased
to learn that several children of the astronauts learned to read with the
MKM System at the Winners Clinic in Seabrook, Texas. The appeal is
very broad.

As we identified important linguistic concepts, mnemonic sentences
were created to illustrate them. Originally the child was given the
mnemonic sentence and was instructed to draw a picture that was
suggested by it. We believed that the child's own picture creation
would reinforce his visual imagery and memory.
Characteristically these children had difficulty in carrying out these
instruction. The sentence did not conjure up in their mind's eye any
visual picture. It became apparent that many children who were
having difficulty in school also had difficulty in visualizing.
In order to help these children bridge the gap between the concrete
and the abstract, pictures were developed. Our MKM artist, Darlene
Pond, depicted our sentences in a form that was colorful, unusual,
visually stimulating, and easily remembered.
Picture reading is one of the more primitive forms of reading. The child
"read" the picture and discovered the sentence which contained
certain key words. These words served as models for the specific
concepts being developed. The pictures were presented sequentially
from the most simple concepts to the more complex.


382
As each picture was presented the child stored its concept mentally
and thus established a dependable frame of reference. When a new
situation arose, the child was capable of calling on his memory system
to help him solve the problem. With practice the child thinks of the
appropriate picture, sentence, word, and concept. He applies the
"psychologically new" to the "psychologically old." If it matches his
frame of reference, he can solve the problem. If there is too great a
mismatch, learning will not take place.
The child learns how to form categories, how to draw inferences, and
how to generalize. He learns how to store and retrieve many bits of
information in one big "chunk."
The following examples are presented to demonstrate how these
mnemonic devices are used to build concepts.
Concept-Long and Short Sounds of Vowels
Many children are insecure in identifying the long and short sounds of
vowels. The MKM presentation is developed as follows: The twenty­
six letters of the alphabet are divided arbitrarily into two major
groups: namely, consonants and vowels. The vowels are a,e,i,o, and
u. The letter y can be used as a vowel or a consonant. Also, the letter w
can be used with vowels in certain vowel combinations (aw, ew, ow).
The remaining letters are consonants. With the exception of the c and
9 (which have hard and soft sounds), the 5 that has the sound of z in
many words (his=hiz), and the x that sometimes says ks (box=boks),
sometimes says gz (example=egzample), and sometimes says z
(xylophone), each consonant generally is matched with only one
sound.
The vowels are less consistent. A brief look atthe key of any dictionary
shows that each vowel can have many sounds. For simplicity's sake,
only two of these sounds are discussed here, the long sounds and the
short sounds.
The long sounds are identical with the name of the vowel and are
symbolized as follows: a e i 0 u. If a child knows the names of these
letters, he automatically knows the long sounds of the vowels.
The short sounds are symbolically represented as a e iou, buttheir
speech equivalent is less obvious. To develop the concept of the short
sounds of the vowels, the MKM Reading Systems use the picture in
Figure 13 which suggests the sentence, "Bad Red is not up by 3. TheII


boy's hair is red in the colored picture and if he were a good guy he
would wear a white hat.

                                                                        383
               bad red is not up               by    3

           Figure 13.


Analysis shows that the sound that the vowel makes in each word
(bAd rEd Is nOt Up by 3) represents the short sound. The yin "by" is
included as a reminder that y is sometimes used as a vowel, and the
"3" is included only to complete the sense of the picture (see clock).
Concept-The Sounds of the Y
Let's look more closely at the sounds that the letter y represents. Here,
one visual symbol is matched with four different sounds-the
consonant sound of y and three vowel sounds-long e, short i, and
long i. This concept is developed by the picture in Figure 14. The pony
in the colored print is yellow and is named Cyclone. The sentence that
this picture suggests is, "Cyclone, the yellow pony, can fly." Decoded,
this means:
y at the end of a two syllable word will usually have a long e sound
(po'/ne).

384
            Cyclone, the yellow pony, can fly.
           Figure 14.

y at the end of a one syllable word usually will have a long i sound (fli).

y in the middle of a word will have a long i or short i sound, depending

upon how the word is divided into syllables. (Ci/clone). How Cyclone

got his wings is a "mystery." The word "mystery" gives an example of

the internal y that has the sound of short i, and also the y atthe end of

a word of more than two syllables that says long e (mis/ter/e).

y at the beginning of a word will be a consonant and have the

consonant sound of y as in yellow.

Concept-Sounds of C and G

Suppose that you were asked to write the words that are formed by

adding the endings ing and able to the word "change."

Change + ing=

Change + able =



                                                                       385
Before you read on please complete this exercise, and write your
answers in the spaces provided.

If you were like most people, you probably wrote "changing" without
much hesitation. Somewhere in your stream of consciousness came
the concept, "drop the e and add iog. "However, if you were like many
people, you paused after the 9 on the second word, not knowing for
sure whether you should drop or retain the e. If you were ear minded
you may have said to yourself, "drop the e and add able?" or "retain the
e and add able?" but neither rule matched your prior experience. If you
were eye-minded you may have written both "changable" and
"changeable" to see which looked right. If one of these visual patterns
matched your visual memory for the word, there was no problem. But
if both looked right or if neither looked right, you guessed.
The concept which solves this problem is contained in the picture in
Figure 15. The sentence that is suggested by the picture is: "Circus
giraffe eats yellow ivy." The concept is developed as follows:
The visual symbols c and 9 represent two different sounds, hard and
soft. The hard sounds are the more commonly used. Hard c has the
sound of k and is pronounced like the c in the word "cat." Hard 9 is
pronounced like the 9 in the word "gum." The picture in Figure 16
develops this concept and is decoded simply as "cat-gum."
The soft sound of c is the same as the sound of the letter s and is
pronounced like the first c in the word "circus." The soft 9 sound is the
same as the sound of the letter j and is pronounced like the 9 in
"giraffe." But when should the hard sounds and when should the soft
sounds be used? The answer is that c and 9 are usually soft when
followed bye, y, or i and hard at all other times. This means that the
letter which follows the cor 9 has a great influence in determining
which sound should be used. The picture reminds us which letters
make the C and 9 soft. Decoded, the picture says, "c and 9 are usually
soft (as in circus and giraffe when followed bye (eats), y (yellow), or i
(ivYl·"
In analyzing the word "change." the 9 is soft because of the e. When
we add ing to change, we can drop the e because the i (in iog) will
continue to make the 9 soft (ivy). However, in adding able to change,
we must retain the e to keep the 9 soft (changeable). If we dropped the
e and added able (changable) the 9 would have the hard sound as in
gum, since a is not one of the letters (e. y, i) that makes the 9 soft. This
word (changable) would rhyme with hangable and is not the word we
wanted to form.

386
              Circus giraffe eats yellow            IVY.
           Figure 15.


Now. take the following test: add the endings ing and able to

"service."

service + ing =

service + able =

If there is any hesitation, please reread this section, for transfer of

training has not occurred.

Large colorful mnemonic posters (11 V2 X 14) have been developed

for classroom presentation. Small colorful mnemonic pictures are

included in a foldout in each of the two Reinforcement Books for

constant reinforcement. A manual of instruction has been produced

for teachers.

Playing cards containing the keywords are used in several games. The

games develop word recognition skills, teach sequencing, give

immediate purpose to learning, and are fun.


                                                                   387
                        cat            gum

           Figure 16.

Reinforcement Book "A" contains concepts for consonant sounds.
short sounds of vowels, consonant blends, consonant digraphs. and
the magic "E."
Reinforcement Book "B" contains the concepts of adding endings,
syllabication, soft sound of "c" and "g", vowels in combination with
"r," sounds of the "y," vowel combinations, silent letters, and sounds
of "all" and "ull."

Although originally developed as a remedial technique, experience
has shown that it is also very effective as a primary teaching program
beginning at the first-grade level.
After a child has learned the individual sounds and can blend them
into meaningful words,. the child is encouraged to write original
stories. This develops his creative imagination and expands his
language experience.

388
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      Other programs and materials that complement the MKM Reading
      Systems include:
      (1) LaBarge Electro Therapist (10). See Figure 17. David Nickerson,
      principal of the Meadowbrook Elementary School in Corpus Christi,
      Texas, once said, "If only I had something mechanical that would
      entice boys into reading!" The LaBarge Electro Therapist fills the bill
      very nicely. It is an electronic device with 49 buttons that light up when
     touched. Templates are available which encourage eye-hand
      coordination, form perception, directionality, letter recognition,
      blending, and word recognition. An electronic metronome provides a
      variable beat to develop the concept of rhythm. Templates and a
      manual of instruction were produced by Wold et al. (11). Blank
      templates are available so that individually prescribed programs can
      be developed as necessary.
      (2) Kleeco Paper (12). This is a special chalk paper which gives more
      tactile feedback than writing on paper with a pencil. We find this to be
      especially good for practicing forming letters or writing words.
      (3) Wordcraft Series by Vocab (13). See Figure 18. Occasionally a
      student will be referred to us because of a slow reading ability. This is
       usually at the fifth- or sixth-grade level or above. Our diagnostic tests
       may show a fairly good language development and a sound visual
      system but a low vocabulary score. Attempts to increase speed in such
      a case generally are not productive because as speed goes up,
      comprehension goes down.
     Our suggestion is to first stress structural analysis skills. For many
     students who cannot "attack" long, unfamiliar words, we recommend
     a vocabulary development program.
     The Wordcraft Series was developed by Dr. Bergen Evans, and
     consists of a series of lessons sequentially programmed on tape or
     record. The student listens to the exercise as he follows along in his
     workbook. Then he takes a series of tests, until he has mastered the
     meaning of the words in a variety of contexts.
     The series starts with words at about the fourth-grade level.
     Continuous programs through the college level are available if
     desired.
     This type of program does demand a certain amount of attention on the
     student's part. But it is the most interesting of any vocabulary
     development program that we have tried. It encourages visual­
     auditory integration at a high linguistic level.

                                                                            389
Figure 17.

             A PROVEN SIGHT -AND-SOUND WAY TO GREATER WORD POWER.




Figure 18.



390
.

     Observations
     Acting as visual consultants and lecturers, we have had the
     opportunity to visit many schools in many parts of the country. We
     have made some general observations:
     (1) Some teachers do not like children.
     (2) Children's academic success is in direct proportion to the
     teacher's enthusiasm.
     (3) The elementary principals can create the atmosphere for the
     entire school.
     (a) Some principals have the attitude that: "This is my school, these
     are my children and teachers and there aren't any problems here that I
     can't handle." Such principals often refer to a problem child by
     saying, "He's working at his own level." Instead of getting at the
     child's problem, they would rather "touch up the X rays."
     (b) Some principals are true leaders. They ca n motivate their teachers
     and develop an esprit de corps that really makes the school hum. They
     identify the high-risk children early and provide immediate and
     intensive remedial education. They are quick to refer those children
     for outside help when additional consultation is needed. They take an
     interest in the children and their parents and their teachers'and are
     dedicated to the child's well-being.
     (4) Some schools grope from one new idea to another without ever
     putting together a workable program. They give lip service to concepts
     like behavior modification, accountability, team teaching, open
     classroom, programmed reading, computer assisted instruction,
     prescriptive teaching, etc., but a certain percentage of their students
     continue not to respond. One teacher once told me: "We used to have
     reading problems in our school, but now we have programmed
     reading." Another tells the story of how she was having a lot of trouble
     reaching one particular child in her class. The educational service
     center in her district was hooked up with the computer center of a
     nearby university. She was told to fill out a form describing Jose's
     problem areas and the center would run it through the computer and
     obtain a print-out of suggested remedial materials. A few days later
     two men from the center came carrying a large wooden box full of the
     programs and equipment that the computer had recommended. One
     man said "This is for Jose." The teacher took one look at the coffin-like
     box and said, "Jose's in trouble, but he's not dead yet!"
     (5) Teachers who use the MKM Reading Systems in their classroom
     tend to become enthusiastic teachers.
     (6) Some kids are turned off to learning by the time they finish first
     grade. We see no reason why learning can't be fun.

                                                                          391
The learning disability concept is a broad umbrella encompassing
many disciplines. Professions that limit themselves to a rigid classical
definition will contribute little to this field. A new creative outlook is
needed.
The pediatrician who can only see the hyperactivity and whose only
solution is to prescribe Ritalin because "if I don't give it to him his
mother will just go down the street until she finds somebody who
will," perhaps should be examining more closely for hypoglycemia or
calcium deficiency or allergy or soft neurological signs, or perhaps he
should refer the child to someone more perceptive.
The psychologist who sees only the emotional disturbance and notes
the cause as "sibling rivalry," or "mother complex," or "an attention­
getting device," or "maturational lag," perhaps should consider the
possibility that the behavior problem may be secondary to a learning
disability. Psychotherapy under such conditions has not proven to be
too effective.
The educator who views the child as a disruptive influence in the
classroom and considers him only as a threat to her teaching ability
perhaps should look upon the child as a challenge, a puzzle to be
solved, an opportunity to discover in what ways he can learn best.
   In Dave Nickerson's school the teachers take the responsibility of
   teaching their children upon themselves. If a child has difficulty in
   grasping a concept, the teacher does not blame the child but says in
   effect, "I apparently have failed in this approach. Let me try to
   explain it another way."

This does not imply that these teachers can solve all their children's
problems. Many times a referral to an outside source for medical,
optometric, or psychological consultation is needed. What is implied,
however, is that a positive teaching attitude is present, an expectancy
that each child will succeed.
   Dave likewise expects his teachers to take care of discipline
   problems in their rooms. He doesn't want to see a child when the
   child is in trouble. The teachers bring children to the principal's
   office when they've done something especially good. Dave checks
   their work and then ceremoniously applies h is seal of approval to
   the paper. Dave can call every child in his school by name and he
   can go into every classroom on any day and teach. Teacher morale
   is high. Truancy is nonexistent and parent support is prominent.



392
\'




     There are children who are underachievers and there are parents that
     are ove rexpecte rs. An interest ing psycho logica I fact is that more ti mes
     than not, you get what you expect to get. If you expect disruptive,
     bizarre, inappropriate behavior from a child you probably won't be
     disappointed.
     If you expect a child to act in an appropriate manner and guide him in
     that direction you have a pretty good chance of getting that type of
     behavior; a self-fulfilling prophecy.
     Sometimes we are asked if the success of the MKM program is
     perhaps due not to the program itself but from: (1) the close personal
     contact that gives a child TLC (Tender Loving Care); (2) our ability to
     motivate a child to develop a good attitude toward learning. We do not
     deny the value ofthese principles. We expect our kids to be successful.
     We think that to prejudge failure is to court disaster. More times than
     not, we get more than we expect.
     The book, Love, by Leo Buscaglia (14) is recommended reading for
     anyone who would like to become more sensitive to the power of love.
     The optometrist or ophthalmologist who sees only a pair of eyeballs
     and says, "He has 20/20 acuity, there is nothing wrong with his
     eyes," perhaps should look a little more closely at near binocular
     performance, subtle refractive problems, directionality, visual
     memory, or visual auditory integration.
     Most professionals have developed a rather high level of competence
     over a relatively small domain. They have difficulty communicating
     with one another because of their varied frames of reference and
     vocabulary.
     The fact is that most educators do not have a good background in
     psychology or vision. Most psychologists do not have a good
     background in language development and vision. Most optometrists
     do not have an extensive linguistic background and knowledge of
     learning theory. Most pediatricians are so busy working on a crisis
     level trying to regain health that they do not have the time, training, or
     desire to become involved in learning problems.
     The problem is that most children with learning disabilities are hung
     up somewhere in between.
     No one profession has all the answers. It would seem to me that it
     would be valuable for all of us to learn as much as we can about

                                                                              393
everything relating to learning, do that which. each profession can do
best. and refer those cases that are outside one's areas of competency
to someone more skilled. Eventuallyan effective team approach would
emerge, a team that is not profession-biased but one that is child­
centered.

REFERENCES
 1.	 National Advisory Committee on Handicapped Children. First
     annual report. Washington, D.C.: U. S. Office of Education. 1968.
 2.	 Wold, Robert M. Personal correspondence.
 3.	 MKM Monocular and Binocular Reading Test. MKM, Inc.,
     809 Kansas City Street, Rapid City, South Dakota 57701.
 4.	 MKM Binocular Preschool Test. MKM, Inc., 809 Kansas City
     Street. Rapid City, South Dakota 57701.
 5.	 Perceptual Form Test. Winter Haven Lion Research Foundation,
     Box 1045, Winter Haven, Florida 33880.
 6.	 Circle Publishing Company, P.O. Box 3737, St. Louis, Missouri
     63122.
 7.	 Childcare, Inc., Box 366, Loveland, Colorado 80537.
 8.	 Optometric Extension Program Foundation, Inc., Duncan,
     Oklahoma.
 9.	 MKM Reading Systems, MKM, Inc. 809 Kansas City Street,
     Rapid City, South Dakota 57701.
10.	 LaBarge Electro Therapist, LaBarge Learning Systems, LaBarge
     Electronics, 500 Broadway Blvd., Suite 2200, St. Louis, Missouri
     63102.
11.	 Wold, R. M., Wilson, W. K., & Kratoville, B. L. General skill devel­
     opment and reinforcement manual for the LaBarge electro
     therapist. Los Angeles, Calif.: A-V Scientific Aids, Inc., 1974.
12.	 Kleeco Paper, Kleeco Publishing, Inc., 834 North Church,
     Elmhurst. Illinois 60126. (Distributed by MKM, Inc., Rapid City,
     South Dakota.)
13.	 Wordcraft Series, Vocab, Inc., 3071 South Broad Street, Chi­
     cago, III. 60608. (Distributed by MKM, Inc., Rapid City, South
     Dakota.)
14.	 Buscagha, L. Love. Thorofare, N.J.: Charles B. Slack, Inc., 1972.
     (Distributed by MKM, Inc., Rapid City, South Dakota.)




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