Unraveling the Mystery of Learning Difficulties

Ron J. Swatzyna, Ph.D., LCSW


A child's ability to learn is the litmus test for brain functioning. Learning is the output measure that gives us so much information as to the internal workings and health of the brain. When the best teachers, tutors, caring parents, and doctors fail to help a child learn, it is likely that there are neurological issues that are not being addressed. In the past year of using EEG and QEEG data, we have identified some pretty interesting barriers to learning. The barriers can be delineated into three categories and each takes a different approach.

Paroxysmal Transient Discharges

The first is paroxysmal transient discharges (PTD). This type of activity can have many causes: an epileptic lesion, a head injury, an electrolyte imbalance, thyroid disease, and often, "from no known eitology." Regardless, if these discharges are occurring in the area of the brain responsible for learning, anticonvulsant medication may help to reduce and or eliminate these discharges and thus enabling learning to occur.


Encephalopathy is a disease, damage, or malfunction of the brain that desynchronizes the electrical activity. There are many causes for encephalopathy. The most common causes we have identified are metabolic (hypothyroidism), toxic exposure, anoxic (lack of oxygen) and electrolytic (electrolyte imbalances). When we can identify the cause (through further testing) and correct the problem, the brains will eventually return to normal. In several cases, we used Interactive Metronome to help the brain resynchronize itself which greatly improves processing speed.

Focal Slowing

Focal slowing is when a part of the brain is dominated by high amplitude slow wave activity that can be either gray matter or a white matter (or both) issue. Gray matter focal slowing can be caused by a mild traumatic brain injury (concussion), a cerebral vascular issue or something that interferes with the transmission of electrical activity in that area. When the focal slowing involves the white matter, the morphology of the EEG is noticeably different. A more severe head injury can cause a subcortical lesion that can disrupt the electrical input from this area. Subcortical tumors also can cause such slowing, although we rarely find these in our practice. Focal slowing, for whatever reason, greatly diminishes a medication approach. If you medicate to speed up the focal slowed area, you overmedicate the rest of the brain and the side-effect profile becomes unacceptable. We have found that focal slowing can be effectively targeted using neurotherapy. Until the focal area is sped up, the part of the brain that is slowed is disconnected from the rest of the brain. Processing speed and subsequently memory is greatly affected rendering learning very difficult.

If your child's learning is not progressing as you expect, you may want to consider having us do an EEG/QEEG study to help unravel this mystery.

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