Einstein Syndrome: Down Syndrome with a Positive Attitude

Mary has just finished 13 weeks on Prozac (fluoxetine) as a treatment to stimulate neurogenesis in Down syndrome.   Before I tell you what we are seeing, I need to tell you where she was developmentally before we started.

She turned 16 this month. When Mary was born my goal for her was that she’d be able to read her Bible for herself — a goal she reached several years ago.  Thirteen weeks ago she tested at 5th grade for word recognition.  Old sitcoms like Gilligan’s Island, I Love Lucy, and Lassie were exactly at her comprehension level.  She could “get” the humor of Gilligan’s Island.  Her life skills are good.  We attribute her success so far to both the neurodevelopmental program we’ve had her on since infancy and the targeted nutritional intervention we’ve done since she was three years old.

But, Mary had plateaued. We have always run our homeschool by providing an educationally rich environment and allowing the children a lot of freedom to explore, experiment and pursue their interests. Mary has thrived in this environment. Aside from her required therapy activities, she had a lot of time to interact with siblings, play educational computer games, read, listen to books on tape, make things, play outside, etc. But lately, she was losing interest in being academically involved at all. We were no longer seeing academic progress.

Let’s look at math. Back when she was seven I wrote on the web that Mary could do 1^st grade arithmetic. And she could. Well. The ND program that we had her on had done a good job of teaching her the preliminary numerical concepts, and she was great at handling basic counting and number manipulation.

However, before Prozac Mary was 15 and still stuck on 2^nd grade math. I have used numerous 2^nd grade curriculums.We have used many different manipulative systems. I have several math software games. We worked and worked on math.

Mary didn’t “get” math. She could memorize a method (for example adding with carrying, even borrowing). She could use her manipulatives to do the problem. She could get an answer, even a correct one. But she simply did not understand what she was doing. She could do double and triple digit adding, and she could count the numbers, but there was never an intuitive sense that she understood what it was about.

If we asked her what 15 + 5 was, she could count and answer “20″. Then if we immediately asked what 20-5 was, she would start over and count to get the answer. She couldn’t make connections that these were the same problem. We could work with number lines, and hundred charts, and manipulatives, and coins, and drill and memorization, all trying to get her to “get” the concepts that she was working with. And she could learn a method and consistently do it, but she could never cross apply the knowledge to a different method or problem.

Multiplication was a barrier that she couldn’t pass. She could follow directions and do it with manipulatives. We have some that are similar to these. She could put five 3 blocks out there and count. But she couldn’t “get” that 5×3 is the same as 3×5 which is the same concept group as 15 divided by 3 or 15 divided by 5.  To Mary, those were four entirely unrelated problems.  Using one of our math computer games, she had mastered the concept of doubling. She could rapidly double, in her head, almost any number under 50 and reliably get the right answer. But, she could not do multiplying by 2. They weren’t the same in her mind.

Mary had learned to skip count by two (2, 4, 6, 8, …) up to 24. Yet, she could not understand that multiplying by 2 is just like skip counting by two. She could not memorize skip counting by 3. My oldest daughters, Ruth and Grace, had worked with her on skip counting by three for two years. She could not learn it.

We had worked with counting money. To count coins you have to first count by 25, then midstream switch to counting by 10, then switch to counting by 5 and then by 1. This was too difficult.

The result of this math barrier was that I had quit trying. What’s the point? Mary had quit playing with math games as well. As I planned the current school year last summer, I dutifully listed 2^nd grade math again for Mary. But I didn’t expect anything. Instead I planned a cooking curriculum. Life skills.

We started Prozac at the end of August. There wasn’t much solid change for the first 8 weeks, just an eagerness and sparkle that were encouraging. One of the first things I noticed was that Mary wanted to work on math. She was eager to sit with me and work problems. We had left off last year’s math book in the middle of multiplying by three.  So we picked it up and were working, yet again, on skip counting manipulative blocks by three. About a month ago, about 9 weeks after starting Prozac, Mary correctly skip counted by three up to 30. She was elated! She remembered all those hours that her sisters had worked with her on this, and her first exclamation was that she couldn’t wait to show them what she could now do.

But, still, that was just rote memorization. What I have been watching for is some proof that Mary can cross-apply a math routine and apply it as a concept. I want to see her “get” it.

Then last week we were counting money. The routine I’m teaching is to count the quarters first, then dimes, nickels and pennies in that order. She often still stumbles on the skip counting transition from one to the next, but it is getting easier. The problem she had to count was one dime, four nickels, and a penny. She deviated from the routine, first counting the nickels, then the penny, and finally the dime. Here is how she counted: “5, 10, 15, 20, 21, 31.” She had correctly applied a concept rather than following a routine by rote. She usually can’t deviate like this, but three months ago it would have been unthinkable.

Then this week we were doing a story problem that came down to this: 3 + ____ = 18. I wrote that down and asked her, “Mary, three plus something is 18. What is it?”

To answer she started skip counting by three. “3, 6, 9, 12.” Inwardly I groaned. “No, Mary,” I thought, “this is not a multiplication problem. It’s an addition problem.” But Mary wasn’t multiplying. She was cross applying the concept of skip counting to an addition problem. She counted to 15, then 18, and then answered that 3 + 15 = 18.

Ask me again in a few months what we are seeing in math. I hope we are moving from math as method and rote memory to math as concept. The second half of this math book has pages and pages of mental math, expecting use of mental shortcuts for working problems in your head. I’m rather shaking in my boots on this, because this is pure concept. I’m tempted to bail out and go back to one of the other curriculums that do more rote drill. I’ll tell you in a few months what is happening.

Another area that has changed for Mary is the social. During last spring and summer we saw a behavior that was becoming increasingly worrisome. My normally social Mary would go somewhere alone and jabber and giggle and act to herself— loudly.  Sometimes it would be outside, sometimes shut into the bathroom or her room.  Sometimes it was “alone” in a roomful of people.

It did not seem like self-talk. I know that normal children do imaginary play as they grow, but this just felt different.   What Mary was doing was weird and socially inappropriate.  She would lose her surroundings and get lost in imagination.  And she would jabber loudly in words that were not understandable, possibly because she was talking too quickly to bother enunciating. I think it was either stimming or compulsive behavior.  It may have been early signs of dementia. She strongly resisted being interrupted.

It may have been that for the first time in her life, Mary did not have a younger sibling at her same cognitive level.  She has, one by one, seen each of four younger siblings first become her best playmate, and then outgrow her. She was not naturally drawn to the more complicated play activities that they engage in.

Whatever the reason, Mary was increasingly disappearing and engaging in jabbering, acting, and giggling to herself. Many times a day I would hear her, go find her, and attempt to engage her in some interactive activity.

This weird behavior has almost ended with the Prozac. A month ago (after 8 weeks on Prozac) I thought the behavior was lessening. Now, after 13 weeks, I am sure. She almost never does this anymore. Maybe once a day, or maybe not at all in a day. Instead she goes to the bookshelf and finds a book to read. Or she goes to the computer and puts on one of the old standby educational games we have it loaded with (games that she had not played with for years, they had gotten too hard). Or she practices sign language homework for the class she is taking. Or she cleans her room (!!)

Mary is just over 100 pounds, and takes 10 mg of fluoxetine per day. The full Changing Minds protocol consists of several other components.   She had already been taking gingko for the last couple years, takes an Omega-3 oil supplement (but I haven’t switched to Body Bio yet), she gets choline and folinic acid in her Nutrivene-D, but we don’t give phosphatidylcholine or extra folinic. She does not need Focalin. She takes a thyroid supplement.

We have seen zero negative results so far.  The only physical change of note is that she commonly takes an afternoon nap now, where that was infrequent before.