Rewiring Our Understanding of Learning Disorders

Neuroimaging research is showing the links between learning and emotions

Recently, I've been revisiting some fascinating neuroimaging research from my fellowship days at Columbia. This work, which has profoundly shaped my career, reveals something crucial about learning disorders that many of us have long suspected but lacked hard evidence to confirm: anxiety isn't just a side effect of learning challenges—it's a core feature of them.

Back in 2018, my colleagues and I published a study examining the relationship between reading disorders and anxiety in children. Using functional magnetic resonance imaging, we looked at the brain's emotion regulation circuitry in children with and without reading disorders. What we found was striking: children with reading disorders showed increased connectivity between the amygdala (our brain's emotion center) and the prefrontal cortex (our brain's executive control center) compared to typically developing children.

This altered connectivity pattern suggested ineffective regulation of anxiety. More importantly, the data revealed that anxiety actually mediated the relationship between brain connectivity and reading impairment among the children in our study. This suggests that anxiety and reading difficulties share underlying biological mechanisms, with anxiety potentially playing a causal role in exacerbating reading challenges.

What's particularly exciting is how robust these findings have proved to be. Since our initial publication, this relationship between emotional regulation and learning difficulties has been replicated across several important populations. Studies showed similar patterns in children with non-verbal learning disorders, children exposed to air pollutants, and children with math disorder. Recently, similar findings were published from a large-scale NIH-funded study of over 1,500 participants with ADHD.

These findings collectively challenge our traditional understanding of neurodevelopmental disorders. Rather than viewing emotional challenges as secondary problems that develop downstream, we now see them as fundamental aspects of these diagnoses—as deeply rooted in the underlying neurobiology as the learning challenges themselves.

The evidence is clear: cognitive and emotional processes are inextricably linked in the developing brain. This understanding has profound implications for treatment. The traditional approach of focusing solely on academic interventions is insufficient, and we need to work in a more holistic way. We must ensure that children with neurodevelopmental disorders have access to comprehensive approaches that address the full range of their needs: cognitive, academic, and emotional.

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I saw Audra in Gypsy, and she was incredible as usual, but Patti might just be my favorite!