Can writing predict Alzheimer’s Disease?

Can writing samples predict who will develop Alzheimer’s Disease years later?

Yes, according to researchers from IBM.

IBM studied 80 men and women in their 70s, none of whom showed signs of Alzheimer’s.  They were asked to write about a drawing of a kitchen scene.  A boy stood on a wobbly stool, grabbing for cookies in an upper cabinet while a girl his age watched.  Nearby a woman, with her back to the children, washed dishes, not seeming to realize that the boy was in danger or that water from the kitchen sink was overflowing.

To describe the scene, some of the subjects wrote simple phrases such as “washing dishes” and “stool tipping ove.”  Others wrote longer phrases such as “Mother washing dishes” and “water overflowing in sink.”  Still others wrote complete sentences, such as “He is standing on a stool and is almost falling over” and “The water from the faucet is running over on to the floor.”

Seven and a half years later, half of the original subjects showed signs of Alzheimer’s while half did not.  Researchers studied the writings of years earlier, using an artificial intelligence (AI) program.  The earlier writing of those with Alzheimers showed several characteristics such as

  • Repetition in word usage
  • Incorrect spelling
  • Incorrect capitalization
  • Simple grammatical structures and missing words like “the,” “is,” and “are.”

The AI program with 75 percent accuracy identified who would develop Alzheimer’s based on the subjects’ earlier writings.  Results were recently published in The Lancet journal EClinicalMedicine.

With such knowledge, researchers hope those who will develop Alzheimer’s can be identified before the onset of the disease.  When drugs to combat Alzheimer’s become available, those people can be targeted to prevent the disease or to slow its progress.

Another study of writing and Alzheimer’s Disease considered Agatha Christie’s writing.  Researchers from the University of Toronto conducted a study of her writing and concluded she developed Alzheimer’s while she was still writing.  They based this conclusion on changes in Christie’s writing style as she aged.  They analyzed the variety of words she used and the number of indefinite nouns and phrases she used in each of her books from the time she was 28 to 82.

Researchers found that the vocabulary variety in her novels decreased by 15 to 30 percent while the repetition of phrases and indefinite words (something, anything) increased dramatically.  The largest changes showed in a book written in her 80s.

Another study of writing and Alzheimer’s is a study of nuns in Wisconsin.  When they were young (average age 22), they wrote their autobiographies.  After death, their brains were examined for Alzheimer’s disease.  Those women who had low idea density in their autobiographies all developed Alzheimer’s while none of those with high idea density did.  Idea density was a better predictor of Alzheimer’s in the nuns than was low grammar complexity.

Use color to highlight essential parts of essays

When I teach students how to revise essays, I use color coding to show how the main idea must be repeated in the body paragraphs and in the conclusion.  On computer-shared documents, I swipe the main idea in one color, say pink, and supporting ideas in different colors throughout the writing. 

I ask students to look for the main idea in the introduction and in each body paragraph.  If it is there, we swipe it pink.  If it no pink appears in a given paragraph, that tells the student she needs to insert the main idea somewhere in that paragraph.  If a supporting idea is stated in a body paragraph, and it is swiped in blue, for example, we look for a blue swipe in the introduction.  If it is not there, we insert it.  We look for a pink swipe in the conclusion, and a rainbow of other colors corresponding to the supporting ideas used in the body.

Let me show you an example a sixth grade student wrote this week.

Hi. My name is ___.

“Hi.  My name is Jane.  Do you want to hear about my vacation?”

This kind of opening—“Hi.  My name is ___” followed by a question—is the way almost all elementary school students whom I tutor begin their writing.  By the time they reach middle grades, they drop the “Hi.  My name is ___” and instead start with the question.  “Do you want to hear about my vacation?”

Just like primary grade students print their letters from the bottom up—the part closest to their bodies first—so do they write content from themselves out.  Since I see it so often in new students I work with, I suspect starting that way comforts students and instills confidence.

But of course, the primary effect of this kind of writing is to show the immaturity of the writer.  I suspect teachers cure students of “Hi.  My name is ___” by suggesting they start with the question first.

But with the kind of question the child asks—“Do you want to hear about my vacation?” the child still talks to the reader, and asks acceptance from the reader, as if the reader smiles and nods her head.  “Yes, of course, honey, I want to hear all about your vacation.”

The real problem with these kinds of openings is that they show a lack of imagination and an inability to engage the reader.  What if the reader thinks, “No, I don’t want to hear about your vacation.”  Oh. Okay.  Sorry.

The student should ask himself why a reader might want to hear about his vacation.  What was exciting or strange about the vacation?  Did your baby sister toddle into the woods and inspire a search party to find her?  Did you visit the Atlanta Aquarium and see a shark as long as a school bus?  Did you fly in a plane with masks on?

Teachers need to wheedle interesting responses from children by asking question after question until an engaging topic emerges.  How?

One way is to write a first sentence as a class.  Pick an event everyone has participated in—a test, recess, lunch in the cafeteria, a fire drill.  Ask for student volunteers to suggest something that happened.  When you hear a good idea, ask for details.  What did kids see or smell or taste?  What did kids think?  What did you hear someone say?  Write down clues on the board in the form of a mind web.  Pick something that students think will interest readers.

Then write the first sentences as a whole class.  Ask students to throw out suggestions.  Write them on the board.  Ask for student input.  Which sentence makes you want to keep reading?  Discuss why various sentences are good, better and best.

Don’t ask students to write the essay.  Instead, start over with a different event everyone has participated in.  Repeat the process.  Then repeat it again until most students are comfortable with this approach.  Ask students who are comfortable to work in pairs or small groups on how to write the opening sentences for another topic.  Meanwhile, you work in a small group with students who are not ready.

What if a student persists with “Hi.  My name is Frank.”  Remind the student about how the class brainstormed for good ideas to write about.  Help Frank on-to-one.

Read aloud good openings written by students.  Ask the class to describe why they are good.  I find sharing student writing is a sure way to inspire students to write better.

Frustration in teaching remotely

As many teachers and students head back to their virtual classrooms this week, I’d like to share my experience learning Zoom and Google Docs, changing from a PDF to an editable format and teaching reading and writing to students ten miles and three time zones away.

In four words:  I have been overwhelmed.

Before the pandemic, I had used GoToMeeting with one student whose father set everything up for us.  That worked, in part because the father hovered nearby and anticipated his daughter’s and my needs.

But as I returned to teaching in November, after seven months of babysitting grandchildren, I struggled to learn Zoom.  For my first classes, my husband (my IT person) sat at my side off camera and slipped his hands on the keyboard from time to time to rescue me.  I couldn’t have done it without him.

For me, teaching via Zoom has been like my trying to teach English in Vulcan aboard the Starship Enterprise with Mr. Spock at my side.  I know the content, but grapple with how to use the technology.  For example,

  • If my student writes her homework in a workbook, how can I see her answers via Zoom? She can hold the workbook in front of the camera, but she might hold it too close or too far away or she might jiggle it.  With time, I learned how to solve this problem.  Her parents can scan her work before our lesson and send it to me as an email attachment which I can then open and share on Zoom.  It took me weeks to learn that.
  • And what if I want to scan information to send to my student as an email attachment? Before, I would make a photocopy and bring it with me to a lesson.  Scanning and inputting is on my to-learn list.
  • If I want to see what my student is writing by hand, how can I? Her writing surface is out of camera range.  I learned that if I ask her to reread the corrected writing, I know if she changes it.
  • For some students, I can see only the tops of their heads. Asking a student to sit up works until the student slumps a minute later.  I have asked parents to adjust the camera angle, and that helps, but some children deliberately hide.
  • One of my students is hyperactive, sliding in his chair, contorting his body, standing, stretching, walking around and darting off camera. He even falls asleep.  When I teach in person, I use eye contact or a tap on the desk to engage him.  But via Zoom, if he is not looking at the camera, I have only my voice.  I am still working on this problem.
  • Many of my students are either immigrants or the children of immigrants. Sometimes I ask my students to bring their parents to the camera at the end of our classes. When I try to explain homework expectations or student behavior to the parents, they nod, smiling without saying a word, and I know I have not made my message clear.  I have learned to recap a lesson in writing immediately after the lesson concludes.  I include the homework assignment and any other work a student might need—like a prewriting organizer the student worked on.  I send everything as an email to a parent’s email.

These are small problems.  Bigger ones are caused by my lifetime of relying on my husband to handle online technology.  On Monday, for example, I kept losing Google Docs I had downloaded and opened, ready to revise with a student.  My husband pointed out something basic that I was unaware of:  At the top of my screen are tabs for documents I unload from the internet.  At the bottom of my screen are browser and application icons.  Duh.

I am writing about my frustration using virtual technology because many of your children’s teachers are going through the same ordeal.  They were trained in math or reading, not in how to teach remotely.  They were trained to walk the classroom to engage students, but they were not trained to monitor two dozen children on a computer monitor, peering at faces the size of postage stamps.  Older teachers, who are experts in their subjects, are wrestling with a technology learning curve.  What might seem so basic to a thirty-year-old who was born with a smart phone on her hip seems odd and even frightful to a veteran teacher.

Two months teaching in this new mode is not enough for me to master it.  Nor is a semester for many of your children’s teachers.  My New Year’s resolution is to forgive myself for my ignorance and to practice, practice, practice Zoom and Google Docs and any other technology that will help me be a better teacher.

As Mr. Spock said, “Computers make excellent and efficient servants, but I have no wish to serve under them.”  I have no wish either, but we all must to get through this pandemic and beyond.

Coherence, the most important element in writing

Writing well requires following certain steps in sequence:

  • Narrowing your topic
  • Organizing your information, including writing an overarching topic sentence or thesis and subtopic sentences or plot lines
  • Writing a first draft
  • Revising, revising, revising
  • Editing

Once your first draft is complete, revising becomes most important.  So many tasks comprise revising—checking for complete sentences, tightening wordiness, analyzing ideas for logic, honing vocabulary, fixing grammar errors, adding figures of speech and style.  Students wonder where to begin.

Begin with coherence, the most important element of writing.  Coherence means making sure all your sentences make sense and flow from one to another.  Coherence means making sure your readers understand what you mean—easily, at first read, without an interpreter.

How do you do that?  Some ways include:

  • Make sure every sentence in the body paragraphs supports the thesis. If you use an anecdote, make sure it is an example of the ideas in the thesis.  If you use a simile or metaphor, make sure it fits with the topic.  If the topic is igneous rock, for example, the simile “as hot as the steam from a steam boat” is off topic, whereas “as hot as a lava lake” is on topic.
  • If you use numbers (three kinds of rocks, five members of my family, one favorite memory), check that you have named all the numbers and no more.
  • Use logical transitions. “Because” means something causes something else.  Make sure you have named a cause and an effect if you use “because.”  “Finally” means the last one in a series or the last point.  If you have only two or three points, you shouldn’t use “finally.” You should use “secondly,” or “next,” or “third.”
  • If you use a pronoun, make sure you have named the noun the pronoun refers back to. And make sure you have named that noun before you use the pronoun (not “When she fell, Mary broke her arm,” but “When Mary fell, she broke her arm.”  If you use “this,” make sure your reader can know in a word or phrase what “this” refers to.  If “this” is vague or complicated, add a noun after “this” (this situation, this erosion, this loss of interest).  If you have two women talking, make sure if you use “she,” the reader knows which one you are referring to.  Otherwise, use her name or title or position.
  • Check that your sentences are complete thoughts–not fragments or run-ons.  Make sure your complex sentences contain no more than two dependent clauses so readers needn’t hold multiple ideas in their minds at once.  Check that your sentences vary in length, with most more than ten and fewer than 20 words.
  • Change your weak, vapid verbs to active, dynamic verbs.  Eliminate the verb “to be” and passive voice verbs.

If what you write lacks coherence, no matter how specific the vocabulary, no matter how beautiful the description, no matter how lofty your aim, your writing will flop.  Your writing must make sense to a reader without you standing at her elbow explaining, “Well, what I mean is. . .”