Sharp Brains: Brain Fitness and Cognitive Health News

Neuroplasticity, Brain Fitness and Cognitive Health News

Icon

Cognitive Training and ADD/ADHD: Interview with Prof. David Rabiner

On Fri­day we had the oppor­tu­ni­ty to inter­view Pro­fes­sor David Rabin­er. He is a Senior Research Sci­en­tist and the Direc­tor of Psy­chol­o­gy and Neu­ro­science Under­grad­u­ate Stud­ies at Duke Uni­ver­si­ty, and also advo­cate for chil­dren and adults with ADD/ADHD.

Alvaro Fer­nan­dez (AF): wel­come, Pro­fes­sor Rabin­er. Could you first pro­vide us with some back­ground on your research inter­ests?

Prof. David Rabin­er: in sum­ma­ry, I will say that my long stand­ing inter­ests have been how to improve the qual­i­ty of care received by chil­dren with ADD/ADHD and how to ensure a pos­i­tive rela­tion­ship between children’s social expe­ri­ence and their social cog­ni­tive func­tion­ing.

One of my first ADD/AD­HD-relat­ed projects was a NIMH-fund­ed grant to assist pri­ma­ry care pedi­a­tri­cians in pro­vid­ing more evi­dence-based meth­ods for eval­u­a­tion and treat­ing chil­dren with AD/HD.

Right now I am an an inves­ti­ga­tor on two research stud­ies. In one that is fund­ed by the Nation­al Insti­tute of Men­tal Health, we are con­duct­ing a lon­gi­tu­di­nal study of a large, com­mu­ni­ty-based sam­ple of youth with ADD/ADHD, and track­ing their aca­d­e­m­ic, clin­i­cal and behav­ioral per­for­mance over 6–7 years.

The oth­er one is a 3-year grant by the Depart­ment of Edu­ca­tion, to eval­u­ate how com­put­er-based pro­grams can help kids with ADD/ADHD. We are ana­lyz­ing the impact of two types of pro­grams: a) Captain’s Log, which is a cog­ni­tive train­ing pro­gram, and b) cur­ricu­lum-based pro­grams such as Riverdeep’s Des­ti­na­tion Read­ing and Math.

AF: when will we start to see results from those stud­ies?

DR: for the Men­tal Health lon­gi­tu­di­nal one, you may have to wait 4–5 years to see the first papers. For the Depart­ment of Edu­ca­tion one, some pre­lim­i­nary results will be pub­lished in 2008.

AF: can you pro­vide us with some back­ground on the field of Cog­ni­tive Train­ing and its appli­ca­tions to help peo­ple with ADD/ADHD?

DR: cog­ni­tive train­ing rests on sol­id premis­es, and some pro­grams already have very promis­ing research results. Cog­ni­tive areas, such as atten­tion, or work­ing mem­o­ry, can be con­cep­tu­al­ized as skills and there is grow­ing evi­dence that like oth­er kinds of skills, they can be devel­oped and improved with con­cert­ed prac­tice. (As Pro­fes­sor Rabin­er men­tions this, I remem­ber Dr. Goldberg’s insis­tence on the need for “intense men­tal chal­lenges”).

Some of the most are promis­ing areas are: neu­ro­feed­back, which as a whole (not for any spe­cif­ic brand­ed pro­gram) is start­ing to present good research results, and work­ing mem­o­ry train­ing, led by Dr. Torkel Kling­berg, Cogmed and RoboMemo (we recent­ly inter­viewed Dr. Torkel Kling­berg about work­ing mem­o­ry train­ing and ADD/ADHD, here are the inter­view notes).

AF: when Mark Katz and I met some school super­in­ten­dents, he stressed that “atten­tion deficit” is being reframed by the research com­mu­ni­ty as “exec­u­tive func­tion deficit”. The bot­tle­neck, the prob­lem, is not atten­tion itself, but on reli­able and self-direct­ed capac­i­ty to exe­cute. Can you please elab­o­rate?

DR: Dr. Rus­sel Barkley, Research Pro­fes­sor of Psy­chi­a­try at the SUNY Med­ical Uni­ver­si­ty and Clin­i­cal Pro­fes­sor of Psy­chi­a­try at the Med­ical Uni­ver­si­ty of South Car­oli­na, has been a key advo­cate for that view. Sev­er­al years ago he pub­lished a com­pre­hen­sive the­o­ry of ADHD in which he argues that the core prob­lem is a deficit in “behav­ior inhi­bi­tion”, and that this deficit inter­feres with the nor­mal devel­op­ment of impor­tant exec­u­tive func­tions.

In this the­o­ry, the behav­ioral symp­toms that are cur­rent­ly used to diag­nose ADHD — includ­ing inat­ten­tion — reflect these under­ly­ing exec­u­tive func­tion­ing deficits. There cer­tain­ly is sub­stan­tial evi­dence that indi­vid­u­als with ADHD per­form poor­er than oth­ers — as a group — on a num­ber of exec­u­tive func­tion­ing tasks that require plan­ning, orga­ni­za­tion­al skills, inhibit­ing respons­es (as assessed through tasks such as the Stroop test), deci­sion mak­ing, work­ing mem­o­ry and oth­er Frontal lobes exec­u­tive func­tions. His the­o­ry is gen­er­at­ing sig­nif­i­cant amounts of research and it is like­ly that our con­cep­tu­al­iza­tion of ADHD will con­tin­ue to evolve in response to new find­ings.

AF: I under­stand Dr. Bar­bara Inger­soll and you are co-lead­ing a pan­el at the CHADD Con­fer­ence, in late Octo­ber in Chica­go. What will the pan­el be about?

DR: the title will be “New and Com­ple­men­tary Approach­es to the Assess­ment and Treat­ment of AD/HD”, and we will pro­vide an overview and update of research on com­ple­men­tary approach­es to the eval­u­a­tion and treat­ment of AD/HD, includ­ing the use of Quan­ti­ta­tive EEG (QEEG) as part of a com­pre­hen­sive eval­u­a­tion for AD/HD, cur­rent research per­tain­ing to neu­ro­feed­back and com­put­er­ized train­ing of work­ing mem­o­ry as treat­ments for AD/HD. We will also high­light the ratio­nale and need for new evi­dence-based approach­es to eval­u­a­tion and treat­ment.

AF: I have also seen in CHADD’s agen­da that Cogmed’s Dr. Torkel Kling­berg will be pre­sent­ing research on work­ing mem­o­ry train­ing results. The pan­el is called Com­put­er­ized Train­ing of Work­ing Mem­o­ry in Chil­dren with ADHD. (For any­one inter­est­ed, the descrip­tion is “Work­ing mem­o­ry train­ing, an evi­dence-based method for chil­dren with AD/HD, can sig­nif­i­cant­ly improve work­ing mem­o­ry, response inhi­bi­tion and rea­son­ing and reduce inat­ten­tive symp­toms. The focus in this pre­sen­ta­tion is on research stud­ies on work­ing mem­o­ry and its clin­i­cal use today). The inter­ven­tion was devel­op­ment in con­junc­tion with Karolin­s­ka Insti­tute, and is com­mer­cial­ized by Cogmed with the name RoboMemo. The ques­tion: what do you rec­om­mend par­ents do when they are look­ing for new inter­ven­tions for their chil­dren? How can they nav­i­gate through mul­ti­ple com­pa­nies and cen­ters mak­ing a vari­ety of claims?

DR: very rel­e­vant ques­tion. Par­ents are always look­ing for ways to help their chil­dren. Not only that, adults with ADD/ ADHD are also a very self-moti­vat­ed group. How­ev­er, there have been a num­ber of dis­ap­point­ments. I would rec­om­mend par­ents dis­cuss new inter­ven­tions with their doc­tors, and also make informed deci­sions that include read­ing peer-reviewed pub­li­ca­tions, or at the very least being aware of what spe­cif­ic inter­ven­tions have pub­lished results in respectable jour­nals.

AF: how can par­ents, and any­one who is not a sci­en­tist, access those pub­li­ca­tions you men­tion?

DR: There are dif­fer­ent ways. One, they can search for papers in PubMed. Some­times the papers them­selves are not avail­able in PubMed, but the sum­maries, abstracts, are. If they want to read the whole arti­cle, they can go to any uni­ver­si­ty libraries with free access to Med­line.
For peo­ple who may not want to read the research papers, but be informed of the high­lights of new research devel­op­ments, I launched Atten­tion Research Update, a free month­ly newslet­ter helps par­ents, pro­fes­sion­als, and edu­ca­tors stay informed about impor­tant new research on ADHD.

AF: Prof. Rabin­er, this has been very help­ful. Thank you for your time.

DR: Thank you. See you in CHADD con­fer­ence.

Leave a Reply...

Loading Facebook Comments ...

10 Responses

Leave a Reply

Categories: Attention and ADD/ADHD, Cognitive Neuroscience, Education & Lifelong Learning, Health & Wellness, Neuroscience Interview Series, Peak Performance, Professional Development, Technology, Uncategorized

Tags: , , , , , , , , , , , , , , , , , ,

All Slidedecks & Recordings Available — click image below

Search for anything brain-related in our article archives

About SharpBrains

As seen in The New York Times, The Wall Street Journal, BBC News, CNN, Reuters, and more, SharpBrains is an independent market research firm and think tank tracking health and performance applications of brain science.