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A CDC report estimated that, in 2003, 4.4 million youth ages 4–17 lived with diagnosed ADHD, and 2.5 million of them were receiving medication treatment. Now, which is the core deficit underlying ADHD-so that treatments really address it? and how are ADHD and brain development related? Keep reading…
ADHD & the Nature of Self-Control — Revisiting Barkley’s Theory of ADHD
— By David Rabiner, Ph.D
As implied in the title of his book, ADHD and the Nature of Self-Control, Dr. Barkley argues that the fundamental deficit in individuals with ADHD is one of self-control, and that problems with attention are a secondary characteristic of the disorder.
Dr. Barkley emphasizes that during the course of development, control over a child’s behavior gradually shifts from external sources to being increasingly governed by internal rules and standards. Controlling one’s behavior by internal rules and standards is what is meant by the term “self-control”.
Shelley launched a good discussion on The Neuroscience of ADHD in her blog, discussing the situation and providing a technical overview of drug-based interventions. Something I hadn’t heard is that “For example, babies born prematurely face a significantly greater risk of developing ADHD than full-term babies (socioeconomic status was controlled for).”
- “The Preschool ADHD Treatment Study, or PATS, conducted by the National Institute of Mental Health (NIMH), is the first long-term study designed to evaluate the effectiveness of treating preschoolers with ADHD with behavioral therapy, and then, in some cases, methylphenidate. In the first stage, the children (303 preschoolers with severe ADHD, between the ages of three and five) and their parents participated in a 10-week behavioral therapy course. For one third of the children, ADHD symptoms improved so dramatically with behavior therapy alone that they did not progress to the ADHD medication phase of the study.”
As Shelley’s post and the article explain, drugs do help when used appropriately. Now, they are not the only answer. I am happy to see that behavioral therapy can be as useful when appropriate. Which is not a surprise, given the growing literature on different methods of cognitive training, including therapy and working memory training like the one discussed with Notre Dame’s Bradley Gibson and in our post Cognitive Neuroscience and ADD/ADHD Today.
Today we interview Dr. Arthur Lavin, Associate Clinical Professor of Pediatrics at Case Western School of Medicine, pediatrician in private practice, and one of the first providers of Cogmed Working Memory Training in the US (the program whose research we discussed with Dr. Torkel Klingberg and Dr. Bradley Gibson). Dr. Lavin has a long standing interest in technology-as evidenced by Microsoft’s recognition of his paperless office- and in brain research and applications-he trained with esteemed Mel Levine from All Kinds of Minds-.
- Schools today are not yet in a position to effectively help kids with cognitive issues deal with increasing cognitive demands.
- Working Memory is a cognitive skill fundamental to planning, sequencing, and executing school-related work.
- Working Memory can be trained, as evidenced by Dr. Lavin’s work, based on Cogmed Working Memory Training, with kids who have attention deficits.
Context on cognitive fitness and schools
AF (Alvaro Fernandez): Dr. Lavin, thanks for being with us. It is not very common for a pediatrician to have such an active interest in brain research and cognitive fitness. Can you explain the source of your interest?
AL (Arthur Lavin): Throughout my life I have been fascinated by how the mind works. Both from the research point of view and the practical one: how can scientists’ increasing knowledge improve kids’ lives? We now live in an truly exciting era in which solid scientific progress in neuroscience is at last creating opportunities to improve people’s actual cognitive function. The progress Cogmed has achieved in creating a program that can make great differences in the lives of children with attention deficits is one of the most exciting recent developments. My colleague Ms. Susan Glaser and I recently published two books: Who’s Boss: Moving Families from Conflict to Collaboration (Collaboration Press, 2006) and Baby & Toddler Sleep Solutions for Dummies (Wiley, 2007), so I not only see myself as a pediatrician but also an educator. I see parents in real need of guidance and support. They usually are both very skeptical, since [Read more…] about Working Memory Training from a pediatrician perspective, focused on attention deficits
Kevin brings a new edition of the IQs Corner Headlines from the Brain and Mind Blogsphere. Worth reading if you are interested in cognitive and educational psychology.
Have a great celebration today!
Notre Dame Professor Bradley Gibson, whom we interviewed a few months ago (see below) presented the results from his study recently at the Society for Research in Child Development (SRCD):
University of Notre Dame Professor and Research Team are First in U.S. to Validate Breakthrough Study on the Effectiveness of Working Memory Training in Improving Attention Deficits in Children (pdf)
- “Dr. Bradley Gibson, associate professor of psychology at the University of Notre Dame, and his colleagues (Gibson, Seroczynski, Gondoli, Braungart-Rieker, & Grundy, 2007) will share new findings from the first U.S. study on the effectiveness of Cogmed Working Memory Training for improving attention abilities in children with ADHD. The study validates previous research from Sweden’s Karolinska Institute which revealed a fundamental breakthrough in the way attention problems are proactively treated. Gibson will unveil the results of the U.S. study during the Society for Research in Child Development (SRCD) bi-annual conference in Boston. Cogmed is a pioneer in neurotechnology and a developer of software-based working memory training products.”
- AF: Tell us about ADD/ ADHD and development trajectories.
- BG: There is a very insightful study by Walter Mischel on pre-schoolers aged 4 and 5. Some of them had a [Read more…] about Cogmed Working Memory Training