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Treatment of ADHD Through Working Memory Training: Mitra Encyclopedia Web Resources

Mitra Encyclopedia. Encyclopedia Resources On The Net. GMT:2012-03-11 00:56:08.

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ADHD Executive Function and School Success

ADHD, EXECUTIVE FUNCTION AND SCHOOL SUCCESS

      Chris A. Zeigler Dendy, M.S.

                                                                                                                                                                                                       (updated in 2011)

The primary source for this article was my new Teaching Teens with ADD, ADHD, & Executive Function Deficits, 2nd ed (2011)

A Personal Comment: Our youngest son, Alex, struggled terribly throughout his high school and college years with ADHD and executive function issues. We’re proud that he beat the odds and graduated from college. So if your child is struggling in school, don’t give up. My family offers living proof that there is hope and help for ADHD and coexisting conditions.

Please visit our website www.chrisdendy.com to learn more about my family and how we have coped with ADHD.  Several helpful articles are also available for you to download and share with friends. Best wishes for school success to you, your children and students with attention deficits!!

Five years ago, most parents and teachers of students with ADHD didn’t have a clue that a child’s academic success was contingent upon strong executive skills. However, today’s savvy parents and educators realize that deficits in critical cognitive skills known as executive functions  (EF) are slower to mature in many children with ADHD. In 2007, researchers made a startling discovery: the brains of students with ADHD mature three years more slowly than their peers. This helps explain why their executive skills are delayed. Two years later, scientists found that the part of the brain that enables students to work on “boring tasks” such as school work has a reduced number of dopamine receptors and transporters. More simply stated the reduced levels of brain chemistry in this key area explains why students can play video games for hours but struggle to complete their homework in a timely manner.

Read more…

Psychology Today Article: Working Memory Training as an Alternative to Medication for ADHD

Keep It in Mind

Understanding and improving your working memory.

ADHD and Medication: What’s New?

To medicate or not? Research in children with ADHD.

Scientific American on Alternative Therapies for ADHD


Training the Brain

Cognitive therapy as an alternative to ADHD drugs

To medicate or not? Millions of parents must decide when their child is diagnosed with attention-deficit hyperactivity disorder (ADHD)–a decision made tougher by controversy. Studies increasingly show that while medication may calm a child’s behavior, it does not improve grades, peer relationships or defiant behavior over the long term.

Consequently, researchers have focused attention on the disorder’s neurobiology. Recent studies support the notion that many children with ADHD have cognitive deficits, specifically in working memory–the ability to hold in mind information that guides behavior. The cognitive problem manifests behaviorally as inattention and contributes to poor academic performance. Such research not only questions the value of medicating ADHD children, it also is redefining the disorder and leading to more meaningful treatment that includes cognitive training.

“This is really a shift in our understanding of this disorder from behavioral to biological,” states Rosemary Tannock, professor of psychiatry at the University of Toronto. Tannock has shown that although stimulant medication improves working memory, the effect is small, she says, “suggesting that medication isn’t going to be sufficient.” So she and others, such as Susan Gathercole of the University of Durham in England, now work with schools to introduce teaching methods that train working memory. In fact, working-memory deficits may underlie several disabilities, not just ADHD, highlighting the heterogeneity of the disorder.

“Working memory is a bottleneck for everyday functioning independent of what category you fit into,” comments Torkel Klingberg, a neuroscientist at the Karolinska Institute in Stockholm. Based on Klingberg’s research, Karolinska founded Cogmed–a biotech company that has developed a software program to train working memory. In a recent paper in the Journal of the American Academy of Child and Adolescent Psychiatry, Klingberg reported that 60 percent of 20 unmedicated ADHD children no longer met the clinical criteria for ADHD after five weeks of training. The company has already rolled out its training service in Sweden and Germany, and Karolinska is collaborating with New York University to launch a clinical trial with ADHD kids later this year.

“It’s intriguing data,” Tannock remarks. “The emphasis is on visual-spatial memory, which is where we find the strongest link to inattention and ADHD. But they have to go further. You want to show that training improves ability on a range of tasks, not just holding information.”

That ADHD children would respond to cognitive training does not surprise experts such as Lawrence H. Diller, a child psychiatrist and author of Running on Ritalin. “Hyperactivity and inattention are bell-shaped spectrum disorders,” he says. “The majority of kids who are getting medication are borderline normal versus abnormal.” In Diller’s experience, the former benefit the most from nonpharmaceutical training approaches. Medication has been overemphasized by a pharmaceutical and medical industry “that has changed people’s view of themselves,” he continues. “Personal responsibility has taken a backseat to lifelong disorders.”

Moreover, because there is no industry to back it, behavioral therapy has been grossly underrated, Diller and others opine. Unpublished data from the Multimodal Treatment Study–the largest U.S. long-term study of ADHD treatment in children–show that after two years, kids treated with behavioral therapy only (parent training, school intervention and a special summer camp program) functioned just as well as kids on high-dose medication, says lead researcher William Pelham of the University at Buffalo. Also, only an additional 8 percent of the children in the behavioral arm were medicated at the end of the second year, indicating that most parents in this group were satisfied with behavioral therapy.

Cogmed: Some satisfied, and some unsatisfied users

http://www.greatschools.org/special-education/community/discussion.gs?content=53307

Complaints that Cogmed providers and coaches are not disclosing that they make a profit from recommending this treatment are relevant and important!  Hopefully, there are few professionals out there who would gouge their customers/patients or prey on them due to their troubles. Be a good consumer!!  Always shop around (whether it is for a new shirt, medical or psychological treatment, or a new pair of shoes) and remember that prices are not set in stone.  The providers are determining cost based on the market, and it never hurts to ask for a discount or reduced price.  The worst that can happen is that they’ll say “no.”

Used at Universities…

From the NC State website:

A. Cogmed Working Memory Training is a home-based program that helps children and adults with attention problems by training and increasing their working memory capacity, thus resulting in improved ability to follow directions, compete tasks, refrain from becoming distracted, and in general, function more independently. Clinically proven results demonstrate that after training, children improve their ability to concentrate, control impulsive behavior and better utilize complex reasoning skills. In the end, better academic performance can be achieved especially in math and reading.

It is a comprehensive, home-based program. Through active engaging exercises, children (and adults) train at home five days a week for five weeks. An office visit is not necessary. The software automatically increases in difficulty, improving attention abilities. Every participant has a personal coach who leads the training, analyzes results, and provide encouragement through weekly phone calls. Two versions are available, one for children and adolescents, and one for adults. A preschool version is also available.

Q. What is working memory?

A. Working memory is a function of the brain that helps to temporarily store and manage the information required to carry out complex competitive tasks such as learning, reasoning, and comprehension. Working memory keeps information in the mind for a short time, typically for a few seconds, in order to use that information for thinking. In daily life, we use working memory for a number of tasks such as remembering instructions, solving problems, controlling impulses, and focusing attention. These are the activities that typically plague individuals with attention deficits.

Q. What are the signs of weak working memory?

  • Problems focusing
  • Distractibility
  • Difficulties starting and finishing tasks
  • Forgetting instructions

Q. What are the benefits of training working memory?

  • Improved ability to sustain attention
  • Improves impulse control
  • Better complex reasoning skills
  • Better academic performance
  • Parents and teachers also report other benefits in daily life:
    • improved social skills
    • taking initiative
    • remembering things
    • completing tasks like homework assignments more independently
  • When asked one year after training to report on their experience, 79% of parents whose children had benefited from training reported effects had remained or increased.

Q. What does research show?

Research has established an important connection between working memory, attention, and school work. Most children with an attention problem also have working memory deficit. That means they don’t have the same working memory capacity as their peers. Increasing working memory capacity improves attention which helps improve academic performance.

Published, peer-reviewed, and controlled clinical studies have demonstrated that, upon completion of Cogmed Working Memory Training, 80% of participants have significantly improved their ability to concentrate and use complex reasoning skills over the long term. Cogmed Working Memory Training is scientifically validated by placebo-controlled clinical studies published in respected professional journals, and there is an on-going research at several leading U.S. universities. New research suggests positive results for normally-aging adults as well.

Q. How can I get more information?

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