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Cogmed Working Memory Training Outline: Everything You Want To Know About ADHD
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Return to ADDvisor, Volume 1 1999 Index Number 3, September, 1999 ================================================= In this issue:
====================================================== THE BROWN MODEL OF ADD ====================================================== When I was in Boston this August for the American Psychological Association, I had the opportunity to hear Thomas Brown of the Yale University School of Medicine speak about “Inattention” and “Executive Functions:” New Understandings of “ADD Syndrome.” In his workshop, Dr. Brown enumerated the six executive functions that are impacted by ADHD. What is executive function? The executive functions of the brain are those located in the cerebral cortex. These are the functions that allow us to manage our thinking (cognition) and behavior. Brown’s theory assumes that ADD consists of impairments in a broad range of cognitive functions in addition to problems with attention, concentration and hyperactivity. The six executive functions are listed below.
Organize, Prioritize and Activate for Task Focus and Sustain Attention to Task Sustain Alertness, Effort, Processing Speed Manage Frustration and Modulate Affect Utilize Working Memory, Access Recall Regulate Verbal and Motoric Action Organize, Prioritize and Activate for Task The ADHD individual who experiences difficulty in this area procrastinates, needs pressure to get started on a task, is unrealistic with estimating time and money, has difficulties setting priorities and has poor follow up on plans and intentions. Focus and Sustain Attention to Task These individuals are preoccupied with their own thoughts, easily distracted both internally and externally, lose focus when reading and/or listening, need reminders to stay on task, and switch tasks frequently, getting easily sidetracked. Sustain Alertness, Effort, Processing Speed ADHD individuals have an arousal problem. They are excessive daydreamers, appear unmotivated and apathetic, effort fades quickly, and processing speed slows. All this leads to very inconsistent productivity. How many times have we said about our ADHD kids, “But he was able to do it last week.” Manage Frustration and Modulate Affect Difficulties in this area include: becoming easily frustrated, overly sensitive to criticism, having a short fuse, excessive irritability, worrying excessively, perfectionistic, often sad, unhappy and discouraged. Utilize Working Memory, Access Recall Working memory is the ability to hold information in one’s head while applying it to a problem. Problems include: forgetting intended words and actions, losing track of papers, belongings, learning things and then not being able to retrieve them, difficulty following sequences directions, and quickly losing thoughts put ‘on hold.’ Regulate Verbal and Motoric Action Inability to regulated actions leads to impulsive behavior, fidgetiness, motoric restlessness, and being overly quick to jump to conclusions. These individuals act before they think. If parents and kids can be knowledgeable about what their impairments are, they are in a better position to seek accommodations and modifications at work or at school. Proper identification can also lead to appropriate treatment. ===================================================== PHELAN’S FOUR CARDINAL SINS ===================================================== Dealing with adolescents is tough enough but when they have an attention deficit disorder, they can be positively exhausting. In our frustration, we often employ desperation tactics to try to get through to our teenagers. Some probably make matters worse. Tom Phelan, in “Surviving Your Adolescents,” lists the Four Cardinal Sins that must be avoided if you are to have any chance at having a good relationship with your adolescent. Spontaneous problem discussions By bringing up a problem that needs to be addressed when noticed, a parent usually catches their teenager at a time when their motivation to discuss the problem is near zero. Thus, irriability is increased and cooperation is decreased. Try to make an appointment with your teenager to discuss the important problem. For example, “I’m concerned with your use of the car. When would be a good time to talk about this? It shouldn’t take very long.”
Nagging is a set of repetitive, often hostile, verbal reminders about something a person wants accomplished. The person to whom it is directed does not share the first person’s desire to complete the task. Therefore, it just produces more conflict Behind nagging is what Phelan calls ‘a psychotic parental delusion’- that the repetition of an idea or request will actually sink in. A better way would be to determine whether your request is an important one and again, set an appointment with your teen to discuss the issue.
Phelan has a wonderful way of describing things. This is the parental lecture, but the notion of surgically implanted insight highlights how foolish the parental lecture is. They usually block you out within the first sentence. When you need to provide advise to your teen, pay attention to the response you are getting, ask yourself how many times you have said the same thing and do not expect immediate change.
Everyone recognizes that arguing gets you nowhere. The goal is to argue as little as possible. Don’t worry about who gets the last word. Avoid the power struggle that inevitably results from arguing. If an argument starts, just stop, say “I’m not arguing any more.” and walk away. Then, when cooler heads prevail, if the subject is worth discussing, arrange a time with your teen to discuss the issue. We all commit these cardinal sins but if we try to avoid them, we may be better able to communicate with our kids and may eliminate a lot of frustration within the family.
CONTACT INFORMATION _______________________ Alan R. Graham, Ph.D. Bill Benninger, Ph.D. ADDvisor.com Voice: 1-866-ADDvisor Fax: 847-824-2386 Email: Alan@ADDvisor.com Bill@ADDvisor.com Web: www.ADDvisor.com
c) Copyright 1999 ADDvisor.com, Ltd. All rights reserved The above material may be retransmitted or distributed to whomever you wish as long as not a single word is changed, added or deleted, including the contact information. However, you may not copy it to a web site. Republication of "The ADDvisor" in paper media is encouraged and permitted by organizations and associations which serve parents of ADHD children at the national, state and/or local level as long as the issue is reprinted in its entirety without charge and includes the contact information. With advance permission, we are happy to edit an issue to fit your space requirements. Republication is also encouraged under other circumstances, however, the advance permission of Alan R. Graham and/or Bill Benninger must be obtained in the event that changes in the text are desired or republication is to be made by individuals or by organizations other than those mentioned above.
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