Number 15 August 1, 2001

In this issue:

1. Remediation Strategies - Part 4

2. Resource - add.about.com

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REMEDIATION STRATEGIES - PART 4

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The series of articles, which are appearing in the first ADDvisor newsletter of each month, are focusing on remediation strategies for neuropsychologically based difficulties. The suggestions that follow will benefit those with ADHD, widely considered a neurologically based impairment.

These strategies are adapted from Morse, P. A. and Montgomery, C.E., Neuropsychological evaluation of traumatic brain injury, in R.F. White (Ed.) Clinical Syndromes in Adult Neuropsychology: The Practitioner's Handbook. The Netherlands: Elsevier Science Publishers B.V., 1992)

In this fourth article on executive function issues we will talk about two final executive functions, working memory and self-monitoring.

Working Memory

Working memory is your ability to keep something in mind long enough to act on it, at the right time. For example, if you ask someone to stop at the neighbors house on their way home and to retrieve their jacket and their socks they may either come home remembering only one item or, come home and then remember that they were supposed to stop and retrieve the two items. The individual is either forgetting what they're supposed to retrieve or remembering what they're supposed to retrieve at the wrong time.

Solutions

Strategies, to improve this dysfunction, work best (as Russell Barkley says) at the "point of performance". This means that strategies that are in place at the exact time they are needed are the best option. In this case, the ideal strategy would be an electronic reminder (such as a Palm Pilot) that would beep at the appropriate time and provide a written message such as "pickup socks and jacket." The next best thing would probably be a watch timer which would beep the appropriate time to provide a written message. Other things come to mind include paging the person on a pager at the appropriate time, having a hand written message placed in view so that it would be seen at the appropriate time, or calling the person on their cell phone at the appropriate time. The worst strategy would be to rely on the individuals deficient working memory to remember what they need at the appropriate time.

Self-Monitoring

Self-monitoring is the final executive function we will discuss. Self-monitoring is the ability to be aware of behavior and to analyze, monitor and adjust behavior according to needs. This is an ongoing process, we are all doing this all of the time.

Solutions

Strategies used to help with this problem may include; 1) increase self-awareness and error recognition by asking the person to anticipate whether they will complete the task correctly and to write this down. Next, compare their actual performance with their anticipated performance and help them recognize the differences. 2) videotape someone performing their task and then view the tape together to recognize self-regulation and monitoring errors. 3) Help the individual to use "verbal mediation" or talking themselves through an activity. Develop some key phrases that they can use such as "am I doing what I need to right now?"

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RESOURCE - ADD.ABOUT.COM

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About.com has a new guide for its ADD section. Her name is Eileen Bailey and it looks like she has a lot of good information available. Go to: http://add.about.com/