Is ADHD all in your head?

Posted by Peter on July 19th, 2010 | Comments off

A study published in the June 14 edition of the Journal of Developmental and Behavioral Pediatrics has sparked controversy regarding ADHD medication and the brain’s power to regulate itself.

The study was funded by the National Institutes of Health and conducted by Dr. Adrian Sandler, a developmental-behavioral pediatrician and medical director of the Olson Huff Center for Child Development at Mission Children’s Hospital in Asheville, North Carolina. The research was performed over the course of eight years using 99 patients from Western North Carolina.

Sandler found that children with ADHD can do just as well on half their medication when the medication is combined with a placebo. They performed as well even when parents and children had full knowledge they were taking a placebo.

[Placebo -- A substance containing no medication and prescribed or given to reinforce a patient's expectation to get well. The placebo in this research was akin to a harmless inert pill].

Previous studies have shown that common stimulant medication causes side-effects like tics, weight loss, stunted growth, and even heart complications in some instances. This often causes trepidation in parents afraid of the possible side-effects on their children.

Sandler compared fully medicated children, children on reduced medication, and children on reduced medication with a known placebo. The results were quite intriguing. Both the fully medicated and reduced medication groups had increased side-effects while the reduced medication with placebo demonstrated decreased side-effects. Furthermore, the reduced medication group reported decreased control of their ADHD symptoms. However, the control of ADHD symptoms was no different in the reduced medication with placebo group than in the full dose group, i.e. the reduced medication with placebo performed as well as the fully medicated group with less side-effects as well.

“I’ve been getting a lot of calls and e-mails,” said Sandler,, who conducted the research with James Bodfish, a professor in the departments of psychiatry and pediatrics at UNC Chapel Hill School of Medicine, and study coordinator Corrine Glesne.

“Medications work,” Bodfish said in a statement. “The question is whether we always need to use them at the highest dose. Many parents are concerned about placing their child on medication. Some choose not to treat their child because of concerns about side effects.”

While the research doesn’t address it, the obvious question is, Why? Parents and children in this study knew they were taking a placebo. Why then did they perform as well as their peers without the side-effects — at essentially half the dose as their peers? While the placebo effect has been studied widely, the exact mechanisms are unknown. We do know that the mechanism is governed by the brain. This clearly tells us that having ADHD or not, our brain is still a powerful weapon in our arsenal.

We also cannot exclude the influence of the parents during this research. Did they expect their child to do better? The authors suggest that this was so. This dynamic cannot be overlooked in your family either.

The bottom line is that we likely have far more control over our behaviors and cognitive processes than we are given credit for. Modern medicine, as this research suggests, is just beginning to understand the brain’s role in shaping our lives. We’ve known this for years at Play Attention. Cognitive training. Memory training. Motor skills. Attention training. Behavioral shaping. It’s time to take control over our lives. We’ve all got the power to do it. It lies right behind our eyes.

PDF

New research on attention and video games

Posted by Peter on July 6th, 2010 | Comments off

Research published in the July issue of Pediatrics reveals that too much time spent watching television and playing video games can cause attention problems.

A graduate student at Iowa State University, Edward Swing, found that excessive screen time, whether in front of a computer or TV, could double the risk of attention problems in children and young adults.

Swing’s research confirms previous findings from Dr. Dimitri Christakis, the George Adkins Professor of Pediatrics at the University of Washington in Seattle. Christakis’ research found that faster-paced shows increased the risk of attention problems. "You prime the mind to accept that pace. Real life doesn’t happen fast enough to keep your attention,” says Christakis.

The American Academy of Pediatrics (AAP) has long recommended that children over the age of 2 view less than two hours of TV or computer per day. Prior to that age, they suggest no TV viewing or computer.

Swing compared data of 1300 children in grades three, four, and five who watched TV or played video games less than two hours a day to children who watched more. He found that more video time could nearly double the risk of attention problems in children and young adults

"The children were reporting their TV and video game use and the parents were also reporting TV and video game use," Swing said. "The teachers were reporting attention problems," he said of the middle school students.

While both Swing’s and Christakis’ studies do merit attention, they are quite limited. For example, Swing used teacher rating reports to assess whether children had problems paying attention, if they interrupted classmate’s work, if they had trouble staying on task, or showed problems in other areas related to inattention. Teacher reports typically vary over time and from teacher to teacher. They are also highly subjective. To account for this, Swing had more than one teacher rate the children and that the ratings tended to be in agreement.

The greatest flaw in this research is that Swing did not account for content, i.e. what were the students watching or playing? Were the students watching educational TV or playing educational games? Were they playing race car games? Shooting games? Were they playing problem solving games? Were the games fast paced? Slow? Did they require reasoning skills? We’ll never know and that’s problematic because it leaves so many questions unanswered. As we are what we eat, we are what we stimulate ourselves with.

"These media aren’t going away," Christakis said. "We do have to find ways to manage them appropriately." On this I can agree. Limiting time to the AAP recommendations is prudent parenting.

PDF

The ADHD link to social dynamics

Posted by Peter on June 21st, 2010 | Comments off

If I told you that women who received only basic education were 130 % more likely to have a child on ADHD medication than women with university degrees, you’d see a link, wouldn’t you?

Well, that’s what a study published this month in Acta Paediatrica found. That implies that nearly half of the serious cases of ADHD in children are closely tied to social factors. The study reveals that factors like single parenting and poor maternal education were directly tied to ADHD medication use.

While we know that a genetic propensity likely exists, the human brain develops based on a complex interplay between nature and nurture; between genetic endowment (nature) and environment/social factors (nurture). Epigenetic theory tries to explain this relationship.

Curiously, few large-scale studies have tried to determine the impact of social and family influences on ADHD. Researchers at the Karolinska Institute in Stockholm, Sweden assessed data on 1.16 million school children and examined the health histories of nearly 8,000 Swedish-born kids, aged six to 19, who had taken ADHD medication.

"We tracked their record through other registers … to determine a number of other factors," said lead author Anders Hjern.

Here’s what the researchers found:

Living in a single parent family increased the chances of being on ADHD medication by more than 50 percent.
A family on welfare upped the odds of medication use by 135%.
Boys were three times more likely to be on medication than girls.
Social dynamics affected both sexes equally.

"Almost half of the cases could be explained by the socioeconomic factors included in our analysis, clearly demonstrating that these are potent predictors of ADHD-medication in Swedish school children," Hjern said.

It’s clear that this study found a link between socioeconomic factors and ADHD medication use/diagnosis. Other US studies have found that minority children and children of low socioeconomic status were more likely to receive ADHD medication.

Factors like low income and diminished quality time are more common in single-parent families. These typically lead to stressors like family conflict and a lack of social support, Hjern said.

While more research must be done, one has to ask, is medication the answer to social stressors like lack of time and money? Sounds too silly to ask, but it seems that our answer, ridiculously, is a resounding, YES!

We are the masters of our lives. We can make significant personal changes, but we must have the tools to do so. That’s why I began Play Attention (www.playattention.com) years ago.

PDF

Summer ADHD brain drain

Posted by Peter on May 10th, 2010 | Comments off

Research tells us that during the summer, the average student loses one to three month’s math and reading gains made over the prior year. Academic losses are so common among students that educators have given the phenomena a name: Summer Brain Drain.

Summer Brain Drain may even be worse for ADHD students already having trouble at school.

Going to school daily provides schedules and routines. The summer break means those routines aren’t there. Expectations are lowered or relaxed. Even sleep schedules are often totally abandoned.

Unfortunately, exercise is often replaced with computer time, watching movies, or playing video games with friends. That’s a bad idea. While there’s nothing wrong with playing video games or watching movies, sedentary activity must always be balanced with exercise. This is especially important for an ADHD student.

I’ve included some specific articles that approach this topic from varying perspectives. Enjoy and gain the benefits this summer!

Children with ADHD benefit from time outdoors enjoying nature

(http://www.news.uiuc.edu/NEWS/04/0827adhd.html)

News Bureau at the University of Illinois at Urbana-Champaign from May 15 through June 8. — Kids with attention deficit hyperactive disorder (ADHD) should spend some quality after-school hours and weekend time outdoors enjoying nature, say researchers at the University of Illinois at Urbana-Champaign.

The payoff for this “treatment” of children 5 to 18 years old, who participated in a nationwide study, was a significant reduction of symptoms. The study appears in the September issue of the American Journal of Public Health.

“The advantage for green outdoor activities was observed among children living in different regions of the United States and among children living in a range of settings, from rural to large city environments,” wrote co-authors Frances E. Kuo and Andrea Faber Taylor. “Overall, our findings indicate that exposure to ordinary natural settings in the course of common after-school and weekend activities may be widely effective in reducing attention deficit symptoms in children.”

ADHD is a neurological disorder that affects some 2 million school-aged children, as well as up to 2 to 4 percent of adults, in the United States. Those with ADHD often face serious consequences, such as problems in school and relationships, depression, substance abuse and on-the-job difficulties.

“These findings are exciting,” said Kuo, a professor in the departments of natural resources and environmental sciences and of psychology at Illinois.

“I think we’re on the track of something really important, something that could affect a lot of lives in a substantial way,” she said. “We’re on the trail of a potential treatment for a disorder that afflicts one of every 14 children – that’s one or two kids in every classroom.”

If clinical trials and additional research confirm the value of exposure to nature for ameliorating ADHD, daily doses of “green time” might supplement medications and behavioral approaches to ADHD, the authors suggest in their conclusion.

Kuo and Faber Taylor, a postdoctoral researcher who specializes in children’s environments and behavior, recruited the parents of 322 boys and 84 girls, all diagnosed with ADHD, through ads in major newspapers and the Web site of Children and Adults with Attention Deficit/Hyperactivity Disorder. Parents were interviewed by means of the Web and asked to report how their children performed after participating in a wide range of activities. Some activities were conducted inside, others in outdoor places without much greenery, such as parking lots and downtown areas, and others in relatively natural outdoor settings such as a tree-lined street, back yard or park.

The researchers found that symptoms were reduced most in green outdoor settings, even when the same activities were compared across different settings.

“In each of 56 different comparisons, green outdoor activities received more positive ratings than did activities taking place in other settings, and this difference was significant or marginally significant in 54 of the 56 analyses,” Kuo said. “The findings are very consistent.”

The two researchers have been pursuing the ADHD issue as an extension of a long line of previous research they’ve conducted on the nature-attention connection among the general population in mostly urban settings.

“The medications for ADHD that are currently available work for most kids, but not all,” Kuo said. “They often have serious side effects. Who wants to give their growing child a drug that kills their appetite day after day and, night after night, makes it hard for them to get a decent night’s rest? Not to mention the stigma and expense of medication.”

Simply using nature, Kuo said, “may offer a way to help manage ADHD symptoms that is readily available, doesn’t have any stigma associated with it, doesn’t cost anything, and doesn’t have any side effects – except maybe splinters!”

There are a number of exciting possible ways in which “nature treatments” could supplement current treatments, she said.

Spending time in ordinary “urban nature” – a tree-lined street, a green yard or neighborhood park – may offer additional relief from ADHD symptoms when medications aren’t quite enough. Some kids might be able to substitute a “green dose” for their afternoon medication, allowing them to get a good night’s sleep.

“A green dose could be a lifesaver for the 10 percent of children whose symptoms don’t respond to medication, who are just stuck with the symptoms,” Kuo said. As Kuo and Faber Taylor wrote, a dose could be as simple as “a greener route for the walk to school, doing classwork or homework at a window with a relatively green view, or playing in a green yard or ball field at recess and after school.”

The National Urban and Community Forestry Advisory Council, U.S. Forest Service, and the U.S. Department of Agriculture’s Cooperative State Research, Education, and Extension Service supported the project.

Exercise Improves Learning and Memory
Chalk up another benefit for regular exercise. Investigators from the Howard Hughes Medical Institute (HHMI) have found that voluntary running boosts the growth of new nerve cells and improves learning and memory in adult mice.
"Until recently it was thought that the growth of new neurons, or neurogenesis, did not occur in the adult mammalian brain," said Terrence Sejnowski, an HHMI investigator at The Salk Institute for Biological Studies. "But we now have evidence for it, and it appears that exercise helps this happen."
USA Today (http://www.usatoday.com/news/health/2006-03-26-adhd-treatment_x.htm)

ADHD treatment is getting a workout

http://www.usatoday.com/news/health/2006-03-26-adhd-treatment_x.htm
Doctors haven’t done many definitive studies about exercise and ADHD, says David Goodman, an assistant professor of psychiatry at the Johns Hopkins University School of Medicine. But Goodman says it makes sense that working out would help people cope with the condition. Studies show that exercise increases levels of two key brain chemicals — dopamine and norepinephrine — that help people focus.

"Your cognitive function is probably better for one to three hours after exercise," Goodman says. "The difficulty is that by the next day, the effect has worn off."

If kids could exercise strenuously three to five times a day, they might not need medications at all, says John Ratey, an associate clinical professor of psychiatry at Harvard Medical School. Ratey is so intrigued by the question that he’s writing a book about how exercise can reduce symptoms of ADHD or at least help patients cope.

Team sports might help children with ADHD in several ways, says James Perrin, a professor of pediatrics at Boston’s MassGeneral Hospital for Children. Children with the condition benefit from following a regular schedule. Coaches who lead kids through structured exercises also might help build concentration and organizational skills.

PDF

Immediate rewards and the ADHD brain

Posted by Peter on April 23rd, 2010 | Comments off

A Nottingham University research team in the United Kingdom found that the brains of children with ADHD appear to respond to immediate rewards in the same way as they do to medication. Their research was published in the journal Biological Psychiatry.

“Our study suggests that both types of intervention [medicine and immediate reward/reinforcement] may have much in common in terms of their effect on the brain,” said Professor Chris Hollis, the lead investigator of the study.

The research team used an EEG (electroencephalograph) to measure the brain activity of children as they played a computer game that provided extra points for less impulsive behavior.

The researchers devised a computer space game which rewarded the ADHD children when they caught aliens of specific colors while avoiding aliens of designated colors. The game design actually tested the children’s ability to resist the impulse to grab the wrong colored aliens.

To test whether immediate reward/reinforcement made a difference, one iteration of the game rewarded the children fivefold for catching the right alien and penalized them fivefold for catching the wrong one. All of this was done while activity in different parts of their brains was monitored with an EEG.

Hollis found that the immediate rewards helped the children perform better at the game. This was verified by the EEG which revealed that both medication and immediate reward/reinforcement were "normalizing" brain activity in the same regions.

Many parents of ADHD children are aware that giving a reward to an ADHD child a week after their good behavior is insignificant to that child. ADHD children respond better to immediate reward, not delayed reward.

"Although medication and behavior therapy appear to be two very different approaches of treating ADHD, our study suggests that both types of intervention may have much in common in terms of their effect on the brain. Both help normalize similar components of brain function and improve performance," said Hollis.

"We know that children with ADHD respond disproportionately less well to delayed rewards – this could mean that in the ‘real world’ of the classroom or home, the neural effects of behavioral approaches using reinforcement and rewards may be less effective."

It’s obvious that providing immediate rewards/reinforcement 24 hours a day and 7 days a week would be impractical and impossible. But what does this research tell us? It tells us that if we are to train an ADHD student, feedback, reward, and reinforcement need to be immediate if we are to get their brain to rewire.

We at Play Attention have known this for many years. This is why we integrated immediate feedback/reinforcement for attention training, cognitive training, memory training, and behavioral shaping by using feedback technology. We patented this method years ago because of its inherent strength. While we knew this was the best way to achieve success, we feel research like this rather reinforces our approach. It’s about time the world caught up!

PDF

Should I play or should I grow?

Posted by Peter on March 1st, 2010 | Comments off

PART TWO OF THREE

Entertainment vs. learning
Entertainment is usually a passive act that includes an activity which provides a distraction to everyday events or provides amusement. A good example of entertainment is watching a movie or concert. However, one may also actively participate in recreational entertainment such as playing video games or sports. One does not participate in an entertaining activity to be educated. That is far from the goal of entertainment. In fact, we participate in entertainment to be relieved of having to work, having to learn, or having to be actively engaged for those purposes. We seek entertainment for fun and pleasure.

Entertainment is a vast industry. The modern American video game industry made about $18.85 billion on video-game hardware, software, and accessories in 2007. That’s nearly twice what movie theaters made and triple what the video game industry made in 2000. Most authorities on video games estimate that 70 to 80 percent of boys and approximately 20 percent of girls play video games daily.

Learning is on the other end of the spectrum from entertainment. In order to learn, we need attention, challenge, and deliberate practice. We need to be actively engaged. To apply the mind with the intent of long-term retention, assimilation, and application of new information. This implies both effort and commitment. While we may employ some of these elements, the purpose is far different in a learning environment. The purpose of learning in Star Trek: Bridge Commander is to keep the ship from exploding by using the controls correctly. Learning is there to benefit your game play. While this takes some reasoning and trial and error, is this useful in the classroom or at the office? Not likely. It’s not likely transferrable or to generalize either unless your child’s job is commanding Star Fleet.

If I may paraphrase the late martial artist and film legend Bruce Lee, you cannot learn to swim by kicking your legs and stroking with your arms on land. You have to jump in the water. You cannot learn to run a marathon by jogging around the track.

In other words, if we want to learn something, it has to be taught with a purpose or aim, and we have to practice it deliberately to improve. If we closely examine what video games our spouse, child, or clients are playing, then we might just be alarmed at the violence, the lack of humanity, and gratuitous sex involved.

The most popular video games are those that are visually intense and graphically frenetic. It’s important to mention here that paying attention to visually stimulating and frenetic activity is another hallmark of an ADHD individual. Offer a 3-ring circus and their brain is quite capable of attending to it. Ask them to clean their room, a much less stimulating activity, and it’s very difficult. This predisposition towards highly stimulating activities seems to involve the brain’s reward and gratification systems as well as its processing and other regulatory systems.

Thus, a high stimulation Xbox or Play Station game is quite satisfying; ADHD individuals can hyperfocus on these games for hours on end. What does that teach? Research tells us that people who play these games do learn visual recognition skills, i.e. they can rapidly determine the number of opposing characters on screen far faster than the average human being. So, if the only thing they’re going to be is a fighter pilot, then these games might be suitable.

Other research tells us that if one chronically plays these games (chronically would be classified as one hour or more per day), one is more likely to report lower grades at school, diminished attention at school, and a greater probability of being addicted to these games or the Internet itself. Good Japanese research also noted that entertaining, highly stimulating video games that involve little else than pointing and shooting can lower both the metabolic rate and EEG in the frontal lobes of the brain. The frontal lobes, among other capacities, govern attention, aggression, and impulsivity. This is important to know especially if you have an ADHD person in your household using these games.

It seems that most ADHD children and adults are prewired to pay attention to overly stimulation things. That seems to be a hallmark of the trait. They frequently become hyperfocused on them for hours at a time. Taking these games away is probably not practical. However, limiting play time is quite sensible.

If one is to learn skills, techniques, or methods that will strengthen the brain, then the video game must be quite different than the Xbox or Play Station most popular list.

Upcoming, part 3, Play Attention vs. off the shelf video games.

PDF

Should I play or should I grow?

Posted by Peter on February 14th, 2010 | Comments off

PART ONE OF THREE

This blog is partially based on material I presented to the International Atomic Energy Agency of the United Nations in Vienna, Austria.

Playing vs. learning
What’s the difference between playing and learning? Sometimes there is no difference. People can learn through play. Educators have known this for years. Grade school teachers often try to teach using games. Games engage, excite, and motivate students. However, there is a significant difference between games that simply entertain and games that facilitate learning.

When learning through games or other modalities, three fundamental catalysts are necessary for the brain to create and grow a neural pathway facilitating long-term retention. These catalysts are attention, challenge, and deliberate practice.

Attention
A student must pay enough attention to incoming stimuli to even begin the learning process. Too little attention causes the student to constantly redirect attention to other stimuli. Picture your ADHD child trying to learn multiplication tables. While the teacher is teaching 2 x 2, he’s paying attention to the bird outside the window. Little chance that multiplication tables will be learned soon. So, attention is crucial, in fact, it’s the core to all learning. For an ADHD person, the ability to direct attention and sustain it without distraction is impaired.

Challenge
If the teacher can get a student to pay enough attention to multiplication tables, the student must then be challenged. Challenge arrives when the brain confronts something it doesn’t quite understand. The brain attempts to place the information into a tenuous relationship with information it already possesses. If the brain already knows the information, it simply retrieves the data from its storage bank. So, if the teacher presents 2 x 1, and the student knows immediately the answer is 2, then there’s no challenge and little is learned. However, if the teacher presents 2 x 7561, then the student is challenged and must use all of his pre-existing knowledge to find a solution. Attention and challenge spark creation and growth of new neural pathways for long-term retention. However, long-term retention is not guaranteed until we practice.

Deliberate practice
Educationalists have known that haphazard studying or practice results in haphazard learning. Deliberate practice is a term coined by Dr. Anders Eriksson, a professor at Florida State University (http://www.psy.fsu.edu/faculty/ericsson.dp.html). He studied how people become experts in their fields and found that the length of time they practiced and their use of deliberate practice greatly influenced their expertise.

Let’s use multiplication tables again to describe deliberate practice. Chances are that you learned your multiplication tables by practicing one group at a time; multiplying by 1, by 2, by 3, etc. In many years of teaching, I never saw a student learn multiplication tables by learning 2 x 3, then 7 x 9, then 6 x7. We learned in a sequence that was deliberately practiced until mastered.

When I was learning to multiply by 6, I had difficulty with 6 x 7, 6 x 8, and 6 x 9. So, my teacher made special flashcards for me with these specific problems written on the cards. I used these cards, blocks, and other devices to practice these difficult sequences. If I didn’t get the right answer, I got immediate feedback that I was incorrect. I used this feedback to make changes to my strategy in attempting to find the correct solution. That’s deliberate practice; sorting out the difficult elements that we have not learned, developing strategies to learn them, getting feedback regarding correctness or incorrectness of these strategies, and practicing them correctly and long enough to attain long-term retention.

Most people do not use deliberate practice. We just practice, i.e. we just repeat the same thing over and over without taking the time or making the effort to work on the elements that are most difficult for us. We often only practice things that are easy or that we’re already good at performing. We avoid the difficult elements that don’t provide immediate reward, and that seems to be the line that clearly distinguishes expert from amateur.

Coming soon, part two: Entertainment vs. Learning

PDF

What Lurks Below the ADHD Iceberg?

Posted by Peter on February 1st, 2010 | Comments off

Virtually anyone that knows, teaches, counsels, or works with an ADHD person is aware that ADHD is not a simple matter of attention deficit. That’s just the tip of a very large iceberg.

As a matter of fact, the term ‘attention deficit’ is actually a misnomer of sorts. ADHD people have diffused attention, not a deficit or lack of attention. Ask them. I often asked ADHD students what was happening in my classroom. They could tell me about the bird outside the window, the cobwebs in the corner of the room, a little about my lesson, a little about the whispering around them, and a little about when the air conditioner was turning on and off. That’s actually a great amount of attention. It’s just scattered or diffused over a wide area all day long.

A true hallmark of ADHD is the brain’s inability to direct attention for long periods without becoming distracted. So, it’s not a deficit at all; ADHD is an inability to direct attention. But there’s more.

ADHD is also a matter of difficulty in multiple domains of cognition. These domains are also labeled “Executive Functions.” Aside from diffused attention, ADHD also encompasses difficulty in organization of thought and tasks; sustaining effort while filtering out distractions; memory (both short-term and working memory); managing behavior/emotion; and visually directing attention and actions.

How does one cope with all these areas? It seems a monumental task. Of course, the primary medical intervention is medication. Does medication actually address all of these cognitive domains? No, it does not. Medication has limitations. That’s a fact. That’s why many parents do not see academic, behavioral, or social improvements [see the MTA study] over time. Another fact is that many of these cognitive domains can be strengthened by direct instruction.

Several small and large software companies have introduced themselves recently into the brain fitness category. Each company tends to address a specific domain like memory or focus. So, to satisfy the cognitive and behavioral needs of an ADHD person, one would need to purchase many of these games.

As the original pioneer and developer back in the late 1980s, I saw that there was a vast gap in the needs of the ADHD person and what was being delivered. By 1994, I developed Play Attention to teach sustained attention, visual tracking with attention (like watching a teacher move about the classroom), organizing and finishing tasks, memory, filtering out distractions, and motor skills. I even included behavioral shaping. Later this year we’ll deliver social skills, more working memory & short-term memory modules, and more. We’ve received 3 patents for this pioneering effort.

Play Attention is a careful collaboration between you, the Play Attention software, and the Play Attention professional support staff. It’s provided us with a 92% satisfaction rating.

Of course, to get results, you need to use it. Next week I’ll address how Play Attention transcends being useful to being compelling.

PDF

Play Attention Excels in a Controlled Study

Posted by Peter on January 8th, 2010 | Comments off

In late 2009, the University of Hertfordshire in the United Kingdom performed a study on Play Attention. Children in the school system near the university used Play Attention 3 days per week for twelve weeks. Also see: http://www.sciencedaily.com/releases/2010/01/100107083904.htm

We’ll discuss this study at our free webinar on January 13th. Please register here to attend.

These students were compared to a control group of students who did not use the system. Play Attention students showed significant improvement in behavior and attention. One of the authors of the study said:

“Children with a diagnosis of ADHD find it hard to control their impulses and inhibit inappropriate behaviour,” said Professor Pine, “This can lead to educational and behavioural difficulties. The Play Attention method may prevent long-term problems by helping the children to be less impulsive and more self-controlled.”

The study will be published in a peer reviewed journal shortly. The full press release from the University of Hertfordshire:

New Treatment for Hyperactivity in Children

07 January 2010 Hertfordshire, University of

A new thought-operated computer system which can reduce the symptoms of Attention Deficit Hyperactivity Disorder (ADHD) in children will be rolled out across the UK this month.

Professor Karen Pine at the University of Hertfordshire’s School of Psychology and assistant Farjana Nasrin investigated the effects of EEG (Electroencephalography) biofeedback, a learning strategy that detects brain waves, on ten children with an attention deficit from Hertfordshire schools

They used a system called Play Attention, supplied by not-for-profit community interest company, Games for Life, three times a week for twelve weeks.

The system involves the child playing a fun educational computer game whilst wearing a helmet similar to a bicycle helmet. The helmet picks up their brain activity in the form of EEG waves related to attention. As long as the child concentrates they control the games, but as soon as their attention waivers the game stops.

The researchers found at the end of the study that the children’s impulsive behaviour was reduced, compared to a control group who had not used the system.

Professor Pine and Dr Rob Sharp a senior specialist educational psychologist are continuing to work on futuristic projects with Ian Glasscock, Managing Director of Games for Life. A means of assessing learning in children with
severe communication and physical difficulties by a thought-controlled computer game method is likely to have considerable potential for these children who cannot operate a computer manually.

“Attention-related difficulties including ADHD affects many children, young people and adults and has a significant impact on their lives,” said Mr Glasscock. "Mind-controlled educational computer games technology is the only intervention shown to reduce the core symptoms of ADHD, historically medication may have been prescribed for the child.”

Games for Life plans to roll out this new system across the UK this month.

PDF

Sleep Disorders & ADHD

Posted by Peter on November 17th, 2009 | Comments off

It’s suspected that nearly 25% of all cases identified as attention deficit hyperactivity disorder (ADHD) are not really ADHD at all, but are symptoms related to sleep disorders.

One of the leaders in this research is University of Michigan professor Ronald Chervin. Chervin theorizes that very important brain development is done during sleep. Among other things, this includes the ability to regulate emotion and processing. So, if a child has chronic sleep problems, brain development may be impaired. Chervin also suspects that the brain does not receive enough oxygen if the child snores which further inhibits development. According to Chervin’s research, children who snore are more likely to have ADHD.

He likens the ADHD-sleep connection to a child who doesn’t get a nap; he becomes restless, irritable, and acts out.

Chervin developed his theory based on a sleep/behavior survey of the parents of 866 children. Chervin’s data exposed a sleep disorder -behavior relationship. It was only logical to conclude that if the sleep disorder could be corrected, the ADHD symptoms would be extinguished.

According to Newsweek: “To test this theory, Chervin then studied 79 kids (5 to13 years old) who were about to have an adenotonsillectomy. Prior to the surgery, 22 of the 79 were categorized as having ADHD, based on standard measures for such a diagnosis. One year later, Chervin’s team tracked down the kids for a follow-up. Of the 22 identified as having ADHD, 11 kids no longer qualified as having the disorder.”

Two problems lingered: 1) New cases of ADHD cropped up and 2) 50% of the surgical patients received no benefit at all.

Before you go and get your child’s tonsils and adenoids out, let’s discuss the distinct problems in the logic associated with this research.

First, we have a problem of antecedence; does ADHD exist because of sleep problems? or does the sleep problem exist because of ADHD? That relationship cannot be clearly identified and is a confounding problem.

Secondly, new cases of ADHD appeared and others did not benefit at all from the surgery. This would lead one to think that the outcomes may not be related at all to the procedure.

I’m reminded of an old story about researchers who taught a frog to jump upon saying, “Jump!” Many weeks were spent training the frog. The researchers were quite happy that they had proved the frog could hear and could respond to the human voice. One of the researchers decided they should amputate the frogs hind legs. After carefully surgically removing the frog’s legs and rehabilitating the poor frog, the researchers stood in front of the frog and yelled, “Jump!” When the frog did not respond, they all heartily nodded in agreement that the frog’s hearing was severely impaired by the removal of his hind legs.

There is little doubt that sleep problems affect brain development. Past studies have demonstrated that preschoolers with a sleep disorder are twice as prone to substance abuse by early adolescence and more likely to suffer from anxiety in their 20s. Even the American Academy of Pediatrics concurs that sleep problems are not benign.

However, before we undertake invasive, painful surgery as an option, far more research should be performed to absolutely indicate a direct correlation. One currently does not exist and other options should be explored.

It has become obvious that adequate, restful, uninterrupted sleep is essential to our personal well being. Abnormal sleep patterns may result in behaviors that can be easily confused with ADHD.

If your child has a sleep problem, taking them to a sleep specialist may help. Getting adequate exercise, providing a consistent sleep routine/schedule, reducing stress, and eating a proper diet may also assist in getting better sleep and better behavior.

Chervin RD, Arcbold KH, Dillon JE, et al. Inattention, hyperactivity and symptoms of sleep disordered breathing. Pediatrics. 2002;109:449-456

Chervin RD, Dillon JE, Bassett C, et al. Symptoms of sleep disorders, inattention and hyperactivity in children. Sleep. 1997;20:1185-1192

Chervin, RD, Rusicka DL, Giordani BJ, et al. Sleep disordered breathing, behavior and cognition in children before and after adenotonsillectomy. Pediatrics. 2006;117:e769-e778

Cortese S, Konofal E, Lecendreux M, et al. Restless leg syndrome and attention deficit/hyperactivity disorder: a review of the literature. Sleep. 2005;28:1007-1013

Cortese S, Konofal E, Yateman N,et al. Sleep and alertness in children with attention deficit hyperactivity disorder: a systematic review of the literature. Sleep. 2006;29:504-511

Harnish MJ, Boyer S, Kukas L, Bowles AM, et al. The relationship between sleep disorders and attention deficit hyperactivity disorder (ADHD): objective findings. Sleep. 2001;24:A14.

Owens JA. The ADHD and sleep conundrum: a review. Journal of Developmental and Behavioral Pediatrics. 2005;26:312-322.

PDF