ADHD & The Fountain of Youth

A recent study published in the journal PLoS ONE reveals how we can all look younger and decrease cognitive deficits like ADHD. The secret:  exercise! That’s probably not what you want to hear, but it makes sense.

Scientists at Tel Aviv University found that "endurance exercises," aerobic exercise like running or cardio kickboxing not only help burn fat, but can also make us look younger and decrease symptoms of cognitive decline.

The team at Tel Aviv University’s Sackler School of Medicine led by
Prof. Dafna Benayahu propose that their data reveal why older people who have exercised throughout their lives age more gracefully.

"When we age, we experience sarcopenia, a decline in mass and function of muscles, and osteopenia referrers to bone loss," says Dr. Benayahu. So without daily exercise, the muscular and skeletal systems weaken and are more susceptible to injury. This may also play a role in the increased likelihood of falling as we age.

The key to staying young seems to lie in stem cells that get activated during endurance exercise. To determine this, Benayahu and her team studied rats. Basically, making the rats exercise actually increased the number of muscle stem cells that typically decrease as we age.

The results were quite compelling when contrasting rats that exercised against sedentary rats:
* The number of youth producing stem cells increased after rats ran on a treadmill for 20 minutes a day for a 13-week period.
* The younger rats showed a 20% to 35% increase in the average number of stem cells per muscle fiber retained.
* Older rats attained a 33% to 47% increase in stem cells meaning they benefited even more significantly than the younger rats!
* Endurance exercise prompted the older rats to get up and go more often!

Aging while embracing a sedentary lifestyle significantly contributes to the development of disease. Furthermore, it contributes to a decline in cognitive abilities.

In other previous studies, researchers have also found that exercise in outdoor or ‘green’ settings reduces the symptoms of ADHD.

What’s the future? Well, it’s likely that scientists will try to discover the chemical process behind  stem cell activation to produce more youthful bodies. It  can then be sold as a pill. It seems the world would rather do that than just get up and dance! And no side-effects except sore muscles that are getting stronger, more youthful, and defined!

Texting and ADHD

How much has information and communication technology (ICT) affected our lives? Researchers say that the average teenager sends a total of over 3,400 electronic [text] messages every month or surfs the Internet at bedtime. Could texting and bedtime web time influence the severity of your child’s ADHD symptoms?

In a study by the JFK Medical Center in Edison, New Jersey, and presented at the 76th annual meeting of the American College of Chest Physicians (ACCP), lead author Dr Peter G. Polos and his team found that more than half of these bedtime kiddy texters or web surfers are not only prone to have problems falling asleep, but experience mood, behavior and cognitive problems during the day.

"It is significant that these children are engaging in stimulating activity when they should be in an environment to promote sleep," says Polos.

Polos’ team analyzed questionnaire responses from 40 children and young adults aged between 8 and 22. This is a small group and the results must be considered preliminary. However, the researchers found that those who used electronic technology at bedtime (texting, game playing, email, surfing, etc.) also experienced sleep-related problems such as excessive movements, leg pain and insomnia, and also had a "high rate of daytime problems, which can include attention deficit hyperactivity disorder [ADHD], anxiety, depression, and learning difficulties," said Polos.

According to Medical News Today (www.medicalnewstoday.com), the analysis of the questionnaire data showed that:

    * 77.5 per cent of the participants had persistent problems falling asleep.

    * On average, participants were woken once per night by an ICT device.

    * On average, a participant sent 33.5 emails or texts per night when they were supposed to be asleep; and the average number of people texted each night was 3.7.

    * The average number of messages sent via ICT per person per month at sleep time was 3,404 and occurred over periods ranging from 10 minutes to 4 hours after bedtime.

    * Among the adolescent participants, the older they were, the later they went to bed, and the more time they spent with their ICT devices at bedtime.

    * Boys were more likely to use ICT to surf the net and play online games, while girls were more likely to text and make cell phone calls.

    * High rates of cognitive and mood problems during the day were linked with sleep time related use of ICT, including ADHD, anxiety, depression, and learning difficulties.

    * There were also higher rates of nighttime problems such as excessive movements, leg pain and insomnia.

Polos and colleagues concluded that use of ICT at bedtime may have "an adverse impact on sleep hygiene and daytime function which may be significant", and that questions about this should be included in routine evaluations of patients reporting problems sleeping.

"These data suggest that further studies are needed to evaluate the short and long term consequences of STRICT on sleep," they wrote.

Polos explained that "sleep is largely habitual in nature", and if "children begin this type of behavior, they may set themselves up for the need for external stimulation before sleep later in life".

This could lead to problems like difficulty falling asleep, not having enough sleep, and feeling sleepy during the day, he said adding that:

"More research is needed to determine all of the short- and long-term consequences."

Many parents know that healthy sleep habits are especially important to ensure progress at school and healthy development, and are concerned about how best to handle the growing problem of ICT devices in the bedroom.

Polos said that using cell phones or computers, to talk, text, surf the net, or play games, is "more addictive, seductive, and interactive than passively watching television," because of the graphics, rapid responses and interactivity.

"The sooner parents establish appropriate times for children to use this technology, the better," he urged, adding that perhaps they should also "move key items, such as computers, from a child’s bedroom into a common area".

Dr David Gutterman, President of the American College of Chest Physicians said concern about insomnia and other sleep disorders in children is growing and that "research shows that the problem is increasing, so it is more important than ever for physicians to ask questions about technology use when evaluating children for sleep issues".

So Is My ADHD Child Covered by Section 504?

Your child may qualify to receive accommodations under Section 504 of the Rehabilitation Act. Section 504 states that:

“No otherwise qualified individual with a disability in the United States, as defined in section 706(8) of this title, shall, solely by reason of her or his disability, be excluded from the participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance….” [29 U.S.C. §794(a), 34 C.F.R. §104.4(a)].

Under Section 504, students qualify if they are between ages 3 and 22 and have a disability [34 C.F.R. §104.3(k)(2)].

So, the next question is, does ADHD qualify as a disability? The federal law states that:

“An individual with a disability means any person who:

i. has a mental or physical impairment which substantially limits one or more major life activity;

ii. has a record of such an impairment; or

iii. is regarded as having such an impairment” [34 C.F.R. §104.3(j)(1)].

Does ADHD qualify as an “impairment?” This is the gray area in which ADHD seems to fit well but allows wriggle room for schools. Under Section 504, impairment may include any disorder or disability that “substantially” reduces a student’s ability to access learning in the educational environment because of a learning or behavior related condition.

The wriggle room for schools is that the law is always subject to interpretation. So, every school interprets and implements Section 504 differently. Since ADHD has no physical manifestation like epilepsy or cerebral palsy, it is a hidden problem. Compounding this is the fact that many educators still believe the myth that poor parenting causes the problem or that by giving the child medication, all will be solved without need for accommodation at school. Therefore, under these circumstances, the onus is not on the school, they believe, it is on the parent.

Unfortunately, Section 504 does not define a list of specific disorders (again wriggle room). Obviously, that list would have to be highly comprehensive and definitive.

Also, ADHD would have to affect “major life activities” Major life activities do include, among a variety of other things, concentrating (ADHD), learning, sitting, working, thinking, and interacting/cooperating with others. Many of these major life activities are often affected by ADHD. So, your ADHD child may be included, but the school must agree that some of these “major life activities” substantially limit your child’s education.

So, does your ADHD child qualify for section 504? The answer is, yes – most likely. It should be apparent to you that the law has left a large gray area for interpretation in some cases. 

Remember this: The squeaky wheel gets the grease. Squeak loud, know your rights, and document everything. You should be able to make good headway with this approach.

ADHD and the Western diet

A study published online in the international Journal of Attention Disorders examines the possible link between ADHD and a ‘Western-style’ diet in children.

The study was conducted by Perth’s Telethon Institute for Child Health Research in Australia. The researchers found that a diet typically consumed in the Western world consisting of ‘fast foods,’ sugar/corn syrup, processed meats and flour, fried, and refined foods nearly doubled the risk of an ADHD diagnosis. This Western diet is rich in total fat, saturated fat, refined sugar and sodium.

“We found a diet high in the Western pattern of foods was associated with more than double the risk of having an ADHD diagnosis
compared with a diet low in the Western pattern, after adjusting for numerous other social and family influences. We looked at the dietary patterns amongst the adolescents and compared the diet information against whether or not the adolescent had received a diagnosis of ADHD by the age of 14 years. In our research, 115 adolescents had been diagnosed with ADHD, 91 boys and 24 girls,” says Associate Professor Wendy Oddy.

The Perth researchers analyzed the dietary patterns of 1800 youth and separated them as having  ‘Healthy’ or ‘Western’ patterns. A diet rich in fresh fruits and vegetables, whole grains and fish was designated as a healthy pattern.

Dr. Oddy added, “When we looked at specific foods, having an ADHD diagnosis was associated with a diet high in takeaway foods, processed meats, red meat, high fat dairy products and confectionary. We suggest that a Western dietary pattern may indicate the adolescent has a less optimal fatty acid profile, whereas a diet higher in omega-3 fatty acids is thought to hold benefits for mental health and optimal brain function. It also may be that the Western dietary pattern doesn’t provide enough essential micronutrients that are needed for brain function, particularly attention and concentration, or that a Western diet might contain more colors, flavors and additives that have been linked to an increase in ADHD symptoms. It may also be that impulsivity, which is a characteristic of ADHD, leads to poor dietary choices such as quick snacks when hungry.”

Of note, the scientists were unable to determine if poor diet causes ADHD or ADHD leads to poor dietary choices and cravings – a problem of antecedence.  Furthermore, the researchers had to determine and adjust for social and family influences. This, in itself could greatly skew final data. 

The British have performed similar studies examining the role of refined or processed foods and ADHD.  Certain food colorings were found to influence hyperactivity.  Knowing this, in addition to research that indicates better cognitive function through better diet, it would be wise to greatly reduce or totally extinguish consumption of fast food, refined and processed foods, etc. if one wishes to maximize one’s cognitive potential.

Diet alone will not solve the ADHD riddle. Cognitive training, memory training, behavioral shaping, and attention training are key ingredients to the solution.

ADHD and dropout rates

The July issue of the Journal of Psychiatric Research reports a study by the University of California, Davis. The researchers examined whether ADHD could be predictive of failure to graduate high school on time.

When the UC Davis scientists reviewed different types of ADHD, they found all of the types of ADHD are associated with a high dropout rate.

"The study found almost a third (33%) of students with ADHD, don’t graduate with their peers. That’s high compared with the national high school drop out rate of 15 percent. High school dropout rate really is a national crisis. We know that a third of kids nationally who start in ninth grade don’t graduate in four years," says  lead study author Dr. Joshua Breslau.

The researchers conducted structured diagnostic interviews with a US national sample of adults (18 and over). The interview process also correlated smoking and smokeless tobacco use. According to the National Institute of Health, nearly a 25% of high school students in the U.S. smoke cigarettes and another 8% use smokeless tobacco. The study found that students who use alcohol, smoke cigarettes and use other drugs are more at risk to drop out.

"There are really two main disorders, ADHD and conduct disorder, and there is an interlinking of smoking and drop out that is troubling…it really suggests that socioeconomic differences in health are already becoming established very early in life in adolescents…whether they smoke is probably the biggest indicator of their health in adulthood," said Breslau.

Intuitively, as parents and educators, we know this to be true. We have seen it in other families too. Intuitively we also know that we must do something as education and medicine alone fall far short.

Cognitive training, behavioral shaping, memory skills, and more must be instituted if we are to change the tide.

Is ADHD all in your head?

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.

New research on attention and video games

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.

The ADHD link to social dynamics

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.

Summer ADHD brain drain

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.

Should I play or should I grow?

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