Autism and Parents Education

LONDON, UK: The Daily Telegraph reports of a highly controversial study indicating that parents of autistic children tend to be more highly educated than parents of children with other mental problems. Researchers found that 46% of parents of autistic children achieved a General Certificate of Secondary Education (GCSE) compared to 35% parents of other children in the study. A GCSE is the name of a set of British examinations, usually taken by secondary school students.

The study, conducted by the Office for National Statistics, was an attempt to closely examine children with autism as well as to determine whether mental disorders were rising.

Researchers found that autistic children were also less likely to live in poor families. However, many autistic children live in families where neither parent worked. While only nine percent of parents with autistic children earned less than £200 per week, 20 percent of other children lived in homes with a weekly income of less than £200 per week.

Researchers suggested that the unusual combination of high educational status and low economic activity among parents of autistic children “reflects their heavy caring responsibilities.”

Seven percent of US children are suspected of having ADHD while the British study indicates on two per cent had Attention Deficit Hyperactivity Disorder (ADHD), and only one per cent had a less common disorder, such as autism. As is true in the US, boys were more likely to have a mental disorder than girls.

“The prevalence of mental disorders was also greater among children and young people in certain families, such as lone parent families (16 per cent) compared with two-parent families (eight per cent) and in step-families (14 per cent) compared with those with no stepchildren (nine per cent).

Dinah Morley, deputy director of Young Minds, the children’s mental health charity, said the figures were a wake-up call to the “tremendous cost” of divorce.

“We can’t turn the clock back to a time when all children stayed with their birth families,” she said. “But we can start to be more aware that these things that adults do impact very deeply on children. I think it is a wake-up call to adults to be more aware when they decide to divorce of the tremendous cost to the children. It is important for society to think how in the future it is going to support children better.”

However, statisticians emphasised that while there was a link between divorce and mental health problems in children, it was not clear whether the divorce followed the diagnosis of the mental problem or whether it may have triggered it in some way.

They added that mental health problems in children were also more common where the parent had no educational qualifications (17 per cent) compared with those who had a degree (four per cent) and where a parent was an unskilled manual worker (15 per cent) compared to a doctor or lawyer (four per cent).

One per cent of children aged 5-16 had autistic spectrum disorder.

The majority – 82 per cent – were boys. Almost all the children had a physical complaint as well (89 per cent compared with 54 per cent of other children).

Tim Loughton, the shadow Health Minister, said: “The Government urgently needs to make it easier to identify problems early on in schools and to provide appropriate treatment. That does not mean admission to adult wards or excessive reliance on the chemical cosh of drugs.”

(Source: Daily Telegraph, September 1, 2005)

Adult ADD: Many Children Maintain their Disorder into Adulthood

ADHD haunts children into adulthood, study shows

Psychological Association published research from Dr. Mariellen Fischer, a psychologist with the Medical College of Wisconsin. Her study was co-authored by Dr. Russell Barkley. The results of her 13 year study show that if AD/HD is left untreated in childhood, children will carry their disorder into adulthood.

For thirteen years they monitored 147 children with ADHD by age 7, comparing them with 76 neighbor children who didn’t have the disorder. About one third dropped out of high school. This seemed significantly high as none of the neighbor children dropped out. Leaving school is quite likely due to the public school system’s inability to accommodate the needs of ADHD students as well as ADHD student inability to learn coping skills which are seldom taught in school or at home.

Interesting data about adults with AD/HD in this study:

  • They are more likely than their peers to get fired
  • They are more likely to shun birth control and become parents by age 21
  • They are more likely to have higher credit card debt and fewer saving
  • They took medication for AD/HD as children, but few were being treated by their early 20s
  • They are more likely to start having sex a year earlier than classmates
  • 1 out of 3 had become parents by their early 20s vs. 1 in 25 of the classmates
  • They had less than half the savings of young adults they had grown up with and more debt

Dr. Fischer indicated that many children maintain their disorder into adulthood. The article is not clear whether this data was relevant to treated or untreated ADHD. However, clinical data suggests that perhaps 60% of ADHD children will carry their disorder into adulthood. This may be a conservative estimate.

While the data are compelling, the study is too small to conclude that ADHD alone causes these ill effects.

Girls With ADHD and ADD Are Often Overlooked

Girls With ADHD Are Often Overlooked

HealthNewsDigest.com – August 29, 2005 (HealthNewsDigest.com) reports that ADHD likely affects 3% to 7% of the entire child population in the US. However, girls are frequently overlooked because they often do not display hyperactive symptoms.

When teaching at the elementary level, I found this particularly true. Girls with ADHD often were simply daydreamers with poor time management skills. While some did display the outward social and behavioral problems that their male peers did, it was not very frequent.

HealthNewsDigest.com is published by the American Psychological Association. I’ve cited bits of this report and am alarmed by its look and feel. It reads like an endorsement and advertisement for Adderall XR.

Their report, edited down:

The federal Food and Drug Administrations (FDA) recent nod to ADDERALL XR for the treatment of attention deficit hyperactivity disorder (ADHD) in adolescents aged 13 to 17 spotlights an underidentified and under treated population with this disorder, experts tell Health NewsDigest.com.

If left untreated, the symptoms of ADHD can have a profound effect on a child’s life, both inside and outside of a classroom setting.

For Janice Lowder, a quiet, well-behaved child, learning was always stressful.

“My husband and I hired a one-on-one tutor to help Janice with her studies. We also tried to help her, and all dreaded the nightly battle of completing a homework assignment. Janice would get so frustrated with her homework and the fact that she didn’t ‘get it,’ that she would cry,” said her mother Beth Lowder.

“By the time Janice reached the seventh grade, a nurse at her school suggested we talk to a doctor. Janice was diagnosed with ADHD and was started on treatment,” Beth explained.

“I knew my daughter just needed the right help,” said Beth.

By the tenth grade, Janice had improved from a C to a B student but homework was still challenging. In addition, she had low self-esteem and was embarrassed to take her medication at school. Her psychiatrist prescribed Adderall XR®, an extended-release formulation that enabled Janice to take her medication once a day at home.

With continued tutoring and medication, her grades improved.

“She came home from school one day and said, ‘Mom, I’m smart,’” said her mother.

A recent study presented at the American Psychiatric Association annual meeting showed that girls with ADHD demonstrated significant improvement in both behavior and attention with Adderall XR.

“The study suggests that girls with ADHD can benefit from Adderall XR and that this treatment will help them control symptoms all day while they are in the classroom, during after-school activities or doing homework with relatively few side effects,” said Joseph Biederman, M.D., professor of psychiatry, Harvard Medical School and Chief of Pediatric Psychopharmacology at Massachusetts General Hospital. “While ADHD in girls is becoming more recognizable it is still often overlooked, and there is a need for safe and effective treatments that will allow girls to interact more effectively with other children and adults, to concentrate in school and to focus on finishing tasks.”

I’d expect to find a more diluted version in Parents Magazine or Family Journal as an outright advertisement. Makes one wonder who wrote this? Shire Pharmaceuticals?

9/8/2005 Adults with Attention Deficit Hyperactivity Disorder Do Well on Deadline and Love a Challenge?

From the Kansas City Star by DIANE STAFFORD:

ADHD SUFFERERS FIND THEIR NICHE: Adults with Attention Deficit Hyperactivity Disorder Do Well on Deadline and Love a Challenge?

Can you say clueless? Stafford interviews Dr. William Dodson, MD who spoke to about 50 Hallmark Cards employees. His recommendation? If you want an employee who performs best on deadline, hire someone who has trouble staying on task. Dodson apparently specializes in treating with AD/HD. He said that adults with the neuropsychiatric condition generally respond well to urgency and fast pace. This seems true, meeting deadlines? That’s one of the greatest problems for adult AD/HD people.

“Workers with ADD need to be challenged or feel competitive,’’ Dodson generalized. “They like the new, the novel, the fleeting. They need ADD-friendly jobs – not accounting.’’

Sure they do. They are great in marketing. But don’t rely on them to get a job done on time. I’ve worked with many AD/HD adults. They’ll accept 20 jobs and finish none of them. Dodson truly seems clueless here.

Stafford also cites Blythe Gross, who has a doctoral degree in organizational psychology, also specializes in ADD treatment. After working with or interviewing hundreds of adult ADD patients, Gross wrote Making ADD Work: On-the-Job Strategies for Coping with Attention Deficit Disorder. Gross has been in the trenches with hundreds of AD/HD adults. She’s much more realistic in her perspective. She indicates that adult AD/HD “symptoms can range from an inability to get started on a task, to an inability to follow through on a task, to perfectionism that makes a project drag on forever because it’s never good enough.” This statement is the antithesis of Dodson’s.

I’d go with Gross and recommend her book, Making ADD Work: On-the-Job Strategies for Coping with Attention Deficit Disorder. With so many ‘experts’ on this subject, someone has to cry ‘baloney’ when nonsense like Dodson’s is put to press.

Ritalin and Cancer

The FDA has taken an interest in the University of Texas’ preliminary research regarding Ritalin and cancer. While the research is alarming, it is far too premature to be conclusive.

From HealthCentral.com:

Researchers Urge Caution on Ritalin-Cancer Link Finding Despite FDA concerns, Texas scientists say their study was only preliminary.

By Amanda Gardner HealthDay Reporter

FRIDAY, July 1 (HealthDay News) – As the U.S. Food and Drug Administration moved to examine a potential link between Ritalin and cancer, the scientists who first unearthed the connection stressed Friday that the finding was preliminary and should not be cause for panic.

The concerns about the drug, a stimulant that has been used to treat attention-deficit hyperactivity disorder (ADHD) for decades, surfaced during a FDA pediatrics advisory committee meeting Thursday. The findings, by researchers from the M.D. Anderson Cancer Center at the University of Texas, showed damage to the chromosomes of 12 children who had taken Ritalin for three months.

The advisory committee had been called to discuss yet another health issue surrounding the class of ADHD medications known as methylphenidates, to which Ritalin belongs: Some psychiatric side effects have been reported among children using Concerta, Ritalin and other versions of these drugs.

But the Texas scientists said their Ritalin study was far too small to prompt the parents of ADHD patients to abandon the drug.

“We’re not telling people to all go off their medication because you don’t know what this means,” said Melissa L. Bondy, co-author of the study, which first appeared in the Feb. 16 online issue Cancer Letters. “You can’t base changing practice on 12 patients. Look how many millions of kids are on this. Do you want to tell all the mothers and fathers to take their kids off of the drugs?”

Bondy said she and her colleagues have submitted a grant proposal to the National Institutes of Health for a larger study looking at more patients and more ADHD drugs.

“We definitely need a larger study,” said lead researcher Dr. Randa A. El-Zein. If approved, the study would not even be funded until March 2006.

The government interest is there, however.

Scientists from the FDA, the NIH and the Environmental Protection Agency traveled to Texas on May 23 to examine the study methods used by the researchers. “They thought, ‘Yes, we do have a public concern,’ and that a larger study should be performed,” El-Zein said.

“We’re hoping that they’ll see this as a major public health issue, and as something that needs to be done,” Bondy added.

Meanwhile, the question of labeling changes because of possible psychiatric effects of Ritalin and other methylphenidates have been put on hold after the advisory committee told FDA officials that it was hesitant to recommend such changes.

According to an FDA release, committee members suggested waiting until more safety data have been collected on two other types of drugs used to treat ADHD – methamphetamines such as Adderall and the non-stimulant Strattera, something that won’t happen before early 2006.

The FDA should “delay the labeling change until they have a good sense of class effect,” Acting Committee Chairman Robert Nelson, of The Children’s Hospital of Philadelphia, told FDA officials according to the release.

“We heard there is no terrible signal,” Office of Pediatric Therapeutics Director Dianne Murphy added.

The FDA had been considering labeling changes to all methylphenidates with regard to psychiatric events and potential cardiovascular side effects. A review had found 36 psychiatric events for Concerta, compared to 16 for Ritalin and other methylphenidates. These side effects included hallucinations and suicide ideation. Concerta had 20 cardiovascular event reports, while the other methylphenidates had four such reports.

Despite the committee’s advice, Murphy said the agency still may change labeling about psychiatric side effects to “try to make it clearer what the situation is with regard to certain adverse events.”

The FDA’s decision to take a closer look at the psychiatric side effects of medications for ADHD did not surprise some experts.

“These types of issues theoretically were possible with the medication because of the way it works. It’s not surprising that they’ve had some reports that relate to psychiatric side effects… ” said Dr. Lenard Adler, director of the Adult ADHD Program at New York University Medical Center.

The drugs have been around for 40 years, Adler added, and have a “wide margin of safety.”

“Any medicine that has therapeutic effect can have some side effects,” Adler continued. “This is appropriate scrutiny by the FDA, but the benefits are also very clear and clearly outweigh the risks.”

Another expert believes labeling changes may not be the answer.

“Labeling is an oversimplification of the problem,” said Dr. Eugenio M. Rothe, director of the child and adolescent psychiatry clinic at Jackson Memorial Hospital and an associate professor of psychiatry at the University of Miami School of Medicine. “It scares people, and it doesn’t address the other problems that are affecting the outcome. The problem is much more complex than that, and has to do primarily with the stigma associated with mental health conditions.”

This is just the latest chapter in the ongoing debate over the safety of ADHD medications.

In February, Health Canada ordered Adderall XR off the market, after reports of sudden cardiac death in 20 patients. The FDA, however, elected at the time only to require the company to update Adderall’s label to warn that it should not be used in anyone with structural cardiac abnormalities.

Almost 2 million children in the United States have been diagnosed with ADHD, according to the National Institute of Mental Health.

ADHD Diagnosis Caution: No Test Exists to Support Chemical Imbalance Claim

Is there a trend here or much ado about nothing?

Hollywood actor Tom Cruise created quite a stir recently in his heated debate with NBC Today Show anchor, Matt Lauer.  Cruise proposed that psychotropic drug use, especially the drugging of children was unnecessary and immoral. Following suit, Sebastian Sainsbury of the Sainsbury family (one of Britain’s wealthiest and most respected families known for it patronage of the arts, and its commercial and political influence) spoke to United National Newspapers:

“As a parent of two young children, I hold an inherently responsible position for the welfare of my children. Following some of the recent media and speaking with other parents, I feel the need to extend that responsibility to encompass a wider sphere by informing parents of a situation that could potentially affect all children.”

“I’ve come across recent FDA warnings that I have found quite chilling. Ritalin, an amphetamine classified in the same category as cocaine, has been used for over four decades by psychiatrists and doctors, over much controversy and now the FDA comes up with black-box labels warning parents of side effects that include suicidal tendencies, hallucinations, aggression, violent actions, heart failure. The FDA has also recently issued black-box warnings on all anti-depressants both for children as well as adults.”

“We have all witnessed children being somewhat argumentative, perhaps a little boisterous and even disruptive at times. This would be described as poor behaviour, just as it has been described for centuries. However, these behavioural characteristics have been redefined by today’s psychiatrist as a mental disorder called Attention Deficit Hyperactivity Disorder or ADHD.”

“ADHD was literally voted into existence eighteen years ago when the American Psychiatric Association (APA) by a show of hands. A show of hands was enough to see ADHD enshrined in the psychiatric textbook, the Diagnostic and Statistical Manual of Mental Disorders (DSM). They also created “Reading Disorder”, Oppositional Defiance Disorder”, “Expressive Language Disorder”, “Mathematics Disorder” and a litany of similarly ridiculous disorders by the same show of hands. The treatment for these disorders are drugs.”

“Psychiatrists are telling parents, whose children may be displaying poor behaviour, that their child has so-called ADHD due to a “chemical imbalance” in the brain. A parent would be prudent to ask the psychiatrist for evidence to support the claim of a “chemical imbalance”. If they did ask however, they’d find that the evidence would not be forthcoming – as it doesn’t exist.”

Psychiatrist David Kaiser said, “Patients [have] been diagnosed with “chemical imbalances” despite the fact that no test exists to support such a claim, and … there is no real conception of what a correct chemical balance would look like.” The words of the President of the APA should also be noted. Mr. Steven Sharfstein said, “We do not have a clean-cut lab test [to detect chemical imbalances in the brain].” How then would the psychiatrist know when the child has recovered?”

“Poor behaviour is empirical, but the purported cause for such behaviour is usurping the inherent rights of both the child and the parent. Environmental factors of the child need to be addressed rather than prescribing powerful psychiatric drugs on the basis of a subjective decision that is entirely unsubstantiated. Current figures from the Prescription Pricing Authority for England and Wales reveal that in 1991, the number of prescription items for psychiatric drugs commonly prescribed for children labeled with ADHD were 2000. In 2004, that figure had risen astronomically to 359,100. Remember, this is for a so-called “disorder” that has never been scientifically validated.”

“As with all problems in life, we pursue the avenues of knowledge open to us to find the solution. As far as poor childhood behaviour goes, parents want only the best for their child, a corollary of being a responsible parent, and will look high and low for those solutions. Consider this: a study carried out last year by Professor John Warner, Professor of Child Health at the University of Southampton, revealed the adverse reactions that food additives were having on behaviour. The incredibly talented Jamie Oliver has demonstrated through his series Jamie’s School Dinners that changing a child’s diet can bring about a desired change in behaviour. And educational psychologist Dr Madeleine Portwoodhas demonstrated that essential fatty acids, a natural organic product, produced improvements not only in childhood behaviour but in academic performance as well.”

“We are in the 21st Century, full of technological advancements that defy science. If however we consider the psychiatrist to be the custodian of poor behaviour, we are bowing to a profession that masquerades as technically advanced, but which in reality could be called nothing more than a pseudoscience at the behest of the pharmaceutical industry.”

“The ramifications of being a poorly behaved child in this contemporary society are too gruesome to comprehend.”

Turning Adult ADHD Around

ABC News online probes the work of Robert Jergen, and ADHD adult who carefully manages and optimizes his attention difficulties.

What is important to realize in reading this report is that he is a minority; he is one of the very few ADHD adults who successfully manage their attention difficulties. Although his success story is quite moving, it is not the norm as Dr. Joseph Biederman found in his recent study that indicated ADHD adults lose $77 billion yearly to ADHD related job issues.

Also, note the fact that Jergen almost committed suicide because of ADHD. Obviously, what doesn’t kill you will make you stronger. However, one must wonder how many adults haven’t adapted and successfully put an end to their ADHD troubles by suicide.

What can be gleaned readily from Jergen is that ADHD is manageable using a variety of tools. The true question may be what enabled him to succeed where others fail?

ABC’s story:

Robert Jergen writes two books a year, works on several research projects simultaneously and, after finishing a PhD in half the normal time, began a successful teaching career. It takes a special person with special skills to complete such a heavy load, but one would never guess the secret to Jergen’s success.

“I have ADHD,” says Jergen.

ADHD, or attention deficit hyperactivity disorder, is often considered a childhood disorder. Yet an estimated four percent of adults may also suffer from the hyperactivity, inattentiveness and impulsivity that ADHD causes.

With information about this disorder spreading quickly, many adults are suddenly realizing that their previously unexplainable childhood and adult problems may have stemmed from ADHD. Jergen, now in his late 30s, didn’t have a name for his problems until he was 22, and ironically, taking a class on special education.

But, as Jergen explains in his book, The Little Monster, the signs started much earlier.

“As soon as my eyes would pop open after a nap, the crib would start to tremble and [my mother] would always know when the little monster was awake,” says Jergen.

Growing Up Different

The nickname “little monster” was bestowed upon Robert as he destroyed everything in his path; his parents just didn’t understand that he couldn’t control his actions. Jergen describes numerous situations where he would impulsively throw a knife, dismantle a lamp or toss lit matches at a model ship, each time thinking a moment too late, “Now that wasn’t such a good idea.”

It’s not that Jergen didn’t know right from wrong; he just acted without realizing. And being hypersensitive, like many other ADHD children, Jergen’s head is still filled with his mother saying over and over, “Jesus Christ, give me strength! You are such a rotten kid!” even though he is not entirely sure if she ever said it more than once.

It was the constant disappointment and scolding, both at school and at home, and constant comparisons to his athletic, intelligent, sweet brothers that caused a slow slide into depression.

“I always heard, ‘Rob, I love you, but you don’t do what you’re told, you don’t finish what you start, you do things without thinking,’” he says. “And what I grew up hearing was, ‘I really don’t love you, but I would, if you would stop doing this.’”

By eighth grade, Jergen had twice attempted suicide.

The Lowest Point

Jergen’s outlook improved after meeting an accepting group of friends in high school, but the hopelessness returned in college when he fell in with a group who called themselves the “All-American Drinking Team.”

Jergen, typical of those with ADHD, found alcohol to be the one tool that could be used to quiet his head, which helped him concentrate in class, improve his grades and calm his constant anxiety over how he appeared to others. But alcohol also brought out years worth of pent-up rage. So, after an ugly night at a bar, Jergen realized he had to stop drinking.

With the drinking stopped, Jergen’s head became noisy again. And while he loved his job teaching adolescents with special needs, it was the quiet paperwork, long meetings and coworkers angry with his antics that made work miserable. The stress was quickly driving Jergen back to alcohol and depression.

To try to stem the tide, Jergen returned to school, where he last felt most comfortable. It would be here that he would receive an answer to all of his problems.

A Wall of TVs

At the beginning of a master’s program, Jergen’s condition became steadily worse. Rude comments would just pop out of his mouth without him even realizing. He once poked his boss in a thin patch of hair and proclaimed “bald spot!” Unable to concentrate on any of his reading assignments, unable to control his actions or even his mind, Jergen was again considering suicide.

Oddly enough, Jergen would find help in a student, Troy, who had schizophrenia. Jergen was furious one day when he found out that Troy was not taking his medication and lectured him about how smart and successful he could be if only took a little pill every day.

A bell went off in Jergen’s head.

“I thought, ‘you are such a hypocrite. You are just sitting there waiting for death or a white padded room. Maybe there is some drug that you could take to make you normal.’”

This was the beginning of Jergen’s turnaround. After countless therapy sessions, incorrect diagnoses of hypoglycemia and hyperglycemia, an abnormal MRI and EEG (two tests that are commonly used to diagnose ADHD), Jergen happened to attend a support group meeting of ADHD adults for a special education class, when someone said:

“My mind is like a wall of television sets, each on a different channel and I don’t have the remote.”

For the first time, Jergen found a way to describe what was going on in his head. “One second I thought that I was a loser. A freak,” he says. “The next moment I knew that I had ADHD. I wasn’t alone.”

Turning ADHD Around

Most patients with ADHD go through years of trying different types and doses of medications before a successful combination is achieved. For Jergen, after two years of trying various medications with no success, or unbearable side effects, he became resolved to make ADHD work for him, instead of relying on medications to control it.

Jergen is not against medication, and he openly agrees that it can help one focus. “But medications do not teach people to learn, do math or act appropriately,” he says. So, he reminds parents and teachers that one will not just “get better” with medication and advocates behavior therapy to help a person with ADHD learn the organizational and social skills they may not have learned as a child.

For Jergen, however, the goal became to use the hyperactivity of ADHD instead of masking it. “All my problems were when I was trying to slow down, when I was trying to go at everybody else’s pace,” he says.

He became hyper-productive. Jergen kept a log outlining when and where he got the most work done. Then, he designed a work environment that would push out distractions and allow him to remain focused.

For example, Jergen’s office is dimly lit with one bright light shining on his computer, constantly reminding him where his attention should be. Soft music playing in the background blocks any outside noise. A computer game runs on a nearby laptop to give him something to do for a few seconds when his mind begins to wander. If the heavy clouds of ADHD begin to roll into his head anyway, Jergen hops on his treadmill. He has found that a short burst of exercise clears his head and allows his focus to return.

Most importantly, Jergen understands the importance of a strong support system. An honest, encouraging mentor got him through his PhD program and, now, his wife helps to keep him on track, reminding him to take a walk when he seems most on-edge. It is this support system that has helped Jergen build his self esteem after so many years of failures.

There are still problems. Jergen has a hard time staying quiet when his students are taking a test, and not everyone at work is so understanding of his disorder. Even his parents still doubt that he has ADHD, saying instead that he just needs to try harder. Nevertheless, Jergen is currently testing some of his techniques to see if they will help others with ADHD turn their greatest challenge into their greatest advantage.

“Don’t repress ADHD, utilize it,” says Jergen. “ADHD is A-OK.”

Are We a Nation of ‘Psuedo-ADD’ Sufferers?

Are We a Nation of ‘Psuedo-ADD’ Sufferers?

Society’s Breakneck Pace Encourages Lack of Focus, Concentration, Some Say

Americans often have hundreds of television channels to choose from, and high-speed Internet access, e-mail and personal digital assistants keeping them connected – but if you are so “connected” that you’re beginning to feel rather disconnected, you may not be alone, some mental health experts say.

We are becoming a nation of attention deficit disorder sufferers, says Dr. John Ratey, a professor at Harvard Medical School and the author of “Delivered from Distraction.”

“We value not spending much time thinking about one thing,” Ratey says. “These are hallmark symptoms of people with what we call pseudo-ADD.”

A Nation of Multi-Taskers

Hundreds of thousands of children and adolescents have received a clinical ADD diagnosis for an inability to focus and concentrate in school. But what about the non-medical problem of “cultural” ADD?

Being able to multi-task effectively is a prized quality in our society. Take Eileen O’Connor, a former ABC News producer and now a wife, mother of five, law student and non-profit executive. She feels like being able to multi-task is the only way to cram all she needs to do into her hectic days.

“I would go to class, listen to the lecture and on one [computer] screen be taking notes,” O’Connor says. “And on another screen, I was on my e-mail, actually e-mailing [my kids] or people in the office.”

But Ratey argues that multi-tasking is not as efficient as we might think.

“The brain is not riveted, it’s not focused,” he says. “You’re seeing a lot more noise in the brain. You’re using more of your brain to try and pay attention.”

One recent study showed that workers don’t spend more than three minutes on any given task, and they’re usually interrupted every two minutes.

Other research said it takes a person 50 percent longer to complete two tasks done simultaneously than if they were done separately.

In other words, asking your brain to keep hitting pause and play doesn’t save time.

Kids in Overdrive

Even busy, supercharged moms like O’Connor worry about kids growing up in overdrive, trying to do a million things at once – even homework.

Jim Steyer is the chief executive officer and founder of Common Sense Media, a non-profit group that encourages family-friendly entertainment. He says Americans are raising a generation of media-saturated kids.

In fact, the latest figures show kids spend 8½ hours a day using different kinds of media – from television to computers to video games.

“They’re spending too many hours in front of the screen – either a TV screen or a computer screen – and it does contribute in some ways to attention deficit disorder,” Steyer said.

Video Game Helps Concentration

Some parents are trying to get their kids to refocus by using a video game.

Former teacher Peter Freer invented a concentration game called “Play Attention,” which borrows from technology and exercises developed by NASA to sharpen pilots’ focus.

To play the game, a person will put on a helmet with sensors attached to it. The goal is to use your powers of concentration to make a virtual alien rise to the top of the screen. If you get distracted, the alien will fall down the screen.

Freer says that after logging 40 to 60 hours playing the game over several weeks, children and adults showed permanent improvement in their attention spans.

“The more [you] do this, the better you’ll be able to do it at will,” Freer says.

But do you really need a video game to improve concentration? O’Connor and her family are determined to slow down a bit and enjoy the simpler things.

“A typical day is nuts,” O’Connor said. “But then there are times when we say, ‘Whoa, we just gotta stop here.’ We do stop with a family dinner, and I think that sort of brings us back to reality.”

Copyright © 2005 ABC News Internet Ventures

Children Today: Multi-tasking or Multi-distracted?

As I’ve qualitatively interviewed hundreds of people that I meet at conferences and seminars, I’ve found one underlying current especially relevant to the pace of life right now: most of us feel overwhelmed. We are exposed to information from cell phones, faxes, email, TV, radio, pagers, PDAs, print media, computers, the Internet, etc. This constant bombardment results in a feeling of information overload. It’s probably the brain’s natural response to being inundated by information non-related to its survival as most of the information transmitted to us is fairly useless; it’s throw-away, disposable information. Most people I’ve interviewed say that they cannot even recall what they received in their email or heard on the news the previous week. Throw away, disposable information.

According to USA Today in an article entitled, “So much media, so little attention span“, children that are exposed to 8½ hours of TV, video games, computers and other media a day — often at once — may be losing the ability to concentrate. The article questions, “Are their developing brains becoming hard-wired to “multi-task lite” rather than learn the focused critical thinking needed for a democracy?

These troubling questions are raised by a Kaiser Family Foundation media study this month, says educational psychologist David Walsh of the National Institute on Media and the Family, a Minneapolis non-profit. Even more troubling is the answer: We don’t know, Walsh and other experts in the field say.”

As I noted previously, adults feel inundated by information. Children respond differently. School psychologists and teachers typically report that children have a more difficult time attending now than every before. Children have a more difficult time staying still and listening if the presentation is not highly entertaining.

“The problem intensifies after third grade, when harder course work requires children to concentrate, adds Susan Ratteree, who supervises other public-school psychologists in suburban New Orleans. Diagnoses of attention-deficit hyperactivity disorder (ADHD) “have gone through the roof,” she says. Though the disorder is more recognized these days, children seem to be different too, “and many teachers think the fast-paced media is having an effect.”

Children are more attuned to distractions around them. “They attend to everything — the air vents creaking, someone talking. They bounce from task to task. Teachers here say kids have more trouble getting organized, and their attention spans are not as good as they used to be,” says school psychologist Tamara Waters-Wheeler of the Bismarck-Mandan, N.D., public schools.

Studies with college students and adults show that the brain doesn’t work as well when it focuses on more than one task, Walsh says. If the challenge demands a lot of attention, mental performance is particularly poor. But he says there are no such studies on today’s kids as they multi-task with new media — instant- messaging, plugged into an iPod and doing homework at the same time.”

Science Daily from a study that appeared in the May 13, 1999, issue of the journal Nature(1), relates multitasking behaviors to the prefrontal cortex. “Investigators have mapped a region of the brain responsible for a certain kind of multitasking behavior, the uniquely human ability to perform several separate tasks consecutively while keeping the goals of each task in mind. Using imaging technology, scientists from the National Institute of Neurological Disorders and Stroke (NINDS) found that a specific type of multitasking behavior, called branching, can be mapped to a certain region of the brain that is especially well developed in humans compared to other primates.”

“The results of this study suggest that the anterior prefrontal cortex, the area of the brain that is most developed in humans, mediates the ability to depart temporarily from a main task in order to explore alternative tasks before returning to the main task at the departed point,” says Jordan Grafman, Ph.D., Chief of the Cognitive Neuroscience Section at the NINDS and a co-author of the study.

“We believe that this finding is important because branching processes appear to play a key role in human cognition,” says Etienne Koechlin, Ph.D., also of the NINDS Cognitive Neuroscience Section and a co-author of the study. “In everyday life, we often need to interrupt an ongoing task to respond to external events and we all experience how demanding it is to react to these events while keeping our minds on the original task.”

According to previous studies, humans may be the only species capable of performing branching, which involves keeping a goal in mind over time (working memory) while at the same time being able to change focus among tasks (attentional resource allocation). For example, people who are interrupted by a phone call while reading must be able to keep in mind the memory of what they were reading just before talking on the phone. Once the phone call is over, they should be able to return to the last sentence read and continue reading.”

Almost everyone shifts attention from one task to the next during a normal day. ADHD people shift attention more so than others, but have lesser ability to focus for very long on mundane or ordinary levels of stimulation.

It is important to put the following question: how much can we shift our attention before the tasks at hand do not get completed or begin to suffer in performance. Given our differences as a species, this will likely vary among the population and the complexity of the tasks.

Recent research issue of Psychological Science, a journal of the American Psychological Society,>indicates that our brains weren’t made to multitask. A splendid example is driving while speaking on a cell phone. Some states have outlawed this behavior due to increased accident rates. It seems that we are far too distracted to focus on driving if we’re talking or dialing.

The researchers explain the multi-tasking/distracting phenomenon using two terms: “passive queuing” and “active monitoring.” Passive queuing implies that new incoming information has to line up for a chance at being processed – a queue – just as you wait in a queue in the doctor’s office. A focal point in the brain receives and processes the information one piece at a time.

Active monitoring (people who swear they can multi-task) suggests that the brain can process two things at once – it just needs to use a complicated mechanism to keep the two processes separate.

Researchers from MIT think that the brain works by passive queuing, the non-multi- tasking approach. “…in a study to be published in the June issue of Psychological Science, a journal of the American Psychological Society, [researchers] examined the brain activity involved in multitasking. They gave people two simple tasks. Task one was identifying shapes, and for some subjects, task two was identifying letters, for others it was identifying colors. The subjects were forced to switch from one task to the other in either one and a half seconds or one tenth of a second. When they had to switch faster, subjects would take as much as twice as long to respond than when switching more slowly.

Using MRI technology, Jiang, Saxe and Kanwisher examined subjects’ brain activity while performing these tasks. They observed no increase in the sort of activity that would be involved in keeping two thought processes separate when subjects had to switch faster. This suggests that there are no complicated mechanisms that allow people to perform two tasks at once. Instead, we have to perform the next task only after the last one is finished.”

It is logical to ask then, if we expose ourselves to enough high-input stimulation (media, computers, cell phones, etc.) will this rewire the brain to accommodate the input? The USA Today article suggests that some research on media-exposure “suggests that children’s brains might be changing so they can juggle and concentrate better than their elders.

Scores on intelligence tests have been steadily rising since the 1940s, says University of Utah neuropsychologist Sam Goldstein. The tests measure a child’s ability to shift and divide attention, but they also cover problem-solving and comprehension skills. “They’re smarter,” Goldstein says.

Another germane fact: In the Kaiser study, computer use and TV didn’t seem to affect grades, but more time playing video games and less time reading were linked to poorer grades. About half of kids have a video game player in their rooms; more than two-thirds have TV sets.

Violent video games and TV have been shown to encourage aggressive behavior, says Michael Rich, a Harvard pediatrician and director of the Center on Media and Child Health in Boston. Also, the more TV watched, the more overweight a kid is likely to be, he says.”

Although no long-term research has been performed to verify brain changes, it is widely accepted that the brain changes due to the external environment (neuroplasticity). Therefore, it makes perfect sense that all initial indications point to the fact that we are changing as a species due to our technology.

Is our change for the better or worse? If the answer is related to driving and speaking on a cell phone, the answer is obviously worse. If it’s related increased IQ scores it’s for the better.

Still, the fact that children want to be entertained more now than ever before, the fact that they have a more difficult time sitting still and listening, the fact that they cannot pay attention to something as simple and beautiful as a flower because “it’s boring” is most disturbing. Proponents of the technology evolution/revolution propose that children can now learn faster and must have more stimulating input. It’s difficult to argue against that. However, there exists a fine line between entertainment and education. Our finest discoveries have come from carefully examining the nuances of relationships, cells, atoms, and the cosmos. I would maintain that our survival as a species depends on our ability to fathom the great subtleties of life. This is not discovered through high stimulation, but by a careful, quiet examination of the world around us.

Multitasking, ADD and the Workplace

real life: Dana Knight
Attention, please. Distracted workers often fail to produce

April 8, 2005

I was just about to get down to the nitty-gritty of writing when an evil little temporary tattoo I received in the mail peeked from beneath my towering stack of files.

Wonder what that would look like on my ankle?

I rushed to the restroom. One damp cloth and 30-second rub later, the funky, mustard-colored sun tattoo looked pretty darned good.

The work I was trying to do at my desk? Not so good.

But I’m back. Settled down in my chair with the Diet Pepsi I picked up on the way back from the tattoo task and ready to admit: ADD is a problem for me.

ADD as in Always Doubly Distracted at work. With e-mails, phone calls, life. With the boss, the touch-ups to makeup, the alluring infohole called the Internet, sometimes I feel like staying focused on one task is impossible.

My American co-workers are with me on this one and more distracted than ever, according to a recent Harvard University study.

The average employee’s attention span is, at most, 12 minutes. The average worker switches to a different task every three minutes and gets interrupted every two minutes, says Gloria Mark, a professor at the University of California-Irvine who studies the effects of multitasking on workers. She reported her findings to Ergonomics Today.

With technology overload (experts estimate workers respond to at least 200 e-mails daily) and the multitasking culture, employees’ brains are about to fizzle out.

“We’re inundated with information, and we don’t really know what to do with it all or how to process it,” says Peter Freer, founder and chief executive officer of Play Attention, a funky new piece of technology that can retrain a brain to focus (I’ll explain later). “It comes in cell phones, PDAs, faxes, e-mails, regular phones, radio and TV. Many of us have attention problems.”

I just noticed a book on my desk called “Speak Like a CEO: Secrets for Commanding Attention and Getting Results.” It says to always walk on stage as if you belong there and to be unpredictable. Interesting. Now what was I doing? Oh yeah.

Overworked employees are triply distracted and unproductive, says Paul Riley, a psychiatrist with St. Vincent Stress Center.

“You are not focused,” says Riley. “You make a lot of mistakes.”

It’s a problem, a big one for employers, who lose valuable hours in productivity and attention to detail, as well as other distraction downfalls.

Experts say distracted workers have more unscheduled absences and higher medical expenses.

Often, the mere mention of a sick co-worker can cause a distracted worker to . . .

OK, I’ll admit it. I need new return address labels, and I’m sick of the same old ones. So I just Googled it. There were 2.57 million hits.

And the bosses wonder why work isn’t getting done.

An estimated 8 million adult Americans struggle with the inattention disorders like attention deficit disorder and attention deficit hyperactivity disorder, according to researchers from Harvard Medical School. But, they say, only 20 percent realize it.

It shouldn’t take your boss long to figure it out.

“It is very difficult for a person with an attention problem to survive in the workplace without being discovered,” says Freer. “They’ll start 20 or 30 projects and finish none of them.”

Freer’s technology, called Play Attention, has been a big hit among major corporations that realize the problems with unfocused workers.

The way it works is simple. The employee wears a helmet lined with sensors that monitor brain activity. The software is popped into the computer and the worker is instructed to focus on the computer screen and the tasks at hand.

For example, if a fax shows up on the computer screen, the user is to move it using only brainpower to the in box. Same for a piece of junk mail that shows up; the user should concentrate until the mail lands in the trash can.

The more the user practices, the more the brain improves and gets used to being focused.

Nikko Smith just got booted off “American Idol.” Bummer.

I haven’t used the Play Attention yet. Can you tell?