Category — ADHD

As many as three million children in the United States are being treated for Attention Deficit Disorder. And they’re not the only ones. 4.4 percent of the adult population have A.D.D. or a related disorder, making it the second most common psychological problem in adults after depression. VOA’s Paige Kollock reports on a new ‘game’ that might be able to help them.

New Video Game Shows Promise In Treatment of Attention Deficit Disorder

By Paige Kollock
Washington, DC
29 August 2005

Medical studies have shown that television and video games may contribute to the rise in Attention Deficit Disorder, especially in children.

Doctor Stephen Hinshaw of the University of California researches children with attention deficit hyperactivity disorder. He says, “Very fast paced media are in some ways overwhelming the young brains.”

Now a company called Unique Logic and Technology has created a video game that helps re-train those young brains. It’s called “Play Attention,” and the company claims it can teach your brain how to pay attention. It works by using a helmet that has sensors.

The sensors can tell whether or not the user is paying attention. In conjunction with computer software, the sensors teach the user what it feels like to pay attention and reward them for paying attention for longer periods. Over time, the user acquires the skill of concentration.

Former Principal Pat Faulkner says the $1,795 program is worth the money. “I think Play Attention was worth every penny they ever spent on it, and all the time that was spent on it, because it has the power to change a child’s life. When a child can learn to participate in class, then he can learn, and that’s a life changing experience.”

Adults are using Play Attention too. While the U.S. Women’s Olympic bobsled team may not have A.D.D, using Play Attention helps them increase their focus, which gives them a competitive edge.

Educators say the game takes between eight and 12 months to become permanently effective. From that point on, they say, users can fall back on the skill for the rest of their lives.

Medical News Today reports that ADDERALL XR® from Shire Pharmaceuticals Group plc has been indicated for use among adolescents aged 13 to 17 with attention deficit hyperactivity disorder (ADHD) by the US Food and Drug Administration. (ADHD – FDA expands indication for ADDERALL XR® (CII) confirming safety and efficacy in adolescents)

The drug was originally approved for treatment in ADHD children aged 6 to 12 years in October of 2001 and since August 2004 in adults 18 years and older. ADDERALL XR is currently the most commonly prescribed brand of ADHD medication in the United States.

“There has long been an unmet need for ADHD research and treatment among the adolescent population despite an increasing awareness of ADHD’s potential impact on quality of life. Therefore, approval of an ADHD treatment for this underidentified age group is an important milestone,” explained Dr. Timothy Wilens of Massachusetts General Hospital. “The symptoms of ADHD often continue past childhood into adolescence and adulthood, where they can have a significant impact on an individual’s family, academic performance, and overall quality of life. Stimulant therapies are effective and generally well tolerated, and have been used medically in patients for more than 60 years.”

This directly contrasts with Health Canada’s decision to remove ADDERALL from the Canadian market (Health Canada Suspends ADHD drug Adderall XR) due to 20 or so deaths associated with the drug’s use. According to Shire Pharmaceuticals, “ADDERALL XR may not be right for everyone. ADDERALL XR was generally well tolerated in clinical studies. The most common adverse events in pediatric trials included loss of appetite, insomnia, abdominal pain, and emotional lability. The most common side effects in the adolescent trial included loss of appetite, insomnia, abdominal pain, and weight loss. The most common adverse events in the adult trial included dry mouth, loss of appetite, insomnia, headache, and weight loss.

The effectiveness of ADDERALL XR for long-term use has not been systematically evaluated in controlled trials. As with other psychostimulants indicated for ADHD, there is a potential for exacerbating motor and phonic tics and Tourette’s syndrome. A side effect seen with the amphetamine class is psychosis. Caution also should be exercised in patients with a history of psychosis.”

One must wonder whether the side effects are worth using a drug whose efficacy has not been evaluated for long-term use. Terms like ‘emotional lability’ appear as an attempt to obfuscate. It is much clearer to say, ‘emotional change or breakdown.’

Dr. Sydney Zentall from Purdue urges new techniques for teaching ADHD children. I agree wholeheartedly. However, the new techniques should be based on an IEP (Individualized Education Plan) that should be given to ALL students thus teaching to their strengths and strengthening their weaknesses. While advocating new teaching methods for ADHD students sells books, it is only a small portion of this nation’s massive education problem.

From United Press International:

New ADHD educational methods urged WEST LAFAYETTE, Ind., July 11 (UPI) – A Purdue researcher says teachers and parents need to learn new methods to help children with attention deficit hyperactivity disorder.

Fads and ‘how-to lists’ are more prevalent than methods based on educational research, said Sydney Zentall, a professor of special education and psychological sciences in Purdue’s College of Education.

But, she added, because students who have ADHD spend the majority of their time in general educational settings, it’s critical to get scientific information to the people who are going to help them learn how to live in society.

She said part of the reason for the scarcity of ADHD information in textbooks is ADHD has not been categorized as a disability in special education until recently.

Purdue News Service said Zentall is an internationally recognized authority on hyperactivity and ADHD. She developed a theory in 1975 called Optimal Stimulation Theory, suggesting hyperactive children might have a greater need for stimulation and would benefit from a more active learning environment.

Essentially, the researchers used a computerized dance program to stimulate neural pathways thus increasing attention and therefore reading comprehension. Another example of neuralplasticity.

The story from ABC News:

Get Out! Popular Dance Video Game Helps Kids with ADHD

The same video game that endlessly distracts kids from schoolwork may improve concentration and memory, according to a study on a small group of children with attention deficit disorder. Researchers found that playing Dance Revolution, the arcade hit from Japan where dancers try to match the steps of a gyrating computer animation, led to an intriguing boost in reading comprehension.

“We’re still in the beginning stages,” cautioned Tammy McGraw, an education specialist with the Appalachian Educational Laboratory and lead author of the study. “But if we can demonstrate that video games help, we can find solutions that do not require us to medicate children as much.”

The game McGraw and her colleagues tested is a far cry from the gang violence found in Grand Theft Auto or the bloody martial arts action of Mortal Kombat. There isn’t even any bumping or grinding. Available for such popular home gaming systems as Sony’s PlayStation II and Microsoft’s Xbox,  Dance Revolution involves stomping on four large buttons to a danceable beat in what educators describe as a mix between Twister and Simon Says.

McGraw, who presented her findings at a recent Digital Games Research Association conference in Vancouver, Canada, said that she first got the idea to study the game after seeing a long line outside a mall. Following the endless convoy of adolescents, McGraw was surprised to find what everyone was waiting for: a chance to shake it against a virtual dancer.

McGraw had recently read about research suggesting visual and rhythmic stimulation could improve reading and attention. Perhaps, she thought, this emerging theory about learning could be matched with the latest video game craze.

“There are a lot of ways to help kids read better,” said McGraw, adding that few children find them interesting. “Kids naturally gravitate toward video games.”

As part of the study, McGraw and colleagues recruited 62 sixth graders who suffered from attention deficit hyperactivity disorder (ADHD). First, the children were given a series of reading tests. Half the kids were then instructed to play Dance Revolution for about an hour a week. The other children continued with their normal routine.

Just to ensure that no parent was taken aback by the unusual educational aid, McGraw said they chose the Disney version of the game, which includes a dancing Mickey Mouse and songs by Chubby Checker.

Three months later, the kids took the same reading tests again. The scores were largely the same for both groups, but those who played Dance Revolution did slightly better with so-called receptive coding skills, the ability to immediately recall a word or series of numbers. This type of testing indicates greater focus and attention, a key issue for children with ADHD. The more times the kids played the game, the better they did.

“This was the real hot spot,” said McGraw. By quickly matching their movements to visuals and music, children who play Dance Dance Revolution seem to strengthen the areas of the brain that are necessary for better memorization, McGraw explained. Since the game is exciting, these skills are more easily improved.

McGraw hopes to press ahead with her research to find a broader educational role for Dance Revolution, as well as other video games.

“Everyone is playing them,” she said, “And it’s something schools can afford.”

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.”

The following press release was issued by researchers at the FPG Child Development Institute of North Carolina at Chapel Hill.

CHAPEL HILL, NC — For decades, researchers have wondered why some children from poor, at-risk families manage to perform better in school than other children raised in similar environments.

Now, researchers from the FPG Child Development Institute (FPG) at the University of North Carolina at Chapel Hill (UNC-Chapel Hill) and the University of Louisville in Kentucky find that children who have trouble paying attention exhibit different motivation patterns and temperament characteristics than children who don’t have problems paying attention.

This suggests that attention is more complicated than previously thought, according to lead researcher Dr. Florence Chang of FPG. “These findings provide evidence that helping children at risk for academic problems involves understanding more than a child’s attention and learning skills,” she said. “It also involves understanding their social and emotional make-up.”

The results of the study were published in the January/February 2005 issue of the journal Child Development.The researchers recruited 73 mothers and their preschool children, ranging in age from 3 to 5, all of whom attended a Head Start program and came from low-income backgrounds.

The children played a series of computerized games designed to measure their attention skills. The mothers completed a questionnaire that measured the temperament traits their children were born with, such as activity level and frustration.

To measure motivation, children were asked to complete a series of puzzles of varying difficulty levels. Children who preferred completing a challenging puzzle (deemed “mastery-oriented”) exhibited better attention skills than children who preferred completing an easier puzzle (deemed “performance-oriented”).

Previous research found that children who prefer more challenging tasks have more positive outcomes in school than children who avoid challenge and prefer easier tasks.

Overall, researchers found that temperament, motivation and attention are interrelated. This may indicate, said Chang, that screening tests that measure preschoolers’ school readiness, which today focus primarily on cognitive ability or developmental maturity, should be reexamined. Instead, it may also be important to consider other factors, such as how a child reacts to challenging tasks and his or her ability to adapt to new situations, she said.

“The findings from this study suggest problems that arise from attention difficulties are not limited to difficulty with concentration and sitting still, but are related to how children approach challenging or new situations,” said Chang. “Clearly, it is the case that much more needs to be understood about the nature and implications of having an attention problem.”

Perhaps the most significant statement the researchers claim is their final statement relating to a child’s response to challenging or new situations. When a child or an adult has diffused attention – attention spread over a wide area for short periods of time – their ability to command their environment is greatly reduced. Things happen out of their control. Accidents happen more frequently including traffic accidents. Indeed, there is some truth that some things are out of their control as they cannot control or manage things they do not perceive. Subsequently, the child or adult may develop a short temper as frustration easily sets in during new or challenging situations. Obviously, becoming quickly frustrated and shutting down during challenging situations may cause delays in emotional maturation and cognitive development. Adults experience organizational problems as they frequently do not manage things that are out of their immediate focus.

Generally, this research lends itself to a holistic perspective of diffused attention pointing not only at diffused attention, but at the subsequent problems it causes affecting daily function. It is not likely that medication can repair this as medication does not instruct the child how to manage challenging situations. It can place a child in a mental place where he might be able to learn to manage better, but who’s teaching management 101? This is where teaching tools like Play Attention play a major role in skill development both behaviorally and cognitively.

The November 13, 2004 Boston Globe article, Playing their Way to Improved Concentration, refers to Play Attention, a feedback based learning system I created for persons with attention problems. It uses a video game format to teach cognitive skills typically deficit in children and adults with diffused attention.

I have always considered attention problems to be learning disabilities rather than brain damage (minimal brain dysfunction). In an evolutionary sense, people with diffused attention have always existed among us. In primitive times, they were likely the people standing or walking the perimeter of the camp fire while the rest of us ate our catch. Their orienting reflexes quickly triggered at the slightest sign of danger.

I synthesized my experience in education, computer education, and psychology to devise a system to optimize human potential. However, at the time I began this journey, my university training was of little help. None of my classes mentioned attention problems and therefore I received no training to assist my students.

The Globe cites that ‘…Peter Freer, who developed the product, used to teach school in West Virginia [actually Western Carolina] in the 1980s. Confronted with hyperactive students, Freer didn’t know how to help them. “At that point, at university level, they didn’t even teach anything about how to cope with these kids,” he said.’

I researched experimental data from NASA regarding astronaut performance and attention. I founded Unique Logic and Technology (ULT) in 1994 to provide technology to educators and the general public.

As the Globe points out,‘Freer was trained in computer programming, and he wondered whether technology might help his hyperactive students. While researching the matter, he found that the National Aeronautics and Space Administration had developed computer systems for improving the concentration skills of astronauts and test pilots. NASA scientists attached electrodes to pilots’ heads to capture their brain waves. They learned to identify the kind of brain activity that occurs when a person is concentrating on a task. Then they wrote software that lets pilots control images on a computer screen. The more they focused their minds, the better they performed. In the process, they learned how to how to set aside distractions and concentrate on the task at hand.’

I vastly altered and advanced NASA’s technology to make it appropriate for educational use. I did this by incorporating cognitive skill training and behavior shaping. ULT has been awarded three patents with others pending based on the advancements.

Everything we know about the brain indicates that it can restructure provided the right challenge is provided. The difficulty is that this process takes time. Play Attention takes time, too – perhaps forty to sixty hours of training to gain permanency. ‘Hours of practice can teach a child what it feels like – and looks like – to pay attention. As Joyce Bowen put it, “after you do it a couple of times, you develop muscle memory in your brain.”’

Joyce’s child has rewired his brain to perform quite well at school. He no longer strikes his sister impulsively. He’s a normal, might one say, average kid – bright and happy. Sometimes it’s great to be average.

ADHD Strategies for School & Work

Diffused attention during the learning process greatly decreases the amount of information that can be transferred from short-term memory to long-term. When questioning an ADHD student about the material just presented during a lesson, typically he’ll recall bits and pieces of the material presented, but seldom a holistic perspective. Other areas of life are affected including everything from personal interactions to work or school.

School

Diffused attention also makes reading a challenge as the student must read a passage two to four times before he can gain fundamental meaning from the text. Academic work becomes tiring and tedious. Children often claim homework is ‘boring’ after failing to be successful at simple assignments they are highly capable of accomplishing in short order if their attention were not diffused. Equating boredom with academic work is usually the result of lack of success and an assignment that is not highly stimulating.

Social Interactions

Socially, diffused attention causes an inability to perceive social cues. A look of disapproval, a simple shake of the head meaning NO, and other social cues are overlooked. For adults, this can cause conflict between workers or embarrassing situations at social gatherings. For a child, peers tend to shy away from kids who cannot recognize social cues. ADHD kids are labeled as nuisances and are often excluded from parties, etc. ADHD kids also discern themselves from their peer which results in reduced self-esteem.

Adults

 Typical symptoms of ADHD such as hyperactivity, poor organizational skills, distractibility, impulsivity, etc., often are challenges for the adult in the workplace. A recent article in WebMD.com reports that Joseph Biederman, MD, professor of psychiatry at Harvard Medical School, has surveyed ADHD adults and found that the incomes of households with an ADHD member are substantially lower than households without an ADHD member. Biederman calculates that households with an ADHD member have incomes that are $10,791 lower for high school graduates and $4,334 lower for college graduates. This extrapolates to an annual revenue loss of close to $77 billion in the US.

Biederman reports that an adult with ADHD has greater difficulty keeping a job due to lack of organizational and social skills. In fact, he thinks the disorder may actually make it more difficult to get an appropriate education to obtain a job that offers a higher pay scale. Lost days at work due to ADHD also provide a negative financial impact. “About 50% of the people with ADHD who had jobs in the survey said they lost work directly related to their ADHD symptoms,” says Biederman. “The symptoms of ADHD are very difficult for employers to deal with.”

However, there are strategies that can be employed to maximize function, skill, and satisfaction in the workplace.

Know your strengths and weaknesses

It is important to realize that many ADHD adults have successful careers. Edison, Mozart, and even Einstein may have had AD/HD.  Success seems to be linked to employing good coping strategies once you’ve discovered your strengths and know your weaknesses. Once you become aware of your specific set of challenges, it will become easier for you to plan a strategy. Therefore, consider your unique characteristics as you design your strategies. Below is a checklist describing many of the symptoms typically associated with ADHD. Strategies for coping are listed below each symptom.

Distractibility – people walking by your desk, or talking near you, distract you from your work

• Try to place yourself in the least distracting environment. This may be a private office or cubicle with little foot travel by other office workers. You may retreat to a conference room if possible.
• Maintain a memo pad to keep ideas and assignments from slipping away if you become distracted. Use the memo pad to jot down notes when you receive a phone call.
• Come in early or do your work when others are not in the office.
• Don’t multi-task. Set a goal to finish your current task before starting another.
• Background noise, sometimes known as “white noise” can be effective. Special white noise CDs, audio tapes, or earphones are available for this purpose. Simple classical or new age music may also help.

Poor Memory – you can’t recall dates, names, or appointments.

• First and foremost, buy a day planner and use it religiously to keep track of your schedule and upcoming tasks.
• Many freeware and commercial computer programs are available that automate scheduling and task reminders.
• Make use of pocket recorders. Current recorders no longer need audio tapes as they record on microchips. These are effective for personal reminders or note taking at meetings.
• Write checklists and set reasonable goals for projects.

Poor Organization – you can’t seem to finish projects on time or you fail to keep good records.

• If possible, find a job that does not require long-term task management.
• Set goals for your current task by breaking it into a series of manageable tasks. Mark the deadline for each mini-task with a timer. Computer programs are available for this or you may use a simple kitchen timer.
• Reward yourself when you reach a goal.
• Use an automated computer scheduler to set meeting times. These usually come with an alarm. Set it alert you five to ten minutes before each meeting.
• Allow adequate time between meetings or projects to you do not overload or overbook your schedule.
• Partner with a co-worker who has good organizational skills. This person may act as your coach. The coach will help set goals and reward you as you achieve your goals.

Impulsivity – you respond, at times, without thinking of consequences, sometimes your respond with outbursts

• Have a trusted co-worker provide constructive feedback about your interactions with other staff. This co-worker may also act as a personal coach to role-play appropriate responses to common office dynamics.
• From this feedback, develop strategies to be used when you become frustrated.
• Yoga and some martial arts classes may prove effective in teaching relaxation and concentration skills. A meditation class may be effective, too.

Procrastination – you put things off until the last minute sometimes frustrating or angering colleagues

• Set goals for your current task by breaking it into a series of manageable tasks. Mark the deadline for each mini-task with a timer. Computer programs are available for this or you may use a simple kitchen timer. Reward yourself when you reach a goal.
• Use an automated computer scheduler to set meeting times. These usually come with an alarm.
• Partner with a co-worker who has good organizational skills. This person may act as your coach. The coach will help set project goals and reward you as you achieve your goals.

Hyperactivity – you find it very difficult to sit still during meetings or at your desk o Maximize your personal time like breaks, lunch, etc. to exercise and burn off some energy. This can include walking around the block or trips up and down the stairwell.

• Break up your day to include trips to the mailroom, photocopier, fax, and restroom. o Bring a notepad to meetings and take copious notes.
• A rubber band or paperclip in your free hand can provide stimulation while you take notes.

Daydreaming – when you find something boring you block out the stimuli and think of something more fun.

• Remember, if you have a job you truly enjoy, you’ll find you’ll daydream less. o A job with challenging responsibilities will provide less opportunity for daydreaming than a job shuffling papers.
• Set goals for your current task by breaking it into a series of manageable tasks. Mark the deadline for each mini-task with a timer. Computer programs are available for this or you may use a simple kitchen timer.
• Reward yourself when you reach a goal.

Avoiding details – details like paperwork bore you and you find them virtually impossible to finish o Rule number one; if you can get someone else to do it properly (like an office assistant), let them handle paperwork.

• Make filing more fun by color coding folders and using catchy labels. o Personalize your filing (sensibly) by using fun labels and folders – possibly color coded.
• For paperwork that requires immediate attention have your filing system close at hand, perhaps directly on your desk

Poor social skills – your interactions with your colleagues are marked by your interruptions, blunt comments, or poor listening skills.

• Have a trusted co-worker provide constructive feedback about your interactions with other staff. This co-worker may also act as a personal coach to role-play appropriate responses to common office dynamics.
• Pay particular attention to social cues and work on them with a personal coach to develop awareness and appropriate response.
• From this feedback, develop strategies to be used when you become frustrated.
• Learn to pick up on social cues more readily. Some adults with ADHD have a hard time picking up nonverbal cues that they are angering a co-worker or supervisor.

Summary

A person with ADHD must develop skills and strategies that will enable him/her to function optimally in the workplace. Should skills and strategies fail, it may be necessary to switch careers after careful assessment of your work attributes and skills.

To the man who only has a hammer in the toolkit, every problem looks like a nail.
–Abraham Maslow

As I’ve maintained for years, if we keep thinking of ADHD as unalterable brain damage, dysfunction, or dysregulation, it will be difficult to move forward with positive change. I contend that ADHD is a trait in the spectrum of human neurological variation. It is essentially no different that other genetic traits like intelligence, or eye and hair color, etc. Therefore, a new conceptualization of the basic nature and etiology of ADHD behaviors is necessary in which current known research about human potential and learning are incorporated to produce a scientific, systematic approach to teach sustained attention and improve subordinate deficits in related cognitive skills like short-term memory.

The problem is simply diffused attention. While this statement is quite simple, diffused attention greatly affects every aspect our one’s life. It makes the learning process much more difficult and therefore subsequently affects one academically, socially, and personally. However, having focused attention to a task, currently termed fluid intelligence, can be improved by providing correct challenges – both cognitive and behavioral. Therefore, one can learn to focus on any level of stimulation. The brain has a remarkable ability to compensate by either strengthening current neural networks.

In the very recent past, the brain was considered a gray lump that declined in function as it aged. We now know that this is entirely false. The brain is in a constant state of reorganization. This restructuring/reorganization of the brain is termed neuroplasticity. One of the root words is plastic. Its denotation is moldable or pliable like clay. It is not used in the sense of the hard plastic case covering a computer. Recent advances in brain scanning and analysis have revealed that the brain is plastic – always reorganizing not just in a sense of shuffling files, but architecturally as well. The wiring or neural circuitry is constantly changing depending on external challenges.

Children and adults with brain injury or developmental difficulties offer dramatic proof of the brain’s amazing capacity to compensate if provided a correct challenge that will stimulate the growth of a compensatory neural network or strengthen a previously existing one. Many neurological journals report cases where children who lose language due to a stroke at a young age often recover the ability to speak. This is due the fact that the brain is able to shift this function to another area (compensation through adaptive neural networks). According to UCLA pediatric neurologist Dr. Donald Shields, “if there’s a way to compensate, the developing brain will find it.”

Scientists apply the term neuroplasticity to the action of brain growth and adaptation in response to challenge. Provided the correct challenge and environment, children and adults frequently compensate (shift brain function from one area to another) when a certain area of the brain cannot function correctly. It is documented in many medical and neurological journals that the brain will increase activity in another region to overcome loss of another region.

Implications for ADHD

There is no question that the brain can compensate even if it has problems focusing attention. However, it has to be provided the correct environment prompting challenge. As recently as twenty years ago, scientists believed that the genes we were born with wholly determined the structure of our brains. However, current extensive research performed by scientists worldwide proves that how our brains develop, learn, and grow depends on the vital interaction between nature and nurture. Nature, or more accurately, genetic endowment, is directly affected by the environment, care, challenges, and teachings received (nurture).

As recently as twenty years ago, scientists believed that the genes we were born with wholly determined the structure of our brains. However, current extensive research performed by scientists worldwide proves that how our brains develop, learn, and grow depends on the vital interaction between nature and nurture. Nature, or more accurately, genetic endowment, is directly affected by the environment, care, challenges, and teachings received (nurture). Furthermore, the old notion that early childhood experiences have little impact on later development has been proven false. We now know that the brain is directly and decisively affected by early experiences. This includes the architecture of the brain and the nature and extent of adult capacities; the actual capacity to form new neural networks is directly affected by early childhood experiences.

It was also thought that brain development is linear: the brain’s capacity to learn and change grows steadily as an infant matures into adulthood. It is now known that brain development is non-linear: there are optimum times for acquiring different kinds of knowledge and skills. For example, it is often easier for a very young child to learn a new language than a person past the age of 25. However, the brain can grow and continue development through death provided the right conditions are met.

When I was training at university, psychologists contended that an infant’s brain was very inactive. However, scans now reveal an infant’s brain to be three times as active as that of a college student. Much has changed in the last ten years. In upcoming commentary, I’ll describe how learning takes place, its connection to neural networks and neuroplasticity, and site studies which support that brain development can be greatly enhanced via cognitive re-education.

In upcoming articles, I’ll discuss how we learn. We’ll look at this perspective from an external cognitive approach to learning and then proceed to an internal perspective involving the actual structural neural changes that occur when we learn. Finally, I’ll examine the molecular (DNA) changes that trigger the learning process and encode it to long-term memory.