Anxiety, Focus and Video Games

This week I listened to two broadcasts by Suvrat Bhargave (drbhargave.com), a renowned child and adolescent psychiatrist. The first was about anxiety and the second was about ADHD. In the first, Bhargave talks about how people with anxiety feel the need to control the environment, and can often be overly concerned with "fair" and "unfair." He indicates that this "black and white thinking" can help things seem clearer for the person with anxiety. He says that anxious people can be "emotional sponges," and pick up on what everyone around them is feeling. Therefore, tone is an important thing to keep in mind when interacting with anxious people, especially children. The more calm your tone, Bhargave says, the less the child will feel increased anxiety.

In the second broadcast I listened to (Focus, Focus), Bhargave began by saying that while ADHD may be overdiagnosed, it most definitely is real. He noted the three main characteristics of ADHD:

1. Not surprisingly, the hallmark of ADHD is difficulty with attention. The person tends to be distracted. This may lead to behaviors such as a child forgetting to turn in his homework or recalling specific details.

2. Fidgetiness is often present. This may be characterized by tapping feet, playing with hair, biting a pencil, etc.

3. Impulsivity is present. This can be shown by a person interrupting others or blurting out answers in class. This can also be seen by how a child overreacts when his or her emotions are running high.

Bhargave mentions that the difficulty with memory often associated with ADHD is really about retention, i.e., the focus involved when the person is learning the material in the first place, and that people with ADHD are generally at average or above average intelligence. He believes that people do not really outgrow ADHD, but they can learn to compensate using a variety of tools (see my earlier post about this on August 25th): structure, routine, reward, consequence, motivation, organization and medication. Interestingly, Bhargave says that the computer games that so many children with ADHD are obsessed with provide all of these (excepting the medication), which is why they are so appealing to the child with ADHD.

Glass houses

It is hard to be a parent and not to feel judged by others, at least once in a while. I remember a friend confessing to me that her first child was so well behaved that when she saw other children misbehaving, she mentally gave herself a pat on the back for being such a good parent and wondered what the other parents did not have more control over their children. Then this friend had her second child, who was quite challenging in contrast to her first, and this friend gained both an empathy for those struggling parents and a little more understanding of how much is nature rather than nurture when it comes to children.

I, myself, have found myself judging other parents for not intervening when I perceive (by my standards) that their children are "out of control" or "rude" or "inappropriate,"  and I often have to remind myself that I have no idea how it is to be that parent or what else is going on in that family's world. Also, truly, it is often none of my business. I am thinking of the words of Byron Katie, "I can find find only three kinds of business in the universe: mine, yours, and God's…If you are living your life and I am mentally living your life, who is here living mine?" Or Eckhart Tolle's words of caution:  "Watch out for judging others - when you judge others, you are in essence judging yourself. Notice that."

Breaking Fast

We finally reached the end of our family "30 days without fried food/eat well" challenge. I have to give props to my son, who demonstrated incredible willpower over the time period. The hardest time for him was probably the first weekend when we went to a restaurant and all the tables around us seemed to be eating french fries. He really struggled that day, having an actual visceral reaction to the temptation just out of his reach.

In contrast, last weekend, when we were nearing the end of the "cleanse," french fries were brought to our table at a restaurant even though we had told the waitress repeatedly that we did not want fries. Amazingly, my son allowed us to send them away without any noticeable reaction. What a difference 30 days make!

My son is currently away on a 3-day class camping trip and has requested chicken tenders and fries for the night he returns. I am happy to let him have this as a reward, but am now tasked with figuring out how to help him achieve balance in his diet going forward. One plan is to make sure the habits we established during our 30 day cleanse will continue. These are:

- No sugary drinks including fruit juices (with the exception of fruit and veggie smoothies).
- No snacking after 7:30pm during the week
- A fruit or vegetable with every meal
- Protein for snacks as much as possible

No matter what happens, my son has learned that he can have power over food rather than food having power over him. I would think it is never too early to learn a lesson like that.

Common Core

I am very interested in how the Common Core standards are being implemented in Pennsylvania. If you are not familiar with them, the Common Core State Standards Initiative is an "educational initiative in the United States that details what K-12 students should know in English language arts and mathematics as the end of each grade…and seeks to establish consistent standards across the states as well as ensure that students graduating from high school are prepared to enter credit-bearing courses at two- or four-year college programs or to enter the workforce." (Wikipedia)  In other words, in most states (43 states so far, I think), there are specific subjects a student will now have to demonstrate working knowledge of in order to graduate high school. (See the Common Core website to read about it yourself www.corestandards.org)

 In Pennsylvania, the Common Core has led the Keystone exams, which means my daughter,a member of the high school graduating class of 2017, is in the first class in Pennsylvania that has to pass state-wide tests in Biology, Algebra and Literature in order to receive her high school diploma. I am not concerned for my daughter, who is a traditionally good student and who passed the Biology and Algebra exams as a Freshman and who will be taking the Literature test as a Sophomore. I am, however, interested in how these Keystone exams are going to be passed by kids with learning challenges.

 I have been told by parents of high school students with learning needs that their children are allowed extra time and can take the exams as many times as they want, but that some of them are not getting any closer to passing after multiple attempts. This raises other questions for me. Are these students not going to receive their high school diplomas if they never pass? Will the state have to offer two degrees: one "with Keystone exams passed" and "without Keystones passed"? How is this going to affect the future prospects for the students who don't pass? Also, how much educational time is being wasted helping these children pass these exams?

For the record, I certainly do not object to the idea of "core standards." I believe that many students are going off to college without fundamental abilities and knowledge, and that the educational system in the United States, which performs far below many other first world countries, needs a serious over-haul. I just think there needs to be a little more flexibility in how it is going to be implemented for students with  learning needs (not to mention English Language Learners). One size fits all does not work here.

Brain Games

Last week I went to a Cognitive Neuroscience Conference at my alma mater, Temple University, on the topic of Working Memory and Working Memory Training. In addition to discussing the areas of the brain (e.g., pre-frontal cortex, parietal lobe) and neurotransmitters (e.g., dopamine, GABA) involved in Working Memory, the presenters discussed the difference between maintaining something in working memory (for example, recalling a phone number or a shopping list verbatim), and manipulating something stored in Working Memory (such as performing mathematical calculations on numbers stored in memory).  In terms of attention, it seems that attention does not affect the former, Working Memory maintenance, but may affect the latter, Working Memory manipulation.

As far as the efficacy of Working Memory Training programs, such as Cogmed and Lumosity, there was some disagreement among the presenters, but all presenters believed that these trainings are imperfect as they are currently designed. In the end, it seems that there is not enough transfer from a trained task in one of these programs to a new task in terms of working memory improvement. As one presenter put it, "Practice the skills you want to acquire. If you want to learn to play the piano, practice on the piano, not the violin."

One thing several presenters did agree on is that these Working Memory Training programs seem to help individuals learn strategies to use in similar Working Memory tasks. I'm sure this came as no surprise to anyone involved with children or education today. The best thing you can do for children is to teach them HOW they learn.

Saved by my Kindle

Since my son has required reading for school, I've found it helpful to read the same book as him while sitting alongside him (he reads the paperback and I read on the Kindle) and we discuss the chapters after we finish them. Yesterday, my son's allergies were bothering him and his eyes were tearing, so I used the Text to Speech feature on my Kindle and the text was read aloud to us as we followed along. The Kindle has a computer generated voice, which had unnatural pauses and accelerations, along with some mispronunciations, which we found quite humorous. It was a great solution for a night in which I didn't know how effective reading was going to get done, and I didn't have to buy an audio book, which I had considered. Caveat emptor: you have to follow along by reading the text or it would be close to impossible to understand everything!

A Fine Balance

Yesterday, two minutes after I dropped my son off  IN FRONT OF HIS SCHOOL, I received a phone call from his school saying my son had fallen and hit his head. How? He said he tripped on the sidewalk. Because of all the current concerns about concussions, I took my son to the pediatrician to have him checked out (he was fine), and he rested for the remainder of the day.

 Interestingly, during a web search about something unrelated, today I came across information on the web about a doctor, Harold Levinson, who for decades has been treating children with dyslexia, dysgraphia, ADHD and related dysfunctions under the theory that these symptoms are related to a type of dizziness or motion sickness, and can be treated with inner-ear enhancing medications in combination with other treatments.

Levinson theorizes that certain disorders "are due to a simple signal-scrambling disturbance of inner ear (and cerebellar) origin, In other words, the inner-ear and its supercomputer, the cerebellum, act as a 'fine-tuner' for all motor (balance/coordination and rhythmic) signals leaving the brain and all sensory and related cognitive signals entering it. As a result, normal thinking brains will have difficulty processing the scrambled or distorted signals received." (dyslexianonline.com)

I am not sure of the efficacy of this theory, but it sounds like an interesting one to explain my son, who struggles with many of the things Levinson discusses including balance, coordination, dysgraphia, spelling, and processing speed, and who spent the first year and a half of his life with middle ear (not inner ear) infections. Is there a relationship? I don't know. Something new to consider.