Reference: Alloway TP & Alloway RG. Attentional control and engagement with digital technology, 2011, Nature Precedings.

The topic of medicating individuals with ADHD is still controversial. That is why I am always interested when research on this topic is published. I was recently asked to write a commentary on one such article that will appear in ‘Developmental Medicine and Child Neurology’.

Children with ADHD exhibit deficits in both cognitive and behavioral domains. In particular, response inhibition has been proposed as a core element of individuals with ADHD that can impact both these types of functioning. Given the widespread prevalence of ADHD, with some reports as high as 16% of children receiving this diagnosis, treatment is a priority.

Stimulant medication, such as methylphenidate, is considered to improve certain cognitive functions in children with ADHD. The suggestion is that methylphenidate acts to increase levels of dopamine and norepinephrine, which are associated with attention and focus.

However, most research in this area has focused primarily on immediate-release stimulant medication. Clinical studies in continued-release of stimulant medication have produced mixed results and it is as yet unclear which cognitive and behavioral functions associated with response inhibition can be improved as a result of stimulant medication.

Thus, the authors—Blum et al—sought to investigate this issue. Children aged 6 to 12 participated in a double-blind placebo controlled crossover trial, using the individual’s most effective dose of OROS- methylphenidate. The benefit of this approach is that neither the person administering the medication, nor the child taking it was aware of whether they were receiving the medication or the placebo. The conditions were then switched, so the Medication group took the placebo, and the Placebo group took the medication.

The findings indicated that hyperactive and inattentive behaviors (measured by both parent and teacher ratings) improved when the child was receiving their optimal dose of OROS- methylphenidate. Cognitive functions also improved in some cases, but not all. For example, the students were no better at tasks involving motor inhibition and working memory.

Studies like this one by Blum et al. are very valuable because they raise the issue of the efficacy in using this approach for individuals with ADHD. Amidst increasing concerns regarding side effects and the potential for abuse, some parents and clinicians are seeking alternative methods to ameliorate the cognitive and behavioral deficits associated with ADHD.

One promising alternative is adaptive working memory training, where the intensity and difficulty of working memory sessions are individually customized to the aptitude of the child. Traditionally, working memory was viewed as genetically fixed, and thus unable to be modified by an individual’s environmental experiences or opportunities. However, an increasing body of recent studies has challenged this notion, demonstrating that considerable cerebral plasticity exists within the developing brain and that working memory capacity may potentially be improved by environmental intervention and support.

Such findings highlight important opportunities for improving the learning, behavioral and social opportunities of the large number of children with working memory problems. Working memory impairments are widely reported in students with ADHD, and several studies have found that adaptive working memory training can improve behavior ratings by parents (Klingberg et al., 2005), as well as IQ and attainment scores (Alloway, 2009).

Research like Blum et al.’s illustrates the limited impact of continued-release of stimulant medication and highlight the need to consider alternative forms of intervention. When such measures prove to be insufficient, then the option to prescribe stimulant medication can be discussed with a physician who is aware of the severity of the individual’s symptoms. Care should also be taken when considered the type of stimulant medication—immediate vs. continuous release; as well as the optimal dose for the individual.

References

Alloway TP. Cognitive Training: Improvements in Academic Attainments. Professional Association for Teachers of Students with Specific Learning Difficulties 2009; 22: 57-61.

Klingberg T, Fernell E, Olesen PJ, Johnson M, Gustafsson P, Dahlstrom K. et al. Computerised training of working memory in children with ADHD -a randomized, controlled trial. J of the Am Acad of Child and Adolescent Psychiatry 2005; 44: 177-186.

http://www.dailymail.co.uk/health/article-1347310/The-Old-Grey-Matter-Test–How-brain-best.html?ito=feeds-newsxml

I wanted to find out if working memory influences our happiness together with the British Science Festival. If you have high working memory, will you be more likely to see the glass half full, than half empty?

WHAT WERE THE FINDINGS?

1. People who have high working memory are more optimistic. They are more hopeful and confident about the future compared to those with low working memory; they are more likely to expect the best possible outcome from a situation. Why is this finding important? There is substantial evidence that people with a high sense of optimism are less likely to suffer serious illness; also, when they do fall ill, it is less severe and they are better able to cope with their condition, and as a result recover faster.

The take-home message? High working memory is an important feature in preventative health because it can actually help keep you in better physical condition.

2. People with low working memory spend more time brooding over life events. They often have a poor coping style in a time of crisis and instead of facing their problems straight-on, they will often abandon their goals instead.

Why is this finding important? People who are ‘brooders’ are more likely to experience depression. They tend to focus on the negative aspects of a situation, which affects mental health and increases stress levels.

The take-home message? High working memory prevents you from fixating on a problem and allows you to be proactive to plan ahead and solve the problem.

So working memory does influence happiness for the better and this improves our mental and physical well-being.

READ IT IN THE NEWS: BBC, DAILY MAIL

I recently completed a study together with Dyslexia Scotland and the Autistic Treatment Trust on the impact of brain training. A group of students aged between 8 to 16 years old took part. They completed some tests of IQ and working memory and then participated in an 8-week training programme called Jungle Memory.
The findings were very exciting! The students who used the Jungle Memory training programme regularly (4x a week for 30 minutes) had higher IQ and working memory scores, compared to those who only trained 1x a week and those who didn’t train at all. By training your brain you will be able to improve your child’s prospects in classroom and beyond.

Read the REPORT

Do you ever have days when you wake up and everything seems wrong with the world? Hopefully for most of these types of days are not the norm but the exception. However, there are some people who see everything as ‘half-empty’ instead of ‘half-full. Using cutting-edge psychological research, I am interested in finding out if it really matters–Does it matter if we see the glass as half-empty?

We are on the cusp of a new revolution in intelligence that affects every aspect of our lives from work and relationships, to our childhood, education, and old age. Working Memory, the ability to remember and mentally process information, is so important that without it we could not function as a society or as individuals. One way to visualise working memory is as the brain’s “Post-it Note”: we make mental scribbles of bits of information we need to remember and work with. For example, we use working memory to remember directions while driving or someone’s name and phone number. Without it, we would be literally lost; we wouldn’t know how to get to that important meeting and would forget important contacts. Working memory is critical for many activities at school, from complex subjects such as reading comprehension, mental arithmetic, and word problems to simple tasks like copying from the board and navigating the halls.

Working memory makes a difference beyond the classroom walls as well. People with superior working memory tend to have better jobs, better relationships, and more happy and fulfilling lives. People with poor working memory struggle in their work, their personal lives, and are more likely to experience trouble with the law. More recently, a growing number of studies demonstrate that working memory is also important for our mental health. In a recent study that I conducted with 20-year-olds, I found that people who view the glass as half-empty but have good working memory are less likely to suffer depression compared to those who view the glass as half-empty and have low working memory. So while we may think that seeing the glass as half-empty, having good working memory acts like a buffer to protect our mental health.

What about you? What does your working memory tell you about your world-view? Why not find out by participating in an online study. Here is what you will have to do:

Take some memory tests: Don’t worry, I don’t want to know how often you forget where you left your car keys or if you can remember your loved one’s birthday. You will have to do something much easier. You will see some shapes and just have to remember where you saw them on a grid.

Next, tell me your views about different sentences, like “I felt hopeful about the future”; or  ”I was bothered by things that don’t usually bother me”.

There is also a Memory board where you can tell more me more different strategies that you use to keep your memory alert.

PARTICIPATE NOW

So this week I have burnt the pasta (twice!), put the milk away in the cupboard with the glasses, and locked the car and house keys in the car. If you asked me in my six-month of pregnancy whether pregnancy brain is a myth, I would say NO!

Some pregnancy women blame such actions as the result of the lack of sleep. However, it seems that I can’t use sleep deprivation as an excuse for my forgetfulness. Studies have found that the lack of sleep is not actually linked to memory loss and forgetfulness in pregnant women.

Thankfully, there is a reason for my new (and unwanted!) absent-minded brain. Scientific studies show that during pregnancy, a woman’s brain changes*. For starters, the hippocampus, which is linked to spatial memory and long-term knowledge, actually shrinks during pregnancy. This means that a pregnant woman’s sense of direction is not always as reliable as it used to be.

Why does the pregnancy brain shrink? The brain shrinkage is the result of hormone changes during pregnancy, especially in the final trimester. Some hormone levels, such as progesterone and estrogen, rise and fall during pregnancy. We need a perfect balance of these hormone levels to use working memory-our ability to incorporate new information with long-term knowledge stores. When estrogen are very high, such as during the last trimester of pregnancy, working memory is not as efficient. This makes simple tasks like remembering that the milk goes in the fridge (and not the cupboard) or juggling multiple tasks at work a little more difficult than usual.

Happily, brain size goes back to normal after the baby is born. Pregnant women can be confident of performing to their usual cognitive capabilities, but be aware that the pregnancy brain means that they may be more affected than usual when taking on additional responsibilities.

From TRAINING YOUR BRAIN for Dummies (due Dec 2010)

* Galea et al. (2000). Hormones and Behavior.