ADHD Self-Management™ Center

Letter from the Director…. The decision to put a child on medication is a very difficult one for most parents. We analyze the problem, make a diagnosis, define a treatment plan, and then assess all the risks. We go on to weigh the risks against the benefits and finally discuss: What are the risks of not giving medicine? What are the alternatives? In the past, we had few available choices and few medicines proving their effectiveness. Regardless of other types of treatment, I always recommend that children be in some form of therapy to teach the child about alternatives and give them new skills. Obviously for me, Self-Management^SM is an essential tenet of my approach. I think patients need to feel their own power for health and change to occur. Children will not simply “grow out of it” by themselves!  They need to be taught skills they don’t inherently have. In the past 10 years, we have seen an explosion of knowledge regarding the brain. This essential organ system has been the big mystery in medicine. One of the main reasons for this is the difficulty in measuring the functions of the brain. Being such a delicate organ, there have been major limitations in exploring the way it works. In 1990, the U.S. Congress and the National Institute of Medicine declared this “The Decade of the Brain.” New techniques were developed to study how it operates. Two of these methods are the fMRI-Functional Magnetic Resonance Imaging and PET Scans. This technology has helped us understand that the brain is plastic, and it can actually grow and repair itself given the right conditions. We originally thought that brain cells could not regenerate. But, we have recently learned that the fibers of the brain cells, called axons and dendrites, can biforcate like the roots of a tree. These roots can then grow around damages in the brain, which is why people who have had strokes often regain all their faculties. We now know that the pathways in the brain that connect different parts of the brain and integrate our cognitive functioning can be manipulated to have more rapid transmission. Many learning problems have been understood as either too slow transmission (slow processor) or a lack of connections. Major research is being conducted in how to direct this process more precisely since the brain is such a precise computer. These pieces of research have opened up amazing possibilities in rehabilitation.  Our upcoming newsletter is dedicated to such research findings, especially the methods being developed using the plasticity of the brain to help children, adolescents, and even adults learn to develop new skills. This discovery has given us all hope. Hope that problems like ADHD, Learning Disorders (Dyslexia), and Autistic Spectrum Disorder can be fixed at the foundation, not just by applying a medication band-aid to cover it up.   At The Tarnow Center for Self-Management, we are constantly searching and evaluating new methods and techniques. We are looking for ways to help the child with brain problems concentrate, focus, improve memory, and decrease impulsivity without the use of medication. But, we need to be careful to evaluate these new programs for their scientific efficacy. It is easy to make claims on the Internet that this or that game or herb can cure a child’s problem. I wish it were that simple. American society wants fast, quick, and easy fixes for ADHD. If you want to take that route, then stick with medication. However, medication doesn’t fix the underlying problems. It won’t change the brain.  In the upcoming newsletter, we will also discuss the evidence and our own personal experiences with 3 non-medication brain stimulating methods – Cogmed, Fast ForWord, and Interactive Metronome. In addition, Ron Swatzyna, Ph.D., will discuss new research with Neurofeedback and QEEG. 

Jay D. Tarnow, M.D. Psychiatrist/Medical Director

Tarnow Center for Self Managment

 Good Day College Students Every Where,

As another semester end approaches, everyone is preparing for winter break. Along with making fun vacation plans, many college students are starting to combat their academic struggles. Both students and professors might suspect such difficulties stem from attention problems. It is easy to spot surface behaviors unique to attention deficit (ADHD): lacking focus, frequently distracted, and impulsive. The challenge lies in identifying underlying problems.  Thankfully, there is extensive research to provide a better understanding of ADHD. One noteworthy discovery shows working memory to be a key contributor to successful academic performance. Working memory is a brain function that allows us to keep information active for brief time periods. This type of memory aids in following instructions, maintaining focus, and running math calculations. When compared to a computer, working memory is like random access memory (RAM) and similarly, it can be upgraded. The upgrade for human working memory is via specific training to strengthen parts of the brain. For more information on working memory, go to www.aboutworkingmemory.org. 

Even though the majority of adolescents and adults do not and will never have ADHD, a segment of the population struggles with staying focused because of poor working memory—and that’s normal. As clinicians and professors, we need to recognize these conditions and assist our young adults with ways to better manage and address attention and working memory deficits during these critical years in higher education. And now, this can be done in the comfort of home… I am excited to announce a new method for improving working memory and attentions deficits, which was recently launched in the

United States by Cogmed, a Swedish company. Their specially designed Working Memory Training Program, “Cogmed QM,” is a computer software responding to a breakthrough discovery by Dr. Torkel Klingberg, Professor of Neuroscience

that individuals can train and improve their working memory. Original research was conducted at the Karolinska Institute with stroke victims suffering from working memory deficits. After seeing significant improvements, the research team along with gamers developed various game-like memory exercises. Their goal was to help children and adults with ADHD improve working memory and attention deficits by using the concepts they had success with in the original program. This was accomplished and Cogmed’s program has been validated by high-impact research in controlled scientific studies, as well as being published in peer reviewed scientific journals, such as Journal of the Academy of Child and Adolescent Psychiatry. 
The program entails 5 weeks/5 days per week of training (25 sessions), supplemented by personalized weekly coaching sessions (via phone). The trainee only needs a PC with Internet connection and the proprietary software installed by their certified Cogmed training coach.  I have had great success in training college students using Cogmed QM this past summer. A few examples of what they verbalized as results from  the training were improvements in their reading comprehension and ability to remember their class schedule. I foresee winter break as another ideal opportunity for more college students to improve their working memory and attention ability before going on to the next semester.  

For more information, please visit our website at www.adhdselfmanagment.com or feel free to contact me directly at (704) 808-9976. 

Best Regards, Myah T. Gittelson, Psy.D.Certified Cogmed Training CoachQuality Assurance Manager

ADHD

Self-Management

Center OnlineAffiliate of

Tarnow

Center for Self-Management