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Greetings:
Below you will find a preview of the February issue of
ADHD RESEARCH UPDATE that was recently sent out to
subscribers.
This month's preview contains a summary of an interesting
study that examined whether children with ADHD can be taught
better attention skills. I've also included brief summaries
of the other articles from the new issue.
Should you be interested in becoming a regular subscriber,
you can find information about this at:
https://www.helpforadd.com/subscribe.htm
** FREE GIFT **
Have you received the ADHD Monitoring System yet?
I have developed a system that makes it easy for parents
to monitor how their child is doing at school and to
determine when changes to their child's treatment may
be necessary.
In the past, I have provided the ADHD Monitoring System as a
for new subscribers, but I'd be happy to send it to you regardless
of whether you choose to become a regular subscriber at this time.
To receive the ADHD Monitoring System just click on this
email link mailto:[EMAIL PROTECTED] and hit send.
The system will be sent to you immediately.
This can be enormously helpful to you and I hope that you
will request it and use it. It works best with children
in elementary school rather than for middle school and
high school students.
Please feel free to forward this information to others you
know who may be interested in it.
Sincerely,
David Rabiner, Ph.D.
Licensed Psychologist
Duke University
**************************************************
ADHD RESEARCH UPDATE - Preview of February Issue
**************************************************
In this issue...
* CAN CHILDREN WITH ADHD BE TAUGHT BETTER ATTENTION
SKILLS? - REPRINTED IN FULL BELOW
The other articles subscribers received in this issue were:
* DOES ADHD PREDICT EARLY DRUG USE?
This is an interesting study of the relation between ADHD,
behavior problems, and early drug use. The role parents can
play in preventing early drug use in their children is
examined.
* PATTERNS OF BRAIN ACTIVITY IN CHILDREN WITH ADHD
In this study, the authors look at how brain activity may
differ in young children with and without ADHD. Differences
between boys and girls with ADHD are also explored and the
implications of these findings are discussed.
* A NEW RATING SCALE TO ASSIST IN DIAGNOSING ADHD
IN ADULTS
This study describes the development of a new scale to assist
in evaluating adults for ADHD. The scale provides a good
indication of how ADHD tends to effect adults, which is not
identical to how it effects younger children.
___________________________________________________________________
* CAN CHILDREN WITH ADHD BE TAUGHT BETTER
ATTENTION SKILLS?
Over the past decade researchers have studied techniques for
training individuals to pay better attention. Initially, these
attempts were focused on adults with traumatic brain injuries
who regularly demonstrate poor attention. More recently,
researchers have applied similar techniques used with these
adults to help children diagnosed with ADHD. A recently
published study evaluates the effectiveness of one such
attention training tool called Pay Attention! (Kerns, K.,
Eso, K, & Thomson, J. (1999). Investigation of a Direct
Intervention for Improving Attention in Young Children With ADHD.
Developmental Neuropsychology, 16, 273-295). This is a small
scale study that is best thought of as a pilot investigation.
The study addresses an interesting and important topic that
has been the subject of virtually no prior research, however.
For these reasons, I wanted to include it in this issue of
ADHD RESEARCH UPDATE.
The authors provide a compelling rational for efforts to
directly train children with ADHD to improve their attention
skills. They note that although medication treatment is
helpful to the majority of children with ADHD, many children
continue to experience residual difficulties with attention.
Thus, non-medical means to improve children's ability to attend
could be quite useful for many children with ADHD. They also
note that non-medical interventions for ADHD typically attempt
to either 1) use behavioral strategies to increase a child's
attentive behavior by providing incentives for better attending,
or 2) provide children with compensatory strategies for dealing
with their attention difficulties through such means as teaching
better self-control or problem-solving strategies. Efforts to
directly improve children's attention skills through a systematic
training procedure, in contrast, has been the subject of virtually
no research.
Pay Attention! is an attention training program specially
designed for use with younger children (targeting ages 5-10 years)
in an ADHD sample. The materials are modeled after the Attention
Process Training (APT) system developed for adults a decade ago.
It is based on the idea that there are several different
components to attention. There are lower levels of attention,
including basic functions such as being able to focus
attention and sustain attention over time, and there are
higher levels of attention, such as being able to alternate
attention quickly between tasks, or to divide attention in
order to perform multiple tasks.
According to the theory behind the APT, higher levels of attention
are dependent upon smooth lower level functioning. Pay Attention!
was designed to train multiple levels of attention. In theory,
then, this would target the different types of problems with
attention that a child with ADHD may have.
The Tasks in Pay Attention! cater to the knowledge,
skills and concepts that are established in younger children.
In an attempt to make the materials interesting and engaging
to younger children, they are colorful and visually interesting.
They also focus on familiar concepts such as family relationships
(e.g., siblings, parents, grandparents), features of people
(e.g., hair color, sex, clothing), and household characteristics
(e.g., the purpose of particular rooms). Other constructs
considered are the concepts of same and different, relative size,
comparisons of visual features, and basic counting. Both
visual and auditory stimuli are used, and the treatment
tasks have been graded to determine whether or not the
individual should move onto more challenging tasks.
In this study the authors were interested in examining the extent
to which children's attention improved following a series of
training sessions using the Pay Attention! program. The authors
began with 2 groups of 7 children. Each group was comprised
of children diagnosed with ADHD, and consisted of 4 boys and
3 girls. Five of the seven children in each group were taking
stimulant medication throughout the study. (This is obviously
a very small sample, which is why it is best to regard this study
as a pilot investigation.)
Both groups participated in pre- and post-treatment testing on
measures thought to reflect attentional functioning at the beginning
and end of the study. A variety of measures of attention were
collected, ranging from laboratory-based measures of attention to
the more-commonly used method of having children's parents
and teachers complete ratings of the child's attention. Both
groups also participated in 2 half-hour sessions after school
each week over the course of 8 weeks, with one group receiving
the Pay Attention! training program and the other group
participating in various types of computer game activities
(see below).
During the half-hour sessions the group receiving treatment
with the Pay Attention! program performed a variety of
attention-training tasks such as quickly sorting cards into
categories based on the color and picture presented on them.
This was an activity that demanded careful attending in order
to be successful. As the child accomplished these tasks they
would be made progressively more difficult, so that ever-
increasing demands for careful, sustained attention were
made on the child.
Auditory tasks followed a similar procedure (e.g., buzzing
whenever the word ball is heard, versus buzzing whenever the name
of something you might see in the sky is heard). These tasks also
required the child to exercise careful sustained attention to be
successful, and the tasks again became more difficult - and thus
required greater focus - over time. The basic premise underlying
the Pay Attention! program is that attentional abilities can be
improved by providing structured opportunities for exercising
and practicing particular aspects of attention.
The non-treated comparison group participated in computer based
activities. This was a task that was interesting to children,
and which required them to focus their attention. It did not,
however, include a systematic effort to specifically provide
training that would lead to improved attention abilities.
RESULTS
Did the program work?
The results of this study are encouraging. Although the groups
did not differ in IQ or performance in pre-testing, they both
demonstrated improved performance on posttest measures of
attention, particularly selective attention. This suggests the
impact of a practice effect. However, children in the attention
training treatment group demonstrated significant improvement
above and beyond that of the comparison group on 4 of 6
groups of measures considered sensitive to attentional functioning.
Both groups also demonstrated significant improvement on
a measure of academic efficiency called Math Worksheets.
Once again, however, the children receiving the Pay Attention!
program showed significantly greater improvement than children
assigned to the computer game condition. Children receiving
the attention training program also tended to be rated as showing
improvement in attentional functioning by their teachers. (The
teachers did not know which group a child had been assigned
to so these ratings should not have been biased).
In weighing the results of this study, there are several issues to
be considered. First, as noted above, the very small number of
children participating in this study clearly indicates the need
for a replication with a much larger sample. Having said this,
however, it is important to note that it is actually harder to
obtain statistically significant results with such a small sample.
The fact that several such results were found is thus impressive.
It is also impressive to note that some significant improvements
in attention were found even though the majority of children
who participated were already on medication. The gains made,
therefore, were above and beyond the benefits that children
were presumably already receiving from their medication. Thus,
combining this type of attention training program with medication
treatment may offer potential benefits to many children.
Certainly, these results are encouraging enough to support
the need for future investigations of this interesting program.
In addition to employing larger samples, it will be important
to include a longer follow up period to determine whether
any initial improvements in attention as a result of the treatment
are sustained over time.
Efforts to directly improve the ability of children with ADHD
to sustain attention are quite important. I will be sure to
include other studies of this issue as they are published.
______________________________________________________________________
"ADHD RESEARCH UPDATE WILL PROVIDE YOU WITH
CONVENIENT, RELIABLE ACCESS TO THE LATEST
RESEARCH BASED KNOWLEDGE FOR UNDERSTANDING
AND HELPING CHILDREN WITH ADHD."
Dear Parent:
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Chances are that you will be better informed about important
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will enable you to be a more confident and effective
advocate for your child, and help you to make sure that your
child's treatment is based on the latest scientific
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"WHY NOT HAVE THE ADVANTAGE OF THE LATEST RESEARCH
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You can find complete information about becoming a subscriber at:
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On this page you will find feedback from a number of current
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Sincerely,
David Rabiner, Ph.D.
Licensed Psychologist
Duke University
http://www.helpforadd.com
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