• Business and Finance
• Family
• Computers and Internet
• Auto and Trucks
• Education
• Health
• Hobbies
• Home Improvement
• Legal
• Marketing

• Home
• Arthur's Articles Home
• Browse Categories
• Browse Authors
• Submit an Article
• Search for Articles

Home » Family Articles » A Pediatrician On Helping Your Kid With Add Adhd

A Pediatrician on Helping your Kid with ADD/ ADHD

Today we interview Dr. Arthur Lavin, Associate Clinical Professor of Pediatrics at Case Western School of Medicine, pediatrician in private practice, and one of the first providers of a Working Memory Training program for kids with attention deficits. Dr. Lavin trained with esteemed Mel Levine.

AF (Alvaro Fernandez): Dr. Lavin, thanks for being with us. Can you explain the source of your interest in brain research and applications?

AL (Arthur Lavin): I am fascinated by how the mind works. How can neuroscientists' increasing knowledge improve kids' lives?

AF: Some readers may think that a major part of the problem we face today is that kids are simply "lazy". What do you say to that?

AL: I have never met a lazy kid. All people want to succeed, in life if not in school. The ones that are labeled as "lazy" are typically ashamed of their lack of capacity to deal with demands, and resort to evasive strategies.

AF: You mention a "lack of capacity to deal with demands". Is that gap growing?

AL: Yes. I can see how complex homework assignments are these days even in 3-4rd grade. Kids need to plan and prepare a whole matrix of tasks that require good organizational work to complete. They need to sequence what they do today, tomorrow, the day after. The major difficulty, for which such young brains may not be fully ready, is to deal with an overwhelming amount of information and demands.

AF: that seems to imply a higher need for good executive functions than years ago. A kid needs to have good working memory to retain, prioritize and sequence much information into actionable plans, and then execute them. We know that a common problem with many kids with diagnosed attention deficits is, indeed, working memory (the ability to hold in mind and manipulate several units of information). Can you explain what you see in your work with schools?

AL: I am afraid that many schools are too quick to diagnose ADD/ ADHD and consider drugs as the only potential intervention. The label itself can be misleading and counterproductive. School psychologists have wonderful expertise in evaluating subject-related problems and describing attentional deficit symptomatology, but are not trained or asked to complete neuropsychological profiles of a child's cognitive functions. Up to a point, many kids with attention problems would benefit from educational, not medical, interventions to improve cognitive functions such as working memory. I am seeing it first hand, having used a Working Memory Training program with 15 pre-screened kids: 80% of them presented a substantive improvement. With 50%, the results we have seen have been dramatic.

AF: Please give us some examples.

AL: Let me give you 3 vignettes, all 3 with diagnosed attention deficits.

Patient 1: 11-year-old boy, very impulsive, even on medication. Doesn't do homework, constantly forgets chores. After the 5-week program, he is able to sit down and listen instructions, engaging in fewer arguments with his parents. He can do better mental math- for the first time in his life able to do so without using his fingers. He finds that following school and doing homework is easier, grades have improved dramatically.

Patient 2: 16-year-old girl with ADD. She has trouble executing homework, often telling parents she had done it when she really hadn't. Her parents thought she liked to lie. Yet, when I talk to her, she is clearly more ashamed than dishonest. The working memory training program helps her develop a much improved perception of time. For example, she starts to manage her shower time better, being aware of when 5 minutes have passed-instead of spending 30 minutes in the shower, as before. Much improved school work, lying at home has dropped dramatically.

Patient 3: 19-year-old boy in college, who often became paralyzed when he was faced with complex challenges. He had a tough time with the cognitive training program, but after a while he started learning new strategies and developing self-confidence, and showing marked improvement. Now, he can break complex tasks into manageable pieces . His attentional deficits appeared to threaten his opportunities in his family business. Unable to keep track of change at the cash register, lines at the business would grow and customers get angry, leaving him out of consideration for key start-up employment in the business. Now he can manage day-to-day challenges such as these, and the door to being part of the family business is now open. He can sequence tasks and execute then with a clear plan in mind, without being distracted and losing sight of that plan.

AF: Dr. Lavin, this is all very exciting news. Thank you very much for your time.

AL: Thank you.

Copyright (c) 2007 SharpBrains

And here is another random article you might be interested in...

Learning To Be A Boss

"Arghh!!"

Karen, ground her teeth as she looked down at her desk. Instead of the draft report she had expected when she got back from her meeting, there was a note from Ted. "I've still got some issues on the report," the note said. "I don't want to show it to you until it's ready."

Karen pushed back her chair and stood up. She paced back and forth in her cube, gesturing with her hands even though no one was there.

The final version of the report was due to her boss, "The Field Marshal," on Monday. She would look terrible if the report was either late or not up to her boss's high standards. Karen figured she was way too new in her position to risk looking bad.

She looked up, a little surprised to realize that she had walked the length of the corridor while she was thinking. She always did that when she was upset or excited. Walking just seemed to make her feel better.

She was going to need some help and she figured the best shot was one floor up. Karen climbed the stairs and headed toward a cubicle with the light on.

Trying to appear casual, she draped herself over the cubicle wall and addressed the occupant. "Got a sec?"

"Sure, pull up a chair and unload."

Karen dropped into the only free chair. She exhaled heavily and stared down at her lap.

"Ted again?" asked Jim.

"How did you know?"

"Because nothing else seems to penetrate your armor of enthusiasm as quickly as he does. And because I know the signs. Anyone who's been a boss for a while has had at least one Ted."

"OK, then, smart guy," Karen smiled, "how do I motivate him?"

Jim just stared at her. Karen flushed and reached into her purse. "OK, ok, I said the M word and now I'm going to pay."

Jim had several rules for the people he mentored. One of them was that they couldn't ever say that they were going to motivate someone else. Every time they said that, they had to pay a fine.

Jim extended a mason jar filled with coins and bills toward Karen. Theatrically, she withdrew money from her purse and dropped it into the jar. "At least I'm not the only one wracking up fines."

The amount of the fine wasn't much and Jim put it into a fund to buy educational supplies for the families of the people who cleaned the office.

"You can't motivate another person," he said over and over again. "All you can do is use the behavior you can control to influence the behavior of the people who work for you."

Karen had sure heard that often enough from Jim, even though she hadn't been a boss for very long. She had an undergraduate degree in business and an MBA. She'd worked during school and then started with the company in sales.

After her promotion, she was assigned to Ray's unit. It was a high performance group, but Ray wasn't always the easiest person to talk to about people problems. That was why Karen was glad she had met Jim.

It had started out as one of the worst days of her life.

She'd only been in her position for a couple of weeks and her boss, Ray, had sent her an email congratulating her on a piece of market analysis she'd just sent him.

For no particular reason except that she was pleased with herself and the compliment, she'd stopped by Ray's office to talk about her dreams and hopes for the future.

He sat at his desk and listened politely for a couple of minutes. Then he raised his hand.

"Stop," he said. "You just started working for me, so I'll forgive this outburst. Know this. I don't do chit-chat. If you've got something about work to talk to me about, my door is always open, but don't waste my time with warm fuzzy stuff. Just do your job and do it well and things will work out just fine."

Karen started to say something as Ray turned back to his work. He didn't even look up. "Just go," he said.

Karen was devastated. She went to the cafeteria and got some coffee. She was staring into it and listening to Ray's words in her mind when she became aware that someone was standing in front of her.

"I understand you just got the Ray Treatment. Want some help dealing with your boss?"

"Sure." Karen waved him toward a seat. "You're Jim Robertson, right?"

Jim was supposed to be a good boss. His teams were always among the most productive in the company. Jim was also known for mentoring others, helping them develop and get promoted.

"And you're Karen, the new star from the field who's got to learn to work for Ray."

"I'm not sure I've got much future with him."

"Sure you do," said Jim. "Ray's actually a good boss."

"A good boss? You heard what happened and you still say that?"

"OK, he has a few rough edges, but you'll learn from him."

"If I survive."

"You'll survive. Ray's good and he's fair. He's not shy ..."

"He could use a personality makeover."

"Karen, you've got to learn to understand Ray. He's your boss. It's part of your job to help him succeed. When he's in the office work is everything there is to him."

"So I just learned. He doesn't do chit-chat."

"No, he doesn't, but that's OK. If you expect Ray to change or worse, if you expect to change him you'll have lots of trouble."

"I have no desire to change the man. I just want to survive."

"That's a start. Just limit your conversation with Ray to work and professional things and do your best to help him achieve his objectives. You'll do more than just survive."

But if you help him achieve objectives, talk to him about work and professional interests, and are always ready to act you'll do quite well indeed."

That had been the beginning. Karen, like many others at the company had found herself one of "Jim's people." Some were people who worked for him and others, like Karen, were simply people with whom he shared his wisdom.

Jim always seemed to have time for people. He was sincere and caring and, best of all for Karen, non-threatening. Karen had learned a lot from him.

Jim taught her that you manage behavior and that behavior was what people say and do. Nothing else.

He said you couldn't manage attitude or motivation because you couldn't see them; they were inside the other person. All you could manage, according to Jim, was behavior.

Karen remembered something else he'd told her right after they met. Jim told her that she had less power than before she was promoted.

"Think about it," he said. "When you were an individual contributor and you wanted to get a better evaluation, or a raise, all you had to do was work harder or smarter. But now you're responsible for your team and guess what? Their performance is your destiny."

That was when he'd told her something else that she found startling at the time. "Remember," he said, "you can't make anybody do anything."

That had stopped her cold. Karen had always figured that's what a boss could do. But Jim pointed out that if a person was willing to take whatever consequences you delivered for improper performance, there simply wasn't much you could do.

"What are you thinking?" Jim's voice interrupted her reverie. "I don't want to rush you, but I've got to head out to my meeting in just a couple of minutes."

"I was just going over all your little lessons and sayings," said Karen. She gave him a quick recap of what she'd been thinking.

"You forgot one," Jim said, "You got the part about your power going down when you get promoted to being in charge of a group, but what about the other half?"

Karen jumped in as he was finishing. "I didn't realize this was a quiz!" She laughed. "I forgot to mention that when you become a boss your influence goes up because the people who work for you pay attention to what you do and say."

Jim was laughing now, "And ..."

"And so," said Karen sounding like she was reciting in school, "you use your behavior (what you say and do) to influence the behavior of the people who work for you."

She paused. "All of this is wonderful, but it doesn't help me with Ted."

Jim was standing up. "I can't chat right now. We could take some time tomorrow, but if you're free this evening, you might want to come along with me. I'm headed to a meeting of a group we call the Supervisor's Roundtable. It's where I learned a lot of the stuff you were just reciting. I think you might find those answers you're looking for in this group."

Karen only thought about it for a second. "OK, I'm game. Who's driving?"

"No need to drive. We meet at the coffee shop that's over behind the parking garage. A convenient walk to wisdom." Jim laughed. "Let's go."