Navigating the Mindfield of LD - Attention Control, Executiv

I haven’t read the technical work you have so don’t understand the various aspects of attention the way you do. But my son’s attention has greatly improved following Interactive Metronome. We had intended to do a trial of medication this fall, following a diagnosis of ADD-inattentive this summer, but the baseline reports were so good we dropped the whole thing. One of the teachers was the same as last year and she told me she couldn’t believe the difference in him.

Now I think he still has some attention issues but the change has been very striking.

Interactive Metronome has controlled studies showing improvements in attentin.

Beth

Ditto Beth’s comments. My son has had big gains in attention with IM. Interestingly, I didn’t realize how much his poor attention was affecting him until it got better with IM.

I am also considering neurobiofeedback at some point. I still see improvements that I believe are related to IM. I want to see how far he goes. It seems as we improve his motor and visual issues his attention is improving. All of those issues are easier to address since he gained the IM skills. For instance, he couldn’t ride a skateboard before, but now he practices this new skill and I see his balance and coordination getting better. Eye exercises have moved quickly since IM.

I think as these things improve he is gaining more self control. Hard to explain exactly why but he is just making big gains in many areas.

I have read several times about “interactive metronome”. What is it, how does it work and how do I find out more about it? Our son is ADD, inattentive and we are looking for any strategies we can use to help him.

Do a search with Interactive Metronome. The therapy amounts to the child wearing headphones and doing repetitive motions in time to the metronome (on a computer). It works on motor planning. It seems that the same area of the brain involves attention.

It is 15 sessions standardly but many people have found that severe kids have to have more. We did a pretest with IM and my son scored so badly that the recommendation was to get other therapy first. We did and went back and did IM with great success (and only 15 sessions).

My son has a slew of learning problems but IM really moved him forward. We went back to the therapy we had been doing after IM and really made great progress there in areas he had been stalled. IM seems to help reorganize parts of the brain (my interpretation not scientifically validated) and thus make other types of learning easier too.

Beth

Thank you, everyone for your helpful feedback. This is a wonderful forum for sharing ideas.

Hello- I’m a psychologist who specializes in work with ASD kids. I’ll definitely look into Levine’s work- thanks for the tip. I would also recommend that you look into neurofeedback to address executive functioning. I have seen it to be helpful, although not consistently. I would also work directly on helping your child with the saliency issue. His attention focuses on nonsalient information because he does not necessarily recognize what is most salient. You can help him in lots of ways- discuss a person’s characteristics, a class lesson, a movie or book plot, elements of a conversation. I often use a white erase board and help the kid see how the information relates to eachother- for instance, write a category or heading and then all that falls under it or draw a chart or web. Discuss how important each bit of information is (sometimes I have the kid code the level of importance by a color or number) system. Highlight the most important information. He needs to work on highlighting information in his notes, in his texts- point out that the most important information is often in the first sentence in the paragraph- that this is a topic sentence and what follows are often supportive details and then a closing sentence. You are helping him to better understand and interpret the organization and patterns of these things. Then the attention should follow. By the way, I’ve also found Steve Gutstein (connectionscenter.com) to be quite helpful in addressing ASD issues, particularly in the social-emotional realm, you might check his work out also. Good luck.

Thanks for coming to this board. You knowledge and experience are a great windfall to those of us who struggle to help our children.

I really appreciate the input on how to teach children the salient points of material. I see this as a problem with my son. He is extremely creative and often gives the creative answer to a question rather than the logical one. He is frankly so good at thinking outside the box, that he rarely thinks inside the box which is, as you can imagine, a problem in third grade.

Do you have any further advice that would help to improve logic and reasoning? Are there any games you would recommend or other methods?

I am going to try the things you recommended above.

Hi JLH - I’d like to second Linda’s thank you. Some of your suggestions are new and I’ll be following up. When I read Levine’s book, I came to the conclusion that Asperger’s Syndrome is really just a collection of secondary symptoms of deficits in attention control and executive function.

The wonderful aspect of this bulletin board is the opportunity to share and to compare notes.

Thanks again,

Dan

Well, thank you for the thank you’s! I don’t have a lot of time to be on the board, but I like to check in from time to time and offer what I can. I have also certainly gained myself from it- I need to hear from the parent’s perspective! As for Linda F.’s question about logical vs creative thinking- I am in part pleased that her son can play with ideas and be creative. There is some flexibility there in his thinking, then, and that’s a good thing. Many kids on the spectrum tend to be too rigid and literal. But yes, I will work hard to get a kid’s thinking to loosen up and then they become too loose! Again I think there is an underlying deficit in organization (some professionals refer to it has central coherence) that always needs to be worked on directly. When I work with a young ASD child I immediately begin working on the pretend play skills- since that is abstract thinking and social problem solving within play. I simultaneously work with the child on the difference between pretend and real. I also bring these ideas into everyday situations. ie., the light burned out- what’s a pretend solution? (magic wand…) What’s a real solution? (replace the light bulb…). As the child progresses, I then work on generating multiple solutions (too encourage flexibility). Some can be silly (build your own light bulb) or dangerous (build a fire to see by). Then we discuss which solution is best and for what reason- which solutions are not recommended and why. What would be the consequences of each solution? Sometimes the correct solution to a problem is the most direct solution, while at other times it is not- discuss why. It becomes even more complicated when other people’s feelings and experiences are involved! But I add these to the mix when the child is ready- adding them in as factors to address as well. Again I tend to write this all out in visual form- like a math problem. This helps the kid keep track of his thinking- and it helps to develop visualization skills that are so important in this type of thinking. Hope this was helpful!

JLH,
Until we can carve out time for neurofeedback in our busy schedule, are there tips you can recommend on improving exec. function. My son has a cluster of mild deficits - isn’t really dx with any specific disorder, but attention and exec. function are areas I’d like to work on through behavior modification .

Ah a day off from work and I find myself talking shop on a message board- my idea of fun I guess. I think of executive functioning as the conductor of the orchestra- the orchestra being made up of the other cognitive functions. The conductor decides on the instruments to be used, the tempo, which should play together or fade out or step in, what the theme or goal is in the music…That’s as far as I can take that analogy, but you get the picture. When I work with the child I help the child become more aware of being the conductor of all that they do. I help the child stop-look- listen, plan their approach to tasks, plan on the skills that they need, be more aware of different ways to approach a problem, predict consequences… I identify their personal pitfalls (is it distractions by other students? hunger? anxiety? a messy workspace?), help them be aware of those pitfalls, and strive to give them skills to gain a sense of control over them. I address them through not very unusual modifications and accomodations- but my goal is to structure their thinking, their control over their functioning. As I described in the above messages, I also address this through cognitive remediation more directly as well. At home and at school I usually will increase the external structure- but with the goal that the structure becomes internalized. So I’ll recommend the use of schedules and calendars, regular daily routines, a quiet and neat workspace, logical and predictable discipline, clearly stated expectations before tasks and activities… Some children do well with the use of a timer to help them remain focused and motivated for a task- the goal is to increase the child’s internal sense of time and attentional control. A reminder on a child’s desk (what should you be doing right now?) hopefully becomes in internal question. You get what I mean? I also have parents engage in lots of chat and play to encourage problem-solving skills, logical thinking, creativity… Much more hands- on learning and social interaction and much less TV and computer. There should be periods of running around and physical outlet as well as “quiet down time”. None of this should be particularly stressful- you are not grilling the child in your chats. You may have a serious agenda, but follow the child’s interests and have lots of fun! If you embed learning within pleasure and close relationships, it will be more likely to bloom…

Your perspective is really valuable here so I hope you’ll check in frequently and put in your 2 cents often.
THANKS!

Well, thanks. This is a great board- I’m learning a lot myself.

Exactly right! He is too loose. I think I am partially to blame. I have always been in awe of his creativity and have probably promoted this level of thinking without requiring enough logic into the mix.

His creativity is lost without logic. There needs to be a balance or else he will not be able to turn his numerous ideas into something useful and practical.

Thank you so much. I need to read your posts several times and save them.