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The ADD / ADHD Gazette
The FREE online ezine all about ADD and ADHD.
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*** ISSUE #25 ***
16th February 2000

IN THIS ISSUE:
Healthy Place Com
Camp Kodiak
The ADD-Spouse Homepage
ARTICLE; Can Children With ADHD Be Taught Better Attention Skills?



******************SPONSOR ************************

WILD CHILD ~ A Mother, A Son and ADHD.
My story of how I was driven to the edge of despair by my
unruly son and my fight with the powers that be for recognition
and treatment for my son's condition. Full details at;
http://www.Amazon.co.uk/exec/obidos/ASIN/1872229247/gailmiller

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Healthy Place Com

As I mentioned a few months ago, there was to be a brand new mental
health portal opening called Healthyplace.com . I am delighted to inform
everyone that it opened yesterday and visitors can now access a range
of sites all about ADD / ADHD at the ADHD menu page at
http://www.healthyplace.com/Communities/ADD/Site/index.htm
as well as many other mental health topics at the home page. I am sure
you will all agree with me that the site is AWESOME! I have a site on the
portal at http://www.healthyplace.com/Communities/ADD/gail/index.html
and as well as individual sites there are support groups, chats, medical
experts ... there is even Healthyplace Radio! I am delighted at how
fantastic the site is. Check it out!!!!!

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Camp Kodiak

An integrated summer camp for children & teens with ADHD and/or
learning disabilities. With campers from all over North America and
from around the world, the program includes over fifty sports and
activities. Also providing academic tutoring and social skills program.
The staff contains many professionals including psychologists,
teachers, social workers and recreation specialists and the camper
to staff ratio is two to one. http://www.campkodiak.com


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The ADD-Spouse Homepage

This Group has been running since 1998 and is for the support of
Spouses, Lovers and Significant Other who are living with an
Adult who has ADD/ADHD. Aiming to work towards supporting
one another by sharing stories, tips, coping strategies, and by
UNDERSTANDING! The address is http://talk.to/addspouse .

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ARTICLE

Can Children With ADHD Be Taught Better Attention Skills?
by David Rabiner PhD

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 behavioural strategies to
increase a child's attentive behaviour 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 modelled 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 colourful and visually interesting. They also focus on familiar
concepts such as family relationships (e.g., siblings, parents,
grandparents), features of people (e.g., hair colour, 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
colour 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 practising 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.

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 post-test 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.

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The above article comes from David Rabiner's ADHD RESEARCH
UPDATE. David Rabiner, PhD Licensed Psychologist. Visit
http://www.helpforadd.com for information and services designed
to help parents promote healthy development of children with ADHD.
Receive a FREE trial of ADHD RESEARCH UPDATE by going to
http://www.helpforadd.com/nresearch.htm Also, Dr Rabiner has
developed a system to help parents easily monitor how well their
child's symptoms are being managed at school. It is distributed
free via email simply by clicking on mailto:monitor@...


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Resources

EMPOWERED PARENTING EZINE and JOAN'S PARENTING
E-BOOKS ~ Timely Tips for Today's Parent, the most
important job in the world! Joan Bramsch will encourage
you to be Your Best. "Children really ARE different today."
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LEARN MORE: http://www.celebrityhowto.com/JBramsch.html
Or SUBSCRIBE: EmpoweredParenting-subscribe@onelist.com

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Learning a foreign language? Wanting to start?
Subscribe to LANGUAGE LEARNING, a free weekly internet
newsletter helping language learners learn language.
mailto:language-learning-subscribe@onelist.com

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One of my colleagues has just set up a new Tourette Syndrome web
site. her My son has Tourette's and possible ADD and her daughter
shows symptoms of OCD. Also my colleague believes she has
symptoms of all 3! Take a look - at Tourette Syndrome Support UK
http://www.bigfoot.com/~biggrin

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IMPORTANT DISCLAIMER
Items herein are published for education/information purposes
only. Any therapy, product, service, or featured web site mentioned
does NOT imply endorsement by The Gazette. Accuracy and
content of any web sites featured cannot be guaranteed. Views
and statements written by contributors are not necessarily the
views of The ADD / ADHD Gazette.

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LINKS
If you have a website and are looking for links. I am happy to add
a reciprocal link to The ADHD (UK) Website. Take a look at my
site http://home.freeuk.net/theadhdgazette and email me to swap links

subscribe; ADDGazette-subscribe@onelist.com
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SEE YA NEXT TIME ~ Gail Miller 2000
theadhdgazette@...

And remember ..........
"If your not making waves than you ain't kicking hard enough"