By Valerie Maxwell Ph.D.
What does the Factors of Attention mean? The area of the brain known as the pre-frontal cortex takes responsibility for the “executive functioning” of the brain. This is the “thinking brain” which must make decisions, keep track of time, assimilate what is being told, seen or taught, and organize information with prioritization in order to be processed by the brain. This is how we “think about our thinking” so we can function efficiently in the world. Efficiency in our lives helps to create happiness in ourselves and respect from others.
In order to fulfill these executive functions, the brain must have accurate input. Paying attention to what is seen, heard, touched, smelled, and tasted is the way the brain receives this input. According to experts (Reid Lyon) there are 5 parts of paying attention:
- FOCUSED OR SELECTIVE ATTENTION: We need to be able to select the most important information and to ignore the input that is not needed at that time. For example, listening to the teacher’s directions and ignoring a friend kicking your chair is vital to success.
- SUSTAINING ATTENTION: Maintaining awareness is essential to helping us focus on our goal or task. Sustained attention is critical to completing the job, whether that is homework or cleaning your room.
- SHIFTING ATTENTION: Flexibility of attention is key to our ability to change, to grow, and to multitask so that we get everything done that we need to do. Playing Nintendo for 20 minutes and then getting back to the homework is not possible without this flexibility.
- ATTENTION FOR ACTION: We need to be able to route the input to the appropriate brain sites in order to put all the information together so that it comes out at the right time, in the right order, and in socially appropriate ways. This function involves SEQUENCING and PROCESSING the information.
- DIVIDED ATTENTION: Being able to attend to several things at the same time without getting distracted is key to keeping all the balls in the air that modern life demands of us. The child must remember his study-buddy’s phone number, focus on his internet project, and listen with acknowledgement to his mother asking him to call his father in for dinner.
“Although there is a solid core of scientific evidence indicating that speaking and listening have a biological foundation, the human capacity for reading and writing does not.” (Maureen Argus, The ADHD Challenge, March/April 2000). In order for a child to speak, read, listen to the teachers, or write, that child must have developed the ability to pay attention in all ways. Children with ADHD and many with learning disabilities related to cognitive deficiencies have attentional problems. Without proper attention, reading and writing cannot be assumed.
There are 5 senses (i.e., hearing, vision, touch, smell, and taste) that need to be in attention at all times. However, most often in school the child must rely on her ability to hear and see. When we talk about a child’s auditory or visual processing skills, we are talking about a child’s ability to use all of the above 5 attention functions in order to understand, think critically, and to produce results. This is processing.
Getting all the input out (whether it’s on paper or in an oral report) is not enough. The output must be in the right order. This is sequencing.
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Dr. Valerie Maxwell is a clinical Psychologist in Manhattan Beach, CA and a frequent speaker at CHADD meetings in Southern California.
by Dr. Nona Djavid
Our children are facing an epidemic. We live in an age that often replaces health with prescription drugs. 1 out of 10 American children has attention-deficit/hyperactivity disorder (ADHD). But what is even more alarming is two-thirds of those kids are taking prescriptions like Ritalin and Adderall, the very same drugs responsible for 23,000 emergency room visits in 2011. ADHD without prescription drugs is possible!
We may be setting a precedent here, where we are substituting healthy lifestyle choices with ADHD for dangerous prescription drugs. As a chiropractor certified to see children and babies, I try and educate parents who bring in their children to my office about the choices they have to help their children diagnosed with ADHD. When children and parents are given the tools and treatment needed for optimal nervous system function, life changing results happen. This happens every day in our office. There are so many alternatives to prescription drugs. Chiropractic care, which markedly improves neurological function and eliminates blockages in the nervous system, can help restore optimal function of your child’s nervous system and brain function.
3 Things You Can Do:
They Are What They Eat:
Gluten-free diets with little-to-no processed foods are the best choice, but if you can’t fully commit to that, then avoid empty carbs like white breads and buttery cracker snacks. These break down quickly into sugars, providing little nutrients, elevating blood sugar levels and interrupting proper neurological function. INSTEAD: offer grainy breads (oatnut or whole wheat crackers and breads.) You can replace buns and breads entirely with gluten-free quinoa breads or brown rice buns. Also avoid ALL sugary drinks. These are the principle contributor to increased incidence of diabetes in children. This means no sodas, fruit juices, sports drinks or ANYTHING with added sugar or Fructose. INSTEAD: Find clever ways to get them to drink more water. You can try blending or infusing their water with real fruit like strawberries, lemons, blueberries or peaches.
Check Their Spines:
Chiropractic care is a safe and effective method for the treatment of ADHD. Most cases stem beyond neurological, and can even be structural. Postural problems, when correctly adjusted with corrective chiropractic care, can help heal complications associated with ADHD. Postural misalignments can affect neurological development and inhibit complete and healthy brain function. With chiropractic, the structural problem can be identified and the neurological problem improved. With chiropractic adjustments, the spine realigns to its peak state. A correctly aligned spine creates an optimal nervous system – allowing for normalcy and balance in behavioral functions.
Get Them Motivated:
ADHD without prescription drugs is possible! It’s important to look deeper into your child’s wonderful creative mind, and channel their bountiful energy. Find activities that encourage your child to become more active and explore mental facets that they seem interested in. If they’re constantly climbing up on things, get them involved in indoor rock climbing! If they’re constantly peppering you with questions and asking how things work, maybe they’d be interested in film making. Often an overactive brain is misdiagnosed into a behavioral disorder.
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Dr. Nona Djavid
Founder & Lead Chiropractic Physician
Dr. Nona Djavid is a well-respected and trusted doctor of chiropractic and wellness coach with a private practice in Newport Beach, CA. Founder and head chiropractor at the Wellness Choice Center, Dr. Djavid is dedicated to the creation of transformative experiences of vitality for her patients, through nutritional counseling, lifestyle changes, and natural alternatives.
A graduate of University of California at Berkeley in the field of Molecular and Cellular Biology with an emphasis in Neurology, Dr. Djavid continued her education at Life Chiropractic College where she earned her post Doctorate studies in Neurology and Chiropractic Biophysics. With a background in neurological sciences she came to understand the nervous systems control over the body. Through her research the importance of the nervous system was evident as the key to the overall health of the body. Specialties of Dr. Djavid include postural correction, and a unique knowledge in extremity adjustments.
Dr. Djavid is also the founder of WOW – Women of Wellness group – an organization that empowers female health care professionals to build healthy caring relationships through education and integrated health and wellness services.
With a state of the art facility at her disposal, educational background and her genuine passion for life, people, and health, Dr. Djavid provides the very best care with intelligence and compassion. For more information check out her website at: www.wellnesschoicecenter.com
Well, it depends…
The scientific literature abounds with studies claiming to have discovered evidence one way or the other. This often contradictory information can be confusing, but some themes seem to be consistent, and more importantly, to make sense.
For example, there is some correlational evidence that violence in video games may increase aggression in certain vulnerable kids. We believe that kids with excessive anger are attracted to violent games. For these kids, violent games may teach unhealthy conflict resolution skills, glorify aberrant or subversive lifestyles, or desensitize kids to terrible events. Parents should be particularly concerned if a child’s level of aggressive behavior is consistently higher after playing.
On the flipside, there is also evidence that playing video games can act as a healthy outlet for aggressive impulses. Kids who play video games often say that the games help them relax or cope with stress. Violent video games might offer an alternative outlet for aggressive and angry feelings by providing a vicarious, and less destructive, experience of testing limits. In addition, gaming can build self-esteem, provide a sense of accomplishment, and improve socialization. It is unusual, for boys in particular, to not play video games. The shared experience of overcoming certain gaming challenges acts to help some children bond. Game play is often a normal social activity for boys, and lack of interest in social gaming may signal social difficulties.
So if all of this is true, how should parents manage video games in their child’s life? I believe that, for most children, a balanced approach is best. Many kids can use video games in moderation as a healthy tool in their play toolbox. Some children will need their parents to provide structure and moderation for them. For these kids, it is best to make the limits very clear. Parents may want to place a time limit on the game, or a contingency like “you may play for 1 hour after all of your homework and chores are done.” I would also suggest that parents actually play video games with their child. This provides many benefits, not the least of which is forging a stronger bond with your child.
You can also use the time to guide and mentor your child in his or her play. Explain situations or themes that he or she may not understand, or might misinterpret. Use the opportunity to discuss morals and values; parents often underestimate the impact of their words and actions on their child’s beliefs. There are currently several games offering, as a central theme, the moral development of the main character (Fable, Infamous, etc). Use these games as a launching point for discussions about morals.
Playing games with your child also affords you the benefit of a first hand look at the content of your child’s game. Parents can also refer to each games rating from the ESRB (Entertainment Software Rating Board) for a rough guide to a game’s content. Pay particularly attention to games rated “M” as these are intended for people age 17 and above. Your game console, or computer, should have the ability to restrict certain types of games based on that game’s rating.
These suggestions are general, and should work well for most people. For children with significant behavior or emotional problems, the decision to use or exclude video games should be made carefully with attention paid to the potential risks and benefits such a move would have. Allowing the child to use video games, particularly violent games, may increase their aggression, while forbidding the use of their game could remove one of the child’s only sources of self-affirmation and competence.
Some parents have complained to me that their child seems “addicted to their video game”. They spend an excessive amount of time playing alone, and even ignore fun and engaging alternatives. They may not even enjoy playing the game that much, instead they use it to escape from pain or conflict in their lives. In many of these cases, the issue is not the video game itself, but rather the child’s inability to use alternate coping strategies to manage emotional or social problems. If you suspect that your child is suffering from problems like these, I suggest seeking help from a professional in children’s mental health.
Stephen Morris, M.D.
Doctor Morris is an Adult, Child, and Adolescent Psychiatrist operating a private practice in Manhattan Beach, California. For more information, please contact him through his website at https://www.StephenMorrisMD.com
The production controls of attention regulate the quality and efficiency of our output – the creations, activities, and behaviors that we produce. They promote good judgment, effective problem solving, and sound decision making. Based on the work of learning specialist, Mel Levine, MD, I will describe four common forms of production control and provide strategies for strengthening these controls at home.
Previewing control enables us to look ahead and foresee an outcome, a likely result of something we’re about to do or attempt.
Options control entails thinking about choices rather than doing the first thing that comes to mind.
Pacing control regulates output speed, so actions are not too fast or too slow.
Quality control involves monitoring quality of output, so improvements can be made. In performing a task or trying to behave in a certain way, it is important to know how we are doing (self-monitoring).
Strategies for Parents:
*To help develop previewing skills, parents can encourage their kids to come up with a plan before writing a report, starting a project, or drawing a picture.
Children need to preview consciously, to visualize and describe what the outcome or result is likely or desired to be.
*It is often helpful to stress previewing in a child’s area of talent. For example, a child who is good at carpentry might be asked to draw a rough sketch of what the final product will look like prior to starting the actual work. Parents should spend time discussing this sketch and helping the child think through possible revisions in advance.
*Kids can be helped with previewing as part of their summer reading. Before reading a book, they should try to preview what its content is going to be based on the book’s title.
*To work on the aspects of options control, parents can ask questions like: “What are the different ways we might do this? What do you think is probably the best way? What would be the worst way to go about this?” This sort of reviewing of alternative strategies can occur before preparing a report or studying for a test. Such techniques can also help with overall problem-solving skills.
*The same kind of help can be related to behavioral and social planning (e.g., “What’s the best thing to do about that girl who called you a bad name in school today? What are some other things you could consider doing? What would work best? Which of these possibilities is a bad idea?”).
*To help children with improper pacing, parents should discourage frenetic work patterns by avoiding statements such as: “You can watch television when you finish your work.” Offers of this kind may inadvertently encourage children to work as quickly and carelessly as possible.
*It can help a child’s pacing to set aside a certain amount of time each evening (or each weekday evening) for cognitive work. The whole family should be engaged in such activities. There is then no incentive to finish quickly, since it will only mean having to find some other brainwork to do.
*Kids who need specific help with self-monitoring and proofreading (quality control) can benefit from looking for discrepancies or errors in their work or in the work of others. They should be required to proofread their own work but only after an interval of hours or days has passed since the work was completed. It is very tedious for anyone to correct something immediately after completing it.
Dr. Susan E. Cozolino is a Licensed Clinical Psychologist who has a private practice in Beverly Hills. She specializes in the assessment of Attention-Deficit Hyperactivity Disorder and Learning Disabilities in students ages 6 & up. Dr. Cozolino helps students understand and address learning challenges by conducting thorough assessments, creating individualized learning plans, and recommending and advocating for educational services, modifications and accommodations. Dr. Cozolino is also an Adjunct Professor at Pepperdine University Graduate School of Education and Psychology.
by Dr. Andrew McIntosh
For some reason, the discussion of fish oil supplementation conjures up images of a mountebank peddling a potion at an old-style country fair. Indeed, the idea of fish oil supplementation to treat a variety of ailments has been around for many decades. Recently, fish oil has received a great deal of attention in the lay media and professional medical literature for the treatment of behavioral disorders such as ADHD.
After diagnosing a child with ADHD and transitioning to talking about treatments, I often start to feel a bit of tension in the room as parents start to think “I know he’s going to recommend medications and as a family we are not prepared for that”. However, before launching into a discussion of different pharmacotherapies for ADHD, it is important to consider nonmedical management. For example, behavior modification strategies have been adequately studied and proven to be beneficial for many children with ADHD. Three less frequently discussed ADHD treatments which I touch upon during my consultations are essential fatty acid (such as contained in fish oil) supplementation, sleep habits and basic dietary changes.
From scientific studies of essential fatty acids (EFAs) and ADHD we know that (1) individuals who have ADHD may have low levels of EFAs and (2) essential fatty acid supplementation may normalize EFA levels in children with ADHD. The clinical significance of this is somewhat less clear; however, most studies provide evidence of lessening ADHD symptoms. As with most scientific studies, there are concerns with study design and confounding factors but the current body of medical literature generally supports the use of essential fatty acid supplementation in children with ADHD.
The benefit of essential fatty acid supplementation for children with ADHD has been adequately established. However, the next question is “What are the associated risks?”. Fortunately, when used in recommended dosages, there are few potentially serious side effects associated with essential fatty acid supplementation. Reported side effects include: Fishy aftertaste (if the product is made from fish oil), nausea, bloating, or burping. Less common, symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness or trouble breathing may occur. Overall, fish oil supplementation is well tolerated.
There are several commercially available children’s formulations which provide an adequate dosage in a palatable form. The studies evaluating essential fatty acid supplementation for ADHD may serve as a dosing guideline. The three most compelling studies used 500-600mg of Omega-3 fatty acids in a balanced Omega 3, 6, 9 formulation. To keep things simple for my families, I recommend a fish oil-based, balanced product containing Omega 3, 6 and 9 fatty acids with 500-750mg of Omega 3 fatty acids from a high quality manufacturer. Products from Nordic Naturals and other high quality manufacturers are available at local markets (such as Mother’s and some Henry’s markets) and online. If children are not able to swallow the generally large capsules, palatable (“no fishy taste”) children’s formulation liquids and “gummies” are available.
Fish oil-based product (rather than plant-based)
500-750mg of Omega-3 fatty acids
Balanced Omega 3, 6, 9 product
High quality manufacturer (such as Nordic Naturals)
As evidence in scientific studies continues to build, essential fatty acid supplementation is gaining broader acceptance by mainstream physicians. The current medical literature is generally supportive of the benefit for children with ADHD and the common side effects are relatively mild. For families with children affected by ADHD, essential fatty acid supplementation should be considered an important component of a comprehensive treatment plan.
Dr. Andrew McIntosh is a fellowship-trained pediatric neurologist and is highly skilled in behavioral/developmental disorders (including early autism spectrum diagnosis) and general pediatric neurology. If you have any questions or would like information about scheduling an appointment with Dr. McIntosh, contact his office at (949) 249-3780 or visitwww.mcintoshneurology.com for more information.
Learning Disability and Gifted?
Gifted children with learning disabilities are known as “twice exceptional.” In the educational system a child labeled both “gifted” and “learning disabled” is rare. Most children are labeled as either remedial and special needs or honors and college prep. Rarely are these children viewed as a combination of the two. Most educators do not expect a gifted child to have dyslexia or even realize that a child with ADHD (attention deficit disorder) might also be brilliant in creative writing or calculus. Identifying a child as twice exceptional is very difficult since these children may be compensating for and masking their learning disability, and in turn their disabilities may disguise their giftedness.
I recently read a book titled, Light Up Your Child’s Mind. Dr Renzulli and Dr. Reis write about the crucial role parents and educators can play in their children’s development. They discuss that intelligence; creativity and motivation to achieve can be fostered in bright children, even unmotivated ones. The book provides tips on how to identify and encourage giftedness in children, while still helping the child succeed within the educational system. An entire section is devoted to resources and suggestions on where to go to help your child develop constructive and interesting projects within his or her area of giftedness and interests. These include:
- Web site enrichment activities
- Contests and competitions
Light Up Your Child’s Mind presents a practical guide for teachers and parents to help their children “light up” a love of learning forever. This is an easy read and is well organized into three different sections:
- What is this thing called giftedness
- Practical paths to developing your child’s gifts and talents
- Special Considerations
Originally, I borrowed the book from the library, but then ended up buying it since I found this chapter on resources to be extremely valuable. I now have the book on my desk so that whenever my students need a stimulating activity to work on I use the book as a reference guide.
Raising a gifted child and developing those gifts requires a parent or teacher that is open minded, flexible and ready to invest the time and effort needed. Gifted children all have unique strengths and interests that should be recognized and developed.
Karina Richland, M.A., E.T. is the Managing Director of Pride Learning Centers, located in Los Angeles and Orange County. A former teacher for Los Angeles Unified School District, Ms. Richland is a reading and learning disability specialist. You can reach her by email at firstname.lastname@example.org or visit the Pride Learning Center website at: www.pridelearningcenter.com