Research byte: ADHD students may not have slower cognitive speed--but may be more variable (inconsistent) in cognitive speed

Interesting new meta-analysis. File under Gt in CHC taxonomy of human abilities. Click on images to enlarge for easier reading

 

 

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More research suggesting ADHD may be due (in part) to an internal brain clock disorder

Another study linking distorted time-processing and ADHD.  Click here and here for posts about other related studies.  What I find interesting is that the various experimental timing measures used in these studies could easily be made into psychometric tests (with readily available technology) for inclusion on intelligence tests or other special purpose cognitive batteries.  Also, I have hypothesized in a MindHub Pub that some emerging neurotechnologies may improve ADHD (and related symptoms like attentional control and working memory) due to the fine-tuning of the human brain clock.

Other ADHD related research (brain connectivity, etc) can be found here.

Click on image to enlarge for easier reading,

ADHD: And even MORE evidence suggestive of a brain network connectivity disorder

And more evidence for ADHD as being related to poor brain network connectivity. (click here for more posts) Click on images to enlarge.






And, again, this extant research is consistent with the three-level hypothesized explanation of the impact of certain brain training programs on controlled attention (click here for special white paper as well as on-line PPT modules and keynote video presentation of this model).




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ADHD as a brain network disorder: More evidence

It is becoming clear that ADHD is likely related to dysfunctional interactions between certain brain networks (click here for prior ADHD posts). The following two studies add to this growing literature on the importance of brain network connectivity.

This research is also consistent with my previously posted white-paper on brain networks, temporal processing (brain clock) and cognitive efficiency processing with a strong influence of white matter integrity (paper is written around explaining the efficacy of the IM intervention but can also be viewed as a three level explanation of how brain networks influence working memory, attentional control, and executive functioning).

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Research byte: Restless mind--restless body. More on mind wandering

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Research byte: More on ADHD as a default brain network disorder

This is one of the first studies to suggest that some forms of ADHD may be due to altered brain network functioning, specifically a disorder in the default brain network (or other networks that control the default mode network. Click here for prior posts re: this hypothesis. [Click on image to enlarge]





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www.themindhub.com

EDDA 2012 ADHD newsletter article

Newsletter article regarding 2012 Las Vegas conference available here.

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www.themindhub.com

ADHD as a default brain network disorder

Some interesting research regarding the role of the default mode or default brain network and ADHD. Although the blog post is at the IM-HOME blog (conflict of interest - I am an external consultant to IM in the capacity as Director of Research and Science), most of the links are to other non-IM articles regarding the ADHD/default link. The Neuropsychopharm. article link and the link back to an annotated article (at the Brain Clock blog) published in Trends in Cognitive Science are important...IMHO


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Kevin McGrew, PhD
Educational Psychologist




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ADHD as brain-clock based temporal processing disorder - another study

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Yet another article, this time based on a sample of children from China, that supports the hypothesis that ADHD may be related to an underlying disorder of the brain clock (temporal processing).







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ADHD as a default brain network problem?

Trends in Cognitive Sciences, January 2012, Vol. 16, No. 1

I just skimmed this excellent article which is consistent with the hypothesis that problems with controlled attention (focus) may be responsible for a number of the behavioral symptoms of ADHD....and this is due to the poor ability to suppress the random self-talk of the default brain network. As per the IQs Reading feature, an annotated copy of the article is now available.

Based on my reading and research regarding Interactive Metronome technology, I advanced the position that the efficacy of this technology in improving focus or controlled attention is that it helps to "quiet the busy mind" that is due to the REST (random, episodic, spontaneous thought or thinking) of the default brain network. In simple terms, poor ability to suppress or quiet the default network results in poor controlled attention and focus...and one has a hard time with inhibiting the intrusion of these task-irrelevant thoughts when trying to engage in controlled, deliberate cognitive tasks.

This article reviews research that suggests that ADHD may be a default brain network disorder. The authors state "In 2007, Sonuga-Barke and Castellanos suggested that ADHD could be considered a default network disorder"...and the authors of the current article agree.


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Research byte: ADHD as a brain-clock time processing disorder

Yet another study suggesting disordered temporal processing (the brain clock) as related to ADHD. Click on image to enlarge




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Research bytes: ADHD diagnosis--gender and adolescence

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Genetic study points brain signaling pathways in ADHD

PsyPost.org (@PsyPost)
12/4/11 3:15 PM
New gene study of ADHD points to defects in brain signaling pathways Click on link

bit.ly/tlzTpi


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Educational Psychologist

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ADHD due to different brain network use?@TheBrainScience, 11/30/11 8:37 AM

Brain Science (@TheBrainScience) 11/30/11 8:37 AM RSNA: Attention Pathways Altered in ADHD sns.mx/Y7eSy7

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Kevin McGrew, PhD

Educational Psychologist

The brain clock (mental timing) and clinical disorders

The human brain clock is intimately involved in wide array of human cognitive and motor behaviors.  At this blog a number of clincal disorders have been associated with some degree of disturbance or damage to brain mechanisms related to mental timing.  This informaiton is scattered across a variety of posts.  I decided to pull it all together (as of today's date) in this post.

Mental timing (brain clock) has been implicated via research reported at this blog in:

ADHD and attention

Autismhttp://www.brainclock.net/search/label/autism

Various speech and language disorders

• Aphasia
• Apraxia
• Speech and language

Tourette's syndrome

Cerbral palsy

Central auditory processing disorders (CAPD)

Reading disabilities/dyslexia (click here, here and here)

Various dopaminegeric-based disorders

• Huntington's 
• Schizophrenia
• Parkinson's

Gate disorders

Stroke related dysfunction

A more detailed reference list of timing-related dysfunctions/disorder (e.g., aging related disorders--Alzheimer's, dementia; ADHD, motor coordination/timing disorders--gait, stroke,swallowing;  speech and language disorders--aphasia/stroke/apraxia/speech; TBI) can be found in special white paper regarding the efficacy of various rhythm-based interventions.

The cost of ADHD: A need for cost-effective treatments and interventions

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Research byte: Working memory model of ADHD

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Efficacy of Interactive Metronome treatment study (Cosper, 2009): An example of a "non-example" of IM efficacy research

As a member of the Interactive Metronome Scientific Advisory Board I am often asked to review published research studies that have investigated the IM method.

Recently, a investigation of the effectiveness IM (which is a mental timing-based intervnetion) with children with attention deficit disorder and developmental coordination disorders was published in the International Journal of Rehabilitation Research. The citation and abstract for the article are reproduced below.

• Cosper, S., Lee, G., Peters, S & Bishop, E. (2009).  Interactive Metronome training in children with attention deficit and developmental coordination disorders, Internal Journal of Rehabilitation Research, 32 (4), 331-336.  (click here to view)

Abstract: The objective of this study was to examine the efficacy of Interactive Metronome (Interactive Metronome, Sunrise, Florida, USA) training in a group of children with mixed attentional and motor coordination disorders to further explore which subcomponents of attentional control and motor functioning the training influences. Twelve children who had been diagnosed with attention deficit hyperactivity disorder, in conjunction with either developmental coordination disorder (n=10) or pervasive developmental disorder (n=2), underwent 15 1-h sessions of Interactive Metronome training over a 15-week period. Each child was assessed before and after the treatment using measures of attention, coordination, and motor control to determine the efficacy of training on these cognitive and behavioral realms. As a group, the children made significant improvements in complex visual choice reaction time and visuomotor control after the training. There were, however, no significant changes in sustained attention or inhibitory control over inappropriate motor responses after treatment. These results suggest Interactive Metronome training may address deficits in visuomotor control and speed, but appears to have little effect on sustained attention or motor inhibition.

After reading thie manuscript, I decided to make this formal blog post in an effort to educate readers on a few critical issues related to intervention research. After a thorough read of the study, and despite the fact that it reported positive findings in the area of motor coordination improvement (but not in attention), it is my professional opinion that there are enough major methodological flaws which make the study an invalid study of the effectiveness of the IM treatment program.

Below are the major concerns I have about the study. I will only focus on my major concerns and will not highlight other minor concerns I noted during my review of manuscript.

Treatment integrity/fidelity/validity:  The most serious (fatal) flaw  is the lack of treatment integrity or validity. As described in the methods section, the treatment consisted of one hour sessions (per week) of IM treatment over a period of 15 weeks. To readers unfamiliar with the IM program, the standard treatment protocol is for three hourly sessions per week.  The use of only one hourly session per week (versus the recommended three hourly sessions per week) is a clear example of poor treatment integrity as defined below.

Treatment integrity (also known as treatment fidelity) refers to the degree to which intervention is implemented as intended. Interpretations of the obtained results require some assurance that treatment was carried our as it was designed or, in other words, that treatment was implemented with high levels of integrity. Compromised integrity has serious implications for inferences drawn about the relationship between treatment and outcome. Indeed, the obtained results are related not to the intended intervention (i.e., treatment as designed) but to the implemented intervention (i.e., treatment as delivered by treatment agents). [Click here for more information]

This violation of the IM treatment protocol would be analogous to the following:

• Being prescribed three weekly sessions of physical therapy for back pain but only doing one session a week.
• Being prescribed 300 mg/day of some form of medication to treat a condition, but only taking 100 mg/day.
• Having a reading disabled student who is recommended to receive three hourly sessions of reading-focused special education services a week only receive one hourly session per week.

The bottom line is that this this study should not be considered a valid study of the efficacy of the IM treatment program as it was not implemented as per the prescribed IM treatment protocol (poor treatment integrity/fidelity).  This major methodological flaw in itself disqualifies this study as a valid study of the IM treatment program.

Confounding of IM treatment with pharmacological treatments. The sample consisted of 12 subjects with various diagnoses, but whom all shared a diagnosis of ADHD.  As described by the authors, half of the subjects were taking some form of medication during the study. More importantly, "no medication changes occurred over the course of the study". This introduces a potential intervention confound. It is very possible that the medications received by half of the sample were already impacting the ability of these children to attend and concentrate at their maximal levels. As a result, no non-pharmacological intervention would have a chance to prove its effectiveness as these six subjects were already being "treated " via medication (and might already be near or at their optimal level of functioning). When it can be ethically designed, the efficacy of nondrug (or new drug) effectiveness is typically investigated by having subjects on a  current medication regime discontinue their medication for a rescribed period of time to establish a nondrug baseline performance level. Then the new treatment (or new drug) is introduced and performance measured to evaluate effectiveness. This was not done in the current study for half of the subjects.   It can be easily argued that  at least half of the subjects were already receiving treatment or intervention (medication) which confoundes the ability to detect effectiveness for any new treatment (e.g.,  IM). 

Statistical and design analysis: It is well known in the research methodology literature that the simple analysis of change scores (from a pre- post-test design) is a less than optimal research design. The most critical issue is the fact that the reliability of the change or difference score is a function of the reliability of the pre-and post test scores and the correlation between the two. The reliability of change scores is always much lower than the reliability of individual measures. In addition, possible differences in the subjects as they entered the study should be controlled for in the analysis via some form of statistical control (e.g., analysis of covariance, repeated measures designs, etc.). Simple pre-/post-test change score research designs suffer from serious methodological flaws.  This has been recognized for decades.  The results are of questionable value. Click here for additional background information.  Furthermore, the study does not include a control group or the random assignment of subjects to treatment and control groups.

Incomplete literature review:  In the introduction the authors state that "there are only two peer-reviewed studies comparing pretreatment and posttreatment effects that include a control group, and one of these found that the Interactive Metronome improved golf swings in healthy normal individuals."  The authors failed to mention one of the largest and best designed IM efficacy studies (random assigment of subjects to treatment and control groups;  analysis that controlled for initial pret-test scores) by Taub et al.  (2007).  Furthermore, the above quote conveys the implicit assumption that a study of the effectiveness of IM on golf swings is not relevant to the current research. This reflects a narrow understanding of the potential causal mechanisms of the IM program. As discussed in the Taub et al article, and in a recent review of the efficacy of various brain rhythm treatments, a review of theoretical and empirical research (from a diverse range of disciplines) suggests the hypothesis that the effectiveness of IM is due to its impact on a "domain-general" cognitive mechanism. If a treatment programs efficacy is believed to be based on the modification of a domain general cognitive/brain-based mechanism, one would expect it to have generalized treatment effects across a wide variety of human performance domains. This is discussed in greater detail in the Taub et al paper. [Conflict of interest note - I am a coauthor on this paper].

In conclusion, it is my professional opinion that the Cosper et al (2009) IM efficacy study suffers from major methodological flaws which make the study an invalid study of the effectiveness of the IM treatment program.

Technorati Tags: psychology, neurotechnology, neuroscience, Interactive Metronome, mental time keeping, IQ brain clock, interval timing, brain clock, brain rhythm, rhythm perception, rhythm production

ADHD and the brain clock: Rhythm as a diagnostic marker?

Yet another study (n=11; a pilot study so generalization is limited) implicating the IQ brain clock (mental time-keeping) and a clinical disorder---ADHD. The possible role of the brain clock and dopamine and ADHD is nothing new and has been reported previously at this blog (click here, here, and here.)

This study found that adults with ADHD lose their ability to keep rhythm (maintaining a tapping beat) when the tempo is varied. This pilot study suggest that the "effective span of rhythmic feel" is apparently contracted (narrower) in ADHD adults when compared to normals.

Might this not suggest that a sensitive metronome-based measurement technology (e.g., the measurement component of Interactive Metronome - conflict of interest disclosure---I'm on the scientific advisory board for IM), that can carefully calibrate the ability to maintain the "feel" for varying tempo's/rhythms mights serve as a diagnostic marker for possible ADHD?

Hmmmmmmmmmmm....interesting idea.

However....caution is in order. This is a small pilot study and only with adults. Generalization to a larger population and children and adolescents is not possible. Also....ADHD is a complex diagnosis that cannot be reduced to a single test, sign, marker, etc.

I'm excited as a researcher...as this continues to point towards the importance of the IQ Brain Clock


Technorati Tags: psycholgoy, education, educational psychology, school psychology, neuropsychology, special education, LD, brain clock, dopamine, rhythm, tempo

Adult ADHD at work

From BPS blog

http://bps-research-digest.blogspot.com/2009/01/adult-adhd-leads-to-more-accidents-and.html

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