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Tag: ADHD

Do Fidget Spinners Help Children with ADHD?
Andrew Watson
Andrew Watson
September-15-2024

Do Fidget Spinners Help Children with ADHD?

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Good news: cognitive science research can be SPECTACULARLY useful in guiding and informing teachers.

Less good news: that guidance isn’t always clear or prompt.

After all:

Research findings often contradict one another.

They can also contradict our deeply-held beliefs, and/or our school’s policies.

Not everyone who quotes research actually understands research, or quotes it accurately.

And so forth.

Another problem with research gets less focus: it takes so much time.

In this case: fidget spinners were a thing back in 2017!

Perhaps you — like me — frequently heard the idea that “we can give fidget spinners to students to help them get the wiggles out!”

More specifically: “fidget spinners will help those students diagnosed with ADHD let off jittery steam without wandering around or distracting others.”

At that time, those claims sounded plausible or implausible — depending on your perspective and experience. But we didn’t have any research to support or contradict them.

As one group of pediatricians wrote in 2017:

Fidget spinners and other self-regulatory occupational therapy toys have yet to be subjected to rigorous scientific research. Thus, their alleged benefits remain scientifically unfounded. Paediatricians should […] inform parents that peer-reviewed studies do not support the beneficial claims.

Well: SEVEN years later, now we do have research!

Worth the Wait

Researchers in Florida worked with a group of 60 children enrolled in a summer program for young children diagnosed with ADHD.

A closeup of two hands holding fidget spinners out toward each other

This program offered both academic and behavioral training over eight weeks, to better prepare these children for the upcoming school year.

Both in the first two weeks and the final two weeks, the research team gave several children fidget spinners during the 30-minute ELA class. They looked for data on these questions:

Did the fidget spinners change the amount of wandering around?

Did they change the students’ attention to the class work?

And, did they affect the other children who did not get fidget spinners?

Sure enough, the data they gleaned provide helpful classroom guidance.

Good News, Bad News

If you’re in the pro-fidget spinner camp, you’ll be glad to know that the fidget spinners did NOT lead to an increase it problems among the other students who didn’t get one.

They didn’t wander any more than usual; they didn’t pay less attention than usual. (“Area violations” and “attention violations” were the two categories tracked by researchers.)

That’s the good news.

If you’re pro-fidget spinner, the rest of the news won’t encourage you.

First: the spinners reduced wandering a bit at the beginning of the program. But they did NOT reduce wandering at the end.

Second: the spinners raised inattention levels both at the beginning and at the end of the program. And the increases in inattention were greater than the decreases in wandering.

In brief, fidget-spinner champions will not find much support here.

Questions and Caveats

No one study can answer all questions, so we should keep its limitations in mind.

What about older students? This research doesn’t explore that question.

Won’t students get better at using fidget spinners AND paying attention over time? We don’t know. (But: eight weeks is an unusually long research study.)

Don’t they benefits SOME students? Maybe. A 60-person study doesn’t really allow us to look for granular sub-populations.

A later study should show the opposite results! It certainly could.

In other words, passionate fidget-spinner advocates can ask worthwhile questions. And, we shouldn’t be too emphatic based on one study.

But we can say this:

According to this one research study, fidget spinners did not help young students diagnosed with ADHD pay attention; they did more harm than good.

Graziano, P. A., Garcia, A. M., & Landis, T. D. (2020). To fidget or not to fidget, that is the question: A systematic classroom evaluation of fidget spinners among young children with ADHD. Journal of attention disorders, 24(1), 163-171.

ADHD and Asperger Syndrome in Smart Kids and Adults by Thomas Brown
Erik Jahner, PhD
Erik Jahner, PhD
November-22-2022

ADHD and Asperger Syndrome in Smart Kids and Adults by Thomas Brown

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In ADHD and Asperger Syndrome in Smart Kids and Adults: Twelve Stories of Struggle, Support, and Treatment, Thomas Brown shares engaging and informative stories of gifted individuals with ADHD. This series of case studies takes on the traditional definitions and misconceptions of both ADHD and Asperger’s syndrome, focusing instead on how clusters of symptoms including social-emotional skills and an in-depth understanding of the individual’s social environment reveal a fascinating and useful approach to diagnosis and treatment.

Brown does not shy away from critiques of the Diagnostic and Statistical Manual of Mental Disorders (DSM) and illustrates his perspective by walking us through several diagnoses and treatments for individuals with these symptoms from across age groups. Particular attention is given to one of the interesting puzzles of ADHD in which the symptoms are situational and not consistently expressed. When an individual is engaged in an activity they are interested in, the symptoms of ADHD seem to subside, and strong executive function may be expressed in that context. As a result, parents, teachers, and individuals with ADHD may inappropriately interpret the attentional and emotion regulation problems as simply a lack of willpower. Throughout each of the cases, Brown demonstrates how the symptoms of ADHD often lead to these types of misunderstandings and how diagnoses can lead to a sense of relief and enable the utilization of medical and psychotherapeutic interventions to manage the symptoms.

What makes Brown’s case studies so important is that he takes an integrated view of ADHD. He argues that an emotional component of the diagnosis is crucial and often neglected. Individuals differ in their emotional regulation problems and these case studies illustrate these regulatory symptoms and their situational nature. Bringing emotional and cognitive features into the same diagnosis criteria connects well with the literature on the fallacy that cognitive skills and emotional skills are separate psychological functions; both rely on the same neural circuitry leading to motivation, regulation, and potential disruption. Pooling together the traditional reliance on regulating focus as a primary symptom with the regulation of working memory, regulation of emotional reactions and frustration, the initiation of effort, self-monitoring, the regulation of actions, and the ability to activate engagement in work rounds out the diagnosis to include the whole person. This is especially useful when teachers or parents view ADHD as a more academic skill and are made aware of how ADHD is a lived experience across life domains.

Important for this text is also a deep impassioned discussion concerning the now absent diagnoses of Asperger’s syndrome which has now been absorbed into the updated diagnosis of autism spectrum disorder. To be honest, this was an area I began to read with a certain amount of trepidation, but the author offers very convincing arguments for the reintroduction of Asperger’s syndrome into the DSM giving me great pause in my preconceived beliefs. The unique clusters of symptoms and ways to manage symptoms separate this disorder in convincing ways from Autism. Moreover, the integration of ADHD and Asperger’s into this text shows the important and informative comorbidity of the symptoms.

The development of his case studies respects the social ecology of individuals in this group, relying not solely on standardized diagnostics but evaluating how impairments may be displayed differentially across a person’s life. Asking questions of the patients to reveal their unique symptomology rather than imposing a diagnosis. The individual’s perceived relationships with family, friends, coworkers and teachers are key to effective interventions. Building on this, the book also has an extensive final section offering resources for diagnosis and treatment.

While this book is great for the clinician, it would also be of great use to individuals who interact with this population regularly. It helps the reader understand their stories and teaches the reader how the skilled clinician listens to get more complete stories of the individual – not treating the individual as a collection of symptoms but understanding the complex role ADHD plays in their lives. In addition, this book is a useful window into a variety of diverse human experiences. In some ways, these stories are unique while simultaneously speaking to us all – building a sense of compassion for the miraculous ways the brain contributes to what it means to be human and part of a community.

Dodging “Dodgy” Research: Strategies to Get Past Bunk
Andrew Watson
Andrew Watson
January-15-2019

Dodging “Dodgy” Research: Strategies to Get Past Bunk

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If we’re going to rely on research to improve teaching — that’s why you’re here, yes? — we need to hone our skepticism skills.

After all, we don’t want just any research. We want the good stuff.

But, we face a serious problem. If we’re not psychology or neuroscience researchers, how can we tell what’s good?

Over at TES, Bridget Clay and David Weston have four suggestions.

Seek out review articles.

Don’t be impressed by lists.

Look for disagreement.

Don’t be impressed by one shiny new study.

Their post is clear and thoughtful; I encourage you to read it all.

Second Look

I want to go back to their third suggestion: “seek criticism.” This one habit, I believe, can make us all substantially wiser readers of classroom-relevant research.

Here’s what I mean.

When I first started in brain-research world, I wanted to hear the enduring truths that researchers discovered about learning.

I would then (nobly, heroically) enact those truths in my classroom.

As an entirely hypothetical example: imagine I heard a presentation about research showing that fluorescent lights inhibit learning. (To be clear: I have no idea if this is true, or even if anyone claims that it’s true. I just made this up as an example.)

Given that research finding, I would boldly refuse to turn on the fluorescent lights in my classroom, and set up several lamps and candles. Learning would flourish.

Right?

Research Reality

Well, maybe. But, maybe not.

Researchers simply don’t discover “the truth about learning.” Instead, they try to disprove a particular claim in a particular way. If they can’t disprove it, then that claim seem slightly more plausible.

But, someone else might disprove it in some other way. Or, under some other conditions.

Such an incremental, lumpy process isn’t surprising or strange. The system should work this way.

When Clay and Weston warn us against being impressed by one new study, they’re making exactly this point. If one research team comes to a conclusion once, that’s interesting … but we shouldn’t make any changes to our classrooms just yet.

So, back to my example. I’ve heard that presentation about fluorescent lights. What should I do next?

I should — for the time being — assume that the claim (“fluorescent lights inhibit learning”) is UNTRUE, and go look for counter-examples.

Or, perhaps, I should assume the claim is CONTROVERSIAL, and seek out evidence on both sides.

How do I do that?

Skeptical Research, with Boundaries

Believe it or not, start by going to google.

Use words like “controversy” or “debate” or “untrue.”

So, I’d google “fluorescent lights and learning controversy.” The results will give you some ideas to play with. (In fact, I just tried that search. LOTS of interesting sources.)

You might go to Google Scholar, which provides links to scholarly articles. Try “fluorescent light learning.” (Again, lots of sources — in this case including information about ADHD.)

When you review several of these articles, you’ll start noticing interesting specifics. Researchers call them “boundary conditions.” A research claim might prove true for one subset of learners — that is, within these boundaries — but not another.

So: perhaps 3rd graders do badly with fluorescent lights. What about 10th graders?

Perhaps such light hampered learning of math facts. What about critical thinking?

Perhaps the researchers studied turtles learning mazes. Almost certainly, you aren’t teaching turtles. Until we test the claim with humans, we shouldn’t worry too much about turtle learning.

Perhaps — in fact, quite often — culture matters. Research findings about adolescence will differ in the US and Japan because cultural norms shape behavior quite differently.

Back to Beginnings

Clay & Weston say: seek out disagreement.

I say: AMEN!

Science works by asking incremental questions and coming to halting, often-contradictory findings.

Look for the contradictions. Use your teacherly wisdom to sort through them. You’ll know what to do next.

 

Top Neuroscience Stories of 2017, Wisely Annotated
Andrew Watson
Andrew Watson
February-01-2018

Top Neuroscience Stories of 2017, Wisely Annotated

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NeuroscienceNews.com has published its “Top 20 Neuroscience Stories of 2017,” and the list provides helpful — and sometimes surprising — insight into current brain research.

Taken together, these stories add up to 5 important headlines.

Headline 1: Neuroscience can tell us such cool stuff!

Gosh darnit: people who swear more are more likely to be honest, and less likely to be deceptive. Dad gummity.

If music literally gives you chills, you might have unusual levels of connectivity between your auditory cortex and emotional processing centers.

People with very high IQs (above 130) are more prone to anxiety than others.

A double hand transplant (!) leads to remarkable levels of brain rewiring (!).

Forests can help your amygdala develop, especially if you live near them.

When you look a baby in the eyes, your brain waves just might be synchronizing.

Headline 2: Your gut is your “second brain”

Amazingly, fully one quarter of the 20 top stories focus on the connection between the brain and the digestive system. For example:

  • Traumatic Brain Injury Causes Intestinal Damage
  • Research Suggests Connection between Gut Bacteria and Emotion
  • New Light on Link between Gut Bacteria and Anxiety
  • Your Mood Depends on the Food You Eat
  • Gut Microbes May Talk to the Brain through Cortisol

This “aha” moment — our guts and our brains are deeply interconnected! — happens over and over, and yet hasn’t fully been taken on board in the teaching and understanding of neuroscience.

Teachers should watch this research pool. It will, over the years, undoubtedly be increasingly helpful in our work.

Headline 3: Neuroscience and psychology disagree about definitions of ADHD

A psychologist diagnoses ADHD by looking at behavior and using the DSM V.

If a student shows a particular set of behaviors over time, and if they interfere with her life, then that psychologist gives a diagnosis.

However, a 2017 study suggests that these ADHD behaviors might be very different in their underlying neural causes.

Think of it this way. I might have chest pains because of costochondritis — inflammation of cartilage around the sternum. Or I might have chest paints because I’m having a heart attack.

It’s really important to understand the underlying causes so we get the treatment right.

The same just might be true for ADHD. If the surface symptoms are the same, but the underlying neural causes are different, we might need differing treatments for students with similar behavior.

By the way, the same point is true for anxiety and depression.

Headline 4: Each year we learn more about brain disorders

Alzheimer’s might result, in part, from bacteria in the brain. Buildup of urea might result in dementia. Impaired production of myelin might lead to schizophrenia. Oxidative stress might result in migraines.

Remarkably, an immune system disorder might be mistaken for schizophrenia or bipolar disorder. (Happily, that immune system problem can be treated.)

Headline 5: For teachers, neuroscience is fascinating; psychology is useful

If you’re like me, you first got into Learning and the Brain conferences because the brain — the physical object — is utterly fascinating.

You want to know about neurons and synapses and the amygdala and the prefrontal cortex and the ventral tegmental area. (Ok, maybe not so much with the ventral tegmental area.)

Over all these years, I’ve remained fascinated by neuroscience. At the same time, I’ve come to understand that it rarely offers teachers concrete advice.

Notice: of the twenty headlines summarized above, only one of them really promises anything specific to teachers. If that ADHD study pans out, we might get all sorts of new ideas about diagnosing and treating students who struggle with attention in school.

The other 19 stories? They really don’t offer us much that’s practical.

The world of psychology, however, has all sorts of specific classroom suggestions for teachers. How to manage working memory overload? To foster attention? To promote motivation?

Psychology has concrete answers to all these questions.

And so, I encourage you to look over these articles because they broaden our understanding of brains and of neuroscience. For specific teaching advice, keep your eyes peeled for “the top 20 psychology stories of 2017.”

Diagnosing ADHD with MRI
Andrew Watson
Andrew Watson
December-15-2017

Diagnosing ADHD with MRI

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How do we know if a student has ADHD?

Typically, we observe behavior.

To what degree is the student inattentive? (That’s one kind of ADHD.) To what degree is s/he hyperactive? (That’s another type.) Perhaps the student demonstrates both kinds of behavior.

If these behaviors last long enough, and cause enough distress to be “clinically significant,” we can then make a diagnosis.

What would happen, however, if instead of looking at behavior, we could look at the student’s brain? Could a brain scan ever replace a behavioral study to make a diagnosis?

The Future Might Be Now

A just-published study starts us down this road.

By scanning the brains of 33 just-diagnosed/never treated students, and comparing them to the brains of 87 control subjects, researchers identified three brain areas substantially correlated with two subtypes of ADHD: inattentive, and combined inattentive/hyperactive.

(For the neurally curious, those three areas are the left temporal lobe, the bilateral cuneus, and regions around the left central sulcus.)

If the future is now, we might conclude that we can use MRI imaging to diagnose students, without having to observe their behavior.

The Future Might Be a Long Way Off

Despite all this exciting news, we have many reasons not to rush toward neuro-diagnosis of ADHD just yet.

First: the scans correctly distinguished between those who DO and those who DON’T have ADHD 75% of the time. That might sound impressive…unless you’re one of the 25% of cases where they got it wrong.

Second: the scans distinguished between Inattentive-type ADHD and Inattentive/Hyperactive-type ADHD 80% of the time. So, again, 1 in 5 of the participants would have been mis-diagnosed.

Third: the study didn’t include any students with purely Hyperactive-type ADHD. That’s a big gap in the diagnostic ability of MRI. (The authors explain that there is a low prevalence of this subtype in their research pool.)

Fourth: in a switch to cross-cultural perspectives, we must notice that different countries and cultures define “appropriate behavior” differently. Behavior that seems “clinically significantly” hyperactive or inattentive in one culture might be entirely appropriate in another. For this reason, the fact that this research was done in China means we must be very thoughtful about applying its conclusions to students from a non-Chinese cultural context.

(To be very clear on this point: I’m NOT saying that Chinese researchers can’t produce meaningful findings, or that ADHD doesn’t matter in China, or anything like that. I AM saying that cultures define “appropriate behaviors” differently, and so when behavior becomes diagnosable, we must be careful about cross-cultural applications. And we must be especially careful when looking for differences in neural structures that underlie those behaviors.)

Fifth: Chinese psychologists use a somewhat different set of terms in describing ADHD than do American psychologists.  They are, quite possibly, looking for neural correlates of meaningfully different behavior than we would for a Diagnostic and Statistical Manual diagnosis of ADHD.

Sixth: changing perspectives once again, we should note that MRI scans are crashingly expensive. If we’re going to start diagnosing students this way, we need to have thoughtful discussions about the services we’ll stop providing in order to make these funds available.

A Balanced Perspective

With this daunting list of reasons to pause, I don’t mean to dismiss the importance of this research.

Instead, I want to be sure that we look at in with an appropriate balance of enthusiasm and caution.

Enthusiastically, I can say that the future possibility of MRI diagnoses of ADHD could be very helpful.

For one thing, when people recognize that there are consistent and meaningful differences in neural structures, they might be less likely to say “Well, the kid just needs to try harder to pay attention.”

Cautiously, I can say that these helpful possibilities are a long way in the future, and we should not let our enthusiasm prompt us to embrace them before they’re ready for effective, culturally appropriate, and affordable use.

Rates of ADHD Diagnosis: Age, Gender, and Race
Andrew Watson
Andrew Watson
July-21-2017

Rates of ADHD Diagnosis: Age, Gender, and Race

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Dr. David Rabiner offers a helpful summary of trends in ADHD diagnoses.

The short version: rates of diagnosis continue to increase.

The longer version: depending how you analyze the categories, you get very different results. For children younger than 5, the rates are — in fact — falling. For adults over 65, however, the rate rose 348% from 2008-9 to 2012-13.

(That is not a typo: 348%).

One important point as you review these data: percentages are interesting, but so too are the absolute numbers. Diagnoses among those over 65 can increase so much as a percentage because the absolute numbers are relatively low.

By the way: analysis by gender shows an interesting pattern. Among adults, both diagnosis and medication are increasing faster for men than women. Among children, however, that pattern is reversed.

ADHD: Types and Treatments
Andrew Watson
Andrew Watson
February-07-2017

ADHD: Types and Treatments

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Here’s a handy anatomy of ADHD, complete with treatment options.

The key point: people are different, and not all ADHD diagnoses are the same. We need to attend to individual differences if we want to help all our students learn.