Cognitive Training -vs- ADHD Meds or combination???

[Hoosier]

Update: Post #34

Anybody with experience?

My 15yo has proven herself to be capable, but lacks focus. Up to now, I've chalked it up to being a little lazy but we believe she may need some help. The last thing I want her to do is to struggle through the rest of her high school and eventual college careers.

Her grades are OK, but she struggles for them. She is completely disorganized and seemingly incapable of becoming so...no matter my "approach".

Immediately after reading say a 4 paragraph story, she can hardly offer any details from it. Her "reading" is excellent, it's her comprehension that is failing.

She has incredible memorization skills in that she can memorize an enormous amount of material, but if you word a question to her just slightly different than as she memorized it...she struggles.

Mathematical skills are good, but not fast...If posed with 100 math problems and a time allotment to complete, she will get 70 or so completed and ALL will be correct. Whereas average students will get all 100 done but will only manage to get maybe 85% correct.

So...we've consulted with a Psychologist and a Cognitive Training Resource(LearningRx). Of course both believe their treatment method to be the correct course of action. Cognitive people want to do a regimen of training to improve(build) her processing speed. Shrink wants to start with meds(claiming immediate results) and some cognitive skills training(COGMED).

Of course I don't want to use medication, but I'm willing to give it a trial run through her soon to start 1st semester Sophomore year.

What say you? I'm sure some of you have some experience with one or both of these treatments...

[steno]

Andrew,
As an ADD adult I've tried many schools of thought. From my personal experience, I'd go with the training first. I found that the meds made me feel less "me" and my kids thought I wasn't the same funny Dad. I have an autistic son who needs his meds. Try the " less is more" method. Kind of a tweeting more than a major change. May be easier for your child to work with.
Good luck, Sten

[Bob Cowan]

We have a LearningRx outfit here in town, and I have referred people to them with excellent results. They are not cheap, as I recall, but they are good.

"Of course I don't want to use medication"

That's an interesting statement, especially the "of course" part. Why not? If she had diabetes, hypertension, or asthma, would you use medication then? If so, then why not for this?

If it were my child, I would do both LearningRx and meds.

[dukegrad98]

I have no personal experience with either. I just thought you might find it interesting that fully half of my law school class was on Adderall or similar ADHD drugs (basically prescription amphetamines). I'm not a doctor, but my strong suspicion is that very few of them were legit ADHD cases; they were all popping pills for an academic advantage. My girlfriend -- a physician -- says the same thing was going on at her med school. (I like to brag that she was top 1% -- with no pills!)

I'm sure the same phenomenon is happening at top undergrad schools these days, and I even wonder if it's trickling down into competitive high schools. The popular view is that these meds are steroids for the brain, and there's no rule or law against it.

EDIT: I see one of our docs has spoken. Bob, I'd be curious to see your experience or response to what I've described above, as a medical professional.

Cheers, John

[Hoosier]

Originally Posted by Bob Cowan

We have a LearningRx outfit here in town, and I have referred people to them with excellent results. They are not cheap, as I recall, but they are good.

"Of course I don't want to use medication"

That's an interesting statement, especially the "of course" part. Why not? If she had diabetes, hypertension, or asthma, would you use medication then? If so, then why not for this?

If it were my child, I would do both LearningRx and meds.

LearningRx is not cheap and the closest to me is in Indy. The expense coupled with logistics is a lot to bear.

Why not meds? I guess I have been a skeptic on the whole ADD/ADHD diagnosis. I was always of the opinion that is was somehow a cop-out for lazy parents. Perhaps I was mistaken...

[snakeboost]

A very good friend's son was diagnosed with ADD and they wanted to medicate & hold him back a year in school ,7th grade. $5000.00 later at Sylvan Learning for 1 year and he passed his way into high school & just won a full boat scholorship to Framingham State when he graduates in 2 years. Ever since he has been honor role & a much better student.
Now on a personal note I have ADHD [big surprise] it is damn hard work concentrating at times. My thing is this: ITS NOT A PROBLEM. It's a simple fact - we come from animals as animals we were hunted. Its fight or flight that is all. If you did not notice the branch move you would never see the lion ect comming to eat your ass!


Steve

[Dan Babb]

From your description, I think you have properly identified that she needs some help....and that's a big step in the right direction. Meds aren't a silver bullet...but certainly worthy of researching and even trying in small doses first.

But I think you need training in conjunction with the meds. We had some things to deal with when my daughter was in high-school (eating disorder). It was the combination of meds and therapy that worked. One didn't work without the other.

Not a comparison for what you're asking about....just saying that I think both treatments should be considered and probably work well together.

[Hoosier]

Full-Ride Scholarship would be nice, but I'm not shooting for the stars. I just want her to actually absorb more and improve to the point where she could handle a more rigorous curriculum and do so without the hours of help from my wife and myself. I am finding that I am having to learn the material(I don't know a lot of it) just to be able to help her and it's wearing me out.

[crash]

She will do fine in school, most likely, but unless she starts having things taught to her in a way that is interesting and thought provoking to her, most likely she will continue to be an "information in...information out" type of student. I am not a doctor, but I speak from my own persoanl experiences as it is like reading someone writing about me at that age. And I KNOW I wasn't/am not alone. Simply put, the way most schools teach these days does not involve much critical thinking or drawing of conclusions based upon the information, or, really, anything interesting.

For me, I really hit a road block in college when it came to differential equations. It was only when an EXCELLENT teacher related what the numbers meant to a real world circumstance that I understood very well, that I ended up understanding the relevance and real world applications in that instance. Some time after my college career, it dawned upon me what was going on, and why I considered some teachers to be GREAT teachers and others to be totally worthless. It wasn't what they taught, so much as HOW they taught it.

Somehow, someway, your daughter needs to have some of these "aha!" moments, and my feeling is she will then do much better. Does this happen with drugs? Does this happen with training? Does this happen with having an excellent teacher that really cares and understands how to get a pupil with a personality such as myself or your daughter to learn? Maybe a combo of all? I don't know, I am not a doctor or study this stuff. What I do know is that I would attempt to address it WITHOUT drugs first, just as I would any other issue, such as those Bob mentioned. I believe it to be cheaper, and easier in the long run than a seemingly never ending dosage of meds.

[Bob Cowan]

Originally Posted by Hoosier

LearningRx is not cheap and the closest to me is in Indy. The expense coupled with logistics is a lot to bear.

Why not meds? I guess I have been a skeptic on the whole ADD/ADHD diagnosis. I was always of the opinion that is was somehow a cop-out for lazy parents. Perhaps I was mistaken...

Sometimes medicating "difficult" kids is a cop out. Just like antibiotics for pink eye and colds, and medical marijuana for chronic pain. Just an excuse to dose. But, that doesn't mean you should immediately discount meds as a form of treatment. Applied appropriately - with the proper diagnosis - it can be a real life saver. Success stories are so numerous you don't hear about them.

Originally Posted by crash

S
I am not a doctor or study this stuff. What I do know is that I would attempt to address it WITHOUT drugs first, just as I would any other issue, such as those Bob mentioned. I believe it to be cheaper, and easier in the long run than a seemingly never ending dosage of meds.

Not trying to pick on you, but there's a couple of big differances between you and I. I do study this stuff. I have decades of experience. I don't believe, I Know.

[Zulu]

Sometimes despite everything Meds are needed.

We have done all sorts of tests, methods , learning tools, double blind , including empty capsules,

....... and on Meds , even low dose is better than none, but as he grows up he knows the difference, and if not in school makes his own decision to take or not on a given day.

Yes moods etc are different, but when it comes to learning, and working, Meds make a big difference. We started not wanting to go there, but after much agony, and now part of a parent support group, we KNOW it is the better course.

[kobrak]

And my daughter got it from me I guess. She got through High School and dreaded the thought of college. She is now a second year small engine student and is working at the local Harley shop this summer. She says she loves working with her hands, it helps keep her mind focused. Never considered drugs and just told her she is who she is. Also, she has learned what she can and cannot drink, eat, etc......NO CAFFEINE! "L"

[Hoosier]

Originally Posted by kobrak

And my daughter got it from me I guess. She got through High School and dreaded the thought of college. She is now a second year small engine student and is working at the local Harley shop this summer. She says she loves working with her hands, it helps keep her mind focused. Never considered drugs and just told her she is who she is. Also, she has learned what she can and cannot drink, eat, etc......NO CAFFEINE! "L"

I'd much rather her have an opportunity to "learn" more than she is capable of learning right now. She has the ability to retain things long term, just not so much short term. Like your scenario, I'm certain my daughter gets this trait from me although "they" say it's not a hereditary issue.

As far as diet and drink...She does not display any sort of hyperactivity, moodiness, or poor decision making(at least no more than any other 15 yo girl ).

[cwood]

Excuse the length but I have opinions!

I would never debate that certain people need chemistry to intervene and live a normal, happy and productive life. That said, I have watched too many people chase the way they should feel by medicating rather than either accepting who they are or learning what is right for them and how to live.

Not the same thing but anxiety is an example of something that way too many people are medicating themselves out of. Anxiety feelings are for a reason....and of evolutionary significance yet general anxiety is being medicated out of our society rather than people understanding what your brain is telling you and learning how to react. Life isn't always a bowl of cherries.

A great deal of alcoholism is self medication to mask feelings people don't like and would rather hide from. Both of the above have infiltrated my extended family and in most cases one begets the other.

In first year university I had anxiety issues that were stopping me from going to class. In short order I was prescribed anti-anxiety meds....which seemed to do the trick....but they dulled me in other ways that concerned me. I chose to stop and find ways to deal with it myself. It took some time but I killed it (that's still my word for it). What I learned enabled me to move on and have a career where I regularly present and lead large groups of people. I would propose that I would never have been able to do that if I hadn't killed it.

I sometimes worry about my oldest son (17) and his "focus". Whip smart but easily distracted...procrastinator...disorganized. My wife and I look at each other and say...yep, that's the way we were at 17. Lets not forget that kids need to learn lessons...the impact of making the study or non-study decisions etc. I think in marginal cases its dangerous to teach that meds are the way to be normal. I think its something that stays with you and becomes a way of coping with life in general.

All of that said, I fully support meds where people simply can't cope or live a normal life....its the grey area I have issue with.

[AC Bill]

Originally Posted by Hoosier

Anybody with experience?
My 15yo has proven herself to be capable, but lacks focus. She is completely disorganized and seemingly incapable of becoming so...no matter my "approach".

I wouldn't get to wound up over it.
From my experience in raising a teenage daughter, I found that at certain ages she seemed less focused. I think it's just hormones, and the changes she is going through. Another year and things will be different again. By the time my daughter was in the 12th grade, she was back on track and doing great.

It may actually make it worse if she begins to think there is something wrong with her, because of your reactions. Self esteem is important during those developing years, and it could affect her for decades, if your not careful.

[sharkxwife]

To quote my January 2012 post from thread, "kid advice needed- surely someone else has dealt with this"...

Originally Posted by sharkxwife

Concerta (a low-dose ADHD medication) changed my son's life! I'm not sure if he was in elementary school or junior high when behavioral and grade-issues started, but within ONE Month, he went from D's and F's to A's and B's and became a real nice person to be around.

He's now a Freshman in college, still on the meds, and doing Great!

I definitely believe that for those that need this type of treatment, it can be a God-send, especially when yelling, grounding and punishments aren't working!

Blessings,

Lisa

...except He's now a Sophomore in college, still on Concerta, and still doing well. I have never once regretted putting him on meds. I'm sure places like LearningRX help, but if 'focus' is the problem due to a chemical imbalance, I don't believe any amount of tutoring will be the 100% cure-all.

Blessings and Good Luck with any decision you make!

[FFR5452]

There's another school of thought to be considered.
If she's in public school, it could just be that she is not being challenged by either the teachers or the curriculum. Maybe you should consider finding a private school that can offer more personalized instruction and motivation.
It worked wonders on our daughter. Pulled her out of public school after seventh grade. She was floundering due to too many distractions (boys, clothes, etc.). Put her into an all girls catholic school (no more distractions) and she soared. Those nuns will not tolerate mediocrity.
She went on to do well at a prestigious party school
University.
Sometimes drugs are not the answer. Stimulating and challenging environments often work, and the expense is about the same.

[tjo]

While I am in no way an expert on the subject, my wife deals with this kind of thing every day. Her opinion is meds, while they may be necessary for some, should be considered as a last resort due to side effects that have far reaching effects on their lives. They can effect personalites, and subsequently relationships, as well as general interest and enthusiasm. Her opinion is to try training (no experience with that particular company), then move to meds if that is ineffective. Give it a couple of months to see if the cognitive coaching is having an effect. Not necessarily progressing by leaps and bounds, but progressing. There are teachers out there that won't have the patience to deal with a student that is working through these kinds of issues, but that's life as well. Her suggestion is to do some research on "Executive Function".

Even without these kinds of issues teenagers can be a challenge, so good luck.

Tim

[sharkxwife]

Originally Posted by FFR5452

Maybe you should consider finding a private school that can offer more personalized instruction and motivation..

I'm truly NOT trying to sound nasty with this reply!!! ...I'm simply happy to hear YOU are 'Financially-able' to send your child to "Private School" for Junior or Senior High (or even Elementary school). ...The best ones around here (Cleveland, OH suburbs), 'start' at around $14k/per year and that is simply NOT an option for most families, no matter where they live.

Once my son went on Concerta, his grades at the #2-Top-Rated School District in my county, soared from D's and F's to A's and B's (WITHIN ONE MONTH --I swear on my Mother's Ashes) which, years later, allowed him to get into [private college] Ohio Northern's Engineering program at not quite a full scholarship.

I still stand my ground on ADD/ADHD meds. For those that need them to correct an imbalance, they are a God-send.

Sincerely,

Lisa

[dv/dt]

Just curious, how is she with things she is interested in compared to things she is not?

[Hoosier]

Originally Posted by cwood

All of that said, I fully support meds where people simply can't cope or live a normal life....its the grey area I have issue with.

I feel quite the same...

Originally Posted by AC Bill

I wouldn't get to wound up over it.
From my experience in raising a teenage daughter, I found that at certain ages she seemed less focused. I think it's just hormones, and the changes she is going through. Another year and things will be different again.

This has been an ongoing, and increasingly worse as curriculum difficulty has increased, problem for years.

Originally Posted by FFR5452

There's another school of thought to be considered.
If she's in public school, it could just be that she is not being challenged by either the teachers or the curriculum. Maybe you should consider finding a private school that can offer more personalized instruction and motivation.
It worked wonders on our daughter. Pulled her out of public school after seventh grade. She was floundering due to too many distractions (boys, clothes, etc.). Put her into an all girls catholic school (no more distractions) and she soared. Those nuns will not tolerate mediocrity.
She went on to do well at a prestigious party school
University.
Sometimes drugs are not the answer. Stimulating and challenging environments often work, and the expense is about the same.

She was in private school through the 8th grade. The instruction was more personalized and she absolutely fared better. Not only were the teachers more attentive, but her "lifelong" classmates helped her to stay on track. She no longer has that "crutch" and frankly I want her to become successful without the need of such...

Originally Posted by tjo

Her suggestion is to do some research on "Executive Function".

Even without these kinds of issues teenagers can be a challenge, so good luck.

Tim

"A challenge" is an understatement. I've done a small amount of research on executive function as that was part of the diagnosis offered.

Originally Posted by dv/dt

Just curious, how is she with things she is interested in compared to things she is not?

Disorganized...like everything else. Take volleyball for instance, she loves its, she's good at it, but she's never thinking far enough ahead to be great at it. It's not a lack of skill, ability, or practice...it's a lack of focus. She's been playing full-time for 4 years and she still doesn't "get it". She is more capable with things of interest, but who isn't???

[LesMurray]

Do not discount the effects of diet on concentration. The standard western diet with high amounts of sugar and grains have negative effects on brain function such as ADHD and autism. I have read many positive testimonials where parents have been able to control their children's ADHD or autism symptoms through a diet of mostly vegetables and proteins and cutting out all the sugars and carbs.

[FFR5452]

Speaking as a parent of an adult daughter that went through her teen years loaded with emotions and hormones, she often lacked focus and concentration. That said, we had her tested early on and she tested extremely intelligent. She could have cared less about anything that did not hold her interest. That's why we put her in private school rather than administer drugs. It forced her to apply herself with a minimum of distractions. We also told her that if she didnt apply herself, when she graduated she would be going to a local community college instead of heading off to University like her classmates would. That was all the incentive she needed to buckle down. If you have not had your daughter tested, I would do so for your own knowledge. Armed with that info, you can then make a better decision.

As a final thought, she sounds like a normal, average teenage girl. Some kids are just that, average. As much as we want them to be stars, it may not be in her DNA. Have her tested. She may be living up to her ability right now.

These are just my experiences as a father. Good luck with yours.

[Hoosier]

Originally Posted by LesMurray

Do not discount the effects of diet on concentration. The standard western diet with high amounts of sugar and grains have negative effects on brain function such as ADHD and autism. I have read many positive testimonials where parents have been able to control their children's ADHD or autism symptoms through a diet of mostly vegetables and proteins and cutting out all the sugars and carbs.

I hear ya and I don't discount such effect in some people. However, this is the child of mine that actually does have a decent diet whereas my older one has a horrible diet yet proves to be very capable no matter the challenge. If there were ANY behavioral issues, I'd give this idea more consideration. But I don't believe it to be pertinent in this instance.

Originally Posted by FFR5452

If you have not had your daughter tested, I would do so for your own knowledge. Armed with that info, you can then make a better decision.

As a final thought, she sounds like a normal, average teenage girl. Some kids are just that, average. As much as we want them to be stars, it may not be in her DNA. Have her tested. She may be living up to her ability right now.

We have had her tested and the results from both schools of thought confirm our suspicions and all parties agree that she is not living up to her potential. Diagnosis has been made and we've bought into it...treatment options are my where questions lie.

[Someday I Suppose]

Andrew, tough situation and hard to know whats right, at some point you need to trust in the people you have sought out to help you and make a decision on what is right.

I will say though I think a lot of us functional adults would have been diagnosed as ADD in today's world. For me personally I don't know that I call it ADD, but perhaps similar to Crash I have always needed to have an interest in the subject in order to learn. Tell me to read a book I dont care about and ask me about it and still today I won't recall what I read. But I read a book on my own about something that interests me and years later will be able to recall all sorts of details from the book.

Today in the workplace I look at it more as motivators and what are the things that excite and motivate me. If I can draw a line between what I am doing and my motivators I excel, its those times that there is no clear association that I still struggle.

Again, not sure how it pertains to your siutation, but knowing what drives and motivates her I think will help regardless of the path you take.

Good luck and please keep us posted.

-Scott

[slaga]

Originally Posted by Hoosier

My 15yo has proven herself to be capable, but lacks focus. Up to now, I've chalked it up to being a little lazy but we believe she may need some help. The last thing I want her to do is to struggle through the rest of her high school and eventual college careers.

Her grades are OK, but she struggles for them. She is completely disorganized and seemingly incapable of becoming so...no matter my "approach"...

The description you gave pretty much fits my daughter. PM sent.

[Redshift]

Everyone has different learning styles and abilities. I have never been a good speller, and could never memorize the multiplication tables. I always read well, but couldn't concentrate in class and barely had a 2.0 GPA in high school. I joined the Coast Guard, went to (aviation) electronics school, not an easy course, and was at the top of my class. Maybe it was the discipline, maybe a little more maturity. I have done very well in the phone industry for 34 years. I am very sharp at electrical and mechanical things. Some things I get and some things I struggle with.

My son scored in the 99th percentile in science, math concepts (but not math computations) and reading comprehension, but barely graduated high school. We tried various ADHD meds, and they helped some, but not a panacea. I could never quite figure out if we were too strict or too lax on discipline. We butted heads a lot. He is now, at 29, happy and doing well at work. My two daughters are/were on the Deans list at the University. Same household and same parents (as far as I know ;-)).

Let me know if you figure it out.

[slaga]

Originally Posted by dukegrad98

I just thought you might find it interesting that fully half of my law school class was on Adderall or similar ADHD drugs (basically prescription amphetamines). I'm not a doctor, but my strong suspicion is that very few of them were legit ADHD cases; they were all popping pills for an academic advantage. My girlfriend -- a physician -- says the same thing was going on at her med school. (I like to brag that she was top 1% -- with no pills!)...

EDIT: I see one of our docs has spoken. Bob, I'd be curious to see your experience or response to what I've described above, as a medical professional.

Cheers, John

I know your question was not directed at me in any way but my daughter qualified for a school program where only the top top 2% of the kids in the county can attend. I noticed when visiting her class that close to 1/2 of the kids seemed to exhibit inattentive ADD/ADHD type behavior similar to mine. These kids were not unruly or a nuisance in any way but very, very fidgety, way more than my other child's classes, which was not in the program at the time. One boy could not sit still at all. The teacher gave him the option of standing at his desk and I never saw him sit, ever. Over the last few years, we have become friends with some of them and I was astounded by the number of kids in her class that have been diagnosed with ADHD. I asked my kid's pediatrician about it and she basically said it is pretty common for highly intelligent people to exhibit this type of behavior and in many cases, medication can help them. It has most definitely helped mine. She went from failing math to getting a 100 on the EOQ (End of Quarter standardized test), which is extremely uncommon.

I googled "ADD ADHD intelligence" and came up with these articles:
ADHD and IQ: The Effect of Attention Deficit and Hyperactivity on Intelligence | ADHD Medical Expert - ADDitude
Do ADHD or ADD people have normal IQ? Is their IQ above or below average? - Yahoo! Answers

This is my kid in a nutshell:
ADDvance - Does your Gifted Child have ADD (ADHD)?

"For some of these bright students, their unraveling begins in middle school when the demands for productivity, independence, and organization increase dramatically. This is a time when there is a sharply increased demand on the "executive functions" of the brain. Because most research on ADD (ADHD) has been conducted on elementary school aged children, we have not paid adequate attention to executive function problems associated with ADD (ADHD). In elementary school, we do not expect children to monitor themselves, to keep track of time accurately, to keep their own schedule, or to plan, organize and prioritize. A child's mother, father, and teacher take responsibility for most of these functions. Then suddenly, as a child enters middle school, he or she is faced with a complex schedule, multiple teachers, and greatly increased organizational demands."

"he told me of his efforts to keep up with the demands. Unable to organize his books and papers well, he found that he often arrived in class without all of the necessary items. Often, they had been left in his locker. His solution to this problem was to carry ALL books and papers with him at all times in a huge backpack that he could barely carry."

2 years later with meds and we cannot get her to not carry every book, notebook, paper, folder, etc. she has for school. Everything is in her back pack but her grades went from D/F to A/B and the occasional C in an extremely accelerated program. To this day her organizational skills are still minimal but she is only about to turn 12.

My daughter functions without meds 60% to 70% of the time (weekends, vacations, summers, field trips, field days, reading books, etc.) very well. She is involved in many extracurricular activities but when she needs to really concentrate, the meds help her reach her potential. It is the difference between an above average student in an average school and an above average student in an elite accelerated program. Many would consider what I do with my kid juicing, others call it reaching her potential. I am in the latter camp. Without meds it was taking her 2+ hours a night to get those Ds and Fs. With meds it takes her about 30 minutes to do the homework and she is bringing home the A/B with the occasional C. Her self esteem took a big hit those last few months before she started her meds.

I am in no way offended by your observation but I seem to have noticed a similar correlation with kids of a much younger age in a situation where the smarter kids congregate. I guess the only difference may be what people consider "juicing".

[AJuergens]

Your daughter sounds like me when I was her age. Worked really hard to get ok grades.

I was on Ritalin and it had a positive impact.

I agree with the sugar comment, my parents limited me to 40g a day (less than a coke) made a big difference as well.

One thing you may want to look into is a food allergy to dairy products. There was a corolation made in Germany between dairy allergies and ADD / ADHD symptoms. I cut all dairy out of my life, and I mean all of it no butter, cream, beef, whey (it's in a lot of stuff) removing dairy ended up allowing me to drop the meds with no noticeable change in my behavior. This theory is starting to gain ground in the US, my GF bought a dairy free cook book when we moved in together and the first 2 pages discussed this topic.

My parents also forced me to do sports.

PM with you email address, I'm more then happy to share. I'm just over seas and typing on my iPhone is a pain.

[Hoosier]

PMs answered...Thanks everyone!