2010-10-05

Bringing Neuroscience Breakthroughs Home:
Advanced Pediatrics at the 2010 International Meeting on
Evidence-Based Cognitive Training

Advanced Pediatrics at the Forefront of Neuroscience
On September 24, 2010, some of the world’s leading neuroscientists, doctors, and psychologists gathered at the annual Cogmed Conference, held this year in Chicago, to review recent research on evidence-based cognitive training. 
            Advanced Pediatrics was pleased to once more take its place as the first clinical office in the United States to offer Cogmed working memory training, widely regarded as the most substantial form of evidence-based cognitive training to date.
            Every year, the Cogmed Conference has drawn an increasing level of attendance and level of expertise.  This year was no exception.  The number of professionals present was double the prior year’s total.  Clinicians from Korea, Singapore, Sweden, Costa Rica, South Africa, and from over 100 sites across the United States were present.

TOPICS DISCUSSED 
What is evidence-based cognitive training?
Evidence-based cognitive training is any program that has the brain conduct exercises that improve the function of the mind enough to significantly improve the person’s life.  Many programs make such claims, but evidence-based cognitive training are only those programs that can point to research published in well-regarded peer-reviewed journals.

What is Cogmed Working Memory Training?
Cogmed working memory training is perhaps the evidence-based cognitive training with the most evidence of successful impact.  The program is the result of many years of highly regarded neuroscience research at the Brain Institute of the Karolinska Institute in Stockholm.  Its founder, Dr. Torkel Klingberg, received the Philips Award as one of the world’s leading neuroscientists in 2008(?).  After spending years in careful development and evaluation, many thousands of people have completed Cogmed Working Memory Training with results very consistent with the research findings: 80% of those trained have improvement in cognitive function large enough to improve the lives of those trained.  Improvements cited include better attention, organization, and success at school, work, and home.  Centers that have studies and published their findings on Cogmed Working Memory Training include Harvard, Stanford, New York University, Notre Dame, York University (UK), and the Karolinska Institute (Sweden), among a very rapidly growing list of the world’s leading centers of research on the brain.

What is working memory?
Working memory is the ability of the mind to consciously hold more than one piece of information at one time and do something with those bits of information. 

And so, working memory is not really memory as we think of memory.  Memory is about remembering something from the past. Working memory is about doing something with information at hand in the present.

Perhaps the best way to appreciate this idea is to think of the brain’s job falling into three connected goals:
1.To take in information
2.To understand information it takes in
3.To do something, complete a task, with information it understands
 Working memory is the function of the mind that connects understanding and doing. 
 Once you know something, working memory appears to be the most important function of the conscious mind that translates knowing into doing.

How important is working memory?
As noted above, Dr. Alan Baddely developed the concept of working memory about 40 years ago.  Ever since then, neuroscientists have found more and more proof that working memory may be at the root of many of the most common problems in thinking, namely:
·   *Getting something done
·   *Understanding complex directions
·   *Completing assignments on time
·   *Remembering what you were asked to do
·   *Being socially successful
·   *Doing well in school
·   *Doing well at work.


WHO PRESENTED? 
Present were some of the world’s leading experts on how the mind generates attention.  These included:
Dr. Susan Gathercole, head of the British lab where some of the most important work on defining the core element of attention, working memory, has been done.  She presented recent studies that demonstrate how nearly all children who struggle in school have a deficit in working memory, and, further,  enhancing working memory can improve nearly all children’s level of academic achievement.  www.yorkU.edu.en

Dr. Mark Rapport, one of America’s leading researchers on ADHD, from Florida, presented just published ground-breaking work on exactly what in the mind of a person with ADHD.  Key to his findings was the actual causes of the impairments that ADHD causes, namely school failure, social isolation, disorganization. www.childrenslearningclinic.com

Dr. Rosemary Tannock, widely regarded as one of the top authorities on the management of ADHD, presented her recent findings on the impact of evidence-based cognitive training on school performance and the symptoms of ADHD.  www.

WHO BENEFITS FROM EVIDENCE-BASED COGNITIVE TRAINING?
The conference also featured presentations from a wide variety of practitioners across the US and the world sharing their experiences on the impact of evidence-based cognitive training.  Their observations offered proof that evidence-based cognitive training has a positive impact in these settings:
Schools.    Several schools presented their findings that students who undergo evidence-based cognitive training do better in their studies- more organized, calmer, more confident, less distracted, better able to follow directions and expectations, more homework completed, with improved grades.  As noted above, one study demonstrated such improvements for children with and without working memory deficits.

Traumatic Brain Injury (TBI).   Adults who had evidence-based cognitive training noted improvements  on task completion, occupational performance, and satisfaction with performance, overall health.  The adults described being more alert, more awake, more aware of what is happening, lifting the fog, better able to help their children with homework, more focused, and overall more confident.

Down Syndrome.   This presentation was also from Dr. Gathercole’s group, the leading authorities on the working memory in the world.  They found that initial observations on a group of children with Down Syndrome, with intellectual level of function averaging at the five year old level, responded well to evidence-based cognitive training. Teachers of these students, who were unaware of their training, spontaneously reported to parents that these children seemed calmer, more focused.  Parents agreed and also noticed decreased hyperactivity, less frustration, and that they remembered instruction sets better.  Based on the strength of these observations, the group will be conducting a randomized controlled trial to prove and measure the impact of evidence-based cognitive training in children with Down Syndrome.

Depression in the Elderly.  This study from Georgia demonstrated that evidence-based cognitive training can reduce the burden of depression in the elderly.

Cognitive Loss from Cancer Treatment.  Children whose brains are exposed to chemotherapy or radiation lose cognitive abilities an often suffer a loss of ability to concentrate or focus.  This team from Duke presented many years of work demonstrating that evidence-based cognitive training can restore enough of this lost function to make a significant difference.


BOTTOM LINE
·         An explosion of understanding of how the brain actually works is just now leading to applications that can help each of us think better and more effectively.

·         Evidence-Based Cognitive Training represents the best of those applications.

·         Cogmed represents the best of the evidence-based cognitive training protocols.

·         Advanced Pediatric is the first clinical office in the United States to offer Cogmed Training to its patients and to the general public of all ages.


Dr. Arthur Lavin

*Disclaimer* The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

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