Training the Brain: Scientific American (archiving magazine articles 07/2005)

Training the Brain: Scientific American

To medicate or not? Millions of parents must decide when their child is diagnosed with attention-deficit hyperactivity disorder (ADHD)--a decision made tougher by controversy. Studies increasingly show that while medication may calm a child's behavior, it does not improve grades, peer relationships or defiant behavior over the long term.

Consequently, researchers have focused attention on the disorder's neurobiology. Recent studies support the notion that many children with ADHD have cognitive deficits, specifically in working memory--the ability to hold in mind information that guides behavior. The cognitive problem manifests behaviorally as inattention and contributes to poor academic performance. Such research not only questions the value of medicating ADHD children, it also is redefining the disorder and leading to more meaningful treatment that includes cognitive training.

"This is really a shift in our understanding of this disorder from behavioral to biological," states Rosemary Tannock, professor of psychiatry at the University of Toronto. Tannock has shown that although stimulant medication improves working memory, the effect is small, she says, "suggesting that medication isn't going to be sufficient." So she and others, such as Susan Gathercole of the University of Durham in England, now work with schools to introduce teaching methods that train working memory. In fact, working-memory deficits may underlie several disabilities, not just ADHD, highlighting the heterogeneity of the disorder.