Sorry I forgot ...

05/02/2013

 
Almost everyone I assess complains of having a bad memory. While legitimate impairments in acquisition of memory (more of an information processing deficit) and retention (that's pretty rare actually) exist, clients are rarely complaining about forgetting something from the past. Generally people forget and get in trouble for failing to remember to do things in the future. Essentially we are talking about forgetting to not forget to do something. It is as much an mechanism of attention and is referred to as a prospective memory failure.

Wired Magazine had a nice little brief on this (click here) and talked about the use of "geolocation" reminders to prevent you from making these errors. Maybe now you won't forget to bring home your homework.
 
 
Many things compete for your attention as you work on homework, readings, essays, or projects. The same thing happens to those of us in the workforce, as we complete paperwork, readings (we have those to), and website blog updates.

It often happens without you even realizing it. You are working on something important and you have to look up the spelling of a word or a fact for your paper. You go over to Google and while you are there twitter, facebook, or Google+ flashes at you. You start reading this status update and that tweet, next thing you know half an hour has passed.

As we go through our work we will often find ourselves getting bored and seek out some form of stimulus. Unfortunately, social media and youtube are much better at doing this than biology homework. What we need is something else that is stimulating enough to distract us from our surfing and let us get back to work. At the same time, it has to be something that will not distract us from our work if we happen to still be on task.

The best option I have found so far is a Mac and iOS (iPhone/iPod Touch/iPad) app called Mindful Mynah. Mindful Mynah sits on your taskbar or in the background of your phone and sets off a small "ding" at a set interval (say 20 minutes). If you are off task, Mynah will "mindfully" encourage you to get back to work. If you are on task, it will be slight enough to only encourage you to keep working and congratulate yourself for staying on task in the first place.

I started out with Mindful Mynah being set to "ding" me at 20 minutes, but found that I was more often than not off-task by that point. So I set it to 17 minutes and it almost always went off before I was off task in the first place. This just encouraged me to keep going. A couple of hours with Mindful Mynah and I am able to get an immense amount of work done.

Why not check out Mindful Mynah on the MAC and iOS App Stores (only $2). Sorry no Windows version at the moment, but I will keep an eye out for alternatives.
 
 
I first saw Jane (not her real name) when she was in Grade 8. She was referred to me by a parent for a psychoeducational assessment prior to entering high school. Jane had been previously assessed during her early elementary years and had been diagnosed with a Learning Disability. She was known to be a bright student who could be quite successful when accommodated, she simply had difficulty processing certain types of information.

While Jane's family and teachers had not reported any concerns with attention, hyperactivity, or impulse control, a thorough assessment rules out all alternative causes for a student's difficulties and our Grade 8 assessment indeed included interviews, environmental surveys/checklists, and functional hands-on assessments of Jane's attentional capacity. As had been anticipated, Jane performed remarkably well on these assessments.

Fast forward 4 years, Jane has come in to work with me on some learning skills and was shortly after referred again for reassessment prior to leaving for college. It was shared with me that Jane had been diagnosed about a year or so after our last assessment with Attention Deficit Hyperactivity Disorder (ADHD) and was currently receiving stimulant medication supports. While I was surprised and concerned that this diagnosis had spontaneously (in my view) appeared during Jane's teenage years, I also accepted the possibility that I may have missed the initial ADHD diagnosis somehow when I completed the Grade 8 assessment.

This time around I went even deeper and developed a multi-tier assessment that looked at several different attentional and self-regulatory systems. This time, nearly every clinical measure was impaired. Even more concerning was that with the support of psycho-stimulants Jane's attention profile was entirely average. Had I missed the initial diagnosis then?

I went back to look through all my original data. I was particularly interested in a computerized attention-impulse assessment that Jane had completed during her previous evaluation with me (Age 13) and now again as a young adult (Age 18). While nearly every other aspect of Jane's learning assessment was identical to her previous assessment, her attention testing had reflected a sharp decline in all measured attentional domains. In other words, Jane's previous assessment (without medication) now only matched her medication supported assessment. In essence, her ADHD had essentially appeared during her adolescence, well beyond the diagnostic cut-off for its emergence (Note: ADHD symptoms must be present before age 7, though a revision of this criteria to age 12 was being considered at the time of writing).

So what was going on? At one point I thought Jane may have actually been faking ADHD, though I was honestly baffled why this would be the case given a well documented history of learning disabilities. To rule this out I included a number of symptom validity and effort tests. All passed. Honestly, I was a bit perplexed. As Jane had never been much of a talker with me and I was receiving minimal information about the years since my last assessment with her, I decided I would "update" my previous background history through a follow-up interview with Jane's father. That interview would prove to be the missing piece of the puzzle, while it was confirmed that Jane had been diagnosed with ADHD and prescribed psycho-stimulants about two years after my previous assessment this had also co-occurred with the emergence of sleep apnea.

Jane's sleep disorder was being treated through the use of a CPAP machine (some info here). An almost simultaneous psycho-stimulant prescription for Jane's "ADHD" also occurred. In the end, that prescription was probably a proper course of treatment (it did lead to measurable gains in attention and impulse control after all). The only issue was that it was being applied to the wrong disorder. While that may be a semantic argument of sorts, the ADHD label was a new and unnecessary one that could have sent Jane off on a treatment path that was not appropriate given her legitimate sleep disorder and learning disability.

Sleep problems with adolescents are not limited to severe disorders like sleep apnea. I have many students who reportedly stay up until extremely late hours on their smartphones or computers, which are remarkably stimulating devices that can easily counter the natural desire to rest. In the "old days" books and late night TV were just not stimulating enough to bother with battling sleep. Studies have shown that teens need over 9 hours of sleep a night, but that nearly half the population is obtaining less than this amount.

What can be done?

Good sleep hygiene habits, a focused look at what sleep habits one already has, medical referral and a sleep study for more chronic conditions, and potentially the inclusion of some evening relaxation or meditation exercises. I've included some follow-up references for interested readers:

National Sleep Foundations National Sleep Study (some concerning data)

Mayo Clinic's Sleep Disorder info-page 

Reference on using psycho-stimulants for sleep disorders and other non-ADHD conditions (not to be taken as a medical recommendation - just further information for the reader)

UCLA's Mindfulness Meditations for Sleep (a great free guided meditation resource)

A great New York Times article that led to this post and was sent to me by Jane's dad.

 
 
I am frequently asked by students/clients about which tablet I would recommend for use in the classroom as an organizational aid, assistive technology tool, or a laptop replacement. While I am not sure that a tablet is the right tool for all students, there is certainly a number of benefits to a tablet as an alternative to either a smartphone or laptop. While “Is a tablet right for me?” is the question most students and parents should be asking, “Should I get an iPad, Android, or Blackberry Playbook?” is the one I am more frequently presented with.

While I hope to have an opportunity to answer all of these questions over the next few months, I had an opportunity to recently spend a few days with one of the latest tablets on the market, the Canadian made (and now Japanese owned) Kobo Vox.

On paper, there is a great deal to like about the Kobo Vox. Kobo is a reputable ebook reader company that has been made famous in our country through a partnership with Indigo and Chapters. The Kobo e-readers have developed into a great product and their ebook apps for phones and tablets are top notch. Add to that a price point ($200) that is less than half the cost of an iPad and about a third cheaper than it’s direct competition, and the Kobo Vox seems pretty exciting.

The Kobo Vox is a response to the Barnes and Noble Nook and Amazon Kindle Fire, which are both US based and not currently available in Canada. Like those three devices the Kobo Vox is based on the Google’s Android operating system. 

Android is currently considered the only viable tablet operating system alternative to Apple’s iOS. While you will hear complaints from Blackberry fans by that statement, the reality is that the Blackberry Playbook was dead on arrival, has hardly any decent apps available, will likely not see any legitimate app expansion given the lack of users of the device, and after nearly a year on the market the Playbook still does not have an imbedded email or calendar application. The current fire sales on Playbook should be a sign of where that tablet will end up in a year.

What is a little confusing is that there is currently two major iterations of the Android operating system. The first is called Gingerbread or Android 2.x (x represents the update number), which is a modified version of the Android phone operating system. The second is the more resource intensive Honeycomb or Android 3.x, which was designed specifically for tablets. Unfortunately, many lower end tablets have chosen to use the Gingerbread system and are essentially a zoomed in version of the phone system (the reasons they made these choices are logistical and beyond the scope of this review).

This choice is unfortunately also true of the Kobo Vox, which not only went the Gingerbread route, but also went with an underpowered processor, and a tiny amount of  RAM (system memory). Add to this a fairly locked down system that will not let you delete some of the extra and unnecessary “bonus” apps they installed for your benefit, an inability to access the Google AppStore (there is a poor alternative one that does not have some of the most essential apps for students), a tendency to frequently crash, poor battery life, and frustratingly sluggish performance and you have a tool that is likely to get very little use and will eventually be abandoned by most students.

My wife can verify that I spent a lot of time yelling at the Kobo Vox (I was very calm when I returned it). In reality, there were a few things to like about the Vox. First of all, the Kobo app itself was great and worked well. As the Vox is essentially marketed as a full colour Kobo, it is doing what it was advertised to do. Secondly, the keyboard is great. I have since started test driving a Honeycomb based Android tablet, and while there is a lot to love with that piece of equipment, its keyboard is now the new source of my anger. Finally, as noted previously, the Kobo Vox is only $200 (the iPad is $500+).

It is hard to complain about that price point. However, while this is a good deal for a full colour book and magazine reader, anyone who is looking for a tablet will eventually buy something else (sooner rather than later I suspect) and will end up paying a lot more as a result. Since the Kobo app is just as good on every other device I have tested it on (e.g., Android 3.x; iPad; Playbook) there does not seem to be many reasons to justify purchasing a Vox. I also have legitimate concerns of whether the 7” screen size of the Vox limits its utility as an organizational and productivity tool.

As a final note, having also played with other Kobo products, I can tell you that they are notorious for releasing buggy gadgets that improve drastically with system updates. All that being said, I suspect the hardwares limitations hold a lot of blame here and no software update can change that. For now I cannot recommend the Kobo Vox. Users will be much happier with an iPad or potentially a Honeycomb based Android alternative (a review on that one soon!).
 
 
Several of StudentStrats recent book reviews have been focused on navigating the ins and outs of applying for post-secondary programs as a student with a learning disability. While I certainly recommend taking a good look at those books (which you can find by clicking here), you may also want to take a look at a recent series from the New York Times on this very subject.

The first part in the series is available HERE and was followed up by a series of useful Q&A's with an author of a text similar to those I have recommend. They are all worth a look. Here are the Q&A links:

Q&A 1
Q&A 2
Q&A 3
Q&A 4
Q&A 5

It was obviously a popular subject!
 
 
The transition from elementary school learning supports to a more self-advocacy driven high school support system can be a challenging one. It is often one of the first times a student falters and they do not always maintain the drive or resilience they have shown in the past.

The Integra Foundation is offering a parent workshop aimed at smoothing this transition and recognizing the pitfalls before they occur. If you are in the Toronto area and have a child moving into Grade 9 in September 2012, now is the time to get informed and prepared. The workshop is $10 and is offered November 23, 2011 from 7pm to 8:30pm. You can register by phone (416-465-8055) or online at www.integra.on.ca 
 
 
Toronto's Integra Foundation is offering a parent workshop on navigating the public and separate school systems support programs. From their website:

"This workshop will explore both informal and more formals ways of communicating with the school and focus on understanding the process of getting help within the classroom and the school system. Attention will also be paid to relationship development and team building."

If this is all new to you and you are in the Toronto area, this may be a valuable resource for you. The next session is on October 12, 2011 from 7pm to 8:30pm. You can register for $10 by phone (416-486-8055) or online at www.integra.on.ca.
 
 
The "Client Resources" section (passworded) has been updated to provide all of our students with a easy to follow "cookbook" guide that they can use for any projects or assignments they are facing in this new school year. Based on the cookbook outline that you worked with in your first session, we have also simplified the earliest steps in that lesson plan so you will be better prepared for the initial planning stages. 

It is worthwhile to review the new Session 1 handouts and compare them to the one that you worked on with your learning therapist. If you are a previous client and have questions on how to apply this, please do not hesitate to contact our team.
 
 
On Your Own’s authors, Quinn and Maitland, have written quite a number of great resources in the students with disabilities college preparatory space. They have always done an excellent job of modifying their approach to meet the needs of the intended audience (e.g., students or parents).

This text is, in my opinion, the strongest of their entries and easily the best student-centric book preparatory guide that I have reviewed to date. The first 17 pages are a guide for helping students make the transition to a self-directed college and university environment, where supports are usually only available to those who seek them out and show a commitment to the learning process. There is some honest questions here for a student to ask both the disability services department and themselves. The section is remarkably well done and provides a realistic view of what a student can expect at the next level. Before I had even read beyond these 17 pages, I knew that I was going to pick up this book and you should as well.

The remaining 100 pages steps away from the “what should I know” model and engages the student in what is essentially a self-regulation or self-direction booster shot. There is good stuff here that can be applied to focused periods of time management or to the more global demands of managing your daily life. A motivated student will be quite capable of implementing these ideas with little difficulty. A student who is not motivated to self-direct, however, is going to find little of use here.

If there is one text you are going to buy for yourself or your child, On Your Own is the one you should be looking at. While other texts we have reviewed have provided useful information that can certainly augment this book, Quinn and Maitland have put together the single best resource on this topic.


On Your Own is available from Amazon by clicking here.
 
 
Just a quick note for our current and previous strategy/learning-therapy clients that the Client Resources section has been updated and there is likely a more current version available to you regarding the TO-DO/Cookbooking sheet, note taking system, and reading systems. We will also be expanding the Bookstore in the next few weeks, with more material that is focused towards your needs and continued learning.
 

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