A NEW THEORY OF ADHD
Always in search of theories that could explain the many problems faced by children with ADHD, Barkley seems to have been very impressed with the work of Jacob Bronowski, mathematician, physicist and philosopher.
He tries to transfer in children with ADHD these explanatory concepts. Here, rather telegraphic style, thinking that we propose Barkley.
There is a consensus among scientists and clinicians working with ADHD children: they are inattentive, impulsive and hyperactive. One conclusion seems to follow: they have difficulty controlling these aspects of their operation.
However, in their daily lives these children have a myriad of complex problems in several areas: academic, social, familial, emotional, intellectual, occupational, etc....
For example:
- Poor organizational skills and planning;
- Poor ability to understand and manage time;
- Difficulty in social relationships;
- Emotional hypersensitivity or hyposensitivity;
- Little easier to solve problems;
- Poor self-awareness;
- Moral judgment deficit;
- Difficulties in mental arithmetic;
How to explain this range of problems in areas as varied?
Why the adaptation functions of these children are also ineffective in many areas of everyday life?
The response of laboratory research:
a primary deficit in the ability to inhibit a behavioural response
a great inability to see over time the behavioural response following stimulation
a low tolerance interval between events (tasks or any other action).
The answer is that the theory of Bronowski for Barkley.
According to Bronowski, a major advancement in the evolution of human communication came from the fact that man was able, with the development of his brain (the expansion of the frontal lobes, areas involved in the incident command system and adjustment of human action), increasing its ability to defer the time the behavioral response to a signal (message or event). Thus, he learned to inhibit his (or her) answer (s) initial (s). It was therefore, the time available for thinking.
This new and extraordinary capacity would have resulted in the development of four basic mental skills, four major executive functions for self-control of multiple dimensions of human action and management by anticipating the future (see, before action, possible consequences and then act according to what has been glimpsed).
Barkley stands thus reasoned:
If the above is true, there should be among many children with ADHD deficits in relation to the four functions presented by Bronowski.
First function: the extension
Definition: The ability to support (to be extended in time) or mental representations (and also very visual language) of a signal, message, event.
Barkley said in passing the role of working memory in this operation.
This function allows the information (signal, message, events) is fixed, is rooted in symbolic forms or mental representations (especially visual and linguistic) in working memory. It thus is created an internal mental reality, which has its own existence, independent of external signals, allowing human beings to reflect on the events (even in their absence), before acting. It may take time, for example, searching his memory back to see if information relevant to the event lived in it and can use his experience to analyze the present and especially to give a direction his acting future (anticipation of possible actions and evaluations of their consequences, to continue setting goals, actions to (and in what order) to get there, etc....
This reflection before action, promotes the development of a general sense of time and an ability to understand its implementation and use (e.g., understand the past, the future, estimate the time, cut time, planning time ).
This extension allows a best problem-solving process and best control of thought about emotion, which improves the adaptive actions that follow.
Examples of difficulties that children with ADHD Barkley's link to this function:
- Have little attention to what is happening around them and forget what happened;
- Do not benefit from the past to address the future;
- Make little connection between their behavior and its consequences;
- I have limited ability to return to a discontinued operation;
- Move from one activity to another;
- Have a poor "sense of time";
- Believe or not time poorly, with misbehaving, it is wrong, etc..... They may believe that the time goes very slowly, and therefore, they are often caught off guard. They may believe that the time goes very quickly and there is panic.
Understanding and time management are important factors in adapting to everyday life. In particular, they allow us to understand the phenomenon of "delayed gratification."
Second function: inner speech "Internalization"
Definition: the ability of humans to talk to himself.
On the one hand, the time installed between stimulus and response and on the other hand, the function of extension facilitated the development of internal language.
This function allows the control of thought processes and emotions by adjusting the internal language. Consequently, humans can think, return to the past and have access to the future. It can then implement all the mental operations and concrete process of problem solving. It can also extract rules, a set of general information; it can make new rules and above all he can manage (control) its behavior according to these rules.
A major benefit: an increase of freedom. Human beings may well be less variable, more predictable and adequate for his actions in his adaptation.
Examples of difficulties in children with ADHD:
- Impulsivity: quick and strong reaction to stimulation of the moment;
- Poor problem-solving skills;
- Poor emotional adjustment to events;
- Difficult to move towards the future;
- Set goals, organize and plan actions, the check in their head before;
- Difficult to defer gratification;
- Difficulty making rules to control their behavior;
- Therefore, unpredictable behavior;
- Therefore, difficult to establish close links between behavior and its consequences ..;
Definition:
- The brain's ability to divide into small units of information received (analysis)
- The ability to recombine these units of information to reconstruct the original message (synthesis) or make a new one from a variety of information units (creativity) .
- generalization: linking information units, so to make rules, including those that handle social behavior.
- to make problem solving, to imagine, create, generate alternatives and new solutions.
- Difficult to analyze and synthesize information for themselves;
- Difficulty in finding solutions;
- Difficult to generalize, to make connections between different bits of information from multiple experiments.
Fourth function: separation of effect
Definition: the ability to separate the emotion of the event, the emotion of objective content.
An event contains several components (factual, emotional, spatial, temporal, etc....). The fact that the human brain can inhibit its response and install a delay between the receipt of information and production of acting to adapt to separate the components of the message and send them to different areas of the brain for interpretation and this, at the same time.
This separation between affect and allows the real facts:
To deal more objectively, more rational facts
put them into perspective, even to wait before processing. This facilitates the process of problem solving
better control and adjusts the emotions that accompany the events
more than manage the emotions that accompany behavioral responses directed toward certain goals (example: create an emotional desire, based on the motivation and effort, even in spite of fatigue or low interest)
acting of having further suited to situations: the power of adaptation of "objectivity."
Examples of difficulties in children with ADHD:
fast reactions (no delay) and too intense (poor fit) as emotional and behavioral
or weak reactions, or even no reaction (hypoactivity: low interest, low desire, little active engagement, little participation, etc.....).
Reactions to the field located to affect events, they cannot take away. They get angry, attack, blame and accuse. They lack objectivity and perspective. They do not have time to monitor and analyze what is happening. They do not have time to make adjustments and emotional reasoning before acting, not because they are unable to do so, but they do not have time to do so.
This causes several problems like cognitive, social, emotional and even moral.
Barkley summarizes and concludes:
ADHD children have problems that go far beyond the few basic symptoms the best-known problems that cause them many adjustment difficulties in their daily lives.
He believes that these children have the ability to do what they are accused of not doing, but they simply do not have time to do so.
This is where the central concept of the theory of Bronowski: the brain's inability to inhibit a response after stimulation and to install a delay between stimulus and response would cause a disruption in four major executive functions: the extension, establishing an internal discourse, the recovery and separation of effect.
This low self-monitoring system would be due to phenomena of a neurochemical and action of stimulants is precisely to facilitate the process of response inhibition. This would explain that these medications have effects in many different areas, for example: increase attention and improve social relations.
Barkley argues that theories provide explanations Bronowski more "elegant," more comprehensive, encompassing several seemingly disparate research data and make it more responsive to the magnitude of all the adjustment problems faced by these children in their everyday life.
Like all researchers, he ends by saying: "It is tempting; it is promising; it's exciting, but everything must be subjected to research more systematically." However, as a clinician, he is convinced that the explanatory concepts of Bronowski stick perfectly to the clinical reality observed.
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