Dr. Atila Turgay, one of the leading experts in Canada on ADD/ADHD passed away in April. He had been Chief Of Staff at Toronto’s Scarborough Hospital, although recently he had returned to private practice. He was also on the faculty of medicine at the University of Toronto. You can read more about Dr. Turgay at Dr. Kenny Handelman’s blog here. I saw him just before he left his post at the hospital and set up his office at Davisville and Yonge in the heart of Toronto. My reason for being there was a review of medication I had been prescribed for ADD since the physician who was currently writing the prescriptions had not originally either prescribed them nor done the diagnosis. Dr. Turgay performed the shortest test I had ever encountered for the three aspects of working memory. The first two were not uncommon. He asked me to remember a string of seven numbers and then repeat them backwards. He did a similar one for verbal working memory. Then he sat right opposite me and asked me to observe him, without moving, until he asked me to replicate what he did with his fingers and hands. What he did seamed simple enough. His hands were reversed with one finger on one hand touching a finger on the other. But when my turn came to replicate it I could not–even after a couple of tries. I had seen Dr. Turgay describe this test in several lectures sponsored by the Attention Deficit Resource Network but this was my first opportunity to actually do it. His conclusion, after these three short tests, was that I had an impairment in visual/non verbal working memory. Some years ago I did a completed psycho-educational assessment valued at close to $2,000 and a similar component, lasting at least half an hour, had reached the same conclusion.
My visit only lasted a few minutes and the medical part of it was over before I knew it. He concurred with the medication I was taking and with dosages and schedules. Then he quizzed me on my background and interests, as it turned out, to see if I might be of service to the ADD/ADHD community. It wasn’t his suggestion but this meeting was one of the reasons I started this blog. I heard him speak on a couple of times and my appointment with him two years ago only lasted perhaps 20 minutes but I will miss him. Not only was he a great resource to the ADD/ADHD community he was, in my experience, a kind and caring individual.
It was on reading his obituary and remembering his visual/non-verbal working memory test that led to a mini-ah ha moment. I had always marveled that one of the profound and noticeable effects of even a small dose of ritalin would lead to a great improvement in my hand-writing. I’m no expert but I would bet that there is a large component of visual/non-verbal working memory skill in handwriting.
Recently, I came cross a reference to the Mozart effect and, although the term sounded vaguely familiar, I really didn’t know what it meant and had to read a definition. That was illuminating as it lead back to a reference to a physician named Alfred A. Tomatis and his work with children with learning disorders and some other crippling neurological problems by improving listening skills. I was quite familiar with Tomatis. But first to back to the Mozart effect which says that listening to Mozart’s music will increase intelligence by eight to nine points–even if just temporarily. This caused quite a stir in the educational community when it was first revealed some years ago. One State Governor in the U.S. even had each pubic school student in his state supplied with a CD containing classical music. Okay, you run into claims like this on the general topic of education almost every day. However, when I found out much of the original research (actually clinical experience) was performed by Alfred Tomatis who was an ear, nose and throat specialist and used listening therapies (some involved listening to Mozart) to improve learning disabilities in children I became quite intrigued. Some 15 or so years ago when I was working as a management consultant, my firm was contacted by The Listening Centre in Toronto to request some pro bono consulting. I was chosen and went for an initial meeting with the two people who ran the centre. I have forgotten what services they required but I do remember how impressed I was with them as people and the passion they had about their mission to treat children with learning disorders using methods developed by Tomatis. Soon after I left the firm and performed the work for them as an independent consultant waiving any fees. Some time later, a friend came to visit, a man I had shared a flat with many years previous in London. He had become quite a famous actor (instantly recognizable in Dublin if not Toronto or New York) and had actually been passing through Toronto on his way from Vancouver back home to Dublin. Ray suffered from Tinnitus and I knew this was one of the disorders The Listening Centre claimed to be able to treat so I called them and asked if they would see Ray. They agreed to do the assessment for free but since Ray did not live in Toronto and there were no Tomatis practitioners in Dublin they could only recommend alternative treatment to the “electronic ear” that was at the heart of their regular program. Well to cut to the point it worked. Ray went home to Dublin, did the things they recommended (most of which I don’t remember save some things about diet) and got relief from a disorder that had been plaguing him for years.
Now, I know that there are a lot of treatments out there they looked like quackery even a few decades ago that utilize neuroplasticity to effect cures, or at least relief, for ailments that were thought to be permanent. Why am I writing about this in this post on this blog? The Mozart effect did not really go anywhere and I’m sure that almost no one now remembers Alfred Tomatis. The Listening Centre in Toronto fell on hard times, could not pay their rent and closed. One of the practitioners took up another career while the other followed some interest in the method to Mexico where there was a supportive clientele. But these days I read daily about miracles involving neuroplasticity. There are people blinded by strokes who can see again, Alzheimer’s patients that have no neurological symptoms, schizophrenics who improve their working memory and become symptom free. We are on the frontier of many great discoveries but to get there we might have to put away our skepticism and allow ourselves to experience awe and wonder without the dash of skepticism so many of us have developed as adults to prevent disappointment in chasing down blind channels or after miraculous cures. I say us and I mean me and if I write it hear perhaps I will be a little more likely to follow the advice of Herbert Spencer who wrote: “There is a principle which is a bar against all information, which is proof against all arguments and which cannot fail to keep a man in everlasting ignorance–that principle is contempt prior to investigation.”
I have been a fan of natural health products since I managed to lower my blood pressure with Omega 3 capsules and so am a little more friendly to reports such as this one from a study conducted at the Center for Learning and Memory at Tsinghua University in Beijing. Guosong Liu, the center’s director, found that magnesium, “led to significant enhancement of spatial and associative memory in both young and aged rates.” Magnesium is found in some fruits and most leafy vegetables but the study made use of a new magnesium compund–Magnesium-L-threonate (MgT)–but the new compound was just a more efficient way of delivering magnesium to the brain. Mr. Liu said, “Half the population of industrialized countries has a magnesium deficiency which only worsens with age.” He went on to say, “If normal or even higher levels of magnesium can be maintained, we may be able to affect cognitive function.” Mr. Liu is a former professor at MIT in Boston and is co-founder of Magceutics, a California-based company developing pharmaceuticals for the prevention and treatment of age-dependent memory decline and Alzheimer’s disease. He claims that if you consume less than 400 milligrams of magnesium per day, you could be at risk for allergies, asthma and heart disease.
Just last week, I was telling a friend about this research and he mentioned that he had been told by a natural health practitioner to take a magnesium supplement for Restless Leg Syndrome, (RLS) a condition in which, legs at rest, usually when you are just lying down to go to sleep, feel as if they are twitching. I have RLS and thought that perhaps a magnesium supplement would improve my cognitive functioning as well as my sleep if it could stop that dreadful sensation of leg twitches. I would love to report at the end of this post that I immediately went out to the health food store and got some but…I forgot.
I did a full psycho-neurological assessment about five years ago courtesy of a not-for-profit organization dedicated to assisting adults with learning disorders in their careers. The testing indicated I had real problems with “immediate and long term visual and non-verbal memory.” Not long after I had an appointment with Dr. Atilla Turguay (one of the top experts on ADHD in Canada) who does a quick three-part test of working memory and did okay on verbal and numerical but miserably on the visual part. When I told him the results on the psychological testing he just nodded. I have been taking karate now for about seven years. I started because it was recommended by the psychiatrist who diagnosed me with ADHD. I now have a first degree black belt and am preparing for a grading for a second degree this fall. I get by. I have to make some minor adjustments in my learning style to accommodate problems with focus and attention but I do have a black belt so I must be doing something right. Knowing that I had this visual working memory problem I also started classes in Kobujutsu a few months ago thinking it would help with the visual working memory problems. It’s been tough going. Time after time I have find myself standing on the dojo floor, just after the sensei has demonstrated something and is waiting for me to duplicate what he has just shown me. I am searching my mind for a mental picture of what he has just done and there is nothing. He’s waiting. I’m waiting. Nothing is happening. Eventually I do something and get corrected again (my sensai has the patience of Job) and wait for the mental picture…and wait. This Sunday I am being graded for a yellow belt, the first belt after white which is what you start with. The symbolic meaning of the white belt is that it is a clean slate…nothing on it. You know nothing and you don’t know you know nothing. A yellow essentially means you now know enough to know you don’t know anything. The point of all this is how much harder it has been for me to learn weapons than just straight karate. There is something about extending my control beyond my physical self that stops me dead. In Kobujutsu you usually start training with the bo (a six-foot wooden staff). I have to imagine that I am striking some target that is at least three or four feet from where I am gripping the bo. And that’s where my brain gets into trouble. What keeps me going, class after class, is the knowledge, no really the hope, that this training is making a difference in my visual working memory. I wish I could say that I know it is making a difference but I don’t. I just hope.
The Toronto Sun reported today that the Scarborough-North York trustee for the Toronto Catholic District School Board (TCDSB), John Del Grande, has called for an emergecy meeting to reopen the TCDSB’s decision to drop the Arrowsmith Program, for reasons of cost, just two days before the school year end last June. This latest move happened just hours after some parents of chidren who had been in the program filed a lawsuit naming the Minister of Education, Kathleen Wynne and the province’s supervision team as well as the TCDSB. The notice of application for judicial review asks for the immediate reinstatement of the Arrowsmith program and that the court review the decision to cancel it. Lawyers acting for the parents claim the supervision team headed by Norbert Hartman was acting outside of its jurisdiction when they cancelled the special education program. John Del Grande said that the move goes against the decision of the Board’s special education advisory committee which had recommended keeping the program until at least 2011. One of the parents involved in the suit said, “All we want is a fair shake for the kids.”