A new study, that will be published in the August edition of Applied Cognitive Psychology, conducted at the University of York in the U.K. shows that stimulant medication significantly increases visuo-spatial working memory but that Cogmed Working Memory Training leads to significant improvements in all four critical measures of working memory: verbal and visuo-spatial short-term and visuo-spatial working memory. In addition the training effects were still in place when the subjects were retested six months later.
The subjects were 25 children with ADHD. The study is the latest from the team of Joni Holmes Ph.D and Susan Gathercole Ph.D who have been performing independent research examining the impact of Cogmed training on subjects with ADHD and working memory problems.
Simultaneously with the Toronto Catholic District School Board axing the Arrowsmith Program, four other neuroplasticity programs are being considered for adoption by the non-sectarian Toronto District School Board. The four are Arrowsmith, Cogmed Working Memory Training, Fast ForWord and Wasdell SMaRts. Two of the programs, Cogmed and Fast ForWord are being used in Toronto schools now. Arrowsmith has been employed in the Catholic Board for the last ten years and had previously participated in a number of studies of effectiveness although none of these studies measured changes in the actual classroom.
Another study assessing Cogmed is scheduled to start this fall under the supervision of Toronto’s Hospital for Sick Children researcher Rosemary Tannock. This study in Ontario’s demonstration school will track 120 students who are severely learning disabled. According to Tannock, “The big question is not just whether Cogmed can improve working memory but will it really improve classroom performance.” A further study using Cogmed is set to begin with students at the University of Toronto.
I have mentioned several times in past posts that I do marketing work for Cogmed in Canada but this simple description does not really do the relationship justice and I thought it timely to revisit the topic. I chose Cogmed. I went looking for them. That journey began when my most skeptical friend who works for Psychological Services for one of the largest school boards in the country first told me about Cogmed with an enthusiasm he rarely displays and I thought we might together acquire a license. From my first contact with their head office in Stockholm, to my first visit with a practice in Canada I was impressed with their professionalism and integrity.
We didn’t meet Cogmed’s fairly strict requirements for a license and so I decided to offer my services to build their brand in Canada and to further public understanding of the concept of neuroplasticity, which is necessary to understand how Cogmed works or that it should work at all. That is one of the reasons I started this blog. The blog though, as anyone who has been reading it will understand, is very much a personal view. Am I biased towards Cogmed? Yes, is the short answer. I am biased because I know their working memory training does what they say it’s supposed to to. I have a bias towards Cogmed because of their professional and thorough approach to the commercialization of research conducted by the Karolinska Institutet in Stockholm and I am biased towards them because I know their product is backed by solid, ongoing and peer-reviewed, validation studies.
I do work for Cogmed because they pay me to do it but also because I have an intense and personal fascination with the concept of neuroplasticity and the role of working memory in so many mental health issues. For some time I was quite depressed about how my own life had been shaped by what has turned out to be problems with working memory and I was determined that somehow this could be have some meaning if I could make others aware of the role of working memory in mental health disorders and the fact that it can be improved.
Only you the reader can decide whether I have made a dent in that objective. I hope you will post a comment or two on this blog, from time to time, and let me know if you, or someone you know, has problems such as those discussed in the blog and if what is published here has been helpful.
I also hope your journey can be as interesting and exciting as mine has been and continues to be.
On June 30th, The Toronto Catholic District School Board (TCDSB) will decide whether to renew its contract with the Arrowsmith Program. The TCDSB had invited Arrowsmith to waive its fees for two years while the Board conducted a review of the effectiveness of, Arrowsmith, as well as other programs designed to improve cognitive functioning in learning disabled students. Arrowsmith declined in a letter to the Board dated May 27th, 2009.
The Arrowsmith Program was developed at the Arrowsmith School in Toronto and has been available in the TCDSB for about a decade. The goal of the Arrowsmith Program, according to Arrowsmith: “is to help students strengthen the weak cognitive capacities underlying their learning dysfunctions. The Arrowsmith Program deals with the root causes of the learning disability rather than managing its symptoms.” It was one of the first programs for learning disabled students to apply the principles of neuroplasticity.
A memo from the Director of Education for the TCDSB to the Committee of the Whole for the Board indicated that the cost of delivery of the Arrowsmith Program to each student is roughly $14,000. Costs of delivery include yearly salaries for one full time teacher and one assistant at each school. The site license fee from Arrowsmith for the seven schools delivering the program is $174,000. For the TCDSB the issue if both program effectiveness and cost.
Currently, there are 70 students in the TCDSB enrolled in the program.
A couple of weeks ago, Cogmed, the people I do some work for, released results of study that show that Cogmed Working Memory Training changes the density of dopamine (D1 to be specific) receptors in the brain.
I was quite encouraged by this study, for a number of reasons, for one it would appear that the changes brought about by Cogmed Working Memory Training are probably longer lasting than what might be accomplished by medication. It would also seem to indicate that the process is quite complex and, although this was already more or less established by the researchers at Cogmed, the changes have some permanency.
In an interview on a podcast about the study on the Science site*, Torkel Klingberg, the developer of Cogmed, explained that either too much or too little dopamine is not good. He went on to explain that in many of the subjects the number of dopamine receptors was decreased and in a lesser number there was actually a small increase in the number.
It seems to me that what the training accomplishes is an adjustment in dopamine receptor density, the end result of which is an improvement in working memory. I know from my own reading that dopamine is the neurotransmitter that is made more available by stimulant medication. I take Ritalin to accomplish this. Why Cogmed training would decrease the number of dopamine receptors and end up making things work better is a mystery to me, as it would seem that this would make less dopamine available in the brain.
I do realize though that this thinking is just my response of trying to simplify something that is much more complicated than my self-education allows me to understand.
I will write again as the meaning of this study becomes clearer…
*http://www.sciencemag.org/cgi/content/full/sci;323/5915/800/DC2