Gifted Issues Discussion homepage Forums Twice Exceptional Working memory/executive function - how fix? Help!

Okay, so over and over again, testing reveals the same thing. My kid is really very smart; however, his working memory and organization hold him back. He scores very poorly in the working memory sections of the tests (WISC and SB-V as well as others like NEPSY and CVLT-C) ... Like, deplorably low. Specifically, he has difficulty holding an appropriate amount of information in active memory for further processing and/or mental manipulation. I can see this at home. He does not seems to come up clinically as ADD/ADHD on any assessment and I agree with that as well (though I am no expert) but he certainly has this particular problem with working/active memory and metacognition (? is that the right word?) I want to fix it or at least improve it to help him function better, learn better and be more successful. I'd hate to to see this continue to hold him back (and also it IS indeed very frustrating dealing with him at times because of it). And I wasn't sure if it was just that he is spacey (he is creative and always making up stories so I wasn't sure if that were why I see the exectutive functioning issues). He simply can not do certain tests/tasks that specifically test this skill set. Something is off, imo. What do I do to help him improve this? Cogmed? PACE? Some sort of therapy? Drugs? (kind-of kidding there but maybe supplements are known to be good/helpful?) What? I will pay the cost. I really am willing to do whatever it takes at this point because I am concerned that it is not improving with time and age. Any ideas are very welcome and appreciated! Thanks!

Can anyone help?

This sounds an awful lot like my D (now age 17). For us, there was no "fix" for it... just lots and lots of organizational scaffolding and support through the years. Me doing daily checks of her folders for class, online checks of the status of her grades, and reminding her of things. We tried about every kind of organization system there is, but almost every one fell apart. The past couple of years she has had some success with iCal on her computer. As a senior in high school, she is finally showing SOME progress on her own, but she will probably always the "absentminded professor" type. Or as we call her, "the Pigpen of paper" -- Charlie Brown reference for those too young to have followed it.

We were never able to seriously consider a grade acceleration for her because of these issues. But we supplemented a lot with summer programs (Davidson THINK among others). She has done well in high school in honors and some AP classes with some support, and we also got her extra time on standardized tests. Planning now for her launch to college next year.

I don't know much about this. I can tell you that we have worked on it in many small ways. We send our kids on small "trips" in the house ("please go to the basement and bring back one can of chicken broth") that reinforce the skill of keeping something in your head. One can also design the trip to be unsuccessful, which requires a little metacognition ("the item isn't here; now I have to go back to Mom and ask for help"). This sort of exercise does seem to improve that capacity.

You might look at Nancy Ratey's books on coaching for ADHD-- I think one is called The Disorganized Mind. She's very practical.

DeeDee

I don't have any answers although I do understand what you are going through. My son is similar. He can't seem to remember simple things. Just yesterday, I sent him to brush his teeth an went to check on him and he was in the shower! I asked what he was doing and he said "you told me to take a shower". I said, no, you were supposed to brush your teeth, you've already had a shower. Oh, he said, that's right, I am supposed to be brushing my teeth.

Have you tried fish oil as a supplement? That seemed to help a little. We are looking at Neurofeedback Therapy so you might check into that. There was a discussion a while back about it:
http://giftedissues.davidsongifted.org/BB/ubbthreads.php/topics/145803/1.html.

I don't know anything about Cogmed or Pace so I'm not much help. Hang in there.

It's kind of sad in a way that it isn't AdHd. Then perhaps i could try meds. but i believe he doesnt have Add/ADHD. I can see why it isnt coming up. however, this profile/weakness is a big problem! When researching it on the Internet I found that 70% of kids with dyslexia have this specific problem/weakness. I still think looking at his test results he has mild/stealth dyslexia or dysgraphia even though it looks like the psych doesn't believe that to be the case ( he is below average in phonome and has the working memory issues but is above grade level in reading and 2 years behind in writing (despite years of OT which he now does twice weekly!)

Anyway, Thanks for the suggestions all and keep 'em coming !

Hi Mary, I'm curious if there are times when his working memory functions at a high level? Like if he is focused on his own project or such? It could be he always has an internal "master plan" going on that distracts him from things that are outside it (sometimes mislabeled daydreamer.) I'd think figuring out if this memory, attention, motivation, or another factor might be key. It might also be possible that while his brain his catching up with eye therapy that it is demanding a lot of processing. Maybe try some verbal memory games with his eyes closed?

Sounds like basic executive function issues... sadly there are no peer-reviewed/scientific "fixes" for these issues. There are lots of things that MIGHT help - fish oil supplements, vitamin D supplements, neurofeedback, etc. We personally do fish oil, since it's not going to hurt anything, and try and have supports setup. Hopefully those parts of his brain development will catch up sooner rather than later.

Thanks zen...see he's weird because as even in the eval it was noted that his attention and focus are quite good even on difficult tasks and tasks he considers boring... He is very amenable to motivation as well. But where he seems to break down is sequencing / sequential and multi- step tasks? Like he literally can't keep the stuff in his head . His visual memory is fantastic btw. See here is an example of his odd profile - he was great at digit spam going forward but can't do it at all going backwards ( again I have read this is very common with dyslexics). I was thinking its related to the vision issues so I thought I'd see improvement since he's been doing vision therapy for nine months now. However, he seems to be remaining the same with this WM deficit.

Sorry if my posts are not so great I am typing on my phone!

I should add I am not sure exactly what the psych thinks as she simply sent me report, scores and observations - no conclusions yet. We are suppose to meet to discuss.

Attention/lack of attention isn't actually a great indicator of ADHD. My son scores really highly (non-adhd) on the Conner's-type tests... but he's totally ADHD.