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315.02

B1

A2

B2

AD

BA1

A

DEDICATION

COPY

RIGH

TTHANKS TO:

PROC

ESS

RELEARN

I dedicate

thi

s bo

ok t

o my

mom

, Mi

ke,

Daniel and

Cat

, fo

r pu

ttin

g up

wit

h me

during the

gru

elli

ng p

roce

ss.

And

to

those who

were

in

it w

ith

me,

Step

ha-

nie, Krist

en,

and

Feli

cia.

Tha

nks

for

helping ke

ep s

ome

sani

ty.

Publ

ishe

d by

The

Acad

emy of Art University Press

79 N

ew M

ontgomery

San

Fran

cisco, 94107

c 201

0 Sa

rah Rouse-Higgins

ISBN

1-5

9878-259-8

All

righ

ts reserved.

Prin

ted

in San Francisco

10 0

9 08

07 06 05 04 12345

No p

art

of this book may be reproduced in any manner with out

writ

ten

permission from the in publisher in the context of

revi

ews.

01

F84.5

299.80

608638

31268

001549

PED/147

F03.550.325.100

ICD-10

ICD-9

OMIM

DiseasesDB

MedlinePlus

eMedicine

MeSH

Asperger’s Syndrome

F90.

314.00, 314.01

143465

6158

001551

med/3103 ped/177

D001289

ICD-10

ICD-9

OMIM

DiseasesDB

MedlinePlus

eMedicine

MeSH

Attention Deficit Disorder02

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grap

hy is

an

impo

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t to

cons

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whe

n de

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R48.0

315.02

127700

4016

D004410

ICD-10

ICD-9

OMIM

DiseasesDB

MeSH

Dyslexia03

D e v e l o p D e v e l o p m e n t a l r e a d i n g d i s o r d e r ( D R D ) i s n o t c a u s e d b y v i s i o n p r o b l e m s , b u t r a t h e r b y p r o b l e m s w i t h t h e b r a i n ’ s a b i l i t y t o r e c o g n i z e a n d p r o c e s s s y m b o l s . C h i l d r e n w i t h D R D m a y h a v e t r o u b l e r h y m i n g a n d s e p a r a t i n g t h e s o u n d s i n s p o k e n w o r d s . T h e s e a b i l i t i e s a p p e a r t o b e c r i t i c a l i n t h e p r o c e s s o f l e a r n i n g t o r e a d . A c h i l d ’ s i n i t i a l r e a d i n g s k i l l s a r e b a s e d o n w o r d r e c o g n i t i o n , w h i c h i n v o l v e s b e i n g a b l e t o s e p a r a t e o u t t h e s o u n d s i n w o r d s a n d m a t c h t h e m w i t h l e t t e r s a n d g r o u p s o f l e t t e r s . M o r e d e v e l o p e d r e a d i n g s k i l l s r e q u i r e t h e l i n k i n g o f w o r d s i n t o a c o h e r e n t s e n t e n c e . B e c a u s e D R D c h i l d r e n h a v e d i f f i c u l t y c o n n e c t i n g t h e s o u n d s o f l a n g u a g e t o t h e l e t t e r s o f w o r d s , t h e y m a y h a v e d i f f i c u l t y u n d e r s t a n d i n g s e n t e n c e s . M o s t c h i l d r e n w i t h D R D h a v e n o r m a l i n t e l l i g e n c e , a n d m a n y h a v e a b o v e - a v e r a g e i n t e l l i g e n c e . T h e d i s o r d e r i s a s p e c i f i c i n f o r m a t i o n p r o c e s s i n g p r o b l e m t h a t i s n o t c o n n e c t e d w i t h t h e a b i l i t y t o t h i n k o r t o u n d e r s t a n d c o m p l e x i d e a s . D R D m a y a p p e a r i n c o m b i n a t i o n w i t h d e v e l o p m e n t a l w r i t i n g d i s o r d e r a n d d e v e l o p m e n t a l a r i t h m e t i c d i s o r d e r . A l l o f t h e s e i n v o l v e u s i n g s y m b o l s t o c o n v e y i n f o r m a t i o n . T h e s e c o n d i t i o n s m a y a p p e a r a l o n e o r i n a n y c o m b i n a t i o n . O t h e r c a u s e s o f l e a r n i n g d i s a b i l i t y a n d , i n p a r t i c u l a r , r e a d i n g d i s a b i l i t y , m u s t b e r u l e d o u t b e f o r e a d i a g n o s i s o f D R D c a n b e m a d e . C u l t u r a l a n d e d u c a t i o n a l s h o r t f a l l s , e m o t i o n a l p r o b l e m s , m e n t a l r e t a r d a t i o n , a n d d i s e a s e s o f t h e b r a i n ( f o r e x a m p l e A I D S ) c a n a l l c a u s e l e a r n i n g d i s a b i l i t i e s . F o l l o w - u p s t u d i e s w i l l b e r e q u i r e d b e f o r e t h e r e s u l t s o f t h i s s t u d y o n a s m a l l n u m b e r o f b o y s c a n l e a d t o b r a i n - b a s e d m e t h o d s o f d i a g n o s i s , c a u t i o n t h e l e a d r e s e a r c h e r s , R e s e a r c h A s s o c i a t e C h a n d a n V a i d y a a n d A s s o c i a t e P r o f e s s o r J o h n G a b r i e l i o f S t a n f o r d ’ s D e p a r t m e n t o f P s y c h o l o g y . T h e i r s i s t h e f i r s t s t u d y , h o w e v e r , t o s h o w t h a t R i t a l i n , t h e d r u g m o s t c o m m o n l y u s e d t o t r e a t A D D , h a s d i f f e r e n t e f f e c t s o n t h e b r a i n s o f p e o p l e w i t h a n d w i t h o u t A D D , a n d w h e r e t h o s e d i f f e r e n c e s o c c u r i n t h e b r a i n . T h e f i n d i n g s a r e r e p o r t e d i n t h e N o v . 2 4 i s s u e o f t h e P r o c e e d i n g s o f t h e N a t i o n a l A c a d e m y o f S c i e n c e s . T h e s t u d y i s a l s o t h e f i r s t t o u s e f u n c t i o n a l m a g n e t i c r e s o n a n c e i m a g i n g [ F M R I ] i n t h e s t u d y o f A D D . T h i s i m a g i n g m e t h o d c a n s h o w b r a i n d i f f e r e n c e s i n i n d i v i d u a l p e o p l e , i n s t e a d o f i n a v e r a g e s o f d i f f e r e n c e s o f t w o g r o u p s . T h i s i s c r i t i c a l f o r d i a g n o s i s , w h i c h h a s t o b e e s t a b l i s h e d o n a n i n d i v i d u a l b a s i s . U n l i k e m e t h o d s u s e d i n o t h e r s t u d i e s o f A D D , F M R I d o e s n o t r e q u i r e i n j e c t i o n o r i n h a l a t i o n o f r a d i o a c t i v e s u b s t a n c e s . I t r e l i e s i n s t e a d o n n a t u r a l l y o c c u r r i n g c h a n g e s i n b r a i n f u n c t i o n , w h i c h m a k e s i t a p p r o p r i a t e f o r r e s e a r c h a n d c l i n i c a l p u r p o s e s f o r c h i l d r e n . C o - a u t h o r s o f t h e s t u d y a r e m e d i c a l d o c t o r s G l e n n A u s t i n a n d H u g h R i d l e h u b e r a n d s c h o o l p s y c h o l o g i s t G a r y K i r k o r i a n o f t h e C o m m u n i t y / A c a d e m i a C o a l i t i o n i n L o s A l t o s , C a l i f . a n d G a r y G l o v e r a n d J o h n D e s m o n d o f t h e S t a n f o r d M e d i c a l C e n t e r ’ s R a d i o l o g y D e p a r t m e n t . T h e f i n d i n g s h a v e d r a w n c o n s i d e r a b l e a t t e n t i o n f r o m n e u r o s c i e n t i s t s b e c a u s e “ A D D i s s o w i d e s p r e a d , s o c o n t r o v e r s i a l a n d c o n f u s i n g , a n d t h e s e a r e a m o n g t h e f e w c l e a r f i n d i n g s i n t h a t f i e l d , ” s a i d G a b r i e l i , w h o h e a d s t h e b r a i n i m a g i n g l a b o r a t o r y w h e r e t h e r e s e a r c h w a s d o n e . A t t e n t i o n d e f i c i t d i s o r d e r , w h i c h o f t e n i n c l u d e s h y p e r a c t i v i t y , i s c u r r e n t l y d i a g n o s e d o n t h e b a s i s o f s u b j e c t i v e o b s e r v a t i o n s o f y o u n g s t e r s ’ b e h a v i o r . I f t h e n e w f i n d i n g s c a n b e r e p l i c a t e d , h e s a i d , i t m i g h t b e p o s s i b l e t o m a k e a b i o l o g i c a l d i a g n o s i s o f t h e d i s o r d e r b y u s i n g F M R I . S i n c e t h e c o m m o n t r e a t m e n t f o r A D D i s a p r e s c r i p t i o n d r u g w h o s e l o n g - t e r m e f f e c t s o n b r a i n f u n c t i o n a r e n o t k n o w n , p a r e n t s a n d p e d i a t r i c i a n s m o s t l i k e l y w o u l d w e l c o m e a m o r e d e f i n i t i v e w a y t o d i a g n o s e t h e d i s o r d e r . I n t h e s t u d y , 1 6 b o y s b e t w e e n t h e a g e s o f 8 a n d 1 3 w e r e a s k e d i n d i v i d u a l l y t o p l a y a m e n t a l g a m e w h i l e l y i n g i n a m a g n e t i c r e s o n a n c e i m a g i n g d e v i c e , w h i c h w a s s e t t o i m a g e f r o n t p o r t i o n s o f t h e b r a i n , i n c l u d i n g t h e f r o n t a l - l o b e c o r t e x a n d t h e s t r i a t a l s t r u c t u r e s b e l o w i t . T h e b o y s , 1 0 o f w h o m h a d b e e n d i a g n o s e d w i t h A D D a f f e c t e d s t r i a t a l s t r u c t u r e s ( s p e c i f i c a l l y k n o w n a s t h e c a u d a t e a n d p u t a m e n ) w h e n t a k i n g t h e d r u g t h a n w h e n n o t . T h e h e a l t h y b o y s , i n c o n t r a s t , s h o w e d t h e r e v e r s e - l e s s a c t i v i t y i n t h o s e a r e a s w h e n t a k i n g t h e d r u g t h a n w h e n n o t . “ F r o m p a s t w o r k w i t h a d u l t s a n d c h i l d r e n , s o m e o f w h i c h r e q u i r e d i n j e c t i n g r a d i o a c t i v e m a t e r i a l , a c o n s e n s u s d e v e l o p e d t h a t i t i s t h e f r o n t a l s t r i a t a l c i r c u i t r y o f t h e b r a i n t h a t i s w h a t ’ s n o t r i g h t w i t h t h i s d i s o r d e r , ” V a i d y a s a i d . “ T h a t i s w h y w e i m a g e d t h i s p a r t o f t h e b r a i n , a n d o u r s t u d y c o n f i r m e d t h a t t h e s e s t r u c t u r e s a r e , i n d e e d , i m p o r t a n t f o r A D D . ” R i t a l i n p r i m a r i l y , b u t n o t e x c l u s i v e l y , i n f l u e n c e s d o p a m i n e n e u r o t r a n s m i s s i o n . T h e o p p o s i t e e f f e c t s o f R i t a l i n o n b o y s w i t h A D D a n d b o y s w i t h o u t t h e d i s o r d e r s u g g e s t t h a t A D D i n v o l v e s a t y p i c a l d o p a m i n e m o d u l a t i o n i n t h e s t r i a t u m , s h e s a i d . T h e r e s e a r c h e r s c a u t i o n t h a t t h e s t u d y w a s c o n d u c t e d w i t h a s m a l l g r o u p a n d n e e d s t o b e r e p l i c a t e d w i t h g i r l s a s w e l l a s w i t h m o r e b o y s b e f o r e t h e y c a n b e c e r t a i n t h e y h a v e f o u n d a u n i v e r s a l n e u r o b i o l o g i c a l m a r k e r f o r t h e d i s o r d e r . T h e y a l s o r e p o r t e d t h a t t h e y t r i e d t h e e x p e r i m e n t o n t h r e e o t h e r b o y s w h o h a d n o t b e e n d i a g n o s e d w i t h A D D b u t w h o h a d s i b l i n g s w i t h t h e d i a g n o s i s . T w o o f t h e t h r e e s i b l i n g s o f A D D b o y s s h o w e d s o m e R i t a l i n e n h a n c e m e n t o f t h e s t r i a t u m , a s d i d t h e i r a f f e c t e d b r o t h e r s . “ T h i s w o u l d l e n d s o m e s u p p o r t t o t h e i d e a t h a t A D D m a y i n v o l v e a t y p i c a l g e n e t i c i n f l u e n c e s o n d o p a m i n e m o d u l a t i o n , ” V a i d y a s a i d , b u t m o r e s t u d i e s w o u l d b e n e c e s s a r y t o e s t a b l i s h a g e n e t i c i n f l u e n c e . B e c a u s e o f t h e w i d e s p r e a d i n t e r e s t i n A D D , t h e r e s e a r c h e r s a l s o w e r e c a r e f u l t o p o i n t o u t o t h e r l i m i t a t i o n s o f t h e i r s t u d y . A f r a c t i o n o f p e o p l e d i a g n o s e d w i t h A D D h a v e n o t r e s p o n d e d t o R i t a l i n t r e a t m e n t , a n d t h i s s t u d y d i d n o t i n c l u d e s u c h c h i l d r e n , t h e y s a i d . I t a l s o d i d n o t a t t e m p t t o i n v e s t i g a t e p o s s i b l e c h a n g e s i n b r a i n a c t i v a t i o n t h a t m i g h t o c c u r w i t h t h e d r u g o v e r t i m e . T h e A D D b o y s d i d s h o w a d i f f e r e n t b r a i n a c t i v a t i o n l e v e l w h e n n o t o n t h e d r u g , b u t a l l o f t h e m h a d b e e n t a k i n g R i t a l i n p r e v i o u s l y a s p a r t o f t h e i r o n g o i n g t r e a t m e n t . D e s p i t e t h e s e l i m i t a t i o n s , t h e s t u d y p o i n t s t o n e w d i r e c t i o n s f o r r e s e a r c h i n t o b r a i n f u n c t i o n t h a t c o u l d i m p r o v e i n d i v i d u a l s ’ p e r f o r m a n c e . “ T h i s i n s t e a d o n n a t u r a l l y o c c u r r i n g c h a n g e s i n b r a i n f u n c t i o n , w h i c h m a k e s i t a p p r o p r i a t e f o r r e s e a r c h a n d c l i n i c a l p u r p o s e s f o r c h i l d r e n . C o - a u t h o r s o f t h e s t u d y a r e m e d i c a l d o c t o r s G l e n n A u s t i n a n d H u g h R i d l e h u b e r a n d s c h o o l p s y c h o l o g i s t G a r y K i r k o r i a n o f t h e C o m m u n i t y / A c a d e m i a C o a l i t i o n i n L o s A l t o s , C a l i f . a n d G a r y G l o v e r a n d J o h n D e s m o n d o f t h e S t a n f o r d M e d i c a l C e n t e r ’ s R a d i o l o g y D e p a r t m e n t . T h e f i n d i n g s h a v e d r a w n c o n s i d e r a b l e a t t e n t i o n f r o m n e u r o s c i e n t i s t s b e c a u s e “ A D D i s s o w i d e s p r e a d , s o c o n t r o v e r s i a l a n d c o n f u s i n g , a n d t h e s e a r e a m o n g t h e f e w c l e a r f i n d i n g s i n t h a t f i e l d , ” s a i d G a b r i e l i , w h o h e a d s t h e b r a i n i m a g i n g l a b o r a t o r y w h e r e t h e r e s e a r c h w a s d o n e . A t t e n t i o n d e f i c i t d i s o r d e r , w h i c h o f t e n i n c l u d e s h y p e r a c t i v i t y , i s c u r r e n t l y d i a g n o s e d o n t h e b a s i s o f s u b j e c t i v e o b s e r v a t i o n s o f y o u n g s t e r s ’ b e h a v i o r . I f t h e n e w f i n d i n g s c a n b e r e p l i c a t e d , h e s a i d , i t m i g h t b e p o s s i b l e t o m a k e a b i o l o g i c a l d i a g n o s i s o f t h e d i s o r d e r b y u s i n g F M R I . S i n c e t h e c o m m o n t r e a t m e n t f o r A D D i s a p r e s c r i p t i o n d r u g w h o s e l o n g - t e r m e f f e c t s o n b r a i n f u n c t i o n a r e n o t k n o w n , p a r e n t s a n d p e d i a t r i c i a n s m o s t l i k e l y w o u l d w e l c o m e a m o r e d e f i n i t i v e w a y t o d i a g n o s e t h e d i s o r d e r . I n t h e s t u d y , 1 6 b o y s b e t w e e n t h e a g e s o f 8 a n d 1 3 w e r e a s k e d i n d i v i d u a l l y t o p l a y a m e n t a l g a m e w h i l e l y i n g i n a m a g n e t i c r e s o n a n c e i m a g i n g d e v i c e , w h i c h w a s s e t t o i m a g e f r o n t p o r t i o n s o f t h e b r a i n , i n c l u d i n g t h e f r o n t a l - l o b e c o r t e x a n d t h e s t r i a t a l s t r u c t u r e s b e l o w i t . T h e b o y s , 1 0 o f w h o m h a d b e e n d i a g n o s e d w i t h A D D a n d 6 o f w h o m h a d n o t , w e r e i n s t r u c t e d t o p r e s s a b u t t o n w h e n t h e y s a w a n y l e t t e r o f t h e a l p h a b e t e x c e p t t h e l e t t e r X o n a d i s p l a y s c r e e n . B e c a u s e m o s t o f t h e l e t t e r s w e r e n o t X , e a c h c h i l d b u i l u p a p r e d i s p o s i t i o n t o p r e s s t h e b u t t o n a n d n e e d e d t o c o n t r o l h i s i m p u l s e t o p r e s s t h e b u t t o n w h e n h e s a w a n X . T h e t a s k w a s e x p e c t e d t o b e , a n d i n f a c t p r o v e d t o b e , m o r e d i f f i c u l t f o r t h e b o y s w i t h A D D , b e c a u s e p o o r i m p u l s e c o n t r o l i s o n e o f t h e d i s o r d e r ’ s s y m p t o m s . C o m p a r i n g t h e b r a i n i m a g e s l a t e r , r e s e a r c h e r s f o u n d a c l e a r d i f f e r e n c e i n t h e a c t i v a t i o n o f n e u r o n a l t i s s u e i n t w o s t r u c t u r e s i n t h e s t r i a t a l r e g i o n , w h i c h i s k n o w n t o b e i n v o l v e d i n m o t o r c o n t r o l . T h e b r a i n a c t i v a t i o n d i f f e r e n c e s b e t w e e n t h e b o y s w i t h A D D a n d t h o s e w i t h o u t w e r e e v e n m o r e d r a m a t i c w h e n t h e s u b j e c t s w e r e a s k e d t o p e r f o r m t h e s a m e t a s k a f t e r t a k i n g t h e d r u g R i t a l i n . R i t a l i n i s a s t i m u l a n t m e d i c a t i o n u s e d t o t e m p o r a r i l y r e l i e v e s y m p t o m s o f A D D , s u c h a s i n a t t e n t i o n , i m p u l s i v i t y a n d h y p e r a c t i v i t y . “ B o t h t h e n o r m a l k i d s a n d t h e A D D k i d s g o t b e t t e r i n t h e i r i m p u l s e c o n t r o l w h e n t h e y h a d t a k e n t h e d r u g , ” V a i d y a s a i d . “ R i t a l i n i m p r o v e d e v e r y o n e ’ s p e r f o r m a n c e , b u t h o w i t a c t u a l l y d i d i t d i f f e r e d i n t h e b r a i n s . ” T h e b o y s w i t h A D D s h o w e d m o r e a c t i v i t y i n t h e a f f e c t e d s t r i a t a l s t r u c t u r e s ( s p e c i f i c a l l y k n o w n a s t h e c a u d a t e a n d p u t a m e n ) w h e n t a k i n g t h e d r u g t h a n w h e n n o t . T h e h e a l t h y b o y s , i n c o n t r a s t , s h o w e d t h e r e v e r s e - l e s s a c t i v i t y i n t h o s e a r e a s w h e n t a k i n g t h e d r u g t h a n w h e n n o t . “ F r o m p a s t w o r k w i t h a d u l t s a n d c h i l d r e n , s o m e o f w h i c h r e q u i r e d i n j e c t i n g r a d i o a c t i v e m a t e r i a l , a c o n s e n s u s d e v e l o p e d t h a t i t i s t h e f r o n t a l s t r i a t a l c i r c u i t r y o f t h e b r a i n t h a t i s w h a t ’ s n o t r i g h t w i t h t h i s d i s o r d e r , ” V a i d y a s a i d . “ T h a t i s w h y w e i m a g e d t h i s p a r t o f t h e b r a i n , a n d o u r s t u d y c o n f i r m e d t h a t t h e s e s t r u c t u r e s a r e , i n d e e d , i m p o r t a n t f o r A D D . ” R i t a l i n p r i m a r i l y , b u t n o t e x c l u s i v e l y , i n f l u e n c e s d o p a m i n e n e u r o t r a n s m i s s i o n . T h e o p p o s i t e e f f e c t s o f R i t a l i n o n b o y s w i t h A D D a n d b o y s w i t h o u t t h e d i s o r d e r s u g g e s t t h a t A D D i n v o l v e s a t y p i c a l d o p a m i n e m o d u l a t i o n i n t h e s t r i a t u m , s h e s a i d . T h e r e s e a r c h e r s c a u t i o n t h a t t h e s t u d y w a s c o n d u c t e d w i t h a s m a l l g r o u p a n d n e e d s t o b e r e p l i c a t e d w i t h g i r l s a s w e l l a s w i t h m o r e b o y s b e f o r e t h e y c a n b e c e r t a i n t h e y h a v e f o u n d a u n i v e r s a l n e u r o b i o l o g i c a l m a r k e r f o r t h e d i s o r d e r . T h e y a l s o r e p o r t e d t h a t t h e y t r i e d t h e e x p e r i m e n t o n t h r e e o t h e r b o y s w h o h a d n o t b e e n d i a g n o s e d w i t h A D D b u t w h o h a d s i b l i n g s w i t h t h e d i a g n o s i s . T w o o f t h e t h r e e s i b l i n g s o f A D D b o y s s h o w e d s o m e R i t a l i n e n h a n c e m e n t o f t h e s t r i a t u m , a s d i d t h e i r a f f e c t e d b r o t h e r s . “ T h i s w o u l d l e n d s o m e s u p p o r t t o t h e i d e a t h a t A D D m a y i n v o l v e a t y p i c a l g e n e t i c i n f l u e n c e s o n d o p a m i n e m o d u l a t i o n , ” V a i d y a s a i d , b u t m o r e s t u d i e s w o u l d b e n e c e s s a r y t o e s t a b l i s h a g e n e t i c i n f l u e n c e . B e c a u s e o f t h e w i d e s p r e a d i n t e r e s t i n A D D , t h e r e s e a r c h e r s a l s o w e r e c a r e f u l t o p o i n t o u t o t h e r l i m i t a t i o n s o f t h e i r s t u d y . A f r a c t i o n o f p e o p l e d i a g n o s e d w i t h A D D h a v e n o t r e s p o n d e d t o R i t a l i n t r e a t m e n t , a n d t h i s s t u d y d i d n o t i n c l u d e s u c h c h i l d r e n , t h e y s a i d . I t a l s o d i d n o t a t t e m p t t o i n v e s t i g a t e p o s s i b l e c h a n g e s i n b r a i n a c t i v a t i o n t h a t m i g h t o c c u r w i t h t h e d r u g o v e r t i m e . T h e A D D b o y s d i d s h o w a d i f f e r e n t b r a i n a c t i v a t i o n l e v e l w h e n n o t o n t h e d r u g , b u t a l l o f t h e m h a d b e e n t a k i n g R i t a l i n p r e v i o u s l y a s p a r t o f t h e i r o n g o i n g t r e a t m e n t . D e s p i t e t h e s e l i m i t a t i o n s , t h e s t u d y p o i n t s t o n e w d i r e c t i o n s f o r r e s e a r c h i n t o b r a i n f u n c t i o n t h a t c o u l d i m p r o v e i n d i v i d u a l s ’ p e r f o r m a n c e . “ T h i s i s o n e o f t h e f e w s t u d i e s t o e x a m i n e b r a i n f u n c t i o n i n c h i l d r e n , a n d t o f u r t h e r o u r k n o w l e d g e a b o u t n o r m a l a n d a b n o r m a l b r a i n d e v e l o p m e n t , ” G a b r i e l i s a i d . “ I t s u g g e s t s t h a t F M R I i s a p o w e r f u l t o o l t o e x a m i n e b r a i n a n d b e h a v i o r i n t h e c o n t e x t o f b o t h n o r m a l a n d a b n o r m a l d e v e l o p m e n t . ” C u r r e n t l y , A D D i m p a i r s t h e f u n c t i o n o f a n e s t i m a t e d 3 t o 7 p e r c e n t o f y o u n g s t e r s i n h o m e a n d s c h o o l , a n d t h e l o n g - t e r m c o n s e q u e n c e s i n c l u d e l o w e r e d u c a t i o n a l a n d v o c a t i o n a l a c c o m p l i s h m e n t s f o r t h e m a s a d u l t s a s w e l l a s a n i n c r e a s e d r i s k f o r d r u g a b u s e a n d o t h e r r i s k y b e h a v i o r s . D e v e l o p m e n t a l r e a d i n g d i s o r d e r ( D R D ) i s n o t c a u s e d b y v i s i o n p r o b l e m s , b u t r a t h e r b y p r o b l e m s w i t h t h e b r a i n ’ s a b i l i t y t o r e c o g n i z e a n d p r o c e s s s y m b o l s . C h i l d r e n w i t h D R D m a y h a v e t r o u b l e r h y m i n g a n d s e p a r a t i n g t h e s o u n d s i n s p o k e n w o r d s . T h e s e a b i l i t i e s a p p e a r t o b e c r i t i c a l i n t h e p r o c e s s o f l e a r n i n g t o r e a d . A c h i l d ’ s i n i t i a l r e a d i n g s k i l l s a r e b a s e d o n w o r d r e c o g n i t i o n , w h i c h i n v o l v e s b e i n g a b l e t o s e p a r a t e o u t t h e s o u n d s i n w o r d s a n d m a t c h t h e m w i t h l e t t e r s a n d g r o u p s o f l e t t e r s . M o r e d e v e l o p e d r e a d i n g s k i l l s r e q u i r e t h e l i n k i n g o f w o r d s i n t o a c o h e r e n t s e n t e n c e . B e c a u s e D R D c h i l d r e n h a v e d i f f i c u l t y c o n n e c t i n g t h e s o u n d s o f l a n g u a g e t o t h e l e t t e r s o f w o r d s , t h e y m a y h a v e d i f f i c u l t y u n d e r s t a n d i n g s e n t e n c e s . M o s t c h i l d r e n w i t h D R D h a v e n o r m a l i n t e l l i g e n c e , a n d m a n y h a v e a b o v e - a v e r a g e i n t e l l i g e n c e . T h e d i s o r d e r i s a s p e c i f i c i n f o r m a t i o n p r o c e s s i n g p r o b l e m t h a t i s n o t c o n n e c t e d w i t h t h e a b i l i t y t o t h i n k o r t o u n d e r s t a n d c o m p l e x i d e a s . D R D m a y a p p e a r i n c o m b i n a t i o n w i t h d e v e l o p m e n t a l w r i t i n g d i s o r d e r a n d d e v e l o p m e n t a l a r i t h m e t i c d i s o r d e r . A l l o f t h e s e i n v o l v e u s i n g s y m b o l s t o c o n v e y i n f o r m a t i o n . T h e s e c o n d i t i o n s m a y a p p e a r a l o n e o r i n a n y c o m b i n a t i o n . O t h e r c a u s e s o f l e a r n i n g d i s a b i l i t y a n d , i n p a r t i c u l a r , r e a d i n g d i s a b i l i t y , m u s t b e r u l e d o u t b e f o r e a d i a g n o s i s o f D R D c a n b e m a d e . C u l t u r a l a n d e d u c a t i o n a l s h o r t f a l l s , e m o t i o n a l p r o b l e m s , m e n t a l r e t a r d a t i o n , a n d d i s e a s e s o f t h e b r a i n ( f o r e x a m p l e A I D S ) c a n a l l c a u s e l e a r n i n g d i s a b i l i t i e s . F o l l o w - u p s t u d i e s w i l l b e r e q u i r e d b e f o r e t h e r e s u l t s o f t h i s s t u d y o n a s m a l l n u m b e r o f b o y s c a n l e a d t o b r a i n - b a s e d m e t h o d s o f d i a g n o s i s , c a u t i o n t h e l e a d r e s e a r c h e r s , R e s e a r c h A s s o c i a t e C h a n d a n V a i d y a a n d A s s o c i a t e P r o f e s s o r J o h n G a b r i e l i o f S t a n f o r d ’ s D e p a r t m e n t o f P s y c h o l o g y . T h e i r s i s t h e f i r s t s t u d y , h o w e v e r , t o s h o w t h a t R i t a l i n , t h e d r u g m o s t c o m m o n l y u s e d t o t r e a t A D D , h a s d i f f e r e n t e f f e c t s o n t h e b r a i n s o f p e o p l e w i t h a n d w i t h o u t A D D , a n d w h e r e t h o s e d i f f e r e n c e s o c c u r i n t h e b r a i n . T h e f i n d i n g s a r e r e p o r t e d i n t h e N o v . 2 4 i s s u e o f t h e P r o c e e d i n g s o f t h e N a t i o n a l A c a d e m y o f S c i e n c e s . T h e s t u d y i s a l s o t h e f i r s t t o u s e f u n c t i o n a l m a g n e t i c r e s o n a n c e i m a g i n g [ F M R I ] i n t h e s t u d y o f A D D . T h i s i m a g i n g m e t h o d c a n s h o w b r a i n d i f f e r e n c e s i n i n d i v i d u a l p e o p l e , i n s t e a d o f i n a v e r a g e s o f d i f f e r e n c e s o f t w o g r o u p s . T h i s i s c r i t i c a l f o r d i a g n o s i s , w h i c h h a s t o b e e s t a b l i s h e d o n a n i n d i v i d u a l b a s i s . U n l i k e m e t h o d s u s e d i n o t h e r s t u d i e s o f A D D , F M R I d o e s n o t r e q u i r e i n j e c t i o n o r i n h a l a t i o n o f r a d i o a c t i v e s u b s t a n c e s . I t r e l i e s i n s t e a d o n n a t u r a l l y o c c u r r i n g c h a n g e s i n b r a i n f u n c t i o n , w h i c h m a k e s i t a p p r o p r i a t e f o r r e s e a r c h a n d c l i n i c a l p u r p o s e s f o r c h i l d r e n . C o - a u t h o r s o f t h e s t u d y a r e m e d i c a l d o c t o r s G l e n n A u s t i n a n d H u g h R i d l e h u b e r a n d s c h o o l p s y c h o l o g i s t G a r y K i r k o r i a n o f t h e C o m m u n i t y / A c a d e m i a C o a l i t i o n i n L o s A l t o s , C a l i f . a n d G a r y G l o v e r a n d J o h n D e s m o n d o f t h e S t a n f o r d M e d i c a l C e n t e r ’ s R a d i o l o g y D e p a r t m e n t . T h e f i n d i n g s h a v e d r a w n c o n s i d e r a b l e a t t e n t i o n f r o m n e u r o s c i e n t i s t s b e c a u s e “ A D D i s s o w i d e s p r e a d , s o c o n t r o v e r s i a l a n d c o n f u s i n g , a n d t h e s e a r e a m o n g t h e f e w c l e a r f i n d i n g s i n t h a t f i e l d , ” s a i d G a b r i e l i , w h o h e a d s t h e b r a i n i m a g i n g l a b o r a t o r y w h e r e t h e r e s e a r c h w a s d o n e . A t t e n t i o n d e f i c i t d i s o r d e r , w h i c h o f t e n i n c l u d e s h y p e r a c t i v i t y , i s c u r r e n t l y d i a g n o s e d o n t h e b a s i s o f s u b j e c t i v e o b s e r v a t i o n s o f y o u n g s t e r s ’ b e h a v i o r . I f t h e n e w f i n d i n g s c a n b e r e p l i c a t e d , h e s a i d , i t m i g h t b e p o s s i b l e t o m a k e a b i o l o g i c a l d i a g n o s i s o f t h e d i s o r d e r b y u s i n g F M R I . S i n c e t h e c o m m o n t r e a t m e n t f o r A D D i s a p r e s c r i p t i o n d r u g w h o s e l o n g - t e r m e f f e c t s o n b r a i n f u n c t i o n a r e n o t k n o w n , p a r e n t s a n d p e d i a t r i c i a n s m o s t l i k e l y w o u l d w e l c o m e a m o r e d e f i n i t i v e w a y t o d i a g n o s e t h e d i s o r d e r . I n t h e s t u d y , 1 6 b o y s b e t w e e n t h e a g e s o f 8 a n d 1 3 w e r e a s k e d i n d i v i d u a l l y t o p l a y a m e n t a l g a m e w h i l e l y i n g i n a m a g n e t i c r e s o n a n c e i m a g i n g d e v i c e , w h i c h w a s s e t t o i m a g e f r o n t p o r t i o n s o f t h e b r a i n , i n c l u d i n g t h e f r o n t a l - l o b e c o r t e x a n d t h e s t r i a t a l s t r u c t u r e s b e l o w i t . T h e b o y s , 1 0 o f w h o m h a d b e e n d i a g n o s e d w i t h A D D a n d 6 o f w h o m h a d n o t , w e r e i n s t r u c t e d t o p r e s s a b u t t o n w h e n t h e y s a w a n y l e t t e r o f t h e a l p h a b e t e x c e p t t h e l e t t e r X o n a d i s p l a y s c r e e n . B e c a u s e m o s t o f t h e l e t t e r s w e r e n o t X , e a c h c h i l d b u i l t u p a p r e d i s p o s i t i o n t o p r e s s t h e b u t t o n a n d n e e d e d t o c o n t r o l h i s i m p u l s e t o p r e s s t h e b u t t o n w h e n h e s a w a n X . T h e t a s k w a s e x p e c t e d t o b e , a n d i n f a c t p r o v e d t o b e , m o r e d i f f i c u l t f o r t h e b o y s w i t h A D D , b e c a u s e p o o r i m p u l s e c o n t r o l i s o n e o f t h e d i s o r d e r ’ s s y m p t o m s . C o m p a r i n g t h e b r a i n i m a g e s l a t e r , r e s e a r c h e r s f o u n d a c l e a r d i f f e r e n c e i n t h e a c t i v a t i o n o f n e u r o n a l t i s s u e i n t w o s t r u c t u r e s i n t h e s t r i a t a l r e g i o n , w h i c h i s k n o w n t o b e i n v o l v e d i n m o t o r c o n t r o l . T h e b r a i n a c t i v a t i o n d i f f e r e n c e s b e t w e e n t h e b o y s w i t h A D D a n d t h o s e w i t h o u t w e r e e v e n m o r e d r a m a t i c w h e n t h e s u b j e c t s w e r e a s k e d t o p e r f o r m t h e s a m e t a s k a f t e r t a k i n g t h e d r u g R i t a l i n . R i t a l i n i s a s t i m u l a n t m e d i c a t i o n u s e d t o t e m p o r a r i l y r e l i e v e s y m p t o m s o f A D D , s u c h a s i n a t t e n t i o n , i m p u l s i v i t y a n d h y p e r a c t i v i t y . “ B o t h t h e n o r m a l k i d s a n d t h e A D D k i d s g o t b e t t e r i n t h e i r i m p u l s e c o n t r o l w h e n t h e y h a d t a k e n t h e d r u g , ” V a i d y a s a i d . “ R i t a l i n i m p r o v e d e v e r y o n e ’ s p e r f o r m a n c e , b u t h o w i t a c t u a l l y d i d i t d i f f e r e d i n t h e b r a i n s . ” T h e b o y s w i t h A D D s h o w e d m o r e a c t i v i t y i n t h e a f f e c t e d s t r i a t a l s t r u c t u r e s ( s p e c i f i c a l l y k n o w n a s t h e c a u d a t e a n d p u t a m e n ) w h e n t a k i n g t h e d r u g t h a n w h e n n o t . T h e h e a l t h y b o y s , i n c o n t r a s t , s h o w e d t h e r e v e r s e - l e s s a c t i v i t y i n t h o s e a r e a s w h e n t a k i n g t h e d r u g t h a n w h e n n o t . “ F r o m p a s t w o r k w i t h a d u l t s a n d c h i l d r e n , s o m e o f w h i c h r e q u i r e d i n j e c t i n g r a d i o a c t i v e m a t e r i a l , a c o n s e n s u s d e v e l o p e d t h a t i t i s t h e f r o n t a l s t r i a t a l c i r c u i t r y o f t h e b r a i n t h a t i s w h a t ’ s n o t r i g h t w i t h t h i s d i s o r d e r , ” V a i d y a s a i d . “ T h a t i s w h y w e i m a g e d t h i s p a r t o f t h e b r a i n , a n d o u r s t u d y c o n f i r m e d t h a t t h e s e s t r u c t u r e s a r e , i n d e e d , i m p o r t a n t f o r A D D . ” R i t a l i n p r i m a r i l y , b u t n o t e x c l u s i v e l y , i n f l u e n c e s d o p a m i n e n e u r o t r a n s m i s s i o n . T h e o p p o s i t e e f f e c t s o f R i t a l i n o n b o y s w i t h A D D a n d b o y s w i t h o u t t h e d i s o r d e r s u g g e s t t h a t A D D i n v o l v e s a t y p i c a l d o p a m i n e m o d u l a t i o n i n t h e s t r i a t u m , s h e s a i d . T h e r e s e a r c h e r s c a u t i o n t h a t t h e s t u d y w a s c o n d u c t e d w i t h a s m a l l g r o u p a n d n e e d s t o b e r e p l i c a t e d w i t h g i r l s a s w e l l a s w i t h m o r e b o y s b e f o r e t h e y c a n b e c e r t a i n t h e y h a v e f o u n d a u n i v e r s a l n e u r o b i o l o g i c a l m a r k e r f o r t h e d i s o r d e r . T h e y a l s o r e p o r t e d t h a t t h e y t r i e d t h e e x p e r i m e n t o n t h r e e o t h e r b o y s w h o h a d n o t b e e n d i a g n o s e d w i t h A D D b u t w h o h a d s i b l i n g s w i t h t h e d i a g n o s i s . T w o o f t h e t h r e e s i b l i n g s o f A D D b o y s s h o w e d s o m e R i t a l i n e n h a n c e m e n t o f t h e s t r i a t u m , a s d i d t h e i r a f f e c t e d b r o t h e r s . “ T h i s w o u l d l e n d s o m e s u p p o r t t o t h e i d e a t h a t A D D m a y i n v o l v e a t y p i c a l g e n e t i c i n f l u e n c e s o n d o p a m i n e m o d u l a t i o n , ” V a i d y a s a i d , b u t m o r e s t u d i e s w o u l d b e n e c e s s a r y t o e s t a b l i s h a g e n e t i c i n f l u e n c e . B e c a u s e o f t h e w i d e s p r e a d i n t e r e s t i n A D D , t h e r e s e a r c h e r s a l s o w e r e c a r e f u l t o p o i n t o u t o t h e r l i m i t a t i o n s o f t h e i r s t u d y . A f r a c t i o n o f p e o p l e d i a g n o s e d w i t h A D D h a v e n o t r e s p o n d e d t o R i t a l i n t r e a t m e n t , a n d t h i s s t u d y d i d n o t i n c l u d e s u c h c h i l d r e n , t h e y s a i d . I t a l s o d i d n o t a t t e m p t t o i n v e s t i g a t e p o s s i b l e c h a n g e s i n b r a i n a c t i v a t i o n t h a t m i g h t o c c u r w i t h t h e d r u g o v e r t i m e . T h e A D D b o y s d i d s h o w a d i f f e r e n t b r a i n a c t i v a t i o n l e v e l w h e n n o t o n t h e d r u g , b u t a l l o f t h e m h a d b e e n t a k i n g R i t a l i n p r e v i o u s l y a s p a r t o f t h e i r o n g o i n g t r e a t m e n t . D e s p i t e t h e s e l i m i t a t i o n s , t h e s t u d y p o i n t s t o n e w d i r e c t i o n s f o r r e s e a r c h i n t o b r a i n f u n c t i o n t h a t c o u l d i m p r o v e i n d i v i d u a l s ’ p e r f o r m a n c e . “ T h i s i s o n e o f t h e f e w s t u d i e s t o e x a m i n e b r a i n f u n c t i o n i n c h i l d r e n , a n d t o f u r t h e r o u r k n o w l e d g e a b o u t n o r m a l a n d a b n o r m a l b r a i n d e v e l o p m e n t , ” G a b r i e l i s a i d . “ I t s u g g e s t s t h a t F M R I i s a p o w e r f u l t o o l t o e x a m i n e b r a i n a n d b e h a v i o r i n t h e c o n t e x t o f b o t h n o r m a l a n d a b n o r m a l d e v e l o p m e n t . ” C u r r e n t l y , A D D i m p a i r s t h e f u n c t i o n o f a n e s t i m a t e d 3 t o 7 p e r c e n t o f y o u n g s t e r s i n h o m e a n d s c h o o l , a n d t h e l o n g - t e r m c o n s e q u e n c e s i n c l u d e l o w e r e d u c a t i o n a l a n d v o c a t i o n a l a c c o m p l i s h m e n t s f o r t h e m a s a d u l t s a s w e l l a s a n i n c r e a s e d r i s k f o r d r u g a b u s e a n d o t h e r r i s k y b e h a v i o r s . D e v e l o p m e n t a l r e a d i n g d i s o r d e r ( D R D ) i s n o t c a u s e d b y v i s i o n p r o b l e m s , b u t r a t h e r b y p r o b l e m s w i t h t h e b r a i n ’ s a b i l i t y t o r e c o g n i z e a n d p r o c e s s s y m b o l s . C h i l d r e n w i t h D R D m a y h a v e t r o u b l e r h y m i n g a n d s e p a r a t i n g t h e s o u n d s i n s p o k e n w o r d s . T h e s e a b i l i t i e s a p p e a r t o b e c r i t i c a l i n t h e p r o c e s s o f l e a r n i n g t o r e a d . A c h i l d ’ s i n i t i a l r e a d i n g s k i l l s a r e b a s e d o n w o r d r e c o g n i t i o n , w h i c h i n v o l v e s b e i n g a b l e t o s e p a r a t e o u t t h e s o u n d s i n w o r d s a n d m a t c h t h e m w i t h l e t t e r s a n d g r o u p s o f l e t t e r s . M o r e d e v e l o p e d r e a d i n g s k i l l s r e q u i r e t h e l i n k i n g o f w o r d s i n t o a c o h e r e n t s e n t e n c e . B e c a u s e D R D c h i l d r e n h a v e d i f f i c u l t y c o n n e c t i n g t h e s o u n d s o f l a n g u a g e t o t h e l e t t e r s o f w o r d s , t h e y m a y h a v e d i f f i c u l t y u n d e r s t a n d i n g s e n t e n c e s . M o s t c h i l d r e n w i t h D R D h a v e

Ex.Series 1Se: 0/1Im: 0/1LinW: 2047 L: 3468

CHPTR02.00-08Series 1Se: 0/1Im: 0/1LinW: 2047 L: 3468

DIS-EASEASPERGER SYNDROME is an autism spectrum disorder that is characterized by significant significant difficulties in social interaction, along with restricted and repetitive behavior and interests. It differs from autism spectrum disorders because of its relative preservation of l inguistic and cognitive development. Although not required for diagnosis, physical clumsiness and an atypical use of language are frequently reported. Asperger syndrome is named after the Austrian pediatrician Hans Asperger who described children in his practice who lacked non-verbal com- municat ion ski l ls , demonstrated l imited empathy with their peers, and were physically physically clumsy. Fifty years later, it was standardized as a diagnosis, but many ques- tions remain about aspects of the disorder. For example, there is doubt about whether it is distinct from high-functioning autism (HFA); partly because of this, its prevalence is not firmly established. It has been proposed that the diagnosis of Asperger’s be eliminated, to be replaced by a diagnosis of autism spectrum disorder on a severity scale.

med/3103 ped/177 D001289

143465 6158 001551

F90 314.00 314.01

ASPERGERS2010 Dec 15 M 102

AccAcq Tm: 16:03:36

SIZES ARE APPROX.

ASPERGERSRouseHig SAR

2011 OCT 15 M 102Acc

Acq Tm: 16:03:36

SIZES ARE APPROX

ACDMYRTUNIVRouseHig SAR

2011 OCT 15 M 102Acc

Acq Tm: 16:03:36

SIZES ARE APPROX

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A1

B1 B2

Those born with the condition tend not to understand facial expres-sions, body language & other non-verbal communications.

CHPTR0200-10Series 1Se: 0/1Im: 0/1LinW: 2047 L: 3468

B2

Those born with the condition tend not to understand facial expres-sions, body language & other non-verbal communications.

Theory of mind is a theory insofar as the mind is not directly observable. The presumption that others have a mind is termed a theory of mind because each human can only prove the existence of his or her own mind through introspection, and no one has direct access to the mind of another. It is typically assumed that others have minds by analogy with one’s own, and based on the reciprocal nature of social interaction, as observed in joint attention, the functional use of language, and understanding of others’ emotions and actions. Having a theory of mind allows one to attribute thoughts, desires, and intentions to others, to predict or explain their actions, and to posit their intentions. As originally defined, it enables one to understand that mental states can be the cause of—and thus be used to explain and predict—others’ behavior. Being able to attribute mental states to others and understanding them as causes of behavior implies, in part, that one must be able to conceive of the mind as a “generator of representations”. If a person does not have a complete theory of mind it may be a sign of cognitive or developmental impairment. Theory of mind appears to be an innate potential ability in humans, but one requiring social and other experience over many years to bring to fruition. Different people may develop more, or less, effective theories of mind. Empathy is a related concept, meaning experientially recognizing and understanding the states of mind, including beliefs, desires and particularly emotions of others, often characterized as the ability to “put oneself into another’s shoes.” Theorizing in the neo-Piagetian theories of cognitive development maintains that theory of mind is a byproduct of a broader hypercognitive ability of the human mind to register, monitor, and represent its own functioning. Research on theory of mind in a number of different populations (human and animal, adults and children, normally- and atypically-developing) has grown rapidly in the almost 30 years since Premack and Woodruff’s paper, “Does the chimpanzee have a theory of mind?”, as have the theories of theory of mind. The emerging field of social neuroscience has also begun to address this debate, by imaging humans while performing tasks demanding the understanding of an intention, belief or other mental state. An alternative account of ToM is given within operant psychology and provides significant empirical evidence for a functional account of both perspective taking and empathy. The most developed operant approach is founded on research on derived relational responding and is subsumed within what is called, “Relational Frame Theory.” According to this view empathy and perspective taking comprise a complex set of derived relational abilities based on learning to discriminate and verbally respond to ever more complex relations between self, others, place, and time, and the transformation of function through established relations.

THEORY OF MIND


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HEAD-NOD

HEAD-SHAKE

HEAD-TILT

HEAD-FWD

HEAD-BACK

LIP-PULL

LIP-PUCKER

BROW FURROW

02.09.2010ALLISON CRAWFORD

FRAME 3001.305

P(Facial/Head display)


IN OUR EVERYDAY COMMUNICATION, we are constantly monitoring other people’s facial and body cues to discern whether we are enrapturing them, boring them, or confusing them—such that we can maintain or change our social tactics accordingly. But people are born with different degrees of this ability, and some need a little help. People with autism spectrum disorders like asperger’s a soc- social disorder that some scientists believe has afflicted the world’s greatest geniuses, including einstein—often have trouble dec- iphering what other people are thinking or feeling. As a result, they frequently make poor social judgments.BUT WITH THE HELP of a new tool developed by the MIT media lab, this problem may someday be a thing of the past. Researchers have developed “mind-reading” software con consisting of a tiny camera that clips onto a person’s clothing and analyzes the facial expressions of others, reporting the results back to the wearer via a tiny earpiece. While the device isn’t foolproof like the best of us, it sometimes misjudges expressions researchers hope that with further tweaking, it might one day serve as a learning device or prosthesis for people with social disorders.

CON- TACT

DISAGREEING

THINKING

CONFUSED

133192.3 s

133333.3 s

13303.6 s

133276.6 s


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EMOTION

GOOD

HAPPY

ANGRY

SENTIMENTAL

FRUSTRATED

LOVE

SAD

BAD

Machines have no confusing moods or emotional subtleties to sort out.

A1

B1 B2

A2

ASPERGER’S SYNDROME CAUSES a complex array of neurologically related symptoms and associated behaviors, some more noticeable than others. For relatives and friends who have social interactions with some children with Asperger’s on a daily basis, as well for their classmates and strangers who may be less forgiving, few behaviors are as confusing and annoying as the lack of awareness of nonverbal communication that many children with Asperger’s exhibit. According to anthro- pologist Edward T. Hall, “In any encounter, particularly intercultural or interethnic, the correct reading of the other person’s verbal and nonverbal behavior is basic to trans- actions at all levels.” Children with Asperger’s, like people experiencing a foreign culture, may also have difficulty synchronizing their body movements with those of others, something that most of us do unconsciously. Failure to understand nonverbal behavior correctly and failure to give appropriate nonverbal signs in communication can cause serious social problems for people living in cultures different from their own, in ways similar to the social problems experienced by a child with the disorder. These social problems can range from exclusion, to lost friendship opportunities, and even to unintentionally provoking aggressive assaults and verbal abuse.NON-VERBAL SIGNALS ACCOUNT for up to seventy percent of human communication, according to renowned linguist Erv Goffman. In addition, different patterns of nonverbal communication, though rarely spelled out for us verbally, distinguish different cultures. Edward T. Hall discusses these differences in his books, The Hidden Dimension and The Silent Language. He shows that people from Middle Eastern and Arab backgrounds stand closer to each other when talking, finding it acceptable and even desirable to breathe on each other when talking, whereas most Americans of European descent are taught not to breathe on people while talking to them, and to stand approximately eighteen inches to two and a half feet apart from friends and associates while carrying on a conversation. In more formal conversations, such as in a business meeting with unfamiliar people, they stand even further apart. Eye contact patterns during conversation have extreme importance, setting the tone of friendliness, indifference, or hostility. Lack of eye contact can make many Americans suspect dis- honesty, while eye contact that is too intense can imply hostility. Hall worked with a Middle Eastern man who said he was in constant hot water with Americans because of the way he looked at them without the slightest intention of offending; he had on several occasions barely avoided fights with American men. Hall says, “Arabs look at each other with an intensity that makes most Americans highly uncomfortable.” Describing Latin American nonverbal communication, Hall writes, In Latin America the interaction distance is much less than it is in the United States. The result is that when they move close, we withdraw and back away. As a consequence, they think we are distant or cold, withdrawn and unfriendly.


2011 OCT 15 M 102Acc

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SIZES ARE APPROX

SMILE

YELL

HUG

HYPERVENTILATE

KISS

CRY

SENTIMENTAL

FRUSTRATED

ENJOYMENT SMILE6+12D+25C

6+12D+25C

A1

B1

A2

B2


EXTRO-SPECTION

THEORY OF MIND IS A THEORY that states that the mind is not directly observable. The presumption that others have a mind is termed a theory of mind because each human can only prove the existence of his or her own mind through introspection, and no one has direct access to the another’s mind. It is typically assumed that others have minds by analogy with one’s own, and based on the reciprocal nature of social interaction, as observed in joint attention, the functional use of language, and understanding of others’ emotions and actions. Having a theory of mind allows one to attribute thoughts, desires, and intentions to others, to predict or explain their actions, and to posit their intentions. As originally defined, it enables one to understand that mental states can be the cause of—and thus be used to explain and predict—others’ behavior. Being able to attribute mental states to others and understanding them as causes of behavior implies, in part, that one must be able to conceive of the mind as a “generator of representations”.If a person does not have a complete theory of mind it may be a sign of cognitive or developmental impairment. Theory of mind appears to be an innate potential ability in humans, but one requiring social and other experience over many years to bring to fruition. Empathy is a related concept, meaning experientially recognizing and understanding the states of mind, including beliefs, desires and emotions of others, often characterized as the ability to “put oneself into another’s shoes.” RESEARCH ON THEORY OF MIND in a number of different populations (human and animal, adults and children, normally- and atypically-developing) has grown rapidly in the almost 30 years since Premack and Woodruff’s paper, “Does the chimpanzee have a theory of mind?”, as have the theories of theory of mind. The emerging field of social neuroscience has also begun to address this debate, by imaging humans while performing tasks demanding the understanding of an intention, belief or other mental state.AN ALTERNATIVE ACCOUNT of theory of mind is given within operant psychology and provides significant empirical evidence for a functional account of both perspective taking and empathy. The most developed operant approach is founded on research on derived relational responding and is subsumed within what is called “Relational Frame Theory.” According to this view empathy and perspective taking comprise a complex set of derived relational abilities based on learning to discriminate and verbally respond to ever more complex relations between self, others, place, and time, and the transformation of function through established relations.


2011 OCT 15 M 102Acc

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SIZES ARE APPROX

SHAME

INTEREST

DOUBT

CONTENT

CONFUSION

ANGER

9+27D+1C

1+40A+44B

1+4A+4B

7+1C+9B

44+5A+12C

FEAR

1+12A+4E

FEAR

1+12A+4E

1+3A+4B

SURPRISE

6+30D+5C

SURPRISE

6+30D+5C

A1

B1

A2

B2


9+27D+1C

Theory of mind is a theory in so far as the mind is not directly observable. The presumption that others have a mind is termed a theory of mind because each human can only prove the existence of his or her own mind through introspection, and no one has direct access to the mind of another. It is typically assumed that others have minds by analogy with one’s own, and based on the reciprocal nature of social interaction, as observed in joint attention, the functional use of language, and understanding of others’ emotions and actions. Having a theory of mind allows one to attribute thoughts, desires, and intentions to others, to predict or explain their actions, and to posit their intentions. As originally defined, it enables one to understand that mental states can be the cause of—and thus be used to explain and predict—others’ behavior. Being able to attribute mental states to others and understanding them as causes of behavior implies, in part, that one must be able to conceive of the mind as a “generator of representations”.If a person does not have a complete theory of mind it may be a sign of cognitive or developmental impairment. Theory of mind appears to be an innate potential ability in humans, but one requiring social and other experience over many years to bring to fruition. Empathy is a related concept, meaning experientially recognizing and understanding the states of mind, including beliefs, desires and particularly emotions of others, often characterized as the ability to “put oneself into another’s shoes.” Research on theory of mind in a number of different populations (human and animal, adults and children, normally- and atypically-developing) has grown rapidly in the almost 30 years since premack and woodruff’s paper, “does the chimpanzee have a theory of mind?”, As have the theories of theory of mind. The emerging field of social neuroscience has also begun to address this debate, by imaging humans while performing tasks demanding the understanding of an intention, belief or other mental state. An alternative account of tom is given within operant psychology and provides significant empirical evidence for a functional account of both perspective taking and empathy. The most developed operant approach is founded on research on derived relational responding and is subsumed within what is called, “relational frame theory.” According to this view empathy and perspective taking comprise a complex set of derived relational abilities based on learning to discriminate and verbally respond to ever more complex relations between self, others, place, and time, and the transformation of function through established relations.

FACIAL LEGIBILITY


2011 OCT 15 M 102Acc

Acq Tm: 16:03:36

SIZES ARE APPROX

Developmental reading disorder (DRD) is not caused by vision problems, but rather by problems with the brain’s ability to recognize and process symbols. Children with DRD may have trouble rhyming and separating the sounds in spoken words. These abilities appear to be critical in the process of learning to read. A child’s initial reading skills are based on word recognition, which involves being able to separate out the sounds in words and match them with letters and groups of letters. More developed reading skills require the linking of words into a coherent sentence. Because DRD children have difficulty connecting the sounds of language to the letters of words, they may have difficulty understanding sentences. Most children with DRD have normal intelligence, and many have above-average intelligence. The disorder is a specific information processing problem that is not connected with the ability to think or to understand complex ideas.DRD may appear in combination with developmental writing disorder and developmental arithmetic disorder. All of these involve using symbols to convey information. These conditions may appear alone or in any combination. Other causes of learning disability and, in particular, reading disability, must be ruled out before a diagnosis of DRD can be made. Cultural and educational shortfalls, emotional problems, mental retardation, and diseases of the brain (for example AIDS) can all cause learning disabilities. Follow-up studies will be required before the results of this study on a small number of boys can lead to brain-based methods of diagnosis, caution the lead researchers, Research Associate Chandan Vaidya and Associate Professor John Gabrieli of Stanford’s Department of Psychology. Theirs is the first study, however, to show that Ritalin, the drug most commonly used to treat ADD, has different effects on the brains of people with and without ADD, and where those differences occur in the brain. The findings are reported in the Nov. 24 issue of the Proceedings of the National Academy of Sciences.The study is also the first to use functional magnetic resonance imaging [FMRI] in the study of ADD. This imaging method can show brain differences in individual people, instead of in averages of differences of two groups. This is critical for diagnosis, which has to be established on an individual basis. Unlike methods used in other studies of ADD, FMRI does not require injection or inhalation of radioactive substances. It relies instead on naturally occurring changes in brain function, which makes it appropriate for research and clinical purposes for children. Co-authors of the study are medical doctors Glenn Austin and Hugh Ridlehuber and school psychologist Gary Kirkorian of the Community/Academia Coalition in Los Altos, Calif. and Gary Glover and John Desmond of the Stanford Medical Center’s Radiology Department. The findings have drawn considerable attention from neuroscientists because “ADD is so widespread, so controversial and confusing, and these are among the few clear findings in that field,” said Gabrieli, who heads the brain imaging laboratory where the research was done. Attention deficit disorder, which often includes hyperactivity, is currently diagnosed on the basis of subjective observations of youngsters’ behavior. If the new findings can be replicated, he said, it might be possible to make a biological diagnosis of the disorder by using FMRI. Since the common treatment for ADD is a prescription drug whose long-term effects on brain function are not known, parents and pediatricians most likely would welcome a more definitive way to diagnose the disorder. In the study, 16 boys between the ages of 8 and 13 were asked individually to play a mental game while lying in a magnetic resonance imaging device, which was set to image front portions of the brain, including the frontal-lobe cortex and the striatal structures below it. The boys, 10 of whom had been diagnosed with ADD and 6 of whom had not, were instructed to press a button when they saw any letter of the alphabet except the letter X on a display screen. Because most of the letters were not X, each child built up a predisposition to press the button and needed to control his impulse to press the button when he saw an X. The task was expected to be, and in fact proved to be, more difficult for the boys with ADD, because poor impulse control is one of the disorder’s symptoms. Comparing the brain images later, researchers found a clear difference in the activation of neuronal tissue in two structures in the striatal region, which is known to be involved in motor control. The brain activation differences between the boys with ADD and those without were even more dramatic when the subjects were asked to perform the same task after taking the drug Ritalin. Ritalin is a stimulant medication used to temporarily relieve symptoms of ADD, such as inattention, impulsivity and hyperactivity. “Both the normal kids and the ADD kids got better in their impulse control when they had taken the drug,” Vaidya said. “Ritalin improved everyone’s performance, but how it actually did it differed in the brains.” The boys with ADD showed more activity in the affected striatal structures (specifically known as the caudate and putamen) when taking the drug than when not. The healthy boys, in contrast, showed the reverse - less activity in those areas when taking the drug than when not. “From past work with adults and children, some of which required injecting radioactive material, a consensus developed that it is the frontal striatal circuitry of the brain that is what’s not right with this disorder,” Vaidya said. “That is why we imaged this part of the brain, and our study confirmed that these structures are, indeed, important for ADD.” Ritalin primarily, but not exclusively, influences dopamine neurotransmission. The opposite effects of Ritalin on boys with ADD and boys without the disorder suggest that ADD involves atypical dopamine modulation in the striatum, she said. The researchers caution that the study was conducted with a small group and needs to be replicated with girls as well as with more boys before they can be certain they have found a universal neurobiological marker for the disorder. They also reported that they tried the experiment on three other boys who had not been diagnosed with ADD but who had siblings with the diagnosis. Two of the three siblings of ADD boys showed some Ritalin enhancement of the striatum, as did their affected brothers. “This would lend some support to the idea that ADD may involve atypical genetic influences on dopamine modulation,” Vaidya said, but more studies would be necessary to establish a genetic influence. Because of the widespread interest in ADD, the researchers also were careful to point out other limitations of their study. A fraction of people diagnosed with ADD have not responded to Ritalin treatment, and this study did not include such children, they said. It also did not attempt to investigate possible changes in brain activation that might occur with the drug over time. The ADD boys did show a different brain activation level when not on the drug, but all of them had been taking Ritalin previously as part of their ongoing treatment. Despite these limitations, the study points to new directions for research into brain function that could improve individuals’ performance. “This is one of the few studies to examine brain function in children, and to further our knowledge about normal and abnormal brain development,” Gabrieli said. “It suggests that FMRI is a powerful tool to examine brain and behavior in the context of both normal and abnormal development.” Currently, ADD impairs the function of an estimated 3 to 7 percent of youngsters in home and school, and the long-term consequences include lower educational and vocational accomplishments for them as adults as well as an increased risk for drug abuse and other risky behaviors. Developmental reading disorder (DRD) is not caused by vision problems, but rather by problems with the brain’s ability to recognize and process symbols. Children with DRD may have trouble rhyming and separating the sounds in spoken words. These abilities appear to be critical in the process of learning to read. A child’s initial reading skills are based on word recognition, which involves being able to separate out the sounds in words and match them with letters and groups of letters. More developed reading skills require the linking of words into a coherent sentence. Because DRD children have difficulty connecting the sounds of language to the letters of words, they may have difficulty understanding sentences. Most children with DRD have normal intelligence, and many have above-average intelligence. The disorder is a specific information processing problem that is not connected with the ability to think or to understand complex ideas.DRD may appear in combination with developmental writing disorder and developmental arithmetic disorder. All of these involve using symbols to convey information. These conditions may appear alone or in any combination. Other causes of learning disability and, in particular, reading disability, must be ruled out before a diagnosis of DRD can be made. Cultural and educational shortfalls, emotional problems, mental retardation, and diseases of the brain (for example AIDS) can all cause learning disabilities. Follow-up studies will be required before the results of this study on a small number of boys can lead to brain-based methods of diagnosis, caution the lead researchers, Research Associate Chandan Vaidya and Associate Professor John Gabrieli of Stanford’s Department of Psychology. Theirs is the first study, however, to show that Ritalin, the drug most commonly used to treat ADD, has different effects on the brains of people with and without ADD, and where those differences occur in the brain. The findings are reported in the Nov. 24 issue of the Proceedings of the National Academy of Sciences. The study is also the first to use functional magnetic resonance imaging [FMRI] in the study of ADD. This imaging method can show brain differences in individual people, instead of in averages of differences of two groups. This is critical for diagnosis, which has to be established on an individual basis. Unlike methods used in other studies of ADD, FMRI does not require injection or inhalation of radioactive substances. It relies instead on naturally occurring changes in brain function, which makes it appropriate for research and clinical purposes for children. Co-authors of the study are medical doctors Glenn Austin and Hugh Ridlehuber and school psychologist Gary Kirkorian of the Community/Academia Coalition in Los Altos, Calif. and Gary Glover and John Desmond of the Stanford Medical Center’s Radiology Department. The findings have drawn considerable attention from neuroscientists because “ADD is so widespread, so controversial and confusing, and these are among the few clear findings in that field,” said Gabrieli, who heads the brain imaging laboratory where the research was done. Attention deficit disorder, which often includes hyperactivity, is currently diagnosed on the basis of subjective observations of youngsters’ behavior. If the new findings can be replicated, he said, it might be possible to make a biological diagnosis of the disorder by using FMRI. Since the common treatment for ADD is a prescription drug whose long-term effects on brain function are not known, parents and pediatricians most likely would welcome a more definitive way to diagnose the disorder. In the study, 16 boys between the ages of 8 and 13 were asked individually to play a mental game while lying in a magnetic resonance imaging device, which was set to image front portions of the brain, including the frontal-lobe cortex and the striatal structures below it. The boys, 10 of whom had been diagnosed with ADD and 6 of whom had not, were instructed to press a button when they saw any letter of the alphabet except the letter X on a display screen. Because most of the letters were not X, each child built up a predisposition to press the button and needed to control his impulse to press the button when he saw an X. The task was expected to be, and in fact proved to be, more difficult for the boys with ADD, because poor impulse control is one of the disorder’s symptoms. Comparing the brain images later, researchers found a clear difference in the activation of neuronal tissue in two structures in the striatal region, which is known to be involved in motor control. The brain activation differences between the boys with ADD and those without were even more dramatic when the subjects were asked to perform the same task after taking the drug Ritalin. Ritalin is a stimulant medication used to temporarily relieve symptoms of ADD, such as inattention, impulsivity and hyperactivity. “Both the normal kids and the ADD kids got better in their impulse control when they had taken the drug,” Vaidya said. “Ritalin improved everyone’s performance, but how it actually did it differed in the brains.” The boys with ADD showed more activity in the affected striatal structures (specifically known as the caudate and putamen) when taking the drug than when not. The healthy boys, in contrast, showed the reverse - less activity in those areas when taking the drug than when not. “From past work with adults and children, some of which required injecting radioactive material, a consensus developed that it is the frontal striatal circuitry of the brain that is what’s not right with this disorder,” Vaidya said. “That is why we imaged this part of the brain, and our study confirmed that these structures are, indeed, important for ADD.” Ritalin primarily, but not exclusively, influences dopamine neurotransmission. The opposite effects of Ritalin on boys with ADD and boys without the disorder suggest that ADD involves atypical dopamine modulation in the striatum, she said. The researchers caution that the study was conducted with a small group and needs to be replicated with girls as well as with more boys before they can be certain they have found a universal neurobiological marker for the disorder. They also reported that they tried the experiment on three other boys who had not been diagnosed with ADD but who had siblings with the diagnosis. Two of the three siblings of ADD boys showed some Ritalin enhancement of the striatum, as did their affected brothers. “This would lend some support to the idea that ADD may involve atypical genetic influences on dopamine modulation,” Vaidya said, but more studies would be necessary to establish a genetic influence. Because of the widespread interest in ADD, the researchers also were careful to point out other limitations of their study. A fraction of people diagnosed with ADD have not responded to Ritalin

Developmental reading disorder (DRD) is not caused by vision problems, but rather by problems with the brain’s ability to recognize and process symbols. Children with DRD may have trouble rhyming and separating the sounds in spoken words. These abilities appear to be critical in the process of learning to read. A child’s initial reading skills are based on word recognition, which involves being able to separate out the sounds in words and match them with letters and groups of letters. More developed reading skills require the linking of words into a coherent sentence. Because DRD children have difficulty connecting the sounds of language to the letters of words, they may have difficulty understanding sentences. Most children with DRD have normal intelligence, and many have above-average intelligence. The disorder is a specific information processing problem that is not connected with the ability to think or to understand complex ideas.DRD may appear in combination with developmental writing disorder and developmental arithmetic disorder. All of these involve using symbols to convey information. These conditions may appear alone or in any combination. Other causes of learning disability and, in particular, reading disability, must be ruled out before a diagnosis of DRD can be made. Cultural and educational shortfalls, emotional problems, mental retardation, and diseases of the brain (for example AIDS) can all cause learning disabilities. Follow-up studies will be required before the results of this study on a small number of boys can lead to brain-based methods of diagnosis, caution the lead researchers, Research Associate Chandan Vaidya and Associate Professor John Gabrieli of Stanford’s Department of Psychology. Theirs is the first study, however, to show that Ritalin, the drug most commonly used to treat ADD, has different effects on the brains of people with and without ADD, and where those differences occur in the brain. The findings are reported in the Nov. 24 issue of the Proceedings of the National Academy of Sciences.The study is also the first to use functional magnetic resonance imaging [FMRI] in the study of ADD. This imaging method can show brain differences in individual people, instead of in averages of differences of two groups. This is critical for diagnosis, which has to be established on an individual basis. Unlike methods used in other studies of ADD, FMRI does not require injection or inhalation of radioactive substances. It relies instead on naturally occurring changes in brain function, which makes it appropriate for research and clinical purposes for children. Co-authors of the study are medical doctors Glenn Austin and Hugh Ridlehuber and school psychologist Gary Kirkorian of the Community/Academia Coalition in Los Altos, Calif. and Gary Glover and John Desmond of the Stanford Medical Center’s Radiology Department. The findings have drawn considerable attention from neuroscientists because “ADD is so widespread, so controversial and confusing, and these are among the few clear findings in that field,” said Gabrieli, who heads the brain imaging laboratory where the research was done. Attention deficit disorder, which often includes hyperactivity, is currently diagnosed on the basis of subjective observations of youngsters’ behavior. If the new findings can be replicated, he said, it might be possible to make a biological diagnosis of the disorder by using FMRI. Since the common treatment for ADD is a prescription drug whose long-term effects on brain function are not known, parents and pediatricians most likely would welcome a more definitive way to diagnose the disorder. In the study, 16 boys between the ages of 8 and 13 were asked individually to play a mental game while lying in a magnetic resonance imaging device, which was set to image front portions of the brain, including the frontal-lobe cortex and the striatal structures below it. The boys, 10 of whom had been diagnosed with ADD and 6 of whom had not, were instructed to press a button when they saw any letter of the alphabet except the letter X on a display screen. Because most of the letters were not X, each child built up a predisposition to press the button and needed to control his impulse to press the button when he saw an X. The task was expected to be, and in fact proved to be, more difficult for the boys with ADD, because poor impulse control is one of the disorder’s symptoms. Comparing the brain images later, researchers found a clear difference in the activation of neuronal tissue in two structures in the striatal region, which is known to be involved in motor control. The brain activation differences between the boys with ADD and those without were even more dramatic when the subjects were asked to perform the same task after taking the drug Ritalin. Ritalin is a stimulant medication used to temporarily relieve symptoms of ADD, such as inattention, impulsivity and hyperactivity. “Both the normal kids and the ADD kids got better in their impulse control when they had taken the drug,” Vaidya said. “Ritalin improved everyone’s performance, but how it actually did it differed in the brains.” The boys with ADD showed more activity in the affected striatal structures (specifically known as the caudate and putamen) when taking the drug than when not. The healthy boys, in contrast, showed the reverse - less activity in those areas when taking the drug than when not. “From past work with adults and children, some of which required injecting radioactive material, a consensus developed that it is the frontal striatal circuitry of the brain that is what’s not right with this disorder,” Vaidya said. “That is why we imaged this part of the brain, and our study confirmed that these structures are, indeed, important for ADD.” Ritalin primarily, but not exclusively, influences dopamine neurotransmission. The opposite effects of Ritalin on boys with ADD and boys without the disorder suggest that ADD involves atypical dopamine modulation in the striatum, she said. The researchers caution that the study was conducted with a small group and needs to be replicated with girls as well as with more boys before they can be certain they have found a universal neurobiological marker for the disorder. They also reported that they tried the experiment on three other boys who had not been diagnosed with ADD but who had siblings with the diagnosis. Two of the three siblings of ADD boys showed some Ritalin enhancement of the striatum, as did their affected brothers. “This would lend some support to the idea that ADD may involve atypical genetic influences on dopamine modulation,” Vaidya said, but more studies would be necessary to establish a genetic influence. Because of the widespread interest in ADD, the researchers also were careful to point out other limitations of their study. A fraction of people diagnosed with ADD have not responded to Ritalin treatment, and this study did not include such children, they said. It also did not attempt to investigate possible changes in brain activation that might occur with the drug over time. The ADD boys did show a different brain activation level when not on the drug, but all of them had been taking Ritalin previously as part of their ongoing treatment. Despite these limitations, the study points to new directions for research into brain function that could improve individuals’ performance. “This is one of the few studies to examine brain function in children, and to further our knowledge about normal and abnormal brain development,” Gabrieli said. “It suggests that FMRI is a powerful tool to examine brain and behavior in the context of both normal and abnormal development.” Currently, ADD impairs the function of an estimated 3 to 7 percent of youngsters in home and school, and the long-term consequences include lower educational and vocational accomplishments for them as adults as well as an increased risk for drug abuse and other risky behaviors. Developmental reading disorder (DRD) is not caused by vision problems, but rather by problems with the brain’s ability to recognize and process symbols. Children with DRD may have trouble rhyming and separating the sounds in spoken words. These abilities appear to be critical in the process of learning to read. A child’s initial reading skills are based on word recognition, which involves being able to separate out the sounds in words and match them with letters and groups of letters. More developed reading skills require the linking of words into a coherent sentence. Because DRD children have difficulty connecting the sounds of language to the letters of words, they may have difficulty understanding sentences. Most children with DRD have normal intelligence, and many have above-average intelligence. The disorder is a specific information processing problem that is not connected with the ability to think or to understand complex ideas.DRD may appear in combination with developmental writing disorder and developmental arithmetic disorder. All of these involve using symbols to convey information. These conditions may appear alone or in any combination. Other causes of learning disability and, in particular, reading disability, must be ruled out before a diagnosis of DRD can be made. Cultural and educational shortfalls, emotional problems, mental retardation, and diseases of the brain (for example AIDS) can all cause learning disabilities. Follow-up studies will be required before the results of this study on a small number of boys can lead to brain-based methods of diagnosis, caution the lead researchers, Research Associate Chandan Vaidya and Associate Professor John Gabrieli of Stanford’s Department of Psychology. Theirs is the first study, however, to show that Ritalin, the drug most commonly used to treat ADD, has different effects on the brains of people with and without ADD, and where those differences occur in the brain. The findings are reported in the Nov. 24 issue of the Proceedings of the National Academy of Sciences. The study is also the first to use functional magnetic resonance imaging [FMRI] in the study of ADD. This imaging method can show brain differences in individual people, instead of in averages of differences of two groups. This is critical for diagnosis, which has to be established on an individual basis. Unlike methods used in other studies of ADD, FMRI does not require injection or inhalation of radioactive substances. It relies instead on naturally occurring changes in brain function, which makes it appropriate for research and clinical purposes for children. Co-authors of the study are medical doctors Glenn Austin and Hugh Ridlehuber and school psychologist Gary Kirkorian of the Community/Academia Coalition in Los Altos, Calif. and Gary Glover and John Desmond of the Stanford Medical Center’s Radiology Department. The findings have drawn considerable attention from neuroscientists because “ADD is so widespread, so controversial and confusing, and these are among the few clear findings in that field,” said Gabrieli, who heads the brain imaging laboratory where the research was done. Attention deficit disorder, which often includes hyperactivity, is currently diagnosed on the basis of subjective observations of youngsters’ behavior. If the new findings can be replicated, he said, it might be possible to make a biological diagnosis of the disorder by using FMRI. Since the common treatment for ADD is a prescription drug whose long-term effects on brain function are not known, parents and pediatricians most likely would welcome a more definitive way to diagnose the disorder. In the study, 16 boys between the ages of 8 and 13 were asked individually to play a mental game while lying in a magnetic resonance imaging device, which was set to image front portions of the brain, including the frontal-lobe cortex and the striatal structures below it. The boys, 10 of whom had been diagnosed with ADD and 6 of whom had not, were instructed to press a button when they saw any letter of the alphabet except the letter X on a display screen. Because most of the letters were not X, each child built up a predisposition to press the button and needed to control his impulse to press the button when he saw an X. The task was expected to be, and in fact proved to be, more difficult for the boys with ADD, because poor impulse control is one of the disorder’s symptoms. Comparing the brain images later, researchers found a clear difference in the activation of neuronal tissue in two structures in the striatal region, which is known to be involved in motor control. The brain activation differences between the boys with ADD and those without were even more dramatic when the subjects were asked to perform the same task after taking the drug Ritalin. Ritalin is a stimulant medication used to temporarily relieve symptoms of ADD, such as inattention, impulsivity and hyperactivity. “Both the normal kids and the ADD kids got better in their impulse control when they had taken the drug,” Vaidya said. “Ritalin improved everyone’s performance, but how it actually did it differed in the brains.” The boys with ADD showed more activity in the affected striatal structures (specifically known as the caudate and putamen) when taking the drug than when not. The healthy boys, in contrast, showed the reverse - less activity in those areas when taking the drug than when not. “From past work with adults and children, some of which required injecting radioactive material, a consensus developed that it is the frontal striatal circuitry of the brain that is what’s not right with this disorder,” Vaidya said. “That is why we imaged this part of the brain, and our study confirmed that these structures are, indeed, important for ADD.” Ritalin primarily, but not exclusively, influences dopamine neurotransmission. The opposite effects of Ritalin on boys with ADD and boys without the disorder suggest that ADD involves atypical dopamine modulation in the striatum, she said. The researchers caution that the study was conducted with a small group and needs to be replicated with girls as well as with more boys before they can be certain they have found a universal neurobiological marker for the disorder. They also reported that they tried the experiment on three other boys who had not been diagnosed with ADD but who had siblings with the diagnosis. Two of the three siblings of ADD boys showed some Ritalin enhancement of the striatum, as did their affected brothers. “This would lend some support to the idea that ADD may involve atypical genetic influences on dopamine modulation,” Vaidya said, but more studies would be necessary to establish a genetic influence. Because of the widespread interest in ADD, the researchers also were careful to point out other limitations of their study. A fraction of people diagnosed with ADD have not responded to Ritalin


The outer stroke details, en-try and exit strokes differ for each letterform to give differentiation between con-fusable letters.

A1 A2

BRITAIN HAS TWO MILLION severely dyslexic individuals, including some 375,000 school children. Ten percent of people using romance languages are coping with a reading difficulty. Dyslexia is a combination of abilities and difficulties that affect the learning process, displaying a wide range of difficulties. Dyslexia can occur despite normal intellectual ability and teaching, and it is independent of socio-economic or language background.THERE HAS BEEN GROWING innovation to combat dyslexia, especially for children, in the form of computer software. However, relatively relatively little design research has been done in the area of typography and type design that might support dyslexics. Read Regular is a typeface designed specifically to help people with dyslexia read and write more effectively.READ REGULAR AIMS at preventing a neglect of dyslexia, creating a more confident feeling regarding the problems that occur with dyslexia. Read Regular is designed with an individual approach for each of the individual characters, creating difference in the actual characters of b&d itself (not mirroring the b to make the d), to create a large character differentiation. The character shapes are simple and clear, creating consistency. The characters have been stripped down from all unnecessary details, such as a two storey a and a two eyed g. The individual approach creates striking outlines that make sure that each character stands on its own and works together with its previous or next character. Used in the content of words, sentences and text, the following or the previous character does not try to interfere in its readability process. Ascenders (bdfhkl) and descenders (gjpqy) are long to ensure their legibility. Inner shapes for example within the the o,e,a,u and openings in e and g are kept open to prevent from visually closing in. This makes Read Regular a friendly character and a pleasant balance between black and white. Many of the difficulties that occur with dyslexia result in a barrier. Even though the symptoms can vary over an enormously wide range per individual. The difficulties do result in similar patterns of problems. Read Regular is aiming at these similar patterns.

LEGI-BILITY

DYSLEXIARouseHig SAR

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FIX-ATIONDURING A SINGLE FIXATION, there is a limit to the amount of information that can be recog-nized. The fovea, which is the clear center point of our vision, can only see three to four letters to the left and right of fixation at normal reading distances. Visual acuity decreases quickly in the parafovea, which extends out as far as 15 to 20 letters to the left and right of the fixation point. Eye movement studies that I will discuss shortly indicate that there are three zones of visual identification. Readers collect information from all three zones during the span of a fixation. Closest to the fixation point is where word recognition takes place. This zone is usually large enough to capture the word being fixated, and often includes smaller function words directly to the right of the fixated word. The next zone extends a few letters past the word recognition zone, and readers gather preliminary information about the next letters in this zone. The final zone extends out to 15 letters past the fixa-tion point. Information gathered out this far is used to identify the length of upcoming words and to identify the best location for the next fixation point. For example, in Figure 5, the first fixation point is on the s in Roadside. The reader is able to recognize the word Roadside, beginning letter information from the first few letters in joggers, as well as complete word length information about the word joggers. A more interesting fixation in Figure 5 is the word sweat. In this fixation both the words sweat and pain are short enough to be fully recognized, while beginning letter information is gathered for. Because and is a high fre-quency function word, this is enough in-formation to skip this word as well. Word length information is gathered all the way out to angry, which becomes the location of the next fixation. There are two experimental methodologies that have been critical for understanding the fixation span: the moving window paradigm and the boundary study paradigm. These methodologies make it possible to study readers while they are engaged in ordinary reading. Both rely on fast eye trackers and computers to perform clever text manipula-tions while a reader is making a saccade. While making a saccade, the reader is functionally blind. The reader will not perceive that text has changed if the change is completed before the saccade has finished.

ZONE 1 Word rec-ognition takes place

315.02ZONE 1 Word rec-

ognition takes place

ZONE 2 Extends a few letters past word recognition point

ZONE 3 Extends out 15 letters past fixation point

S

Q

P

M

β

α

α

θ₁

θ₂

O₁

p₁m₁

q₁

O₂

p₂m₂

q₂

T

For a typeface to be dyslexia friendly, there needs to be a clear distinction between con-fusing letterforms, such as b, q,d,and p.

A1

B1

THE WEIGHT OF EACH CHARACTER IS CARE-FULLY BALANCED.

SIMILAR LETTERFORMS ARE DIFFERENTI-ATED.


The user research outputs confirmed that ascenders (the upward strokes in letters such as ‘d’) and descenders (downwards strokes in letters such as ‘p’) should ideally be long to ensure their legibility. This, together with other factors, led Frensch to optimise respective character weighting as one of the key drivers of the project, with the weight of each character being carefully balanced to decrease the competition for the reader’s attention between the letterforms and the background. It was found that many of the issues relating to characters also applied to numerals, which were incorporated using similar criteria. Character spacing was increased slightly to support the reader during their attempt to build up the necessary word images, and verified by means of further user testing. It was found that the standard answer to problems experienced by dyslexics of simply enlarging type sizes did not adequately address the issue, in fact it tended to emphasise the problem with dyslexics. Needing to be able to recognise individual letter images rather than the shape of the completed word form, particularly when the spelling is not phonetic (eg. ‘Peugeot’), can and often does lead to guesswork. Alternatives to the ‘Read regular’ family, ie Read regular, Read Smallcaps and Read Space are acceptable providing they adhere to similar design guidelines. Copying or mirroring shapes should be avoided to avoid the ‘swirl-effect’ . Avoid the over-stylised. Italics and underlining are less recognisable. The use of capitals for large amounts of text is not recommended. The user research outputs confirmed that ascenders (the upward strokes in letters such as ‘d’) and descenders (downwards strokes in letters such as ‘p’) should ideally be long to ensure their legibility. This, together with other factors, led Frensch to optimise respective character weighting as one of the key drivers of the project, with the weight of each character being carefully balanced to decrease the competition for the reader’s attention between the letterforms and the background. It was found that many of the issues relating to characters also applied to numerals, which were incorporated using similar criteria.

A2

B2

CHARACTER SPACING IS INCREASED


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DYSLEXIA FRIENDLY

pupil constriction

3.00

2.70

2.40

2.10

1.90

1.50

1.30

1.00

-1.30

-3.30

-4.90

-2.30

-4.30

0.90

-1.00

-1.70

-3.70

-5.00

-2.70

-4.40

-1.90

-3.90

0.10

-2.90

-4.70

-2.10

-4.10

0.50

-3.10

-4.80


WORD ORWDMAVE AMVE

DATA PRO-CESSINGTHE STRONGEST EVIDENCE for the word shape model is perhaps the word superior-ity effect which showed that letters can be more accurately recognized in the context of a word than in isolation, for example sub-jects are more accurate at recognizing D in the context of WORD than in the context of ORWD. This supports word shape because subjects are able to quickly recognize the familiar word shape, and deduce the pres-ence of letter information after the stimulus presentation has finished while the nonword can only be read letter by letter. McClelland & Johnson demonstrated that the reason for the word superiority effect wasn’t the recognition of word shapes, but rather the existence of regular letter combinations. Pseudowords are not words in the English language, but have the phonetic regularity that make them easily pronounceable. Mave and rint are two examples of pseudowords. Because pseudowords do not have seman-tic content and have not been seen previ-ously by the subjects, they should not have a familiar word shape. McClelland & Johnson found that letters are recognized faster in the context of pseudowords (mave) than in the context of nonwords (amve). This dem-onstrates that the word superiority effect is caused by regular letter combinations and not word shape.THE WEAKEST EVIDENCE in support of word shape is that lowercase text is read faster than uppercase text. This is entirely a prac-tice effect. Most readers spend the bulk of their time reading lowercase text and are therefore more proficient at it. When readers are forced to read large quantities of upper-case text, their reading speed will eventually increase to the rate of lowercase text. Even text oriented as if you were seeing it in a mir-ror will quickly increase in reading speed with practice.

WORD SHAPE2010 Dec 15 M 102

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Current studies concerning the co-occurrence, of attention deficit disorder and one or more learning disabilities are examined. Information is reported from four major aspects of the research: statistical accounts of the prevalence of attention deficit disorder and the simultane-ous occurrence of the two disorders; subtypes of attention deficit disorder as they relate to learning disabilities; findings and suggestions as to causes for the co-occurrence; and educational implications based on current research. Research acknowledges that learning dis-ability and attention deficit disorder (ADD) frequently co-occur. In addition to significant inattentiveness, impulsivity, and hyperactivity, primary characteristics manifested in children diagnosed as ADD include “learning disorder” and “academic underachiever”. Estimates of co-morbidity of ADD and learning disability range from approximately 20% to approximately 50%. Estimates of reports vary, depending on the way learning disability is defined or ADD is assessed. While this rate of co-occurrence has led some to theorize that the two disorders share overlapping deficits, other research concludes that ADD and learning disability are separate and distinct entities that often co-occur. The purpose of this paper is to review the contemporary literature related to the cooccurrence of attention-deficit disorder (ADD), with and without hyperactivity, and specific learning disabilities. Factors common to children with either learning disability or attention deficit dis-order as compared to common features of children diagnosed as having both ADD and learning disability are presented. Curabitur ultrices tempus magna molestie auctor. Nunc accumsan sapien eu sapien auctor tristique. Current studies concerning the co-occurrence, of at-tention deficit disorder and one or more learning disabilities are examined. Information is reported from four major aspects of the research: statistical accounts of the prevalence of attention deficit disorder and the simultaneous occurrence of the two disorders subtypes of at-tention deficit disorder as they relate to learning disabilities; findings and suggestions as to causes for the co-occurrence; and educational implications based on current research. Research acknowledges that learning disability and attention deficit disorder (ADD) frequently co-occur. In addition to significant inattentiveness, impulsivity, and hyperactivity, primary characteristics manifested in children diagnosed as ADD include “learning disorder” and “academic underachiever.” Estimates of co-morbidity of ADD and learning disability range from ap-proximately 20% to approximately 50%. Estimates of reports vary, depending on the way learning disability is defined or ADD is assessed.

While this rate of co-occurrence has led some to the-orize that the two disorders share overlapping defi-cits, other research concludes that ADD and learning disability are separate and distinct entities that often co-occur. The purpose of this paper is to review the contemporary literature related to the cooccurrence of attention-deficit disorder (ADD), with and without hyperactivity, and specific learning disabilities. Fac-tors common to children with either learning disabil-ity or attention deficit disorder as compared to com-mon features of children diagnosed as having both ADD and learning disability are presented.

+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ +++++++++++++++++++++++++++++++++++++++++++++++



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A1

CB1

BD

C1

Develop Developmental reading disorder (DRD) is not caused by vision problems, but rather by problems with the brain’s ability to recognize and process symbols. Children with DRD may have trouble rhyming and separating the sounds in spoken words. These abilities appear to be critical in the process of

learning to read. A child’s initial reading skills are based on word recognition, which involves being able to separate out the sounds in words and match them with letters and groups of letters. More developed reading skills require the linking of words into a coherent sentence. Because DRD children have difficulty connecting the sounds of language to the letters of words, they may have difficulty understanding sentences. Most children with DRD have normal intelligence, and many have above-average intelligence. The disorder is a specific information processing problem that is not connected with the ability to think or to understand complex ideas.DRD may appear in combination with developmental writing disorder and developmental arithmetic disorder. All of these involve using symbols to convey information. These conditions may appear alone or in any combination. Other causes of learning disability and, in particular, reading disability, must be ruled out before a diagnosis of DRD can be made. Cultural and educational shortfalls, emotional problems, mental retardation, and diseases of the brain (for example AIDS) can all cause learning disabilities. Follow-up studies will be required before the results of this study on a small number of boys can lead to brain-based methods of diagnosis, caution the lead researchers, Research Associate Chandan Vaidya and Associate Professor John Gabrieli of Stanford’s Department of Psychology. Theirs is the first study, however, to show that Ritalin, the drug most commonly used to treat ADD, has different effects on the brains of people with and without ADD, and where those differences occur in the brain. The findings are reported in the Nov. 24 issue of the Proceedings of the National Academy of Sciences. The study is also the first to use functional magnetic resonance imaging [FMRI] in the study of ADD. This imaging method can show brain differences in individual people, instead of in averages of differences of two groups. This is critical for diagnosis, which has to be established on an individual basis. Unlike methods used in other studies of ADD, FMRI does not require injection or inhalation of radioactive substances. It relies instead on naturally occurring changes in brain function, which makes it appropriate for research and clinical purposes for children. Co-authors of the study are medical doctors Glenn Austin and Hugh Ridlehuber and school psychologist Gary Kirkorian of the Community/Academia Coalition in Los Altos, Calif. and Gary Glover and John Desmond of the Stanford Medical Center’s Radiology Department. The findings have drawn considerable attention from neuroscientists because “ADD is so widespread, so controversial and confusing, and these are among the few clear findings in that field,” said Gabrieli, who heads the brain imaging laboratory where the research was done. Attention deficit disorder, which often includes hyperactivity, is currently diagnosed on the basis of subjective observations of youngsters’ behavior. If the new findings can be replicated, he said, it might be possible to make a biological diagnosis of the disorder by using FMRI. Since the common treatment for ADD is a prescription drug whose long-term effects on brain function are not known, parents and pediatricians most likely would welcome a more definitive way to diagnose the disorder. In the study, 16 boys between the ages of 8 and 13 were asked individually to play a mental game while lying in a magnetic resonance imaging device, which was set to image front portions of the brain, including the frontal-lobe cortex and the striatal structures below it. The boys, 10 of whom had been diagnosed with ADD affected striatal structures (specifically known as the caudate and putamen) when taking the drug than when not. The healthy boys, in contrast, showed the reverse - less activity in those areas when taking the drug than when not. “From past work with adults and children, some of which required injecting radioactive material, a consensus developed that it is the frontal striatal circuitry of the brain that is what’s not right with this disorder,” Vaidya said. “That is why we imaged this part of the brain, and our study confirmed that these structures are, indeed, important for ADD.” Ritalin primarily, but not exclusively, influences dopamine neurotransmission. The opposite effects of Ritalin on boys with ADD and boys without the disorder suggest that ADD involves atypical dopamine modulation in the striatum, she said. The researchers caution that the study was conducted with a small group and needs to be replicated with girls as well as with more boys before they can be certain they have found a universal neurobiological marker for the disorder. They also reported that they tried the experiment on three other boys who had not been diagnosed with ADD but who had siblings with the diagnosis. Two of the three siblings of ADD boys showed some Ritalin enhancement of the striatum, as did their affected brothers. “This would lend some support to the idea that ADD may involve atypical genetic influences on dopamine modulation,” Vaidya said, but more studies would be necessary to establish a genetic influence. Because of the widespread interest in ADD, the researchers also were careful to point out other limitations of their study. A fraction of people diagnosed with ADD have not responded to Ritalin treatment, and this study did not include such children, they said. It also did not attempt to investigate possible changes in brain activation that might occur with the drug over time. The ADD boys did show a different brain activation level when not on the drug, but all of them had been taking Ritalin previously as part of their ongoing treatment. Despite these limitations, the study points to new directions for research into brain function that could improve individuals’ performance. “This instead on naturally occurring changes in brain function, which makes it appropriate for research and clinical purposes for children. Co-authors of the study are medical doctors Glenn Austin and Hugh Ridlehuber and school psychologist Gary Kirkorian of the Community/Academia Coalition in Los Altos, Calif. and Gary Glover and John Desmond of the Stanford Medical Center’s Radiology Department. The findings have drawn considerable attention from neuroscientists because “ADD is so widespread, so controversial and confusing, and these are among the few clear findings in that field,” said Gabrieli, who heads the brain imaging laboratory where the research was done. Attention deficit disorder, which often includes hyperactivity, is currently diagnosed on the basis of subjective observations of youngsters’ behavior. If the new findings can be replicated, he said, it might be possible to make a biological diagnosis of the disorder by using FMRI. Since the common treatment for ADD is a prescription drug whose long-term effects on brain function are not known, parents and pediatricians most likely would welcome a more definitive way to diagnose the disorder. In the study, 16 boys between the ages of 8 and 13 were asked individually to play a mental game while lying in a magnetic resonance imaging device, which was set to image front portions of the brain, including the frontal-lobe cortex and the striatal structures below it. The boys, 10 of whom had been diagnosed with ADD and 6 of whom had not, were instructed to press a button when they saw any letter of the alphabet except the letter X on a display screen. Because most of the letters were not X, each child built up a predisposition to press the button and needed to control his impulse to press the button when he saw an X. The task was expected to be, and in fact proved to be, more difficult for the boys with ADD, because poor impulse control is one of the disorder’s symptoms. Comparing the brain images later, researchers found a clear difference in the activation of neuronal tissue in two structures in the striatal region, which is known to be involved in motor control. The brain activation differences between the boys with ADD and those without were even more dramatic when the subjects were asked to perform the same task after taking the drug Ritalin. Ritalin is a stimulant medication used to temporarily relieve symptoms of ADD, such as inattention, impulsivity and hyperactivity. “Both the normal kids and the ADD kids got better in their impulse control when they had taken the drug,” Vaidya said. “Ritalin improved everyone’s performance, but how it actually did it differed in the brains.” The boys with ADD showed more activity in the affected striatal structures (specifically known as the caudate and putamen) when taking the drug than when not. The healthy boys, in contrast, showed the reverse - less activity in those areas when taking the drug than when not. “From past work with adults and children, some of which required injecting radioactive material, a consensus developed that it is the frontal striatal circuitry of the brain that is what’s not right with this disorder,” Vaidya said. “That is why we imaged this part of the brain, and our study confirmed that these structures are, indeed, important for ADD.” Ritalin primarily, but not exclusively, influences dopamine neurotransmission. The opposite effects of Ritalin on boys with ADD and boys without the disorder suggest that ADD involves atypical dopamine modulation in the striatum, she said. The researchers caution that the study was conducted with a small group and needs to be replicated with girls as well as with more boys before they can be certain they have found a universal neurobiological marker for the disorder. They also reported that they tried the experiment on three other boys who had not been diagnosed with ADD but who had siblings with the diagnosis. Two of the three siblings of ADD boys showed some Ritalin enhancement of the striatum, as did their affected brothers. “This would lend some support to the idea that ADD may involve atypical genetic influences on dopamine modulation,” Vaidya said, but more studies would be necessary to establish a genetic influence. Because of the widespread interest in ADD, the researchers also were careful to point out other limitations of their study. A fraction of people diagnosed with ADD have not responded to Ritalin treatment, and this study did not include such children, they said. It also did not attempt to investigate possible changes in brain activation that might occur with the drug over time. The ADD boys did show a different brain activation level when not on the drug, but all of them had been taking Ritalin previously as part of their ongoing treatment. Despite these limitations, the study points to new directions for research into brain function that could improve individuals’ performance. “This is one of the few studies to examine brain function in children, and to further our knowledge about normal and abnormal brain development,” Gabrieli said. “It suggests that FMRI is a powerful tool to examine brain and behavior in the context of both normal and abnormal development.” Currently, ADD impairs the function of an estimated 3 to 7 percent of youngsters in home and school, and the long-term consequences include lower educational and vocational accomplishments for them as adults as well as an increased risk for drug abuse and other risky behaviors. Developmental reading disorder (DRD) is not caused by vision problems, but rather by problems with the brain’s ability to recognize and process symbols. Children with DRD may have trouble rhyming and separating the sounds in spoken words. These abilities appear to be critical in the process of learning to read. A child’s initial reading skills are based on word recognition, which involves being able to separate out the sounds in words and match them with letters and groups of letters. More developed reading skills require the linking of words into a coherent sentence. Because DRD children have difficulty connecting the sounds of language to the letters of words, they may have difficulty understanding sentences. Most children with DRD have normal intelligence, and many have above-average intelligence. The disorder is a specific information processing problem that is not connected with the ability to think or to understand complex ideas.DRD may appear in combination with developmental writing disorder and developmental arithmetic disorder. All of these involve using symbols to convey information. These conditions may appear alone or in any combination. Other causes of learning disability and, in particular, reading disability, must be ruled out before a diagnosis of DRD can be made. Cultural and educational shortfalls, emotional problems, mental retardation, and diseases of the brain (for example AIDS) can all cause learning disabilities. Follow-up studies will be required before the results of this study on a small number of boys can lead to brain-based methods of diagnosis, caution the lead researchers, Research Associate Chandan Vaidya and Associate Professor John Gabrieli of Stanford’s Department of Psychology. Theirs is the first study, however, to show that Ritalin, the drug most commonly used to treat ADD, has different effects on the brains of people with and without ADD, and where those differences occur in the brain. The findings are reported in the Nov. 24 issue of the Proceedings of the National Academy of Sciences. The study is also the first to use functional magnetic resonance imaging [FMRI] in the study of ADD. This imaging method can show brain differences in individual people, instead of in averages of differences of two groups. This is critical for diagnosis, which has to be established on an individual basis. Unlike methods used in other studies of ADD, FMRI does not require injection or inhalation of radioactive substances. It relies instead on naturally occurring changes in brain function, which makes it appropriate for research and clinical purposes for children. Co-authors of the study are medical doctors Glenn Austin and Hugh Ridlehuber and school psychologist Gary Kirkorian of the Community/Academia Coalition in Los Altos, Calif. and Gary Glover and John Desmond of the Stanford Medical Center’s Radiology Department. The findings have drawn considerable attention from neuroscientists because “ADD is so widespread, so controversial and confusing, and these are among the few clear findings in that field,” said Gabrieli, who heads the brain imaging laboratory where the research was done. Attention deficit disorder, which often includes hyperactivity, is currently diagnosed on the basis of subjective observations of youngsters’ behavior. If the new findings can be replicated, he said, it might be possible to make a biological diagnosis of the disorder by using FMRI. Since the common treatment for ADD is a prescription drug whose long-term effects on brain function are not known, parents and pediatricians most likely would welcome a more definitive way to diagnose the disorder. In the study, 16 boys between the ages of 8 and 13 were asked individually to play a mental game while lying in a magnetic resonance imaging device, which was set to image front portions of the brain, including the frontal-lobe cortex and the striatal structures below it. The boys, 10 of whom had been diagnosed with ADD and 6 of whom had not, were instructed to press a button when they saw any letter of the alphabet except the letter X on a display screen. Because most of the letters were not X, each child built up a predisposition to press the button and needed to control his impulse to press the button when he saw an X. The task was expected to be, and in fact proved to be, more difficult for the boys with ADD, because poor impulse control is one of the disorder’s symptoms. Comparing the brain images later, researchers found a clear difference in the activation of neuronal tissue in two structures in the striatal region, which is known to be involved in motor control. The brain activation differences between the boys with ADD and those without were even more dramatic when the subjects were asked to perform the same task after taking the drug Ritalin. Ritalin is a stimulant medication used to temporarily relieve symptoms of ADD, such as inattention, impulsivity and hyperactivity. “Both the normal kids and the ADD kids got better in their impulse control when they had taken the drug,” Vaidya said. “Ritalin improved everyone’s performance, but how it actually did it differed in the brains.” The boys with ADD showed more activity in the affected striatal structures (specifically known as the caudate and putamen) when taking the drug than when not. The healthy boys, in contrast, showed the reverse - less activity in those areas when taking the drug than when not. “From past work with adults and children, some of which required injecting radioactive material, a consensus developed that it is the frontal striatal circuitry of the brain that is what’s not right with this disorder,” Vaidya said. “That is why we imaged this part of the brain, and our study confirmed that these structures are, indeed, important for ADD.” Ritalin primarily, but not exclusively, influences dopamine neurotransmission. The opposite effects of Ritalin on boys with ADD and boys without the disorder suggest that ADD involves atypical dopamine modulation in the striatum, she said. The researchers caution that the study was conducted with a small group and needs to be replicated with girls as well as with more boys before they can be certain they have found a universal neurobiological marker for the disorder. They also reported that they tried the experiment on three other boys who had not been diagnosed with ADD but who had siblings with the diagnosis. Two of the three siblings of ADD boys showed some Ritalin enhancement of the striatum, as did their affected brothers. “This would lend some support to the idea that ADD may involve atypical genetic influences on dopamine modulation,” Vaidya said, but more studies would be necessary to establish a genetic influence. Because of the widespread interest in ADD, the researchers also were careful to point out other limitations of their study. A fraction of people diagnosed with ADD have not responded to Ritalin treatment, and this study did not include such children, they said. It also did not attempt to investigate possible changes in brain activation that might occur with the drug over time. The ADD boys did show a different brain activation level when not on the drug, but all of them had been taking Ritalin previously as part of their ongoing treatment. Despite these limitations, the study points to new directions for research into brain function that could improve individuals’ performance. “This is one of the few studies to examine brain function in children, and to further our knowledge about normal and abnormal brain development,” Gabrieli said. “It suggests that FMRI is a powerful tool to examine brain and behavior in the context of both normal and abnormal development.” Currently, ADD impairs the function of an estimated 3 to 7 percent of youngsters in home and school, and the long-term consequences include lower educational and vocational accomplishments for them as adults as well as an increased risk for drug abuse and other risky behaviors. Developmental reading disorder (DRD) is not caused by vision problems, but rather by problems with the brain’s ability to recognize and process symbols. Children with DRD may have trouble rhyming and separating the sounds in spoken words. These abilities appear to be critical in the process of learning to read. A child’s initial reading skills are based on word recognition, which involves being able to separate out the sounds in words and match them with letters and groups of letters. More developed reading skills require the linking of words into a coherent sentence. Because DRD children have difficulty connecting the sounds of language to the letters of words, they may have difficulty understanding sentences. Most children with DRD have normal intelligence, and many have above-average intelligence. The disorder is a specific information processing problem that is not connected with the ability to think or to understand complex ideas.DRD may appear in combination with developmental writing disorder and developmental arithmetic disorder. All of these involve using symbols to convey information. These conditions may appear alone or in any combination. Other causes of learning disability and, in particular, reading disability, must be ruled out before a diagnosis of DRD can be made. Cultural and educational shortfalls, emotional problems, mental retardation, and diseases of the brain (for example AIDS) can all cause learning disabilities. Follow-up studies will be required before the results of this study on a small number of boys can lead to brain-based methods of diagnosis, caution the lead researchers, Research Associate Chandan Vaidya and Associate Professor John Gabrieli of Stanford’s Department of Psychology. Theirs is the first study, however, to show that Ritalin, the drug most commonly used to treat ADD, has different effects on the brains of people with and without ADD, and where those differences occur in the brain. The findings are reported in the Nov. 24 issue of the Proceedings of the National Academy of Sciences. The study is also the first to use functional magnetic resonance imaging [FMRI] in the study of ADD. This imaging method can show brain differences in individual people, instead of in averages of differences of two groups. This is critical for diagnosis, which has to be established on an individual basis. Unlike methods used in other studies of ADD, FMRI does not require injection or inhalation of radioactive substances. It relies instead on naturally occurring changes in brain function, which makes it appropriate for research and clinical purposes for children. Co-authors of the study are medical doctors Glenn Austin and Hugh Ridlehuber and school psychologist Gary Kirkorian of the Community/Academia Coalition in Los Altos, Calif. and Gary Glover and John Desmond of the Stanford Medical Center’s Radiology Department. The findings have drawn considerable attention from neuroscientists because “ADD is so widespread, so controversial and confusing, and these are among the few clear findings in that field,” said Gabrieli, who heads the brain imaging laboratory where the research was done. Attention deficit disorder, which often includes hyperactivity, is currently diagnosed on the basis of subjective observations of youngsters’ behavior. If the new findings can be replicated, he said, it might be possible to make a biological diagnosis of the disorder by using FMRI. Since the common treatment for ADD is a prescription drug whose long-term effects on brain function are not known, parents and pediatricians most likely would welcome a more definitive way to diagnose the disorder. In the study, 16 boys between the ages of 8 and 13 were asked individually to play a mental game while lying in a magnetic resonance imaging device, which was set to image front portions of the brain, including the frontal-lobe cortex and the striatal structures below it. The boys, 10 of whom had been diagnosed with ADD and 6 of whom had not, were instructed to press a button when they saw any letter of the alphabet except the letter X on a display screen. Because most of the letters were not X, each child built up a predisposition to press the button and needed to control his impulse to press the button when he saw an X. The task was expected to be, and in fact proved to be, more difficult for the boys with ADD, because poor impulse control is one of the disorder’s symptoms. Comparing the brain images later, researchers found a clear difference in the activation of neuronal tissue in two structures in the striatal region, which is known to be involved in motor control. The brain activation differences between the boys with ADD and those without were even more dramatic when the subjects were asked to perform the same task after taking the drug Ritalin. Ritalin is a stimulant medication used to temporarily relieve symptoms of ADD, such as inattention, impulsivity and hyperactivity. “Both the normal kids and the ADD kids got better in their impulse control when they had taken the drug,” Vaidya said. “Ritalin improved everyone’s performance, but how it actually did it differed in the brains.” The boys with ADD showed more activity in the affected striatal structures (specifically known as the caudate and putamen) when taking the drug than when not. The healthy boys, in contrast, showed the reverse - less activity in those areas when taking the drug than when not. “From past work with adults and children, some of which required injecting radioactive material, a consensus developed that it is the frontal striatal circuitry of the brain that is what’s not right with this disorder,” Vaidya said. “That is why we imaged this part of the brain, and our study confirmed that these structures are, indeed, important for ADD.” Ritalin primarily, but not exclusively, influences dopamine neurotransmission. The opposite effects of Ritalin on boys with ADD and boys without the disorder suggest that ADD involves atypical dopamine modulation in the striatum, she said. The researchers caution that the study was conducted with a small group and needs to be replicated with girls as well as with more boys before they can be certain they have found a universal neurobiological marker for the disorder. They also reported that they tried the experiment on three other boys who had not been diagnosed with ADD but who had siblings with the diagnosis. Two of the three siblings of ADD boys showed some Ritalin enhancement of the striatum, as did their affected brothers. “This would lend some support to the idea that ADD may involve atypical genetic influences on dopamine modulation,” Vaidya said, but more studies would be necessary to establish a genetic influence. Because of the connecting the sounds of language to the letters of words, they may have difficulty understanding sentences. Most children with DRD have normal intelligence, and many have above-average intelligence. The disorder is a specific information processing problem that is not connected with the ability to think or to understand complex ideas.DRD may appear in combination with developmental writing disorder and developmental arithmetic disorder. All of these involve using symbols to convey information. These conditions may appear alone or in any combination. Other causes of learning disability and, in particular, reading disability, must be ruled out before a diagnosis of DRD can be made. Cultural and educational shortfalls, emotional problems, mental retardation, and diseases of the brain (for example AIDS) can all cause learning disabilities. Follow-up studies will be required before the results of this study on a small Ritalin is a stimulant medication used to temporarily relieve symptoms of ADD, such as inattention, impulsivity and hyperactivity. “Both the normal kids and the ADD kids got better in their impulse control when they had taken the drug,” Vaidya said. “Ritalin improved everyone’s performance, but how it actually did it differed in the brains.” The boys with ADD showed more activity in the affected striatal structures (specifically known as the caudate and putamen) when taking the drug than when not. The healthy boys, in contrast, showed the reverse - less activity in those areas when taking the drug than when not. words into a coherent sentence. Because DRD children have difficulty connecting the sounds of language to the letters of words, they may have difficulty understanding sentences. Most children with DRD have normal intelligence, and many have above-average intelligence. The disorder is a specific information processing problem that is not connected with the ability to think or to understand complex ideas.DRD may appear in combination with developmental writing disorder and developmental arithmetic disorder. All of these involve using symbols to convey information. These conditions may appear alone or in any combination. Other causes of learning disability and, in particular, reading disability, must be ruled out before a diagnosis of DRD can be made. Cultural and educational shortfalls, emotional problems, mental retardation, and diseases of the brain (for example AIDS) can all cause learning disabilities. Follow-up studies will be required before the results of this study on a small number of boys can lead to brain-based methods of diagnosis, caution the lead researchers, Research Associate Chandan Vaidya and Associate Professor John Gabrieli of Stanford’s Department of Psychology. Theirs is the first study, however, to show that Ritalin, the drug most commonly used to treat ADD, has different effects on the brains of people with and without ADD, and where those differences occur in the brain. The findings are reported in the Nov. 24 issue of the Proceedings of the National Academy of Sciences.The study is also the first to use functional magnetic resonance imaging [FMRI] in the study of ADD. This imaging method can show brain differences in individual people, instead of in averages of differences of two groups. This is critical for diagnosis, which has to be established on an individual basis. Unlike methods used in other studies of ADD, FMRI does not require injection or inhalation of radioactive substances. It relies instead on naturally occurring changes in brain function, which makes it appropriate for research and clinical purposes for children. Co-authors of the study are medical doctors Glenn Austin and Hugh Ridlehuber and school psychologist Gary Kirkorian of the Community/Academia Coalition in Los Altos, Calif. and Gary Glover and John Desmond of the Stanford Medical Center’s Radiology Department. The findings have drawn considerable attention from neuroscientists because “ADD is so widespread, so controversial and confusing, and these are among the few clear findings in that field,” said Gabrieli, who heads the brain imaging laboratory where the research was done. Attention deficit disorder, which often includes hyperactivity, is currently diagnosed on the basis of subjective observations of youngsters’ behavior. If the new findings can be replicated, he said, it might be possible to make a biological diagnosis of the disorder by using FMRI. Since the common treatment for ADD is a prescription drug whose long-term effects on brain function are not known, parents and pediatricians most likely would welcome a more definitive way to diagnose the disorder. In the study, 16 boys between the ages of 8 and 13 were asked individually to play a mental game while lying in a magnetic resonance imaging device, which was set to image front portions of the brain, including the frontal-lobe cortex and the striatal structures below it. The boys, 10 of whom had been diagnosed with ADD and 6 of whom had not, were instructed to press a button when they saw any letter of the alphabet except the letter X on a display screen. Because most of the letters were not X, each child built up a predisposition to press the button and needed to control his impulse to press the button when he saw an X. The task was expected to be, and in fact proved to be, more difficult for the boys with ADD, because poor impulse control is one of the disorder’s symptoms. Comparing the brain images later, researchers found a clear difference in the activation of neuronal tissue in two structures in the striatal region, which is known to be involved in motor control. The brain activation differences between the boys with ADD and those without were even more dramatic when the subjects were asked to perform the same task after taking the drug Ritalin. Ritalin is a stimulant medication used to temporarily relieve symptoms of ADD, such as inattention, impulsivity and hyperactivity. “Both the normal kids and the ADD kids got better in their impulse control when they had taken the drug,” Vaidya said. “Ritalin improved everyone’s performance, but how it actually did it differed in the brains.” The boys with ADD showed more activity in the affected striatal structures (specifically known as the caudate and putamen) when taking the drug than when not. The healthy boys, in contrast, showed the reverse - less activity in those areas when taking the drug than when not. “From past work with adults and children, some of which required injecting radioactive material, a consensus developed that it is the frontal striatal circuitry of the brain that is what’s not right with this disorder,” Vaidya said. “That is why we imaged this part of the brain, and our study confirmed that these structures are, indeed, important for ADD.” Ritalin primarily, but not exclusively, influences dopamine neurotransmission. The opposite effects of Ritalin on boys with ADD and boys without the disorder suggest that ADD involves atypical dopamine modulation in the striatum, she said. The researchers caution that the study was conducted with a small group and needs to be replicated with girls as well as with more boys before they can be certain they have found a universal neurobiological marker for the disorder. They also reported that they tried the experiment on three other boys who had not been diagnosed with ADD but who had siblings with the diagnosis. Two of the three siblings of ADD boys showed some Ritalin enhancement of the striatum, as did their affected brothers. “This would lend some support to the idea that ADD may involve atypical genetic influences on dopamine modulation,” Vaidya said, but more studies would be necessary to establish a genetic influence. Because of the widespread interest in ADD, the researchers also were careful to point out other limitations of their study. A fraction of people diagnosed with ADD have not responded to Ritalin treatment, and this study did not include such children, they said. It also did not attempt to investigate possible changes in brain activation that might occur with the drug over time. The ADD boys did show a different brain activation level when not on the drug, but all of them had been taking Ritalin previously as part of their ongoing treatment. Despite these limitations, the study points to new directions for research into brain function that could improve individuals’ performance. “This is one of the few studies to examine brain function in children, and to further our knowledge about normal and abnormal brain development,” Gabrieli said. “It suggests that FMRI is a powerful tool to examine brain and behavior in the context of both normal and abnormal development.” Currently, ADD impairs the function of an estimated 3 to 7 percent of youngsters in home and school, and the long-term consequences include lower educational and vocational accomplishments for them as adults as well as an increased risk for drug abuse and other risky behaviors. Developmental reading disorder (DRD) is not caused by vision problems, but rather by problems with the brain’s ability to recognize and process symbols. Children with DRD may have trouble rhyming and separating the sounds in spoken words. These abilities appear to be critical in the process of learning to read. A child’s initial reading skills are based on word recognition, which involves being able to separate out the sounds in words and match them with letters and groups of letters. More developed reading skills require the linking of words into a coherent sentence. Because DRD children have difficulty connecting the sounds of language to the letters of words, they may have difficulty understanding sentences. Most children with DRD have normal intelligence, and many have above-average intelligence. The disorder is a specific information processing problem that is not connected with the ability to think or to understand complex ideas.DRD may appear in combination with developmental writing disorder and developmental arithmetic disorder. All of these involve using symbols to convey information. These conditions may appear alone or in any combination. Other causes of learning disability and, in particular, reading disability, must be ruled out before a diagnosis of DRD can be made. Cultural and educational shortfalls, emotional problems, mental retardation, and diseases of the brain (for example AIDS) can all cause learning disabilities. Follow-up studies will be required before the results of this study on a small number of boys can lead to brain-based methods of diagnosis, caution the lead researchers, Research Associate Chandan Vaidya and Associate Professor John Gabrieli of Stanford’s Department of Psychology. Theirs is the first study, however, to show that Ritalin, the drug most commonly used to treat ADD, has different effects on the brains of people with and without ADD, and where those differences occur in the brain. The findings are reported in the Nov. 24 issue of the Proceedings of the National Academy of Sciences. The study is also the first to use functional magnetic resonance imaging [FMRI] in the study of ADD. This imaging method can show brain differences in individual people, instead of in averages of differences of two groups. This is critical for diagnosis, which has to be established on an individual basis. Unlike methods used in other studies of ADD, FMRI does not require injection or inhalation of radioactive substances. It relies instead on naturally occurring changes in brain function, which makes it appropriate for research and clinical purposes for children. Co-authors of the study are medical doctors Glenn Austin and Hugh Ridlehuber and school psychologist Gary Kirkorian of the Community/Academia Coalition in Los Altos, Calif. and Gary Glover and John Desmond of the Stanford Medical Center’s Radiology Department. The findings have drawn considerable attention from neuroscientists because “ADD is so widespread, so controversial and confusing, and these are among the few clear findings in that field,” said Gabrieli, who heads the brain imaging laboratory where the research was done. Attention deficit disorder, which often includes hyperactivity, is currently diagnosed on the basis of subjective observations of youngsters’ behavior. If the new findings can be replicated, he said, it might be possible to make a biological diagnosis of the disorder by using FMRI. Since the common treatment for ADD is a prescription drug whose long-term effects on brain function are not known, parents and pediatricians most likely would welcome a more definitive way to diagnose the disorder. In the study, 16 boys between the ages of 8 and 13 were asked individually to play a mental game while lying in a magnetic resonance imaging device, which was set to image front portions of the brain, including the frontal-lobe cortex and the striatal structures below it. The boys, 10 of whom had been diagnosed with ADD and 6 of whom had not, were instructed to press a button when they saw any letter of the alphabet except the letter X on a display screen. Because most of the letters were not X, each child built up a predisposition to press the button and needed to control his impulse to press the button when he saw an X. The task was expected to be, and in fact proved to be, more difficult for the boys with ADD, because poor impulse control is one of the disorder’s symptoms. Comparing the brain images later, researchers found a clear difference in the activation of neuronal tissue in two structures in the striatal region, which is known to be involved in motor control. The brain activation differences between the boys with ADD and those without were even more dramatic when the subjects were asked to perform the same task after taking the drug Ritalin. Ritalin is a stimulant medication used to temporarily relieve symptoms of ADD, such as inattention, impulsivity and hyperactivity. “Both the normal kids and the ADD kids got better in their impulse control when they had taken the drug,” Vaidya said. “Ritalin improved everyone’s performance, but how it actually did it differed in the brains.” The boys with ADD showed more activity in the affected striatal structures (specifically known as the caudate and putamen) when taking the drug than when not. The healthy boys, in contrast, showed the reverse - less activity in those areas when taking the drug than when not. “From past work with adults and children, some of which required injecting radioactive material, a consensus developed that it is the frontal striatal circuitry of the brain that is what’s not right with this disorder,” Vaidya said. “That is why we imaged this part of the brain, and our study confirmed that these structures are, indeed, important for ADD.” Ritalin primarily, but not exclusively, influences dopamine neurotransmission. The opposite effects of Ritalin on boys with ADD and boys without the disorder suggest that ADD involves atypical dopamine modulation in the striatum, she said. The researchers caution that the study was conducted with a small group and needs to be replicated with girls as well as with more boys before they can be certain they have found a universal neurobiological marker for the disorder. They also reported that they tried the experiment on three other boys who had not been diagnosed with ADD but who had siblings with the diagnosis. Two of the three siblings of ADD boys showed some Ritalin enhancement of the striatum, as did their affected brothers. “This would lend some support to the idea that ADD may involve atypical genetic influences on dopamine modulation,” Vaidya said, but more studies would be necessary to establish a genetic influence. Because of the widespread interest in ADD, the researchers also were careful to point out other limitations of their study. A fraction of people diagnosed with ADD have not responded to Ritalin treatment, and this study did not include such children, they said. It also did not attempt to investigate possible changes in brain activation that might occur with the drug over time. The ADD boys did show a different brain activation level when not on the drug, but all of them had been taking Ritalin previously as part of their ongoing treatment. Despite these limitations, the study points to new directions for research into brain function that could improve individuals’ performance. “This is one of the few studies to examine brain function in children, and to further our knowledge about normal and abnormal brain development,” Gabrieli said. “It suggests that FMRI is a powerful tool to examine brain and behavior in the context of both normal and abnormal development.” Currently, ADD impairs the function of an estimated 3 to 7 percent of youngsters in home and school, and the long-term consequences include lower educational and vocational accomplishments for them as adults as well as an increased risk for drug abuse and other risky behaviors. did it differed in the brains.” The boys with ADD showed more activity in the affected striatal structures (specifically known as the caudate and putamen) when taking the drug than when not. The healthy boys, in contrast, showed the reverse - less activity in those areas when taking the drug than when not. “From past work with adults and children, some of which required injecting radioactive material, a consensus developed that it is the frontal striatal circuitry of the brain that is what’s not right with this disorder,” Vaidya said. “That is why we imaged this part of the brain, and our study confirmed that these structures are, indeed, important for ADD.” Ritalin primarily, but not exclusively, influences dopamine neurotransmission. The opposite effects of Ritalin on boys with ADD and boys without the disorder suggest that ADD involves atypical dopamine modulation in the striatum, she said. The researchers caution that the study was conducted with a small group and needs to be replicated with girls as well as with more boys before they can be certain they have found a universal neurobiological marker for the disorder. They also reported that they tried the experiment on three other boys who had not been diagnosed with ADD but who had siblings with the diagnosis. Two of the three siblings of ADD boys showed some Ritalin enhancement of the striatum, as did their affected brothers. “This would lend some support to the idea that ADD may involve atypical genetic influences on dopamine modulation,” Vaidya said, but more studies would be necessary to establish a genetic influence. Because of the widespread interest in ADD, the researchers also were careful to point out other limitations of their study. A fraction of people diagnosed with ADD have not responded to Ritalin treatment, and this study did not include such children, they said. It also did not attempt to investigate possible changes in brain activation that might occur with the drug over time. The ADD boys did show a different brain activation level when not on the drug, but all of them had been taking Ritalin previously as part of their ongoing treatment. Despite these limitations, the study points to new directions for research into brain function that could improve individuals’ performance. “This is one of the few studies to examine brain function in children, and to further our knowledge about normal and abnormal brain development,” Gabrieli said. “It suggests that FMRI is a powerful tool to examine brain and behavior in the context of both normal and abnormal development.” Currently, ADD impairs the function of an estimated 3 to 7 percent of youngsters in home and school, and the long-term consequences include lower educational and vocational accomplishments for them as adults as well as an increased risk for drug abuse and other risky behaviors.

Additional and ongoing physical stimulation, such as is offered in interactive computer programs, could positively affect academic achievement by improving attention.

Bup .2001 Hz

Bup .5014 HzBup .8997 Hz

AP


A1

THE AMERICAN PSYCHIATRIC Association reported inattention to be the primary symptom of attention deficit disorder. As a result of this latest pronouncement, two subtypes were specified, nonhyperactive and hyperactive. Although children in both subtypes were assessed to be more impaired in some academic and cognitive areas, significant differences were discovered between the two groups. For example, Accardo, explored the relation- ship between ADD and learning disability and noted a higher incidence of diagnosed learning disability in the nonhyperactive group (85.7%) versus the ADD group with hyper-activity (67.7%). Goodyear and Hynd support support the contention that attention deficit disorder without hyperactivity is a more attention/cognitive/anxious type of disorder in contrast to the the more attention/behavior/ impulsive aspects of attention deficit disorder deficit disorder with hyperactivity. Barkley et. al. appears to corroborate this finding as he reported that ADD students/with hyperactivity hyperactivity are more likely to be assigned to to behavior disorder classes while ADD students without hyperactivity were more often placed in learning disability classes. Rourke furthered this discussion when he found that attention deficit disorder without hyperactivity displays a type of inattention symptomatic of nonverbal learning disorder, including math disabilities. RESEARCH SUPPORTS the hypothesis that children with learning disablities share symptoms with children having attention deficit without hyperactivity. Indications are that children with learning disabilities are more similar to those diagnosed with attention deficit disorder and no hyperactivity with respect to lethargy, social withdrawal, poor organizational skills and learning difficulties as compared to the more disruptive and aggressive aspects of attention deficit disorder.

ADDRouseHig SAR

2011 OCT 15 M 102Acc

Acq Tm: 16:03:36

SIZES ARE APPROX

ATTEN-TION

THE QUICK BROWN FOXJUMPS OVER THE LAZY DOG

1.012 2

3

1

The weight of each character being carefully balanced to decrease the competition for the reader’s attention between the letterforms and the background.

The weight of each character being carefully balanced to decrease the competition for the reader’s attention between the letterforms and the background.

C H A R A C T E R S P A C I N G W A S I N C R E A S E D S L I G H T L Y T O S U P P O R T T H E R E A D E R D U R I N G T H E I R A T T E M P T T O B U I L D U P T H E N E C E S S A R Y W O R D I M A G E S , A N D V E R I F I E D B Y M E A N S

Character spacing was increased slightly to support the reader during their attempt to build up the necessary word images, and verified by means of further user testing.

Copying or

mirroring shapes

should be

avoided to avoid

the ‘swirl-effect.’

Copying or

mirroring shapes

should be

avoided to avoid

the ‘swirl-effect.’

Copying or mirroring shapes should be

avoided to avoid the ‘swirl-effect.’

Copying or mirroring shapes should be avoided to avoid the ‘swirl-effect.’

THE USER RESEARCH outputs confirmed that ascenders (the upward strokes in letters such as ‘d’) and descenders (downwards strokes in letters such as ‘p’) should ideally be long to ensure their legibility. This, together with other factors, led Frensch to optimise respective character weighting as one of the key drivers of the project, with the weight of each character decrease the competition for the reader’s attention between the letterforms and the background. It was found that many of the issues relating to characters also applied to numerals, which were incorporated using similar criteria. Character spacing was in increased slightly to support the reader during their attempt to build up the necessary word images, and verified by means of further user testing. It was found that the standard answer to problems experienced by dyslexics of simply enlarging type sizes did not adequately address the issue, in fact it tended to emphasise the problem with dyslexics. Needing to be able to recognise individual letter images rather than the shape of the completed word form, particularly when the spelling is not phonetic, can and often does lead to guess-work. Alternatives to the ‘Read regular’ family, ie. Read regular, Read Smallcaps and Read Space are acceptable providing they adhere to similar design guidelines. Copying or mirror-ing shapes should be avoided to avoid the ‘swirl-effect’. Avoid the over-stylised. Italics and underlining are less recognisable. The use of capitals for large amounts of text is not recommended. The user research outputs confirmed that ascenders (the upward strokes in letters such as ‘d’) and descenders (downwards strokes in letters such as ‘p’) should ideally be long to ensure their legibility.

REGU-LATIONS

COMMON DUPLICATION REGION

AUTISM CANDIDATE REGION

PATERNAL EXPRESSION DOMAIN

MICROSATELLITES

cen tel

MATERNAL EXPRESSION

DOMAIN

5 cM

20Mb

6 cM

IC

21Mb

9 cM

22Mb

10 cM

23 Mb

12 cM

24Mb

15 cM

25MbD15S817

ZNF127

NDN

SNRPN

IPW

UBE3A

ATP10C

GABRB3

GABRA5

GABRG3

OCA2

D15S122

D15S540

GABRB3

15SCA-2

D15S511

D15S822

D15S219


Protocol: BAEP-L

vV/div (Aug)

0.25vV/div (Sto)

1

C1 Ch I

1.731.68

2.832.91

3.763.74

4.894.94

5.725.74

2.032.05

1.962.00

3.994.06

II III IV V 1-3 3-5 1-5

111 11ms

I

I

II II

IIIIII

IVIV

VV

G1-1 G1-2

ALPHA BRAINWAVES ARE SLOWER, AND HIGHER IN AMPLITUDE. THEIR FREQUENCY RANGES FROM 9 TO 14 CYCLES PER SECOND. A PERSON WHO HAS COMPLETED A TASK AND SITS DOWN TO REST IS OFTEN IN AN ALPHA STATE. A PERSON WHO TAKES TIME OUT TO REFLECT OR MEDI-TATE IS USUALLY IN AN ALPHA STATE. A PERSON WHO TAKES A BREAK FROM A CONFERENCE AND WALKS IN THE GARDEN IS OFTEN IN AN ALPHA STATE.

INDIVIDUALS WHO DO A LOT OF FREEWAY DRIVING OFTEN GET GOOD IDEAS DURING THOSE PERIODS WHEN THEY ARE IN THETA. INDIVIDUALS WHO RUN OUTDOORS OFTEN ARE IN THE STATE OF MENTAL RELAXATION THAT IS SLOWER THAN ALPHA AND WHEN IN THETA, THEY ARE PRONE TO A FLOW OF IDEAS. THIS CAN ALSO OCCUR IN THE SHOWER OR TUB OR EVEN WHILE SHAVING OR BRUSHING YOUR HAIR. IT IS A STATE WHERE TASKS BECOME SO AUTOMATIC THAT YOU CAN MENTALLY DISENGAGE FROM THEM. THE IDEATION THAT CAN TAKE PLACE DURING THE THETA STATE IS OFTEN FREE FLOW AND OCCURS WITHOUT CENSORSHIP OR GUILT. IT IS TYPICALLY A VERY POSITIVE MENTAL STATE.

THALAMUS

CEREBRUM

HYPOTHALAMUS

PITUITARY GLAND

PONS

PINEAL GLAND

CEREBELLUM

THALAMUS

CEREBRUM

HYPOTHALAMUS

PITUITARY GLAND

PONS

PINEAL GLAND

CEREBELLUM

THALAMUS

CEREBRUM

HYPOTHALAMUS

PITUITARY GLAND

PONS

PINEAL GLAND

CEREBELLUM

THALAMUS

CEREBRUM

HYPOTHALAMUS

PITUITARY GLAND

PONS

PINEAL GLAND

CEREBELLUM

Current studies concerning the co-occurrence, of attention deficit disorder and one or more learning disabilities are examined. Information is reported from four major aspects of the research: (a) statistical accounts of the prevalence of attention deficit disorder and the simultaneous occurrence of the two disorders; (b) subtypes of attention deficit disorder as they relate to learning disabilities; (c) findings and suggestions as to causes for the co-occurrence; and (d) educational implications based on current research. Research acknowledges that learning disability and attention deficit disorder (ADD) frequently co-occur. In addition to significant inattentiveness, impulsivity, and hyperactivity, primary characteristics manifested in children diagnosed as ADD include “learning disorder” and “academic underachiever” (Marshall & Hynd, 1997; Stanford & Hynd, 1994). Estimates of co-morbidity of ADD and learning disability range from approximately 20% (Javorsky, 1996) to approximately 50% (Riccio & Jemison, 1998). Estimates of reports vary, depending on the way learning disability is defined or ADD is assessed. While this rate of co-occurrence has led some to theorize that the two disorders share overlapping deficits (Marshall & Hynd, 1997), other research concludes that ADD and learning disability are separate and distinct entities that often co-occur (Riccio & Jemison, 1998). The purpose of this paper is to review the contemporary literature related to the cooccurrence of attention-deficit disorder (ADD), with and without hyperactivity, and specific learning disabilities. Factors common to children with either learning disability or attention deficit disorder as compared to common features of children diagnosed as having both ADD and learning disability are presented. Semrud-Clikeman (cited in Javorsky, 1996) postulated that it is the interaction of ADD and learning deficiencies inherent to learning disability and not a single factor of one of the disorders (e.g. attention) that produces deficits that result in lower academic achievement and specific disabilities. Webster, Hall, Brown, and Bolen (1996) agreed that while ADD subjects displayed information processing problems, the presence of learning disability increased the negative impact of the attention deficit. In 1980 the American Psychiatric Association reported inattention to be the primary symptom of attention deficit disorder, displacing hyperkinesis. As a result of this latest pronouncement, two subtypes were specified, nonhyperactive and hyperactive

CO-OCCURRENCE

CO-OCCURANCE

ATTENTION DEFICIT DISORDER LEARNING DISABILITIES

ADDRouseHig SAR

2011 OCT 15 M 102Acc

Acq Tm: 16:03:36

SIZES ARE APPROX

B1

A2

B2

AD

BA1

AA

C

D

B


Evidence from the last 20 years of work in cognitive psychology indicate that we use the letters within a word to recognize a word. Many typographers and other text enthusiasts I’ve met insist that words are recognized by the outline made around the word shape. Some have used the term bouma as a synonym for word shape, though I was unfamiliar with the term. The term bouma appears in Paul Saenger’s 1997 book Space Between Words: The Origins of Silent Reading. There I learned to my chagrin that we recognize words from their word shape and that “Modern psychologists call this image the ‘Bouma shape.’”This paper is written from the perspective of a reading psychologist. The data from dozens of experiments all come from peer reviewed journals where the experiments are well specified so that anyone could reproduce the experiment and expect to achieve the same result. This paper was originally presented as a talk at the ATypI conference in Vancouver in September, 2003. The goal of this paper is to review the history of why psychologists moved from a word shape model of word recognition to a letter recognition model, and to help others to come to the same conclusion. This paper will cover many topics in relatively few pages. Along the way I will present experiments and models that I couldn’t hope to cover completely without boring the reader. If you want more details on an experiment, all of the references are at the end of the paper as well as suggested readings for those interested in more information on some topics. Most papers are widely available at academic libraries. I will start by describing three major categories of word recognition models: the word shape model, and serial and parallel models of letter recognition. I will present representative data that was used as evidence to support each model. After all the evidence has been presented, I will evaluate the models in terms of their ability to support the data. And finally I will describe some recent developments in word recognition and a more detailed model that is currently popular among psychologists.

WORD RECOGNITION

THALAMUS

CEREBRUM

HYPOTHALAMUS

PITUITARY GLAND

PONS

PINEAL GLAND

CEREBELLUM

AD

DCDSLPCBSMC

AAAAAAAAAAA

DDBDDDPTTTT

ADDRouseHig SAR

2011 OCT 15 M 102Acc

Acq Tm: 16:03:36

SIZES ARE APPROX

ALPHA BRAINWAVES ARE SLOWER, AND HIGHER IN AMPLITUDE. THEIR FREQUENCY RANGES FROM 9 TO 14 CYCLES PER SECOND. A PERSON WHO HAS COMPLETED A TASK AND SITS DOWN TO REST IS OFTEN IN AN ALPHA STATE. A PERSON WHO TAKES TIME OUT TO REFLECT OR MEDI-TATE IS USUALLY IN AN ALPHA STATE. A PERSON WHO TAKES A BREAK FROM A CONFERENCE AND WALKS IN THE GARDEN IS OFTEN IN AN ALPHA STATE.

THETA BRAINWAVES ARE TYPICALLY OF EVEN GREATER AMPLITUDE AND SLOWER FREQUENCY. THIS FREQUENCY RANGE IS NORMALLY BETWEEN 5 AND 8 CYCLES A SECOND. A PERSON WHO HAS TAKEN TIME OFF FROM A TASK AND BEGINS TO DAYDREAM IS OFTEN IN A THETA BRAIN-WAVE STATE. A PERSON WHO IS DRIVING ON A FREEWAY, AND DISCOVERS THAT THEY CAN’T RECALL THE LAST FIVE MILES, IS OFTEN IN A THETA STATE--INDUCED BY THE PROCESS OF FREEWAY DRIVING. THE REPETITIOUS NATURE OF THAT FORM OF DRIVING COMPARED TO A COUNTRY ROAD WOULD DIFFERENTIATE A THETA STATE AND A BETA STATE IN ORDER TO PER-FORM THE DRIVING TASK SAFELY.

INDIVIDUALS WHO DO A LOT OF FREEWAY DRIVING OFTEN GET GOOD IDEAS DURING THOSE PERIODS WHEN THEY ARE IN THETA. INDIVIDUALS WHO RUN OUTDOORS OFTEN ARE IN THE STATE OF MENTAL RELAXATION THAT IS SLOWER THAN ALPHA AND WHEN IN THETA, THEY ARE PRONE TO A FLOW OF IDEAS. THIS CAN ALSO OCCUR IN THE SHOWER OR TUB OR EVEN WHILE SHAVING OR BRUSHING YOUR HAIR. IT IS A STATE WHERE TASKS BECOME SO AUTOMATIC THAT YOU CAN MENTALLY DISENGAGE FROM THEM. THE IDEATION THAT CAN TAKE PLACE DURING THE THETA STATE IS OFTEN FREE FLOW AND OCCURS WITHOUT CENSORSHIP OR GUILT. IT IS TYPICALLY A VERY POSITIVE MENTAL STATE.

Normal 14 year old femalelow theta wave activity.

Normal 9 year old malelow alpha wave activity.

ADD 14 year old female high theta wave activity

ADD 9 year old malehigh alpha wave activity.

INCREASING ACTIVITY

STANDARD DEVIATIONS

DECREASING ACTIVITY

3.00

2.70

2.40

2.10

1.90

1.50

1.30

1.00

-1.30

-3.30

-4.90

-2.30

-4.30

0.90

-1.00

-1.70

-3.70

-5.00

-2.70

-4.40

-1.90

-3.90

0.10

-2.90

-4.70

-2.10

-4.10

0.50

-3.10

-4.80

1

2

3

4


STANFORD NEUROSCIENTISTS have found a clear difference in brain functioning between boys who have attention deficit disorder [ADD] and those who do not, a step that could lead to better diagnosis of the most common developmental disorder of childhood. Follow-up studies will be required before the results of this study on a small number of boys can lead to brain-based methods of diagnosis, caution the lead researchers, Research Associate Chandan Vaidya and Professor John Gabrieli of Stanford’s Department of Psychology. Theirs is the first study, however, to show that Ritalin, the drug most commonly used to treat ADD, has different effects on the brains of people with and without ADD, and where those differences occur in the brain. The findings are reported in the Nov. 24 issue of the Proceedings of the National Academy of Sciences. THE STUDY IS ALSO the first to use functional magnetic resonance imaging [FMRI] in the study of ADD. This imaging method can show brain differences in individual people, instead of in averages of differences of two groups. This is critical for diagnosis, which has to be established on an individual basis. Unlike methods used in other studies of ADD, FMRI does not require injection or inhalation of radioactive substances. It relies instead on naturally occurring changes in brain function, which makes it appropriate for research and clinical purposes for children and adults. CO-AUTHORS OF THE STUDY are medical doctors Glenn Austin and Hugh Ridlehuber and school psychologist Gary Kirkorian of the Community/Academia Coalition in Los Altos, California and Gary Glover and John Desmond of the Stanford Medical Center’s Radiology Department. The findings have drawn considerable attention from neuroscientists because “ADD is so widespread, so controversial and confusing, and these are among the few clear findings in that field,” said Gabrieli, who heads the brain imaging laboratory where the research was done. Attention deficit disorder, which often includes hyperactivity, is currently diagnosed on the basis of subjective observations of youngsters’ behavior. If the new findings can be replicated, he said, it might be possible to make a biological diagnosis of the disorder by using FMRI. Since the common treatment for ADD is a prescription drug whose long-term effects on brain function are not known, parents and pediatricians most likely would welcome a more definitive way to diagnose the disorder.

BRAINACT-IVITY

ADDRouseHig SAR

2011 OCT 15 M 102Acc

Acq Tm: 16:03:36

SIZES ARE APPROX

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THALAMUS

CEREBRUM

HYPOTHALAMUS

PITUITARY GLAND

PONS

PINEAL GLAND

CEREBELLUM

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