Tuesday, April 1, 2014

Izabela's second trip to the Wild West

I enjoyed my first trip into brain training, which I wrote about a few posts back. It was reasonably easy and felt like a success. My useful field of view improved quickly and I noticed a change in real life. Not surprisingly, I decided to do it again. This time it was working memory.

Now, working memory is my personal weakness. In the interest of full disclosure, I have a digits forward span of 7 and digits backwards span of 5. Visually, I can do a block span of 5 consistently, and repeat a sequence of up to 7 blocks inconsistently. I can reverse five blocks consistently, and 6 inconsistently. Not bad, somewhere in the Average range, but not great either.

In practice, this interfered a bit with my functioning. Telephone numbers had to be copied down in chunks of 4, and double-checked for errors. I could at times feel overwhelmed, for example when integrating information from multiple sources when writing complex reports. Yes, I know that this is normal, but I wanted a better function.
When report-writing, I needed more frequent breaks than optimal, and felt that my brain power got used up by about 3pm. And I developed a whole system for avoiding inattentive, 'silly' mistakes - very important to prevent in a private practice. Working at home and being interrupted by requests from Dear Daughter resulted in feeling overloaded and frequently snapping at her. Thus, I avoided working when she was not at school or asleep. The snapping also happened in the morning, during the school run.
Not an uncommon set of problems, really, but worth improving on. Especially that I could do my own training AND acquire Cogmed coaching credentials all at the same time and price. Mind you, the price was 1,500 and it did hurt the wallet.

So, I did the full Cogmed training, and it was tough. 45-60 minutes of major effort for 25 days. The effort was not that surprising - after all working memory tasks are by definition effortful. So I persevered, despite serious sweat running down my brow. I wonder, however, how one keeps ADHD kids doing these tasks. Now I understand the requirement of a training aide to supervise all the kiddie sessions, and a coach to call every week with feedback and reinforcing chat. Trust me, if you do Cogmed, or if you are a training aide you really need someone to coach and support you.

There are three versions of the program: for preschoolers, children and adults. The children and adult tasks are the same, apart from the interface - the adult interface is more boring. I chose the kiddie version and strongly recommend everybody does the same - when you are remembering multiple locations, it really helps if you are tracking aliens and clouds of toxic gas rather than gray circles to keep you amused. Also, exploding asteroids is fun.

One of the tasks was digits backwards. By the end of training I could reverse up to 11 digits (very occasionally, mind you). This was not auditory working memory - by this stage I coded some of these digits visually, some auditorily and some by meaning. Nevertheless, I believe that my actual auditory working memory store did stretch, if only by a digit or so.

Unfortunately, while I managed to get a pre-test (see results above) I had not much luck getting myself re-tested. I can just say that after the training I can hold in mind the entire 8 digits of a phone number or a credit card number when copying them onto various online forms. The training was in September, so if anybody wants to check this n=1 experiment for persistence of working memory effects, I'm game. We'd just have to think up some other task instead of digits backwards, as it was one of the tasks being trained.

Now, did the results generalise? I was expecting to be able to work longer without mental exhaustion, and that seemed to happen. I can now comfortably work until 5pm, and report writing became a bit easier. This is always nice, even if the effect was small. Whether this was an effect of Cogmed or placebo effect, it is hard to say. This levels of mental energy and being able to work a lot persisted till Christmas, but took a dip over the start of the year, when I got truly fed up with the heat. The mental energy is now coming back, but is not at the same level as in December.
Altogether, I am not sure that the cognitive effect of Cogmed were quite worth the money.

What I did not expect, was that the training would stop me snapping at Dear Daughter.  After about a fortnight, I noticed that I became overloaded increasingly rarely when interrupted something. By the end of the training, my snapping completely disappeared - I no longer lose my temper.  This effect, I am glad to say, is continuing to this day, and has not diminished.
Surprisingly, this effect, which I was not expecting, ended up to be the most worthwhile outcome of Cogmed training. I think that ultimately, this one was worth the money I paid.


Friday, January 31, 2014

Dictate your reports - a new option

I've been thinking of dictating my reports for a long time. Those of us who do it say that it speeds up the work. But somehow, I have never got around to buying Dragon Dictate, teaching it to understand my accented English and learning how to dictate, which is a skill in itself.

It seems that there is a new and free option for doing that for Mac users (with thanks to Les Posen, who sent the information in his email). If you have the new operating system (Maverics, free update from the app store), it includes a nice dictation software. Tap the fcn key twice, wherever you are, and you are ready to dictate.

The thing worked quite nicely, translating my accented English into good typing. It was even able to transcribe 'neuropsychology', neuropsychologist' and 'frontal lobes' correctly. It was a shame that temporal lobe ended up being a 'love', and it had some unusual ideas about 'stroke', but it is a good start.

Importantly, you can download extra software and all the transcription happens on your Mac, with no information being sent to the server - a good feature for ensuring privacy.

Worth having a try.

Wednesday, January 29, 2014

Q interactive rumours

I have received an email from the USA saying that WMS-IV, WIAT-III has become available. They also said that WISC-V will be available on iPad this year.

I have checked, and WMS-IV and WIAT-III have not yet arrived in Australia. But they are coming closer. I wonder how long it'll take them to cross the ocean?


Medical food for dementia

This is not exactly technology, but it feels to be geeky enough to include here.

Katie Kirby sent a great post about Souvenaid, which is marketed as a medical food for dementia, with the company claiming that it increases synapse production, thus helping with memory in the early stages of the disease. It comes in small bottles, like a flavoured drink, and is supposed to include fish oils and other goodies in just the right proportion to improve brain function. I have to admit that it sounds good, apart from the price, which currently hovers around $20 for a 4-bottle pack - very expensive as it is supposed to be consumed once a day for a long period of time.

Here are links sent by Katie:

The NPS (National Prescribing Service) has just published its analysis of 3 RCTs involving Souvenaid:

Response from Nutricia:

It strikes me that a synapse-producing supplement could be of much more use in a population that is not actively losing neurons. I wonder how long it will take HSC students to start chugging it.


Friday, January 17, 2014

Excellent autism detection video

I'm back from holidays and ready to do some posting. To start with, an excellent video on autism


This is a brilliant series of comparisons between normal toddlers and those with Autism Spectrum Disorder, with commentary highlighting the differences in their behaviour. Without doubt worth a look - the best training video I've seen in a long time, and only 9 minutes long.


Thursday, December 19, 2013

Latest news from Q-interactive

Pearson is sending out a new version of Q-interactive. There are two changes that may be of interest:

1. Q-interactive now supports an iPad Mini (for the examiner only) and iPad Air.
2. The manuals for all the tests are now available online.

Good changes.


Thursday, December 12, 2013

A low tech gadget to increase food intake in Alzheimer's Disease

Apparently serving food on red plates make DAT patients eat 25% more. That is a lot! The simple explanation is that they can see the food better because of better contrast. For some more information, follow the link:


A bonus goodie: a blog on caring for somebody with Lewy Body Dementia
(yes, that's where I found the red plates)