The Adventures of Fundi Intervention Based on the Cognitive and Emotional Processing in Attention Deficit Hyperactive Disorder Patients

Summary

This protocol illustrates a remedial therapy based on inductive learning and indirect communication (Ericksonian metaphorical hypnosis) that can be applied to children with Attention Deficit Hyperactive Disorder (ADHD). Particularly, this protocol is intended to test the effectiveness of a go/no-go decision task. Neuroscientific rationale is presented throughout the text.

Abstract

Many children with attention deficit hyperactive disorder (ADHD) are known to have executive dysfunction, which weakens their abilities to learn and behave in daily living. This protocol describes the methodology that is required for the intervention (psychotherapy) based on planning, attention, successive, and simultaneous (PASS theory) cognitive processing and fear emotional processing. It provides guiding principles and practical recommendations. A disproportionately high level of fear (dysregulation) increases the vulnerability for dysfunction in learning and behavior. We explain the interplay between emotion and cognition at the neurological level.

A go/no go task (The Adventures of Fundi), which involves decision making, is administered in a PC- mode to a sample of 66 ADHD subjects. The Adventures of Fundi, a computer program, was constructed to induce successive or simultaneous processing when involving the training of planning and selective attention. It aims to improve the executive function with planning and selective attention. If executive function improves, learning improves, and behavior ameliorates. After intervention over 6 months, remission was achieved in 70% of subjects.

The instructor encourages the use of appropriate strategies and points out the ways in which the strategies can be useful in finding the solution to the problem (go/no go). The emphasis is not on rehearsing and adult instructed verbal sequence. The verbalization may reveal the conscious verbalized strategy to solve a task that is not really the strategy being unconsciously used in that case. A self-verbal report is unreliable. This is an inductive learning rather than deductive rule-learning approach central to cognitive PASS training. This inductive training has proved to produce not only near transfer but also far transfer.

Noncognitive factors (emotional factors) must be considered to maximize the benefit of cognitive training. Indirect and metaphorical communication considers the emotional factor.

Introduction

Decision making is linked to the behavior and most behaviors implies decision-making. Decision making, and, also learning, involves both cognitive and emotional processing. The cognitive processing can be conceptualized and assessed according to the planning, attention, successive and simultaneous (PASS) theory of intelligence^{1,2,3,4,5,6,7,8,9}. According to PASS, any be....

Protocol

The protocol follows the guidelines of Fundació Carme Vidal human research ethics committee. Inform consent was obtained.

1. Recruitment of the subjects

NOTE: Recruitment was performed as per the previously published literature¹².  

1. Recruit children with ADHD without comorbidity. In the present study, 66 children, aged 13-15 years, mean 13.89 years with SD ± 0.8, 47 males and 19 females, were recruited. Have trained psychotherapists (qualified in psychology) or psychiatrists perform the procedure of recruitment.
2. Get informed consent from the patie....

Results

A random, prospective, longitudinal, uncontrolled, analytical study (before – after) was designed. We recruited 66 pharmacologically untreated combined ADHD children according to DSM-V criteria, aged 13-15 years with a mean of 13.89 years with SD ± 0.8 (47 males and 19 females). They also met ADHD criteria according to SNAP-IV-18. Statistical analysis was conducted using a paired Student t-test and effect size statistics (Cohen’s δ) was applied.

All 66 children in the stu.......

Discussion

As expected, the training, Adventures of Fundi, was useful to intervene in ADHD behavioral dysfunction based on both the PASS cognitive processing and self-confidence emotional processing. The success is in terms of better cognitive processing and better behavior. The better cognitive processing is mainly in planning and not so much in attention (Table 1). PASS planning and selective attention join the executive function. It is well known that a better executive function is associated with a better behav.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
The Adventures of Fundi	Fundació Carme Vidal Xifre de Neuropsicopedagogia	---	The "Adventures of Fundi" has been designed with the objective of helping to improve the concentration, attention and control of impulsivity for Secondary Education students and it is also possible to apply it to Students in the last cycle of Primary Education. To execute the "Adventures of Fundi" a browser with internet conection is required.
Computer with internet connection and browser	---	---	Mozilla, Firefox, Chrome or Safari