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  #1  
Old 07-31-05, 04:01 PM
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Inattentive adhd may be it's own disorder and when I recently saw Russell Barkley he indicated in all likelihood it will be identified as a unique disorder. The current term being used is SCT or sluggish cognitive tempo. People with "true" SCT are born with this temperament and don't change into it from combined or hyper adhd. SCT are supposed to have more difficulties processing information and are more prone to making mistakes then ADHDers. There is very little info on SCT.


Here are two bits of further reading. Would love to read more if anyone has an online source.
From Barkley-> "As noted earlier, evidence is mounting that the predominantly inattentive type of ADHD (ADHD-PI) may be comprised of a rather heterogeneous mix of children, a subset of whom have a qualitatively different disorder of attention and cognitive processing (Milich et al., 2001). This subset is probably not a subtype of ADHD but may represent a separate disorder (Barkley, 1998, 2001; Milich et al., 2001), manifesting a sluggish cognitive style and selective attention deficit, having less comorbidity with oppositional and conduct disorder, demonstrating a more passive style of social relationship, having memory retrieval problems, and, owing to their lower level of impulsiveness, probably having a different, more benign, developmental course".
http://www.continuingedcourses.net/a.../course003.php

and....

"however, there is some research in support of a higher rate of learning disabilities in children with ADHD,IA".

From ->http://www.kidsource.com/LDA-CA/ADD_WO.html
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Old 07-31-05, 11:30 PM
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I don't think anyone is suggesting that ADD-I is a separate disorder, rather, that SCT is a separate disorder. In other words, SCT is a similar disorder in its manifestations and executive deficits, but has it's own defining characteristics, which may have important implications for treatment and course.

The research suggests that SCT is a small percentage of actual ADHD diagnoses. Just a little clarification
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Old 08-01-05, 12:33 AM
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Quote:
Originally Posted by relvinnian
I don't think anyone is suggesting that ADD-I is a separate disorder, rather, that SCT is a separate disorder. In other words, SCT is a similar disorder in its manifestations and executive deficits, but has it's own defining characteristics, which may have important implications for treatment and course.

The research suggests that SCT is a small percentage of actual ADHD diagnoses. Just a little clarification
SCT = ADHD innattentive subtype (who were always that way and who don't fall into the innattentive subtype later in life. They are not combo or hyperactive ADHDers whose symptoms decrease and who consequently now fit the DSM-IV critera of innattenive). SCT's are seen as being mentally "foggy" or daydreamers and who often lose their attention because they can't process information fast enough. I believe I am one as my report card clearly indicates although I don't know if "not owning the deed", is a symptom.

Are we on the same page?
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Old 08-01-05, 06:10 AM
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Comparing SCT to non-SCT inattentiveness:

http://www.m-net.co.il/english/lifes...alth/adhd.html
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Old 08-01-05, 10:17 AM
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I am a bit skeptical about SCT, at least how it's currently defined. From the link posted above: http://www.m-net.co.il/english/lifes...alth/adhd.html

Subtype C: Sluggish cognitive type (or SCT)

Day-dreamy, foggy, easily confused, has trouble focusing. Canít discern whatís important. Information-processing problems.

Passive, lethargic, hypoactive, not at all impulsive. Shy, withdrawn, passive, uninvolved.

Productivity is okay but problems with accuracy.

Does not respond well to stimulant medication; may respond to social skills training and cognitive therapy.

Out of all the Inattentive subtypes, this one seems to fit me the best, I've always had it, I've never had hyperactivity as far as I can recall (back to age 3). However, some parts don't quite fit, for instance, I'm not easily confused or 'foggy'. 'Can't discern what's important' - I have difficulty acting on whats important, however I can discern it. 'Productivity is okay but problems with accuracy.' - again, it's the opposite for me. Accuracy is ok, but I have problems with productivity. And as for 'does not respond well to stimulant medication' - I've had some success with stimulants, still in the 'trying to get the dose right' stage.

Maybe there is an undiscovered inattentive subtype 'E' not on that list?
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Old 08-01-05, 10:52 AM
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Nope, no undiscovered subtype E .

That article looks to be inaccurate although for the most part factual. Four subtypes? Also these symptoms also seem exaggerated or wrong; "easily confused, canít discern whatís important, good productivity, and does not respond well to stimulant medication".

Remember that SCT is not a true designation. It has not been recognized as such and really the acronym is just a heck of a lot shorter then saying..."ADHD inattentive subtype (who were always that way and who don't fall into the inattentive subtype later in life. They are not combo or hyperactive ADHDers whose symptoms decrease and who consequently now fit the DSM-IV criteria of inattentive)"

There are also not two types of SCT since it is only a designation at this point. So no SCT and non-SCT inattentiveness:
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Old 08-01-05, 11:14 AM
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But the 'ADHD inattentive' description fits me perfectly, but when you break inattentive down into four subtypes, suddenly those subtypes don't quite fit me right.


I have SCT traits, but other inattentive subtype traits as well. Since this classification is so new, I have to wonder if it's not completely accurate yet (as previous classifications weren't). Hey, nobody studied me in order to come up with these classifications
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Old 08-01-05, 11:55 AM
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Quote:
Originally Posted by scuro
There are also not two types of SCT since it is only a designation at this point. So no SCT and non-SCT inattentiveness:
I was only discerning SCT from anything else that featured inattentiveness, including ADHD combined.
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Old 08-01-05, 12:33 PM
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I thought this was an interesting question and needed its own thread.


From a talk by Barkley in 2000:
http://www.schwablearning.org/pdfs/2...f?date=4-12-05

Quote:
First of all, in that group are the true Inattentive kids. But also in that group are AD/HD children who came in one symptom short of being in the Combined group, right? Theyíve got six inattention and five hyperactive symptoms, and according to the DSM, if they donít have six, theyíre not in the Combined type. Well, yes they are, and you should think of them as being Combined type children, even if they come up one symptom short. Donít put those kids into the Inattentive group. The Inattentive group in our clinic is for kids with three symptoms or fewer off of that Hyperactive-Impulsive list. Any more than three and youíre better off thinking of them as what we call sub-threshold Combined type children.
Thereís another group, the group that starts out being in the Combined type and by adolescence or adulthood are no longer so hyperactive, but they meet the criteria on the Hyperactive list. Now you would flip them over into the Inattentive type. Donít do it. You always think of them as Combined type. So, bottom line is this: If any point in your history there was a whiff of problems with inhibition and impulse control, youíre a traditional AD/HD Combined type kid. . .

And you reserve this Inattentive group for kids who have never in their lives had trouble with inhibition. Those are the spacey, daydreamy, confused, in a fog, sluggish, hypoactive . . .
Here Barkley suggests that there's not four types, but three and Inattentive is a separate disorder.

Quote:
There are only two pages in my parentsí book, Taking Charge of ADHD, on this group, and it tells you . . . [t]his is a different disorder. Stay tuned. We donít know what to do with them. Itís up to you. Youíre just going to have to cobble together some help any way you can and hope that it works, because there is no science beyond what I just told you.
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Old 08-01-05, 01:24 PM
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I buy that, Stan.


It sucks to be on the cutting edge of Science. The regular Adhders have had a good med for 50 years!

3,5,...10 years down the road I'm sure they will have a better SCT drug. I'm 44....dang....how long do I have wait?
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Old 08-01-05, 08:10 PM
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Ouch! Watch that cutting edge, Scuro.

Better to be behind the edge than in front of it, eh?


I like this Barkley. He's seems to be asking the interesting questions.
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Old 08-01-05, 08:47 PM
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Quote:
Originally Posted by UnleashTheHound
But the 'ADHD inattentive' description fits me perfectly, but when you break inattentive down into four subtypes, suddenly those subtypes don't quite fit me right.


I have SCT traits, but other inattentive subtype traits as well. Since this classification is so new, I have to wonder if it's not completely accurate yet (as previous classifications weren't). Hey, nobody studied me in order to come up with these classifications
that would be me, too. although i have had impulsive moments .... few and far between, but enough to get me in trouble...
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Old 08-01-05, 09:15 PM
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I was dxed as ADHD-primarily inattentive, and none of the SCT symptoms quite fit. On the contrary, my way of processing information seems to outstrip others more often than not (e.g. I think of something and it takes a while for others to catch on). I'm not 'sluggish', really, or too dreamy for that matter.

But at the same time, I also have my hyperactive moments and it's entirely too easy for me to hyperfocus on things that may matter to me, but aren't critical at the moment. And impulse control has always been a problem for me (case in point: deciding to put a very hot pan with oil in it under a stream of cold water). Methylphenidate has worked quite well for me, so I think that not all primarily inattentive ADHDers have SCT. There are still ADHDers who are mostly inattentive but would qualify for the ADHD label more so than the SCT one.
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Old 08-01-05, 09:23 PM
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Quote:
Originally Posted by pembroke
that would be me, too. although i have had impulsive moments .... few and far between, but enough to get me in trouble...
Yeah, I went back and looked at the diagnostic criteria for combined/hyperactive/impulsive. I see you need to meet 6 of the criteria to be diagnosed with those types. I meet maybe 3. Hyperactive? never, fidgety and squirmy? yes. Impulsive? occasionally. I had a roommate in college who was probably the poster boy for impulsive ADD, I was nothing like that.

So I think it might be some years of revision before they get this these subtypes nailed down right
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Old 08-01-05, 09:33 PM
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Quote:
Originally Posted by sin nombre
I was dxed as ADHD-primarily inattentive, and none of the SCT symptoms quite fit. On the contrary, my way of processing information seems to outstrip others more often than not (e.g. I think of something and it takes a while for others to catch on). I'm not 'sluggish', really, or too dreamy for that matter.
I'm the same way when it comes to processing information, but I was very daydreamy in school or even in boring meetings. So while there may be such a thing as SCT that is distinct from ADHD, I worry that the critera isn't defined completely right, and may put real adhd people into the SCT group, and they might not receive medications that can help them.
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