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Old 11-26-13, 02:39 AM
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Can PLAY Diminish ADHD and Facilitate the Construction of the Social Brain?

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Abstract
The diagnosis of attention deficit hyperactivity disorders (ADHD) has been increasing at an alarming rate, paralleled by the prescription of highly effective psychostimulants whose developmental effects on growing brains remain inadequately characterized. One reason for the increasing incidence of ADHD may be the diminishing availability of opportunities for pre-school children to engage in natural self-generated social play. Pre-clinical work indicates that play can facilitate behavioral inhibition in growing animals, while psychostimulants reduce playfulness. The idea that intensive social play interventions, throughout early childhood, may alleviate ADHD symptoms remains to be evaluated. As an alternative to the use of play-reducing psychostimulants, society could establish play “sanctuaries” for at-risk children in order to facilitate frontal lobe maturation and the healthy development of pro-social minds.
Can PLAY Diminish ADHD and Facilitate the Construction of the Social Brain?





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Old 11-26-13, 02:44 AM
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Re: Can PLAY Diminish ADHD and Facilitate the Construction of the Social Brain?








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Old 11-26-13, 08:35 AM
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Re: Can PLAY Diminish ADHD and Facilitate the Construction of the Social Brain?

Whilst I agree all children should play since it's extremely beneficial for all aspects of their physical and mental health, the article doesn't really focus on the main aspects of ADHD, which are lack of attention and concentration problems, but just social inhibitions. Personally, I played as much as other children in my neighborhood and school, but I still have all symptoms of ADHD-PI. Also, certain issues may impair a child's social interaction even at a very early age. Again, I use myself as an example: having a lousy pronunciation of words and lacking good motor coordination, speed and agility, I was a lot worse than all other kids at games, something which damaged my self-esteem from the very first years of childhood.
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Old 11-26-13, 09:08 AM
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Re: Can PLAY Diminish ADHD and Facilitate the Construction of the Social Brain?

I need to shake their hand...

Quote:
Originally Posted by Corina86 View Post
Also, certain issues may impair a child's social interaction even at a very early age.
http://bjp.rcpsych.org/content/187/2/103.long
Quote:
A major challenge arising from the success of genetic research is to identify the neurocognitive processes that mediate genetic influences on ADHD.
http://www.ncbi.nlm.nih.gov/pubmed/1...eport=abstract
Quote:
The stability of the relationship between poverty and depression warrants the attention of caregivers and policymakers and raises new questions about strategies for the study of causal sequences.
http://www.pmbogusz.net/publications/12110466.pdf
Quote:
As time passes, the animal habituates to the environment
Intervene early with tools and positive outlet so the loops aren't solidified within. Touche!
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Old 11-26-13, 09:34 AM
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Re: Can PLAY Diminish ADHD and Facilitate the Construction of the Social Brain?

True! But this a whole different approach to just letting the kids play, which is what the first article that your posted suggested.

Last edited by Corina86; 11-26-13 at 09:53 AM..
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Old 11-26-13, 10:34 AM
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Re: Can PLAY Diminish ADHD and Facilitate the Construction of the Social Brain?

I fully appreciate Panksepp's research on play, and have often thought that it's kind of sad that there's a point in our lives at which, for example, we stop running around just for the fun of it, and need to have a purpose and a direction before we start running. However, I think that he's missing some of the additional factors involved in the social impairments to play that are touched on by the first article someothertime linked. That's really the only objection I have to this article (which looks like a meta-analysis being used to support a hypothesis, so its bias is more apparent than in some other meta-analyses.)

Some way down, Panksepp states:

I am not questioning the genetically-based temperamental variability that contributes to the diagnosis of ADHD, and the high efficacy of psychostimulants in reducing impulsive behavior (Faraone, et al., 2006). These are well-established facts. I simply assert that we have, at our fingertips, better social-emotional, maturation-promoting tools to address such problems than are currently widely used to promote childhood development at home or within school systems. At a societal level, we have yet to institutionalize the power of PLAY to promote desirable mind maturation.

This is an assertion without supporting evidence that immediately follows an admission of the existence of evidence-supported findings. Scientifically, not quite kosher. He then continues:

It is a common claim, scientifically undocumented, that following onset of psychostimulant medications, ADHD children become less playful, more adult-like. Such changes are reasonable since psychostimulants promote neo-cortical arousal, and the neocortex inhibits all primary-process emotional urges (Liotti & Panksepp, 2004). Primal playful urges are a subcortical birthright of animals (Panksepp, et al., 1994).

Are ADHD kids generally more playful than typicals? So far it has been noted that pre-schooler with ADHD, during free play periods, engage in less play activity than controls and that ADHD children engage in less social, more solitary play than typical children (Hubbard & Newcomb, 1991). Such findings are not consistent with the idea that untreated ADHD kids have elevated play urges, However, since social-learning occurs rapidly in play, these results may indicate that the social-overtures of ADHD type children have been too rough or primitive – too “rude” - leading normal kids to avoid play with ADHD-type children.

Have ADHD children received less social play in childhood? This has never been documented. But what if it turned out that a substantial percentage of ADHD kids currently receiving psychostimulants are simply normal kids who have excessive, unsatisfied desires to play, and ADHD symptoms would diminish with play supplementation? In our informal efforts to evaluate this, we (at the Memorial Foundation for Lost Children in Bowling Green, Ohio) routinely counseled fathers in families with young ADHD children to expend special effort to have daily periods of happy rough-and-tumble play with their children. Their feedback was consistently that such daily activities were beneficial.


My bold. Unfortunately, at this point, it becomes clear that a distressing amount of information here is undocumented, unscientific, and even self-contradictory. If there is documented, scientific evidence that children with ADHD are less playful and/or engaged in solitary play before they are ever medicated, how can that possibly lend support to the idea that psychostimulant medications negatively affect the ability of children with ADHD to play? If the social aspect of play is vital, but ADHD children have been excluded by their peers from social play because of their behavior, how does it benefit them to try to push them into more social play?


I'm not going to take apart the whole paper, but I did read it. . .and it's incredibly poorly constructed. Panksepp will recount a piece of evidence and follow it with a "What If. . ." proposition that frequently either contradicts the cited paper, or extends the findings to ADHD, which the cited research didn't cover. He makes an error that a scientist never should, and that is stating that he has found something in rats, so it's likely to be the same in humans. Small mammals are excellent for making preliminary findings and proof of concept, but it is absolutely wrong to assume that something that works in animals will work in humans - much less work identically in humans.


The sheer number of question marks alone in this paper are troublesome. Panksepp's ideas could be put to good use if he were not trying to skip past all the intermediate research that would be needed to test the validity of all the suppositions in this article.


After reading it, and reading the British Journal of Psychiatry article, and taking into account all the other research into ADHD of which I'm aware, I'm actually somewhat less supportive of Panksepp than I was before. He has some wonderfully appealing ideas, but if he makes statements like these without having done the work that would support them, it seriously weakens his position.


To my mind, play could indeed be put to use in helping ADHD children, but not for the reasons he supposes, or in the way he's found it to work in rats. Based on what we actually know about some of the reasons children with ADHD don't play the same way as most other children, it actually would make sense to engage them in more organized social play, rather than the free play he advocates. In his very own article, he makes the point that in free play, other children deliberately exclude those with ADHD, because they have perceptual differences that impair free play with others.


Many parents of children with ADHD have found that organized play has been one of the most beneficial activities for them - the rules, the hierarchy, the strategy, the desired outcome, etc., are all set out in advance. Their children have a better understanding of what do to, so they make fewer mistakes. They have their place in the group, which encourages socialization. Both process and goal are known to them, making it easier to focus during the activity.


In addition, while Panksepp doesn't demonize solitary play in this paper, solitary play has benefits as well, and a child with ADHD may benefit from being allowed as much solitary play as he/she needs, as long as it's part of a well-rounded experience that includes social interactions.

I'm afraid that if Panksepp wants to demonstrate his hypothesis that play (or PLAY) could diminish ADHD symptoms, he will have to provide a much better piece than this.
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Old 11-26-13, 11:47 AM
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Re: Can PLAY Diminish ADHD and Facilitate the Construction of the Social Brain?

Quote:
It is a common claim, scientifically undocumented, that following onset of psychostimulant medications, ADHD children become less playful, more adult-like. Such changes are reasonable since psychostimulants promote neo-cortical arousal, and the neocortex inhibits all primary-process emotional urges (Liotti & Panksepp, 2004). Primal playful urges are a subcortical birthright of animals
I thought it was pretty well accepted that kids with ADHD don't play as
well with their peers as they do with children younger than themselves,
and that they also enjoy interacting with adults more than NT children do.
It seems strange to link that to the use of medication when it's already
present in the ADHD child.
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  #8  
Old 11-26-13, 12:41 PM
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Re: Can PLAY Diminish ADHD and Facilitate the Construction of the Social Brain?

There's much more to be learned in this arena.

tc

Robert
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Old 11-26-13, 01:17 PM
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Re: Can PLAY Diminish ADHD and Facilitate the Construction of the Social Brain?

The thing to keep in mind about children's play is that is the way they process their world. We as adults use words and talk to make sense of our world, to bring experiences to manageable level where they can be processed.

Children use toys in a similar way and play as a way to make the abstract concrete. While we as adults talk it out, children play it out. Same purpose, different tools.

Children do not really have ability to talk things out. Verbal abstract reasoning begins to take hold somewhere around the age of 9 more or less. Below that, words and discussion do not have much traction for kids. It is a function of neurological development.

Look at a child's play. You will see them play out their experiences. This is how they make sense of their world. Watch them play out adult and adult/child situations. Watch them play out what they physically experience in life. It is fascinating and if you know what to look for, very informative.

I cannot overemphasize the role of play in children. It is an integral part of their development.


As a point though, it appears that Play Therapy alone has little or no impact on ADHD children. This is quite logical since it is a neurobiological disorder and as far as I know no therapy has much of an impact on this at least in children (I have not researched this specific issue in several years so something might have changed but so far I haven't seen it).

What Play Therapy can do is work with the emotional issues that can go along with an ADHD child's interaction with the world. If it is combined with teaching behavior management to the parents, a Play Therapy/behavior management protocol can be quite effective working with ADHD in children.

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Old 11-26-13, 01:39 PM
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Re: Can PLAY Diminish ADHD and Facilitate the Construction of the Social Brain?

You know, this reminds me of something I hadn't thought about in ages. When I was a child, and the school got a psychologist from the Child Study Center to work with me, a great deal of what she did was let me play - and observe my play and ask me questions about my play. At the time, I knew she was there to help me, and I knew she was tape-recording our time together, but what it meant to me as a child was that someone was letting me play without judging me, and she kept coming back twice a week, every week, regardless of what I did - no rejection.

I think that she was probably observing my play to learn what I couldn't express in words, and at the same time, making me think about what I was doing so that I could express myself and thereby better engage in social interactions.

I don't know how closely this would compare to actual "play therapy," since I was very young, but I do know that the intervention of this therapist was essential to my continuing in mainstream education instead of being wrongly placed in "special ed." It also helped me make and keep friends, which had been a major challenge even in preschool.
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Old 11-26-13, 02:24 PM
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Re: Can PLAY Diminish ADHD and Facilitate the Construction of the Social Brain?

I could be made to see that when the mind is not (di)stressed it is in a state of 'play' - and by this definition - I would agree that an absence of (di)stress is the mechanism for prevention of disorder component of ADHD.
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Old 11-26-13, 04:28 PM
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Re: Can PLAY Diminish ADHD and Facilitate the Construction of the Social Brain?

Allowing the children to change the rules, to fit their interest, is always a blast.








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Old 11-26-13, 06:38 PM
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Re: Can PLAY Diminish ADHD and Facilitate the Construction of the Social Brain?

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Originally Posted by Amtram View Post
Dizfriz

You know, this reminds me of something I hadn't thought about in ages. When I was a child, and the school got a psychologist from the Child Study Center to work with me, a great deal of what she did was let me play - and observe my play and ask me questions about my play. At the time, I knew she was there to help me, and I knew she was tape-recording our time together, but what it meant to me as a child was that someone was letting me play without judging me, and she kept coming back twice a week, every week, regardless of what I did - no rejection.

I think that she was probably observing my play to learn what I couldn't express in words, and at the same time, making me think about what I was doing so that I could express myself and thereby better engage in social interactions.

I don't know how closely this would compare to actual "play therapy," since I was very young, but I do know that the intervention of this therapist was essential to my continuing in mainstream education instead of being wrongly placed in "special ed." It also helped me make and keep friends, which had been a major challenge even in preschool.
Quote:
what it meant to me as a child was that someone was letting me play without judging me, and she kept coming back twice a week, every week, regardless of what I did - no rejection.
Yep this was play therapy. There are a number of different schools of Play Therapy but the good ones work with total approval, accepting children as they are without wishing them to be different in any way. That is the heart of effective Play Therapy and it all the benefits stem from that principle.

Thanks for posting this, you said it well.

Dizfriz

Last edited by Abi; 11-29-13 at 10:53 AM.. Reason: fixed quote
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Old 11-26-13, 10:05 PM
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Re: Can PLAY Diminish ADHD and Facilitate the Construction of the Social Brain?

I've done Play Therapy for nearly 30 years now (01/24/2014 will be 30 yrs. exactly). You

have to be acutely aware of the developmental stage of the child, and the resulting lags

involved. While an interesting idea, the "global" assessment that stimulants decrease

creative spontaneity in play, is (IMO) an over generalization; depending on age + meds.

None-the-less, an intriquing question to be raised. Thanks.

tc

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Old 11-27-13, 12:58 PM
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Re: Can PLAY Diminish ADHD and Facilitate the Construction of the Social Brain?

I am unsure which studies he cites when saying that stimulants reduce play. What I do know about the subject (including a paper he was an author on) is that ritalin reduces play in juvenile rats. I'll have to see if I can dig up the reference.

I sound like a bit of a broken record, but I have to point out again that while rats are an important model, it is very difficult to make direct translations between what occurs in rats and what is likely to happen in kids. Getting the dose of drug right is very hard, because rats have very different metabolisms than humans, and whatever work has been done has either been done in normal rats on Ritalin (ie no sign of ADHD) or, possibly, an imperfect animal model of the disorder that most likely mimics the symptoms in some way (say, hyperactivity) but not in others.
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