So what's the problem?

No brain training yesterday.  I woke up late, had some other things to attend to, and then A-One received a phone call from his work to come in earlier.  He handled the phone call very well, saying that he needed to look up the bus information to work out how to get there by that time. He couldn't remember the address of where he worked, so I suggested he look at Google Maps to see if he can recognise it from the map, which he did.  I saw him call up the transport website ('I know, Mum') and enter the 'to' address (checking with me), and figured out which bus he had to catch and when.

A year ago, he hadn't able to do that, or perhaps had been unwilling to.

This morning he resumed his Lumosity training - resplendent in his PJs (I didn't have time to argue the point today).  Again he showed the same steady improvement since he started, gaining a couple of PBs and dropping his score a little in others.  He is now in the 12.7th percentile for his age group, and is almost at the 30th percentile for speed!  So how does that correlate to his feedback that he was too slow at work the other night?

His lowest area is still problem solving, at 2.6th percentile, while all the others are over the 10th percentile.  The problem solving game is all mental arithmetic, and for a generation used to using calculators, I'm not sure that this really tests out problem solving ability in real life. 

I do the Lumosity training too and my problem solving score is much higher, but I think that's because when I was at primary school we were drilled and drilled in our times tables and number facts, so I'm not 'working it out'; instead remembered facts simply pop into my mind.

The neuropsychologist suggested we try mind mapping with him. Is that a compensatory strategy, or does it exercise the problem solving part of the brain?


He zoomed through another page of 3-handed clocks, but would not do another page. 'Only one page a day, that's all!'  He was about to leave, when:

Mum: Wait a minute.  There's something else today.  I want you to read this paragraph and tell me what you think the central point of it is; what it's about.

A-One: This isn't necessary.

Mum: How about we see that?

Perhaps he was too keen to get on to other things too, because he didn't argue the point much either, and proceeded to read the paragraph.  He took longer than I did (reading it upside down) and reached the end of the page which was mid-sentence, showing all the signs of having finished.

Mum: It goes over the page. The paragraph ends here, see?

A-One: I'm reading to the end of the sentence, not the paragraph.  That's all!

Being obvious that he would proceed no further, I asked him what he thought it was about.  He was able to tell me very well, and when I asked a specific question, he answered that very well too.

I'm starting to wonder whether his impairments are more to do with attitude and motivation.  My next thought is to have him sit with me while we peruse accommodation advertisements and household bills, so that he gains some sense of what independent living requires.  We're not trying to turf him out, but we won't be around forever either.

I don't need to turn the music off!

I noticed that A-One was still up at his computer at 2:37am this morning, and he still had some washing up after dinner to do which would make his going to bed time even later (not an unusual occurrence)!  Again I had no idea what time he went to bed.

So this morning when I had some other things to do, I let him sleep - to give him the best chance of working well on brain training after adequate sleep.  (He had done the washing up.)

Late morning my husband called and after a brief conversation I mentioned that I was about to wake A-One.  'Good luck', he said.



A-One rose willingly enough and we talked about his next steps for today: breakfast, shower, dress, brain training.  He came down for breakfast and turned on a James Bond movie while he ate (including last night's uneaten dinner).  When I saw his empty plate, I reminded him about the next step.  He decided he'd shower later at his 'usual' time.  I asked him to give me a hoy when he was dressed.

After about 15 minutes (or so it seemed to me) I called out to him.  'Wait a minute!', he said. Fairly soon though he came downstairs, opting to work in the study today instead of his room.

As we were about to begin, I noticed that he had a YouTube music video playing as he brought up the Lumosity login screen.

Mum: Better turn off the music while you work.     

A-One: I don't need to turn the music off!

Mum: It's important to be free from distractions while you work on your brain training.

A-One: It doesn't distract me.

Mum: How do we know that?

A-One: It doesn't!

Mum: How about we prove that?

A-One: I don't need to turn it off!

Remembering that he had had headphones on for all the other brain training this week, thinking it was to help him hear any sounds related to the brain training, I asked him whether he had had music on the other days.

A-One: Yes.

This revelation put me off balance.  Freedom from distractability is part of being able to stay on task!

Mum: Will you try it without music just for today?

A-One, closing the music clip: There! You happy now?

There were a few more 'stupid' comments today ... the game of course, not A-One!  He did much better on the vowels game now that he knows what they are. He's doing really well with the cafe orders, remembering everyone's name and giving all the correct orders.  The good news is that while some of his scores were not his best, his overall comparative results show no category now in the 1st percentile!  Today, memory and attention showed as his strong areas. 

I Googled for the effect of music on cognitive performance.  Several results came up, a recent one being http://www.usatodayeducate.com/staging/index.php/campuslife/should-you-listen-to-music-while-you-study. 

So should I argue the case again tomorrow?

I might just ask him what music he plans to listen to, and then our negotiation might be on the choice of music instead.  I imagine that calming instrumental music, rather than music with lyrics might be a better choice, especially when doing any language-based exercises.

We got started today!

A-One and I started today with Lumosity. 

He had asked me to wake him when I woke up.  So I did.  I woke him, went for my shower ... then woke him again.  He was surprised when I told him that I'd woken him once already.

Nevertheless, I took it as a sign that he wanted to start his brain training.  He had a couple of other jobs to do and thought we'd be doing the brain training 'later', but I reminded him that important things get done first.

First we needed to set the priority of areas of training.  I retrieved the neuropsychologist's report and suggested an order.  He accepted 'speed' as top priority.  I wanted to put 'attention' as next priority, but he wanted to put 'memory' second.

Mum: Can you tell me why you want to put 'memory' next?

A-One: I just do.

Mum: Can you tell me what you hope to be able to do if you improve your memory?

A-One: So that I can remember things faster.

Mum: Do you understand what 'memory' means for these exercises?  It's not like 'what was the last movie you saw' or 'when did you last meet up with your friends', it's more like 'tell me your birthdate backwards'.

A-One: We're not changing it.

So ... we didn't change it.

A-One didn't take a lot of time to read all the instructions carefully; he was happy to get into the games.  The things I like about Lumosity are:

• whatever the results, it's affirming - and compares results to personal bests (PBs)
• its look and feel suits adults

While A-One was happy enough to do the games, he wasn't interested in any extension work today.

We looked at his results compared to others in his age range, and I explained to him what that means.  His results today put him in the lowest 1st to 10th percentile in his age range, but I explained to him that what is important is how he tracks against his PB - and he had improved since the trial we'd done a couple of weeks ago!

With a numerical exercise game I wondered whether he was mentally calculating the answers or remembering the number facts.  He said he was doing the counting mentally in his head as fast as he could (as I had suspected). 

I told him another way to do 9+ sums by turning them into 10+ sums, because 10+ sums are often easier.  While I still had his attention, I put out 14 toothpicks: 9 toothpicks, 5 toothpicks.  I moved one toothpick to make 10 toothpicks, 4 toothpicks.  And he said: So if it's 9+3, you can make it 10+2!  I said 'Yes! Had you known about that?' He said 'No'. 

I was thankful for two things today:

• A-One was willing to look at the toothpicks with me, even though he'd finished his 15 minutes of brain training today
• He got it!

Assessments

With our growing concern at the prospect of long term unemployment, earlier this year we took A-One to a neuropsychologist for some vocational guidance. She did some assessments with him, which essentially validated the same impairments that tests had revealed when he was 12 years.

At that time he was diagnosed with Pervasive Development Disorder - Not Otherwise Specified(PDD-NOS) at the mild end of Austistic Spectrum Disorders (ASD). To me that seemed to mean 'I Don't Know', so it wasn't very helpful to us in finding appropriate help, although we had done speech, physio and occupational therapy with him when he was little.


Nevertheless the educational psychologist working with him when he was 12 did some emotion face recognition work with him, and helped him with strategies to respond to bullying.

Today, I think he is sensitive to others' emotions and can respond to them, but not necessarily with a great deal of nuance.