ADHD Medications Should Target Working Memory
Current ADHD diagnostic labels miss the point: Appearances don’t address underlying Function. Function addresses an activity – more to the point. Labels remain static, based upon observation, and most often fail to engage the patient in discussion regarding their own working memory objectives.
Leaving the patient’s insights, regarding their own working memory capacity, out of the clinical discussion renders inadequate definition of treatment objectives – inadequate ADHD treatment.
But metacognition does matter.
The result of not thinking: no metacognitive activity, no learning process, no improvement in working memory in the treatment process itself. Self observation remains neglected, or simply not encouraged, and overlooked. Passivity in treatment with diminished responsibility for self remains the standard of care, in fact encouraged through default by mindless label chasing.
Too many aren’t paying attention to working memory opportunities in treatment – at every new evaluation, every medication check.
What separates us humans from cows, horses, elephants, and even good hunting dogs is working memory. We have it, they don’t – or they only have it in a limited context of the real world. These three attributes briefly summarize how our [prefrontal cortical] working memory functions:
- Think: We see the problem, identify that reality as a problem through working, cognitive tagging.
- Act: We address the problem and take corrective action.
- Remember: We carry that corrective action into the next day, thus learning from inaction or previous mistakes – supporting metacognitive development.
Working Memory Timing: Synchronization
After recognizing that thinking, acting and memory all work together, in sequence, it easy to see how they can become ineffective through desynchronization. In New ADHD Medication Rules I describe in detail the easy, clinically-recognizable symptoms of desynchronization that more specifically identify ADHD challenges with working memory in the prefrontal cortex.
- Acting without Thinking – Impulsivity
- Thinking without Acting – Cognitive Anxiety
- Not Thinking and Not Acting – Denial/Avoidance
Reality continues to change, context matters, and with compromised working memory those with ADHD remain out of touch with effective change, effective timing.
Easily recognizable, right? Stay tuned for more details here at ADHD Insights.