Executive Functions, The New Homunculus

Remember that little guy inside the brain of a character in some cartoon of long ago, Disney sticks in mind, that was working the elaborate machinery that made the guy go.  It was pointed out to us that nothing was explained when you explained human activity by saying there was just another little human inside generating all the human behavior.

That little guy was called a Homunculus.

 But the problem of explaining human behavior remains–is it really just a manner of stimulus, response, consequence as argued by mainstream Psychology since 1913? (John Watson’s original article)?

Over the last 30 or so years a replacement for the homunculus has been developed and we call it the Executive Functions of the brain.  People (Psychologists) have been using the term to mean all kinds of human behaviors, from problem solving to self regulation in general.

Slowly but surely consensus has been converging on the basic componenets of the Executive Functions and, in fact, Russell Barkley has proposed a simple model that provides a nice map for directing assessment and rehabilitation strategies for those with Broken Brains.

He argues that the foundation of the EFs is the inhibition system.  Until an individual is able to stop his ongoing behavior(s) (or, prepotent responses as they say), and resist distractions, the executive functions can not begin to develop.

Immediately, one asks:  Well, how does inhibition occur?  Barkley focuses on the fact that Ritalin, a Dopamine re-uptake inhibitor, facilitates inhibition and promotes EF development in children and adults.  But where does inhibition come in the first place?  Grey, a personality theorist argues that one of the five main neuronal circuits in the frontal lobes is in fact a Behavioral Inhibition System that can be under-activated (ADHD) or over-activated (Depression.)  I will talk about that model in another post.

Another model that I will talk about in another post is Anthony Damasio’s notion of the somatic marker as the key for triggering the BIS.  Stay tuned,

When inhibiton is activated, according to Barkley, a sensory memory system begins to develop (visual memory and auditory memory.)  He calls this system the Working Memory.  The working memory is the palette upon which everything else is constructed and translated into action.

As language develops, it can use the WM palette to construct longer and longer strings of words and symbols, self talk, to make plans and delay gratification.

And as self talks develops, the individual learns to control emotions more effectively.

He then argues that with self talk, working memory and emotional controls in place, problem solving skills can be practiced covertly.

Of course, my description does not do the model justice and I refer the reader to Barkley’s work.  He is a very good writer and if you get the chance to see him speak, I wouldn’t miss it–he is an excellent speaker.

The most recent version of his Handbook came out in ‘05 and you can review at Amazon.  (I can’t seem to get the link in my post yet.)

In case you think I am a starry eyed grad student who is enamored with a new find, well I have been interested in the problem of consciousness and attention since I was a graduate student in 1968 and I am pretty dry eyed now.  I am enthused because I have been working with the developmentally disabled and traumatically brain injured for my whole professional career (34 years) and I am finally starting to see real results in cognitive rehabilitation, especially in attention training (the other way of saying inhibition training) and memory training. 

Comment on!  I am just getting started!

Teaser:  What do you think of computer rehabilitation programs?

Welcome to The Dance!

I am a Neuropsychologist working with brain injured and developmentally delayed adults in Western New York (near Buffalo).

I created this blog as a platform for promoting the use of brain injury tools, “cognitive rehabilitation,” with the DD population.

Change of this sort will face bureaucratic resistance and will require a great deal of organized information to counter the many “why we can’t” reactions. 

Accordingly, I hope to build this site to become a stop-off point for those:

 Who want to comment;

Who want to look for research;

Who have experiences to share in teaching cognitive process;

Links to other Blogs and Websites related to this effort;

Finally, I want to use this Blog to promote this paradigm shift in the way we teach those born with cognitive deficits.

I am new to blogging and beg your indulgence.  For example, I am also making this a page at the top of my blog so that folks down the line can see what I hope to do with it.

I hope this page can grow to be more helpful to those of us in the trenches and so I am open to comments on both the topics and the page itself.  

I am sorry if registering is inconvenient but there are a lot of folks (do I need to label them?) who seem to have too much time on their hands and too little self control. 

Thanks for the visit and I hope to hear from you!

Why ‘Dance of the Broken Brain’?

I am using this title for this Blog (and my work) for several reasons:

1. It is easy to remember. I suppose I could have called it Addressing Variations on the Ontogeny of Genetic Dysmorphisms. But, that title makes my hair hurt.

2. It emphasises the dynamic interaction of the many components of the brain.

3. As in a dance, the interaction changes as the music of the environment, the person’s needs, and the person’s history changes.

4. The dance does not stop when the brain is compromised, it continues but in a different manner.

5. As we begin to identify the various forms of the Dance of the Broken Brain, we can begin to better focus the emphasis of rehabilitation.

6. Because I work primarily in the field of developmental disabilities, I want to emphasize that the brain is compromised (broken) by way of the disability and not just slowed down, “retarded,” or delayed. (Of course, the results of the break will ’slow’ down processing and output but you are not going to fix the problem by addressing the effect of the disability as opposed to its cause.)

7. I use the word ‘Broken” because of the implication inherent in the word that broken things can be fixed!

8. Finally, by emphasizing the fact that the brain is broken, I hope to prod state regulators into making accommodations for including time to teach cognitive processes in day programs. At present, it appears that the emphasis has to be on teaching only functional skills, e.g., setting the table, using public transportation, getting dressed, etc. Hmm, While we could provide cognitive rehab as a clinical service, it is important that it be provided on a daily basis. Any comments from New Yorkers or others with more progressive regulations?

Thanks for your patience: I have a tendency to soap-box and rant!

As will be my continuing encouragement, comments are welcome.

Bob

Purpose of the Dance !

The purpose of this blog is to provide a forum for those of us who want to begin using focused cognitive rehabilitation tools with the developmentally disabled (cognitively challenged) population — children and adults.

I am new to blogging so will ask some indulgence from the reader as I learn the ropes. I hope to have a web page up soon where I can coordinate with this Blog and organize a number of themes including comments/experiences on the various commercially available rehab programs (Brain Train, Neuropsychonline, etc.); Barkley’s work on the Executive Functions; book reviews of the latest looks at genetic disorders, neuropathologies, brain organization; comments on trends in the field of developmental disabilities (i.e., the trend away from “training” to “supports”, Who is teaching Intelligence most effectively); links and references to important research programs; etc.

In addition, I will be open to general comments on one of my favorite topics: “The Myth of the Totemic Power of Words.” That is the notion that words have substance and power and that by saying the word, that power can be invoked, i.e., Don’t say the “C” word, you might get it!

As a Neuropsychologist, I am also interested in the proactive role played by the limbic system (emotions) in memory, attention, and the Executive Functions, e.g., Damasio’s somatic marker hypothesis.

As I get better at this I hope to be able to set up separate forums for discussion and contributions on these topics, as well as others as the Muse dictates! Your suggestions are welcome!

Thank you for reading this far and I look forward to your contributions!

Bob