專注力不足與認知訓練系列之二

由於PowerBrainRX嘅「免費」認知能力測試，（留意6歲以上先係），咁梗係又約嚟玩咗。

同類嘅TEST可以喺Cognifit搵到。

報告都講得好details，起碼同我預計嘅近似，佢係聰明轉數好快小朋友，聽覺記憶力更高（都解釋到點解14個月大就可以哼歌仔），但專注力就…

呢幅圖由powerbrain啲小冊子度嚟，專心係學習嘅第一步，好難唔同意。
直到目前呢點，我基本上都係覺得唔買都睇吓，份報告係話到一啲你小朋友嘅能力畀你聽嘅。同埋consultant亦都幾溫柔解釋得幾詳細。當然，佢哋始絡係商業公司，訓練內容要保密，佢都畀咗一個例子我嘅，有啲似你係Lumosity搵到嘅免費遊戲。咁，訂價當然係唔會平，但我問咗好多意見都話每堂幾百至數千元係呢類私營治療嘅門檻。

好，然後，如果真係有留意薯淘同雞嘅朋友，應該知我份人成日寫攻略。我用還原水「醫好咗」我嘅原發性血小板增生，數據正常當好啦吓，實情係少飲水就會上返，反正要keep住check。

於是就去睇一大堆嘢，好很攰，but seems promising!呢個list應該會繼續expand落去~

了解4項專注力
大致係呢啲:
Types of Attention
Sustained attention is the ability to focus on one specific task for a continuous amount of time without being distracted.

Selective attention is the ability to select from many factors or stimuli and to focus on only the one that you want while filtering out other distractions.

Alternating attention is the ability to switch your focus back and forth between tasks that require different cognitive demands.

Divided attention is the ability to process two or more responses or react to two or more different demands simultaneously. Divided attention is often referred to as multi-tasking.

關於 brain / cognitive training 嘅研究時間好短，甚至比還元水仲短。PowerbrainRX套方法係由美國LearningRX為亞洲人，尤其香港學童修改而嚟（因為要寫中文字，難過英文字母好多咁話，背後理據如何，邊個改，點樣改唔知，反正你又搵唔到原本嚟對比架喇。）

我諗呢個viedo大概可以簡介吓brain training係做乜。大概就係好似鍛鍊二頭肌等你肌肉發逹後可以舉重少少嘢一樣，鍛練你個腦相應腦區。香港呢邊consultant話衝動行為，執行能力不足係前額葉嘅觸突呀連結呀發展得唔夠，佢話透過１對１鍛練就可以增加返呢啲觸突同連結。（嗱，你唔需要去做MRI住，反正唔好期望佢哋講嘅嘢係金科玉律，幾權威嘅人都會錯，我唔係SELL你嘢，冇責任幫你check埋真假。）

咁，如果想睇多啲，可以由喼神入手…啩。LearningRX創辦人。
Dr KEN GIBSON

係，上去做TEST，consultant都好樂意免費送呢本書仔，入面有獨立研究報告指出上完LearningRX各方面能力提升3幾年咁話。

另外佢研究所Gibson Institute都有幾十年呢啲research內容summary
例如最新呢篇Jedlicka, E. (2017). LearningRx cognitive training for children and adolescents ages 5-18: Effects on academic skills, behavior, and cognition. Frontiers in Education, 2(62). doi: 10.3389/feduc.2017.00062
重點：梗係話有效，留意湖池係私立，又唔係話排最top果啲學府。

更多關於間公司嘅:
2013年3月31日
LearningRX Insider Secrets: How to Negotiate a Better Price from LearningRX
重點：
According to one LearningRX insider (who’s contributing under the name Former LRX), despite the company’s claims that its programs benefit nearly every student, the LearningRX program “helps some a lot, some a little, and some not at all…”
“LRX gets good results for those students who work hard and stay focused on training, who have fun through the process,” writes Former LRX.
“Signing up is the right answer as long as you do so with your eyes wide open. That’s why I am here, because I don’t think most parents have their eyes wide open.”
雞髀仔去TEST果日就好開心，佢其實只要有奬pocketmon嘢就好開心，成日問我幾時再去上。

員工點睇
重點：似乎員工幾like公司，不單單為錢。

其他關於認知訓練:

Neuroplasticity 神經可塑性（未睇呀）

2013年02月01日
港大參與研究發現「專注力不足/過度活躍症」的非藥物治療療效存疑
http://www.hku.hk/press/c_news_detail_9186.html
重點：冇詳細講係邊種認知訓練嘅內容。

2014年10月20日
A Consensus on the Brain Training Industry from the Scientific Community
針對美國o既brain training industry，實有業者吹到天花龍鳯，所以有堆科學家出嚟插話呢啲嘢冇用架。

2014年12月17日
127 Scientists Challenge the purported brain training consensus released by Stanford Center for Longevity
但好難得嘅係，同年年尾有另外一堆科學家，更確切係neuroscientists神經學科嘅專家出嚟反駁。

The OPEN LETTER
重點：佢哋覺得有得拗，有啲人有得著，唔應該因為業界誇張失實完全否定brain training

Media Guide on LearningRx Settlement with the Federal Trade Commission
重點：FTC曾經告過一堆BRAIN TRAINING SERVICE PROVIDER，而LearningRX搵返位去反駁，講成件事點settle，照計間嘢目前仍然未執笠，即係有理由相係可能work嘅。

D. Expert Validation of LearningRx’s Substantiation
LearningRx’s substantiation has been reviewed by Dr. Howard Wainer, Distinguished Research Scientist with the National Board of Medical Examiners, retired Professor of Statistics at the Wharton School of the University of Pennsylvania, former Principal Research Scientist with the Educational Testing Service, and author of numerous articles and books on statistics. See Dr. Wainer’s analysis and findings, along with his curriculum vitae. He concludes that:

(1) Research other than RCTs, including powerful observational studies, can and commonly do provide “evidence to estimate causal effect”;

(2) LearningRx’s observational and randomized controlled studies “all support the credibility of the claims made that those trained using the LearningRx approach markedly increased scores on IQ tests and, more particularly, on sub-scores of those tests”;

(3) Randomization was not feasible for the small subgroups, such as TBI, autism, and dyslexia, but “with effects as consistently large as was being observed, the decision to go forward, as was done, was both ethically and scientifically preferable. Within the constraints that exist, therefore, there is convincing evidence supporting the claims of efficacy made.”
In sum, LearningRx’s efficacy claims are well-supported by the pre-post data from the many thousands of students who have completed the program, RCTs, the expert opinion of an eminent statistician, and the scientific literature with regard to the claims of correlation between cognitive ability and academic, financial, and athletic achievement.

佢哋自己做嘅更多independent support (冇人知係咪真係independent)

但brain training只有幾十年，其實佢哋啲研究結果已經比還元水吸引少少，雞髀6歲，等debate到佢7、8十歲？大量testimonial話work，但即使2015年亦繼續有研究話冇乜明顯效果，但依然改善咗working memory:
Cognitive Training for Attention-Deficit/Hyperactivity Disorder: Meta-Analysis of Clinical and Neuropsychological Outcomes From Randomized Controlled Trials

另，繼續搵落去，更多腦部訓練電腦遊戲推介:

其中呢個耶魯大學研發嘅ACTIVATE™
好似幾吸引，仲繼續研究緊有冇效:
Cognitive computer training in children with attention deficit hyperactivity disorder (ADHD) versus no intervention: study protocol for a randomized controlled trial

咁，其實已經同意雞髀去PowerBrainRX上堂，再睇吓點。問咗會唔會有咩可以喺屋企畀佢做，consultant話唔使，但我笨唔係浪得虛名嘅。
6 Brain Training Exercises for Children and Teens
重點：教家長喺屋企幫吓佢哋，睇落都幾合理。
3. The Concentration Game. Activities to improve memory and concentration are important for all of us! For younger children, you can take a few of their toys and line them up. Then cover them and take one away. See if they can tell you which one is missing. You can also have them try to remember short lists of familiar objects in the home. Try remembering them forward and backward. For older children and teens, try putting random objects in front of them for 15 seconds, then remove the objects and see how many they can remember. Start out with five and keep increasing the number as they master the task. You can also help auditory memory by giving them a random list of numbers or words orally and having them repeat them. Start with only 2 or 3 and work up from there.
對雞髀咁差嘅visual short-term memory好似幾有用，可以試吓。

廣告

專注力不足與認知訓練系列之一

家長嘅惡夢！
入完名牌小學被老師叫評估，兩個月（到而家都3個喇）仲未適應小學生活云云，經常控制唔到自己要出位，好易心散，成日掛住傾偈之之類類我哋細個都會做，聽落幾正常嘅事。

但，時代已經唔同，而家我哋年代嘅曳叫做ADHD，Attention Deficit Hyperactivity Disorder。都唔知邊條左膠大愛發明出嚟玩班父母。係，小朋友你冇錯，你唔係曳，你有病啫，你控制唔到自己，你冇能力去專心，父母唔會因為你病就唔愛你，I love you, I accept you for who you are. BUT, 雞髀你係有啲唔好彩（定好彩呢），遇著個強逼症兼衝動鍾意冒險媽媽，我係一定會：

And I will try to fix you~

好多朋友都覺得我係太緊張，話細路係咁，大個咗自然會好返。雞髀只不過太鍾意玩，咁叻仔一啲都唔似有病，應該只係曳。另，大人都可以去專注力促進會自測。

網上大量資料可以搵到點先算ADHD，呢度都幾簡潔。
Types of ADHD
There are three types of ADHD:

1. Inattentive

Inattentive ADHD is what’s usually meant when someone uses the term ADD. This means a person shows enough symptoms of inattention (or easy distractibility) but isn’t hyperactive or impulsive.

2. Hyperactive/impulsive

This type occurs when a person has symptoms of hyperactivity and impulsivity but not inattention.

3. Combined

Combined ADHD is when a person has symptoms of inattention, hyperactivity, and impulsivity.

首先，係薯發現佢成日聽唔到嘢，（爸爸特別容易發現），因為爸爸永遠冇媽媽咁煩，佢哋唔會慢慢令到個仔望自己先講。我可能會就住雞髀，逼佢望住我先講，只要專心望住我時聽到，我就唔覺得佢有問題。（始終對得細路少）
第二，班主任打電話通知，都打咗幾次。課外活動義工家長都有影畀我睇佢點樣唔肯上堂。好幾個家長都話老師「投訴」。
第三，見咗學校社工，話雞髀明顯impulsive，同易分心。呢位社工算係幾open-minded，佢一冇叫我即刻去睇精神科評估或食藥，佢話評唔評估好睇家長需唔需要攞資源。二佢唔會話呢樣嘢係冇得醫只能減低徴狀，反而佢話專注力都係一個能力，可以培訓同提升。

我自己覺得雞髀:
1. IQ 正常（可能偏高添）；
2. 學習（專心時或有足夠趣味或上網或大刑侍候時）冇大問題；
3. 專注力不足(不能集中一件事太長時間，睇電視玩電話例外；一有刺激就分心；控制唔到自己等待或冇打算控制自己－同管教方式亦相關；好容易發脾氣等。)並非只在家或學校，持續半年以上；家中情況無大改變；

Inattention, or trouble focusing, is one symptom of ADHD. A doctor may diagnose a child as inattentive if the child:

is easily distracted
is forgetful, even in daily activities
is unable to give close attention to details in school work or other activities and makes careless mistakes
has trouble keeping attention on tasks or activities
ignores a speaker, even when spoken to directly
doesn’t follow instructions
fails to finish schoolwork or chores
loses focus or is easily side-tracked
has trouble with organization
dislikes and avoids tasks that require long periods of mental effort, such as homework
loses vital things needed for tasks and activities

4. 活躍，但不算太過動…啩。（不過又可能我只係習慣咗）
Hyperactivity and impulsivity
A doctor may diagnose a child as hyperactive or impulsive if the child:

appears to be always on the go
talks excessively
has severe difficulty waiting for their turn
squirms in their seat, taps their hands or feet, or fidgets
gets up from a seat when expected to remain seated
runs around or climbs in inappropriate situations
is unable to quietly play or take part in leisure activities
blurts out an answer before someone finishes asking a question
intrudes on and interrupts others constantly

環境：
1. 班主任 / 興趣班老師 / 社工都已出聲話情況明顯要做嘢；只要想喺度安份畢業過馬路，做minimum是必須的；即使被踢出校，如果是必須而對佢好，都冇法；目前暫時睇唔到有咁嘅可能性。但我冇理由等到呢個同學出事先做嘢 / 要把握時期。
2. 是否ADHD，是否需要評估，是否只係曳？如果需要學校資源當佢弱智咁教就需要評估，否則只需要集中處理提升專注力。唔想嘥呢皮嘢，唔做住。

社工提供資源：

方案（我認為可並行而無砉，係要嘥多多時間同錢）:（或者都睇信則有嘅緣份，撞到邊樣就邊樣先）
1. 學校社工已定期見佢及train佢社交、行為同埋記憶力專注力，免費的（邊個話喇沙冇支援，但一日未評估斷症，冇太多係真嘅）；
2. 社工推薦坊間有提供培訓的NGO：（睇餸食飯揀時間地點價錢）
A. 耀能EASE PROGRAMME，排咗隊要半年；
B. 協康會
C. 小童群益會
D. 青協賽馬會學生支援中心

2. 排政府，睇醫管局呢個專科門診診所名單頁:
要先睇精神科拎到轉介信，見到你住果區，打返去近果區嘅精神科（兒童及青少年精神科中心）登記新症就得，留意佢哋只係做治療，唔係做評估，即係想食藥排定就啱，反正都斷年咁等。

3. 私人牟利型培訓：
A.
朋友話正：STEP CENTRE 邁步兒童發展中心；但又係喺中環，帶佢過嚟遠啲
好早打咗去約評估，不過對方亦好盡責咁提一提我問清楚學校承唔承認臨床心理學家嘅評估，佢話教育局好似寫只限精神科。（由於我嘅sustained attention都麻麻哋，問問吓又飛咗去其他嘢度，未問學校社工。整埋呢啲咁嘅blog文，唔好以為我要打救世人，即使唔覺意扶碌撞棍有咁嘅副作用，我最主要都係想搵個位幫自己整理吓凌亂嘅思緒。）

B.由於緣份嘅安排，睇到PowerBrainRX; 我一向覺得聽多樣冇壞（反正consulting是免費的，要聽咗先可以判斷係咪呃人冇料到）不過我覺得最壞應該係吹到天下無敵而最終做嘅同NGO提供嘅類同。關於呢度，太長篇要去系列二了。

4. 書本：坊間大量類似嘅書，點都應該打啲底，有啲用；
5. 上堂：見到青協有專注力訓練員證書課程，千零蚊上６晚，即報。12月18日開始，再包膠。
6. 健腦操: YOUTUBE搵吓就有，家長教，似啱老人家，反正腦部健康就係需要多做運動，唔拘泥於咩運動…啩；跑步都話有用；

7. 營養: 魚油就算冇用亦無害，食緊；專注力supplement唔知有冇用架；不過雞髀係敏感仔又濕疹，糖、麩質、奶、之之類類都可免則免；要飲多啲還元水，佢成日唔肯飲水。近排隻手仲生嘢:
懷疑係病毒疣，睇過普通醫生搽抗生素無效，醫生話唔好放燶喎，雞髀又怕痛，跟住試疣凍寧（萬寧有售），話用低溫殺喎，但感覺上都係篤爆咗果啲先會自己好。其實好多人叫我再約皮膚科，但太多嘢要處理，而且睇落好似好緊，好似幾個月至成年不等跟住又免疫咁…

8. 管教: 薯傳統式，但針對雞髀我同老師嘅判斷係其實正向較有效；不過都係，為最低程度完成功課唯有用短線方式；
9. 藥物：個人覺得無逼切需要；等政府排到先～

10. 輔助用品，針對過動可以坐波波，唔記得邊度睇過話有效，反正樣樣都話有效；唔想太阻定，就試呢個唔使充氣嘅魚仔算。另，google到香港有賣呢啲嘢舖頭極少，Happy E-BABIES嘅效率好高，聽日就考試，我想快啲畀佢坐定少少溫吓書。
11. 仲有要媽媽support group啦EK啦，我係理性啫都要不斷搵人問意見。各位同學仔家長真係好好人，好多意見畀我，亦難得（有難同當）有朋友有類似經驗，針灸、香熏油等等都聽聞有效，好似寫咁耐未寫認知訓練，下篇啦。

P.S. 養兒一百歲，長憂九十九：我好佩服啲ASD、唐唐、ADHD、資優夫母仲有張超雄。加油長期大作戰~

還元水醫好了原發性血小板增生？！

以上係最新報告，一切正常。

最初試水嘅POST喺呢度

跟進POST

再跟進POST

呢個係15年12月嘅報告

其實2013年報告已超標，不過我冇理佢，跟住聽醫生講去埋抽骨髓驗，結論係原發性血小板增生essential thrombocytosis。要食藥到老兼定期驗血觀察，驚血杰易中風。

咁，我自從16年1月做咗嘅買咗部還元水機後，生活習慣都係咁上下。除咗照顧雞髀仔更加頻撲咗，升咗職由超hea變到得返hea，生活維持好q悶，呢幾個月開始做返瑜伽，同埋呢一個月接受唔到自己肥到盡甜品食盡又開始diet返外，生活無太大改變。醫生開嘅鐵片同亞氏匹靈一概冇食。同飲多咗好多水。

15年度（3月年結）請咗7日病假（堅係病，我好憎但又好負責任唔會呃公司假）到16年度請咗1.5日，飲水之後冇因為傷風感冒睇過醫生。還元水嘅消炎作用我係感覺得到嘅，因為我係好易上呼吸度感染成日喉嚨痕氣管又窄又鼻敏感嘅人，飲咗水後上呼吸道感染消失咗，而且就算有少少徵狀都識自己好返。﹝親戚買咗機都話冇曬呢啲小病，糖尿指數亦回復正常。﹞而血小板數自己不斷跌，連陳醫生都話要睇吓還元水係乜嚟。不過佢話醫療集團唔係咁容易放小冊子喺度sell。

話分兩頭，介紹人Anna好人都講咗一啲之前我唔知嘅相反意見畀我聽：
1. 曾經講過還元水實驗，對老鼠心臟肌肉可能有壞影響，仲未解答到的。但暫時未聽到對人有事。
2. 冷還元水浸菜浸農藥，浸茶葉都出「色」應該唔關滲透力事，而係關強鹼嘅化學反應事，睇落有道理。
3. 還元水越飲越頸渴同頭暈可能同MgOH有關，係不宜過量嘅胃藥，呢點我冇test過，不過水照理冇加料電解唔會多得去邊。so far口渴好處係令我飲到更多嘅水而且所有報告正常，反正我依然要半年驗一次血，有問題自然會發現。目前並無顯示對肝腎功能有任何壞影響。飲水多好處連抽血都見到，姑娘唔需要再用飛機仔，好快搞掂。

所以，我唔理曹博士當我白痴妹都好，到底還元水有幾偽科學都好。事實係我因為接受新事物唔需要終身食藥，只要冇因為飲佢而導致其他壞處，就自然喺度推介比各位有緣人喇。