I am posting again on my infant 360 degree appraisal series. Core abilities include memory, attention span, processing speed and impulse control. These are factors that affect ability in all other areas. Deficits in core ability will detrimentally affect ability on the other aspects of function. In this post I will cover processing speed and impulsivity.
Processing speed in the brain is exactly the same as the processing speed of your computer. Some computers are just faster than others. If your computer downloads a movie instantly, while others are still buffering, you can imagine who has the advantage. I remember as a child marveling at my older sister’s ability to do sums in her head while I was still scrambling around for fingers and toes to count. That’s the advantage of processing speed; she was doing the same thing that I was, but just faster and more efficiently and keeping her socks on. Processing speed improves with age in an individual, but there is clearly variation in processing speed between individuals.
Processing speed is all about “how fast” someone can do things. Therefore, in order to test it, you need to know that the child is able to do what you are asking them to do. Tasks chosen should therefore generally be easy. Clinically one measure of processing speed used is a sheet of paper with different symbols on. The child is timed to cross out all the symbols of a particular shape. The score is then based on time taken with a penalty for any false positives (crossed out shapes that were not the specified shape) and false negatives (the correct shape was not crossed out). The task can be varied in difficulty by having all the symbols look very different or very similar. If you are experimentally minded and have an older infant (3 years upwards), you can easily replicate that test at home to gain an idea of processing speed. Here are handy sheets that you can print and use if you are so inclined: Processing Speed Test. Go on, you know you want to, and share with your friends (to find out what their kids score – whilst feigning disinterest of course).
Other simple ways to test processing speed, particularly of younger children include sorting. Sorting items by colour can be mastered easily by an infant and if you time this you can get an idea of the processing speed (again factoring in accuracy). Equally, the time it takes to push shapes through a shape sorter can be used, although this is more of a test for visio-spatial skills, motor skills and processing speed; rather than processing speed alone. Children with good visio-spatial skills and processing speed will be able to do this task quicker. Children that adopt a trial and error approach to the shape-sorter, will get there eventually, but they will be outclassed time wise by someone who is able to process in their head which shape is likely to fit through which hole. Spatial ability is known to predict performance in mathematics and eventual expertise in science, technology and engineering (Tosto, 2014). By the time Lil Bro was one year old, we had acquired so many hand me down toys that we had several shape sorters. The first had only 3 shapes (square, circle and triangle), the second had 10 shapes and the third had about 24 shapes including complex trapeziums and parallelograms. If you are sad like me, you can monitor development through progression of progressively harder shape sorters.
Impulse control/ response inhibition
It is very easy to observe a child’s impulse control, or largely, lack of it! Most adults are able to control their immediate urge to do something to hold out for a greater reward or avoid punishment. For instance, most of us are able to save money in order to buy something big and we are able to wait our turn rather than push into a queue to avoid being told off. Most toddlers are not able to do this, so if you put a new “toy” in front of them, they will try and grab it even if you tell them not to. Try drinking a glass of wine while holding an alert one to two year old in your lap. Good luck.
Sometime between toddler-dom and adulthood, the ability to control impulses develops and strengthens. The earlier that a child develops impulse control, the better they will be perceived, as this will mean that they will be less likely to do things like touch things that they shouldn’t, shout out in class, push in to queues, interrupt other people talking and running across the road without looking. People tend to like children better if they don’t do these things.
You can easily observe your child’s ability to control impulses by taking them into a fancy department store or if you are more daring a china shop. Immediately, you will be telling your child not to touch anything then you can see how long they last. If you really want to test them, you can mix it up a bit. Say “If you don’t touch anything, I’ll buy you some chocolate on the way out” and see if they fare better, or you can up the ante on the temptation and take them to a sweet shop and expect them not to touch! That would be very cruel indeed.
Cruel though is what child psychologists and psychiatrists are in the pursuit of answers, and they actually do this test in the research labs with a cupcake which cannot be eaten despite being left directly in front of the child, on the promise that they will get two cupcakes for leaving it alone. As expected, older children find this easier. This test is very easily replicable at home for anyone who wishes to be so mean (or who has plenty of cupcakes to be eaten)!
Like for attention, where repeated episodes of bringing back to task and encouraging goal-oriented attention can increase attention span, so too can processing speed, memory and impulse control be improved. The suggested activities for assessing processing speed, memory, impulse control and attention can also be played in order to train infants on these core abilities.
This back of an envelope sketch shows a graph of human brain growth and decline. During infancy the brain is going through massive growth with the child building circuits and connections in the brain in response to its environment at a rapid rate. It is thought that training at this stage in development is likely to physically affect brain development (the interconnections between different parts of the brain) and have larger impact than training at any other time in life. Similarly, continued mental activity (such as playing chess) at the other end of the lifespan can slow the inevitable brain decline in old age by strengthening connections so they are not lost.
There is growing scientific interest in obtaining evidence that attention span and impulse control can be trained. Research into ADHD treatment and prevention are moving towards computer games, aimed at toddlers that will train attention to goal oriented activity (Wass, 2011). Potentially, future ADHD prevention will involve computer-based intervention at infancy rather than medication in childhood. Why wait for a computer game to be developed to do this when parental interaction is much more fun and rewarding. In actuality, many parents are doing this already, only they are doing it instinctively when trying to interact with their child on an activity – encouraging, supporting and helping a child stay focused to complete something fun. Now you can carry on doing these things with the smug knowledge that you are not just passing the time, or playing a game, but also potentially physically improving your child’s brain.
Tosto et al.(2014) Why do spatial abilities predict mathematical performance? Developmental Science (Dev Sci), On-line ahead of print.
Wass et al., Training Attentional Control in Infancy, Current Biology (2011), 21, 1-5.
Core abilities include memory, attention span, processing speed and impulse control. These are factors that affect ability in all other areas; deficits in core ability will detrimentally affect ability on the other aspects of function.
Memory is very easy to assess as it is required in day to day life. I used to have a very good memory. My mother has a story about me when I was three years old. She met up with her brother with me in tow. As he left, he told my mother his new phone number and she wrote it down on a piece of paper. That night, when she wanted to ring him, she could not find the paper. However, I recited back to her the number that I had heard him say. It was correct. Sadly, following the birth of my children, I can no longer remember anything, which is highly frustrating.
Thankfully, my children have inherited my memory, and I often joke with them that they “stole” my memory. I first realised that my daughter had a very good memory when she was about 18 months old. I mislaid my keys. She watched confused at what I was doing as I upturned the flat, until eventually I said out loud “Where have I put my keys?” This was a rhetorical question as I did not really think that anyone would be able to tell me. However, Big Sis got up, walked to another room and showed me exactly where I had left my keys. It was not as if she was playing with them or she had seen them recently as we had been together the whole time. She had seen me put them down some hours earlier, and was able to recall exactly where she had seen me put them down, even though I could not. These days whenever I need to remember something, I just tell Big Sis to remember it and I know that I need never forget again (probably until she has children of her own that “steal her memory”).
Following this incident, it is a given that any CP worth their salt would play memory games with their children. Matching pairs is a good memory game that is easy to play with children (select 10 or 20 pairs of cards and place them face down in random order, each player upturns 2 cards at a time and if they are a pair, they get to keep them, the winner has the most pairs at the end of the game). Other games that I played were putting random objects on a tray and then taking one away and seeing if they could deduce the missing object, or the game “I went on holiday and I packed in my suitcase…” which then involves each person adding to an incremental list of random objects to remember. From games such as this, it is possible to get a good idea of a child’s memory. You can of course also do the more formal testing “digit recall” as in an IQ test, where you recite a random string of numbers and ask the child to repeat them back in order, in reverse order or after a time delay. My telephone number trick as a 3 year old would have been an example of a time-delayed digit recall. A time-delayed 11 digit recall is pretty good for a 3 year old, I’m pretty sure I couldn’t do it now.
Children’s attention span increases with age. An easy way to think about what the average attention span of a child at a particular age is; is to think about school lesson lengths. Educationalists through the years have structured lesson times to roughly match the attention span of the children in their class. Thus, at reception (age 4-5 years), activities are likely to change every 10-20 minutes. By Year 3 (age 7-8), lessons will be between 20-30 minutes, by year 6, 30-40 minutes. At Year 6 (age 10-11), the brighter pupils will be sitting 11+ exams which require attention and concentration for up to 75 minutes in an exam setting. By eighteen, A-level students are treated to the joys of triple maths or triple French; that is a whopping 120 minutes.
You can easily observe your child’s attention span by trying to engage them in a task they should enjoy and seeing how long they last. Which of us parents have not spent ages getting out painting equipment only to find that the child has wandered off after 5 minutes and we are left painting by ourselves. Whenever you do this, you can time how long it actually was that they were engaged in the task and at least you will be able to console yourself on the increasing attention span at each iteration while you tidy up the painting paraphernalia.
Attention span should be tested over a variety of activities, for instance drawing/ painting, puzzles, board games, craft activity, as well as on more academic tasks. Most children with even very poor attention span are able to watch TV and play computer games, so psychiatrists generally do not include ability to watch TV for hours as an indicator of good attention span.
Attention span can be trained. I remember that around the time that Lil Bro turned 1 year, I read somewhere that: children who were regularly read stories from an early age started school ahead of the class. I was already regularly reading to Big Sis but had not started as early as 1 year. Since no one ever tells you when the right time to start reading to a child is, I decided to try it with Lil Bro. On the first day, it was a disaster. Practically after 1 page of “Dear Zoo” he was off, despite my attempts to cajole and encourage him to sit for longer. I could have just given up and thought “Heck, he’s too young – it’s a waste of time at this age”, but for some reason (probably the article that had extolled the benefits of regular reading) I tried again the next day. To my surprise, he lasted 2 pages! This intrigued me enough to continue and I found that by the end of a week or so, he lasted for the whole book.
Pop quiz: Can you deduce from memory the item that has been removed since the last picture of this tray…?
No, I’m not suggesting that we all get our clipboards out and formally appraise our children’s performance. However, just as Jancis Robinson is unlikely to “just enjoy” a glass of wine and David Beckham is unlikely to have a “casual kick about” in the back yard, as a child psychiatrist, it was not possible for me to witness my children’s development without assessment, consciously sometimes, but largely unconsciously.
It became apparent to me that I had done this as I attended Big Sis’s parent’s evening at her nursery (this is the expensive Ofsted Outstanding one). They reported to me their detailed assessments of Big Sis (which did involve a clipboard). “She can jump with two feet together, she can cut along a straight line, she can recite all her numbers to 20, but sometimes misses out 15”. I realised that I knew all this already – down to the number 15 which always went missing. How? Because I had unwittingly been doing 360 degree appraisals on my kids since they were born.
The famous Swiss Psychologist Jean Piaget did experiments into children’s cognition largely using his own children as subjects. Whilst I wouldn’t say I went that far, there are times when I have put forward specific problems to my children to see how they would respond. The majority of the time though, I observed their reactions to problems that happen in day to day life.
Some people that I have spoken to about this have asked me what I look for, and whilst I am not recommending that people go out and do this (it is not validated, comprehensive or scientifically proven and is completely something that I have hodge-podged together when thinking about my own children), if you did want to know, I will tell you what a child psychiatrist observes and thinks about.
For me, there are 6 axes which are important to think about:
1) Core ability – here, I put processing speed, memory, impulse control and attention span. These are factors that affect ability in all other areas; deficits in the core factors will detrimentally affect ability on the other aspects of function.
2) Intelligence – verbal and nonverbal as per the standard IQ test
3) Social ability – ability to read social situations and to adapt in different social situations
4) Emotional regulation- ability to understand one’s own emotions and to control them
5) Motor ability – gross motor (running, kicking, catching a ball) and fine motor (writing, sewing, untying knots)
6) Creativity – ability to problem solve, improvise and generate something new
This information is not just for “tiger mothers” (on which I will blog another time), but my view is that having an accurate view of your child’s ability allows you to push forward or reign in on expectations. An individual’s development waxes and wanes, so continuous assessment is required. Most employees will be expected to do a 360 degree assessment every few years as a minimum and I would suggest that children are no different. Some children will develop quickly then may slow down, others may start slow but catch-up quickly so no one off-assessment, particularly in the early years is going to capture a child’s ability. Saying that, if continuous assessment over childhood into adolescence continues to follow a trajectory then natural outcome may be more predictable.
Bespoke continuous assessment of your own child can also allow you to add or seek help to support areas of weakness although I would always strongly advocate “acceptance” of “ball park ability”. None of us as adult employees would be impressed with our supervisors if following a 360 degree appraisal they sent us on training and then expected a 100% improvement in performance. We should neither expect that from our children and expectations of our children must be bound in reality.
Most schools will be doing this type of assessment as standard on children, but in my mind, its always good to double check external assessments, and also to see that there is consistency of ability in the less structured out-of-school environment, on which teachers will not have access to information. The more you know and understand your child, the more you are able to guide them.
Over the course of the next few months, I hope to blog on each area in more detail.