Episode 47: Understand and Improve Your Child’s Attention – Dr. Giancarlo Licata

Jill Stowell: Pay attention. How many times can you tell your child to pay attention before they finally get the message? For some parents and teachers, it feels endless. But paying attention is not as simple as it seems. And today, we are going to explore ADHD and attention, what’s happening in the brain, what you can do to support your child attention challenges, and how attention can be trained. This is LD Expert Live. 

 

Students with attention challenges may get up every morning determined to pay attention and get their work done and submit it on time only to get to the end of the day and find first period’s homework still sitting there, not completed. 

 

In spite of best intentions, intelligence, motivation, and effort, students with learning and attention challenges often disappoint themselves and their parents and their teachers. The good news is that both learning and attention challenges can be changed. 

 

Welcome to the LD Expert Podcast, your place for answers and solutions for dyslexia, learning, and attention challenges. I’m your host, Jill Stowell, founder of Stowell Learning Centers and author of a brand new book, Take the Stone Out of the Shoe: A Must-Have Guide to Understanding, Supporting, and Correcting Dyslexia, Learning, and Attention Challenges. This book will help you understand why some bright children and teens have more difficulty than expected in school. It provides simple practical tools for supporting struggling students at home and in the classroom. Most importantly, it presents real solutions and the science behind them. 

 

Our guest today is Dr. Giancarlo Licata. You may remember him from our May 19th broadcast on sleep. He is back by popular demand. Dr. Licata is the founder of Vital Brain Training and Vital Head and Spinal Care, which is a brain-based health practice in Pasadena, California, focusing on brain-based tools to improve pain and performance. Vital was established in 2008 and has helped over 2,000 clients including professional athletes from the NFL, Major League Baseball, and the NCAA. 

 

Dr. Licata and Vital have been featured on PBS, ABC, and WebMD. Welcome back, Dr. Licata! 

 

Dr. Giancarlo Licata: Hello! Good morning! Thank you. It’s good to be here. 

 

Jill Stowell: It is nice to have you. When students struggle in school, the first thing that teachers see in the classroom is lack of attention. And now with distance learning, parents are getting a firsthand look at just how much their kids are struggling with attention. 

 

The thing that concerns me is that most people seem to think that attention symptoms automatically mean that you have ADHD and you need medication. You and I both have a little bit different view of attention and I would love for you to just talk about what attention is and how we measure it. 

 

Dr. Giancarlo Licata: Yeah. Great. Well, I’m a parent of three and I understand – I find myself telling my kids all the time, “Pay attention.” I’m going to start this 5-hour monologue on the value of hard work and in 2 seconds, they are off. They are off and they don’t pay attention to me. 

 

So attention is a very powerful word, and we tend to throw it around and it doesn’t mean much because we can’t land on a clear boundary as to what it means and what it doesn’t mean. So from a neurocognitive standpoint, attention is the ability to divert all of our resources of our brain to something. And it’s either external, you, the show, or it’s internal. It’s my thoughts and my racing mind or, “Oh, what am I going to make for breakfast this morning before my kids get up?” Those are the things that demand my attention. 

 

So in an external world, it has to do with my ability to – well, we break that down into two things; my ability to hold my awareness on to one thing and stop my tendency to jump to something else. So there are actually two components to my external attention; hold my awareness on one thing and turn off my tendency to jump to something else. 

 

And so now the problem is, is we are usually defining attention or inattention by just our behavior. If my child can’t pay attention at school then I take him to the pediatrician or I take him to a learning specialist or an educational therapist, and they seem to ask me a bunch of questions and they say, “Well, does your child jitter when he is in class? Does he interrupt the teacher? Does he do these things?” And if enough of the boxes get checked, well, now all of a sudden, we slap a label on this child and we say, “Well, your new identity is that you have ADHD.” 

 

And so that becomes a whole another road that now parents find themselves on, and I think that what you are saying is that there are other roads. There are other ways to look at it. So I hope that should be enough to get this conversation going. 

 

Jill Stowell: [Laughs] Yeah. It’s true when kids are identified as having ADHD, a lot of times then that just sort of becomes their identity in their whole family and in their classroom. Some students treat it like a crutch or an excuse kind of, and sometimes parents and teachers then see that as a limiting factor or reason to have lower expectations for that student. 

 

Dr. Giancarlo Licata: Yeah. Yeah. Yeah. I think as a parent, the only time I really care about my child’s attention is when it impacts my child’s behavior or performance. Really. And so, if my child is getting bad grades, I start worrying about his attention or if I can’t – if my child can’t obey when I’m at the grocery and they’re all over the place, well, now I get concerned about my child’s attention. 

 

And so, I try to get practical about this and attention is something that why is my child not able to sit in class when the other kids are able to sit in class or why is my child not able to sit quietly and read a book when the other kids were able to do so? 

 

And so what that is, is it’s a present level of function really. It’s a current state of – it’s a current level of function. My child has these things that are turned on too high or too low and the problem is, is the second we take them to get tested and the second they give them this label, now what happens is this label gives me and my child about what you’re saying, this permanent identity. 

 

So we are going from current level of function to now a permanent identity. Current level of function is when it’s hard for me to hold attention or resist impulses. The identity is I have ADHD. I have attention deficit hyperactivity disorder. 

 

And so, that’s like I have cancer or I have Alzheimer’s. It’s a label that we now carry and it shapes our whole identity. 

 

So to be able to extricate those two things is already the beginning of something that is very powerful because you now have more choices as a parent. So yes, I think that that’s a really key principle. It’s a very key thing as a parent that we want to be able to understand because if it’s an identity and it’s now a disease, the same way that it falls in the same category as cancer or Alzheimer’s, ADHD, Parkinson’s, they all seem like they’re in the same group. 

 

Well now, we’ve been – we tend to think, “Well, now I need a medication to match this disease. I need a medication to match this condition.” It’s a passive identity. 

 

And so now, I’m not empowered. I need to take a medication to kind of help my child stay focused. And unfortunately, most of the time, medication may not work, and that’s another conversation. But if it does, it’s essentially because what we are taking is a form of amphetamine. And an amphetamine is like a speed. It’s like these – and Ritalin is one version of it and there are others. And it’s designed to speed up the brainwaves in a particular area of the brain that tend to go a little bit too low, and when they are a little bit too slow or low, we become a little bit lost in our thoughts or it’s harder for us to kind of engage and hold our attention in a particular place or resist our impulses to go somewhere else. And that speed or that amphetamine or that Ritalin or whatever that is, now all of a sudden, that helps speed up those brainwaves in that one little area and that allows us to kind of just be calmer. 

 

So for some children, it’s magic. It’s magic. But now, or that child now becomes dependent on that medication to feel normal again. And again, your amazing work, what we are trying to do too is to say, “Look, let’s have a different conversation. Let’s take this from an identity to a present level of function. And if it’s a present level of function, let’s look at seeing if we can maybe identify what those areas are and help them in a way that’s more natural or less dependent on medication.” 

 

So, we are not saying it’s one or the other. We just think that maybe not everything should fall within the category of, “This is my identity. This is my condition and I’m now a passive recipient of some medication that you are to give me.” 

 

Jill Stowell: Right. 

 

Dr. Giancarlo Licata: Yeah. 

 

Jill Stowell: And I’m stuck like this. I can’t do anything about it. 

 

Dr. Giancarlo Licata: Right. 

 

Jill Stowell: Yeah. A couple of times you’ve kind of alluded to something that I find really interesting, so many kids who have attention challenges will be described as impulsive. And I would love for you to talk a little bit about from a brain perspective kind of what that means if we’ve got this impulsivity going on and low attention. I just – I find that a really interesting thing and I think it add some clarity. 

 

Dr. Giancarlo Licata: Yeah. Yeah. And I’m going to – for some of our parents who may have already have children who are diagnosed with attention deficit hyperactivity disorder, I’m going to classify it in the way that the DSM-5, the common way to diagnose ADHD is set up, and then I’ll talk about looking at it from a performance way. 

 

If our child is diagnosed with ADHD, usually based on a checklist, behavior, right? There’s no actual test functionally to see what’s going on. Did we check enough boxes off the list? Then you got it. That’s first of all. 

 

But it seems like they subcategorize that into, do I have ADHD inattentive? Meaning, it’s harder for me to hold my attention. Or do I have ADHD impulsive hyperactive? I’m impulsive hyperactive. I’m just going all over the place. And we all have kids or no kids that are like that. They are just everywhere, “Johnny, sit down. Johnny, sit down. Johnny, sit down. Johnny, stop kicking your sister. Johnny, stop hanging on the chandelier. Johnny, stop, stop, stop.” And so, that’s the impulsive hyperactive. 

 

And then some people, they diagnose them as having a little bit of both. I’m inattentive and I’m impulsive hyperactive. Now, OK, that’s helpful. And they have medications to try to match that. 

 

Now, what we are looking at though is the impulsivity is oftentimes going to be – is going to be driven by another part of the brain and the impulsivity is a part that’s just – it’s just go. It’s go. It’s when I’m interrupting you in the middle of a conversation. It’s when I’m in the middle of something and I just need to get up and go do something else. And so, it’s a jumpiness It’s an inability to just be here. 

 

And so now in the brain, that looks – there are certain regions of the brain around the midline as well as in the front midline that tends to make the brain – that tends to make us feel a little bit more jumpy, just going, going after it. Now – and so that’s a different region of the brain. 

 

Then the brain of our brain that can’t, I can be present but maybe I’m not paying attention to you. I can be present but I’m not following what you’re telling me. This is the child who is staying – they are sitting in their chair. They are cooperating. But you’re like, “OK. Are you following me? Step – point A, point B, point C, point D.” And by point B, they’re just somewhere else. Sometimes they’re kind of in their brain and they’re lost in thoughts or they are daydreaming. That’s another part of attention that’s not right. It’s not performed well. It’s not tuned in. But it’s different than this impulsivity. And sometimes our kids have a little bit of both. 

 

So I don’t know if that answers the question. But that impulsivity is something that is different than just the inattention. And sometimes our kids have a little bit of both. 

 

Dr. Giancarlo Licata: Right. And I know that you and I have collaborated a little bit and it has been really interesting to me to get to see the brain mapping that you do with students. And we have talked about the fact that sometimes with that impulsivity, they are trying so hard to pay attention but they can’t. And then if the attention part of the brain is low and impulse control is high then you’ve got this kid that’s working so hard and so exhausted by this even though that may not be what it looks like on the outside, but that the brain is actually working too hard to pay attention. 

 

Dr. Giancarlo Licata: Oh, yeah. Yes. It’s something that we can see and we will probably – we are already talking about brain maps and I’ll probably start defining that and set the stage for brain maps. But yes, there are a lot of kids who we will map and we will do also additional test like an IVA-2 attention and impulse control test, and that’s something that you do as well I know. 

 

And we can see something called stamina. This is that kind of grit part of the brain. This is the kind of the ability of us to just push through, to just, “This is not easy but I’m going to keep going.” And that’s some of the exhaustion that we will see in a child where they are really trying hard. I mean they’re really trying to pay attention and they just can’t. 

 

And so, I say it’s like you get this amazingly wonderful Rottweiler puppy and it’s just so strong and it’s so powerful and it’s pulling you all over the place. So I have a metaphor of just a very strong, poorly trained puppy that is dragging the owner everywhere all across the neighborhood. And that’s what sometimes our brains or our children’s brains feel like. 

 

And now the problem is, is that that child isn’t mis – they are not being disobedient. They are not trying to get in trouble. They’re not – there is not a – they’re not trying to do the opposite of what you want them to do. They are a little puppy. It’s out of control. It’s not able to be trained. And so, we can try to drag the puppy. OK, that’s one way to do it. But what if we can identify what the puppy is doing, identify where it is, and begin to train it in a way that’s a little bit more humane, a little bit more compassionate, a little bit more – there’s a little bit more wisdom to it? That’s what we are trying to do and that’s what you do so well as well. 

 

Jill Stowell: And we are going to talk about that in more depth a little bit later because I just think it’s so important for people to understand that there are just – there are many ways to look at these things. 

 

So I know when we have talked before, you’ve talked about how there are some things that can disrupt attention or even mimic attention challenges, things that are going on that – so now it looks like the child has ADHD. 

 

Dr. Giancarlo Licata: Right. Right. And so, OK. So we set the stage for this conversation around that attention is not necessarily a disease. It’s more of things that are functioning too high or too low. And we identified already a few different things like my ability to hold attention, my ability to resist the puppy, the impulses. 

 

Now, the challenge is, is when I just go back on that list and I start checking off behaviors, the problem is, there are other things that will mimic those two regions of the brain that will cause the person to check off something of the list. 

 

And so, let’s say that – so what are the impostors that get in the way of our ability to pay attention? Well, internal anxiety and rumination will look like inattention. And I’m sure we’ve done it before. Our spouse is talking to us and they are telling us about their day and all of a sudden we are here just really worrying, just really racking our brains on something and sometimes it’s on loop. It’s not necessarily like we are making any progress about it. We just somehow feel the need to kind of keep going it over and over and over again. Well, that’s the anterior cingulate of the brain. It’s what the brain does. 

 

And if that’s kind of on overdrive or overactive, it will look like I’m not paying attention to my spouse like I don’t care. And of course the spouse is telling themselves the story of, “See, they never cared about what I have to say. They don’t care about my day. It’s whatever their life is more important than mine.” 

 

But in my brain, what’s mimicking inattention is this internal anxiety kind of hamster wheel. And so now – so when we brain map, we can see regions of the brain that are doing that. They are overactive. Again, it’s front midline. We can see it on a map. And it’s very what we call high bait. I’m now throwing terms. I will define them in a second. 

 

But the whole point is, our child is really dealing with a form of again, it’s not a good word but kind of an anxiety. It’s an overstressed. It’s an overstimulation. It’s an internal kind of suffering really. And now, we are yelling at them because they are not paying attention to the teacher and so the child is stressed. The child feels anxious. The child is ruminating. And then the teacher is saying, “Well, Bobby, what’s the square root of 64?” And Bobby is not paying attention. And so it’s like Bobby is never paying attention. It’s all the same thing. I call on him and he is just never responding. He is always like, “What? What? Where?” 

 

And so, that’s a mimic or it mimic the inability to pay attention but really, it’s a rumination. It’s an anxiety. So that’s one. That’s one. And that’s – and I think we had – we worked with Stowell Learning Centers. We have clients in common and that was a common thing that one client who had a form of inattention, that was something we saw on the brain map and that was something we were able to help train a little bit and we saw how all of a sudden, Bobby was able to pay more attention to what’s interacting right in front of them because they are not stuck in their little world. 

 

Jill Stowell: Yeah. I think we kind of forget as we go through our day to day existence that there’s a lot more to what we see. I mean what’s going on in the brain is pretty profound actually. But a lot of times, kids who have attention challenges, they move or they tap or they click their pen and it drives everybody crazy. 

 

Dr. Giancarlo Licata: Yes. 

 

Jill Stowell: But you know that could actually be something that they are doing to try to calm themselves. 

 

Dr. Giancarlo Licata: Yeah. Yeah. It’s interesting. And there are two kind of versions of that that we see or that we know about. I’m sure there are more. And so, there is – moving and tapping sometimes we do to calm. 

 

When my wife knows that I’m overly stimulated about something, I’m stressed out about something, I’m really trying to – it’s getting me all worked up, she knows because my legs are just going, my legs are just moving all over the place. 

 

And so what I’m trying to do is down regulate my nervous system through movement. Movement ends up being a little bit of a down – well, it can down or up regulate our body. 

 

I will give two examples. And so, one of them we know about is when we are trying to down regulate. And so there are certain kids that again, they are dealing with stress – and we are going to call this stress, but just stressful homes, stressful – parents are fighting, maybe parents are going through a divorce, maybe their older brother or sister is dealing with some kind of drugs or issues or of teenage years, corona, and the kids’ whole worlds are just – seems like everything is falling apart. 

 

And so what happens is they feel very, very over aroused, and aroused not in the fancy word of – or fancy way of the word, but aroused like my nervous system is just tuned up too high. And so movement ends up being a way to kind of lower that arousal. It’s trying to regulate a little bit. 

 

Jill Stowell: Yeah. 

 

Dr. Giancarlo Licata: So now, the child, really the solution for that child is to help that child feel reconnected, to feel more regulated. And so, the solution is not going to be to drug the child. And in fact, that child we give certain medications to and they’re going to feel even more and they may feel like they can focus but they will have such an increased level of anxiety inside of them that yeah, they are getting better grades but really, probably their quality of life may not be much better. 

 

Now, if that’s movement to down regulate, there’s also movement to up regulate. And so, think about if you are driving long hours at night and you’ve got another two hours to go and you’re falling asleep at the wheel. What will we tend to do? We will tend to open the windows. We will tend to bring the radio really loud. We will tend to start moving around because what we are actually trying to do is we are trying to up regulate our body. We are trying to get our nervous system to be more aroused because it’s not aroused enough. It’s not tuned up high enough. 

 

And so sometimes we will see kids who are just kind of falling asleep or they are just kind of not there, and all of a sudden you just see them, “OK! All right!” and they are just moving all over the place. Well, that’s – they are trying to up regulate. 

 

Now, the whole point, there are other ways to do it. If you can identify what it is, there are other tools. There are other tools that you can do that. 

 

Jill Stowell: Right. Another impersonator of attention challenges is what we see all the time with our struggling learners is weak underlying skills, weak auditory processing or visual disorientation on the page or difficult – slow processing speed. I mean there are just so many underlying pieces to learning, foundational skills that help us to be efficient learners. 

 

And we think about – most people think about learning as reading and academics and math and that is the tip of the iceberg, but underneath it, there are all kinds of skills that support that. And if any of those underlying skills are weak then it can cause a student – it will impact a student’s attention. 

 

And so, the vast majority of the students who come to us at the Learning Center initially look like they have attention challenges. But once those underlying skills are developed, the attention symptoms often disappear right along with the increased success at school. 

 

However, there are a lot of components to attention and sometimes attention really is the root cause of the student’s struggles in school. And you’ve kind of alluded to this that attention can be trained, and we both know that and we’ve worked together with some students on it and so I definitely want to talk about it. 

 

Before we do that though, what are some things that parents can do to help their struggling students with attention, some day-to-day things? 

 

Dr. Giancarlo Licata: Some day-to-day things. Yes. So what’s interesting about this, so let’s use the arousal challenge. One of the things we saw and everyone can tune back to our sleep episode that happened back in May, what’s fascinating about the brain is that if we don’t get good sleep, we will start to have – our brain will start to be under aroused and will function more on a theta, and so we will go into, a theta brainwave state which will cause us to be – we will tend to be more inattentive. I mean it’s a very – on so many levels, poor sleep will create more inattention as well as more mimickers of inattention. So sleep, that is what’s the big thing. 

 

And so what can a parent do? A parent can try to have good healthy sleep habits for their child. A parent can set some compassionate, yet clear boundaries for their child’s sleep schedule. And so sleep is one. Again, we can go deeper into sleep. 

 

Another one though is our food, our food. So I’ll go into the story about food. But if our child’s brain is going through the sugar rollercoaster, we eat something that turns into sugar or is sugar, we get a huge boost of too much blood sugar in our brain. Our brain becomes over aroused and then our body tries to say, no, that’s way too much and it releases all this insulin and then it takes all that sugar out of the blood, stores in our fat cells, and then we get this crash. 

 

And so, what happens? When Bobby has Fruity Pebbles, two bowls, with some orange juice that’s the equivalent of maybe about 80-90 grams of sugar, and all of a sudden, by the time Bobby gets on the bus or is in the car and ready to kind of drive into school, Bobby is going to be all over the place. Bobby can’t – Bobby wants to jump out of the window and run alongside the car because Bobby had so much energy. Now, that’s not a brain that can actually focus. That’s over aroused. 

 

Now the problem is, by the time Bobby finally get – says hi to his friends, puts his backpack down in the classroom and sits down in his desk, now that’s right about the timing that the insulin did its job and all the sugar is running out of the blood and the brain now just – it just has nothing left. 

 

And so – now, that’s not inattention problem. That’s a diet problem, meaning, that my food is sabotaging me. And what a parent can do is pick our battles, but have compassionate food boundaries and understand what food does to us, both in the short term and the long term. And sugar is going to be a saboteur of good attention. 

 

Jill Stowell: Right. 

 

Dr. Giancarlo Licata: So sleep and food I think are going to be big ones. And then the third one is going to be that emotional connection that when we lack it, that attachment that so many great speakers talk about, that attachment to the parent, that sense of safety and calmness, maybe the world is falling apart but at least my little world at home is OK, that attachment will also become powerful. And many of the behaviors that we tend to associate with inattention start to settle down. 

 

So what we want to do is at the very least, we can do that. We can start there. And so, those are important tips. 

 

Jill Stowell: Great. And just going back to food, just a little bit because our kids are heading back to school whether it’s at home or at school, giving your child protein for breakfast will help the brain to have the energy that it needs to learn. 

 

Dr. Giancarlo Licata: Yeah. Yes. You’re absolutely right. Gosh! Our food – so the brain really needs more – a consistent stream of energy, just consistent. That’s what it wants. Now, we can still have little highs and lows but we need a good consistent amount. So I say it’s like a good drummer on a band. You just need somebody holding a certain beat. Just hold the rhythm. 

 

And so, good proteins and believe it or not, this is a – it used to be controversial. It’s not anymore. The science is very clear on it. Good healthy fats become really great consistent energy sources for the brain and for the body really. 

 

And so, if we have something like the good traditional farmer’s breakfast, believe it or not, maybe some bacon, some avocado, have some veggies in there, but an egg or two, believe it or not, at the end of the day, your child will be better off during the day and for overall health. If they have that versus again, the sugary cereal drinks with sugary OJ or whatever they are having because they are getting that consistency. They are getting that. 

 

And parents oftentimes think, “Well, oh, my gosh! No! That was supposed to be bad. Remember the Heart Association said that fats are bad. Fats are bad.” I mean from 2008, there has been an overwhelming amount of evidence showing that no, fats are not bad. Fats are necessary for the body. Too much inflammation can create good fats to become bad. But really what creates the inflammation is sugar. The sugar is the main inflammatory of the brain, if that was a word. 

 

And so, we are not doing our kids harm if we give them some good consistent proteins and fats. But again, we don’t want to take the fats out. I think it’s almost impossible to have that consistency without healthy good oils and fats. So yeah. 

 

Jill Stowell: Yeah. It can be very confusing, so many conflicting messages. But I think we all do basically know that sleep and diet and of course movement and water are critical to brain health, thinking, memory, and attention. But it’s still hard to make changes. So just putting a little understanding under it I think really, really helps. 

 

We’ve been talking about attention and I’m going to give you some quick takeaways because we explored a lot of things. First of all, poor attention can be a symptom of the learning problem or it can be the cause of the learning problem. And at Stowell Learning Centers, that’s one of the things that we have to sort out in our assessment because the training is going to look different depending on what the real issue is. 

 

Number two, attention is not an all or nothing issue. There are many different components of attention, and any one person can have some attention strengths and some weak areas. 

 

Sleep, low sugar intake, diet, and a calm environment will support your child’s attention, and attention and the components of attention can be trained. 

 

Dr. Licata, it is always great to have you on the show. Thank you so much for taking the time to be here with us today. 

 

Dr. Giancarlo Licata: Always a pleasure. 

Lauren Ma: We have a question from Amanda, really good question. She says, “How can I discern why my child cannot make eye contact when I’m trying to get him to listen? So he was diagnosed – he has a few things going on, diagnosed with mild autism, severe ADHD combined type, and auditory processing disorder. So I think maybe wondering like is it the social component? Is it the attention component that’s making it difficult to make eye contact?” 

 

Dr. Giancarlo Licata: Jill, do you want me to jump in first or would you like to jump in? 

 

Jill Stowell: Go ahead. 

 

Dr. Giancarlo Licata: OK. Well, again, we – my forte is not in autism or Asperger's or any of ASD. But the eye contact can tend to be a different part of the brain and it can tend to be more a function of some of the Asperger's mild autism than the inattention, though sometimes there’s a little bit of both. But yeah, so that maybe – now, that would be a whole another rabbit trail that we can go down, but that would be the short answer is it could be a little bit of both but it definitely will be more likely on the mild autism side. 

 

But even that, even the mild autism, if we look at the brain like a mansion with many rooms and hallways, then we can maybe not necessarily throw away but we can have this kind of binocular vision to be able to see two things at the same time or be able to flicker between the two, not just, “I have autism. I have Asperger's. I have ADHD.” But rather, which rooms are overfiring or underfiring? 

 

Jill Stowell: Right. 

 

Dr. Giancarlo Licata: Which rooms are connecting more or not connected enough? And so, the problem – and I say that because oftentimes, if there’s a certain room that is overfiring, well, it may make me a little bit quirky. It may make me a little bit less socially active. But if it over fires up to a certain level, beyond a certain level, now all of a sudden, that can be now categorized as some type of Asperger's. Right? 

 

And so an Asperger's may involve 5 or 6 or 20 rooms. But again, the label disempowers me. I hate to say it but as a parent, fine, it may give me a little bit of comfort to know at least there’s a name for this thing, but it doesn’t give me any empowerment to do anything about it. But if I can understand that my child and my brain is not just one glob of jelly, it’s actually this mansion with many rooms, specialized rooms and hallways that connect them. And in order for me to do everything I need to do requires each one of these rooms to be able to be not too high and that too little. Ideally, they are little Goldilocks. 

 

And so if I can understand my child’s brain from that perspective, now I can start looking for tools that are going to be able to maybe make this area a little bit higher or this area a little bit lower, and help regulate these things. So I’m now more empowered. I can now start looking for real practical tools. And that’s what Stowell Learning Centers is about is breaking that down to those core functions. And let’s start – let’s find tools to help those different things. 

 

So for me as a parent, I want to be empowered. I don’t want to just be lulled back to think, “Well, at least that’s what he has got so someone else will take care of him.” I’m the type of parent that I want to now go find tools for my child. And that second model is going to help me do that better I believe so. 

 

Jill Stowell: Right. And when you talk about labels, I think the value of a label for me as a practitioner is that it helps me to understand a child’s thinking style a little bit better so that I can identify those rooms that are over or underfiring. But I agree, I mean you are not your ADHD or you are not your autism or whatever it is. 

 

Now in relation to this question, it’s interesting because there are different reasons why someone might have difficulty with eye contact. It could be. And this does happen sometimes with our kids that are on the autism spectrum. Sometimes their eyes are taking in too much light and so it’s just – it’s a little bit painful for them to look at someone else’s eyes. So that could be part of it. And again, that is something that can be trained. The eyes can be trained to – and the brain can be trained to take in light properly. 

 

And then the other thing is with auditory processing, sometimes students have to work so hard to get the information auditorily that they kind of have to shut off the other sense, and they can’t be looking and listening at the same time. 

 

So, that is a really good question and there is not a simple answer, but it is something that we certainly have explored with students and then when we can identify where it’s coming from, then we can really work to make that aspect work more effectively. 

 

Dr. Giancarlo Licata: Yeah. 

 

Lauren Ma: Awesome. I know there are so many factors so that’s really good to hear that all broken down. We’ve got another question. We have a couple of questions kind of about steps to take when seeking a doctor, but I will start here. 

 

So Susan is asking, “What’s the best way and what kind of doctor do I see to test for ADD or ADHD? And once the testing is done, what are some of the treatments besides drugs?” 

 

Any thoughts on that? 

 

Jill Stowell: So the treatment part, we are going to be talking about. We definitely want to devote some time to that. But go ahead, Dr. Licata. 

 

Dr. Giancarlo Licata: Well, again, so what we need to know is that the majority of – again, if we are looking for the diagnosis of ADD or ADHD and there’s an incentive structure behind getting our kids diagnosed. We will get many times governments will pay for extra classes or certain – there are certain benefits to getting a diagnosis, and that’s a little of another conversation. 

 

But in short, it’s usually pediatricians that end up doing the diagnosis. It’s usually the pediatricians. It seems like the majority of our colleagues, it’s the pediatricians that do it and then they are the ones that diagnose it. 

 

Now, psychiatrists also tend to diagnose and prescribe. And so, those tend to be the two avenues through which people end up getting that diagnosis. 

 

Now, what we have to understand though is that we can’t hold our doctors accountable – well, we can’t hold them guilty for then prescribing a medication when in essence, that’s what their license allows them to do is prescribe a medication. And so we – and I think that that’s what they are great at. 

 

And so, I’m trying to kind of tiptoe around this because in essence, where we are going to go get the diagnosis is usually the next step is going to be to get a medication. And if we are OK with that and we understand that that’s the lens that the doctor is going to be wearing when you go get tested then that’s – then we can understand that, “OK, well, that’s my doctor’s lens. I’m going to go now understand that I’m not going to hold them – I’m not going to be surprised when they don’t recommend some other things.” OK? 

 

Jill Stowell: Right. 

 

Dr. Giancarlo Licata: And so now, I’m not going to say to do one thing or the other. But I just want you to be empowered with that. 

 

Now, what you can’t – there are others that can do things that will help look at the breakdown of the brain and see well, what’s overfunctioning and underfunctioning. And again, Stowell Learning Centers is a wonderful place to do that. 

 

We do brain mapping. We can also see what the brain is doing. There’s a whole group of specialists called neuropsychologists, they can also do like one to two-day full testing. I mean it tests everything under the sun to see how is your child functioning and what are the different rooms doing in the hallways and how is that playing out in my child’s personality and their emotions and their ability to do things at school. 

 

So I guess this is kind of a roundabout way to say, there is the conventional and then there are these others. And as long as we have good expectations about which – what they’re going to give us then we wouldn’t be disappointed. OK. So, I don’t know. That’s really my best answer for that one. 

 

Jill Stowell: [Laughs] And so, as a parent, if you really need to have that diagnosis in order for your child to get and IEP at school or get a 504 plan or some kind of support then you are probably going to go to your pediatrician to get that. 

 

But there are people that do a more natural approach to treatment with supplements and diet, sometimes that is chiropractor, sometimes that’s a naturopath. And Stowell Learning Centers, we really look to try to evaluate what are the underlying skills that are not supporting the student well enough and therefore stressing the attention system because then we can develop those underlying skills and the attention symptoms usually go away or if attention is the key issue, then what we know from our experiences, it usually is going to be combination of training which we do, and diet and some kind of biological aspect, usually diet and maybe some supplements that are going to be a good combination. 

 

Dr. Licata, and so then there is the kind of work that Dr. Licata does which is really, really amazing because they are looking at what parts of the brain are overfiring or underfiring and actually have a pretty based on our students’ input, a pretty fun way to treat that and effective. So, let’s go ahead and talk about that and then we will come back and pick up the other questions. 

 

Dr. Giancarlo Licata: Yeah. So we love science and so we like, like Stowell Learning Centers, want to create science-based tools to both measure and improve our function. I mean that’s really what this about. And so, what we do to measure the brain is we have – a child will come into the office and they will wear a cap. It’s like a swimming cap with 19 different sensors. And we will look at the brainwaves. We will literally see their brainwaves, and this is called the EEG. 

 

And so right away, here is the different between check a bunch of boxes off of a list, “Uh, you’ve got ADHD or you don’t,” what about if we actually saw the actual brainwaves of the child and measure those things? 

 

And so, what we want to do is measure what the brain is doing. Measure the different regions. And then we compare that child’s brain into other boys or girls that child’s age. And we don’t want them to be just like everyone else but we want to be able to see, well, does this child have access to a lot of the same things that other kids do? 

 

And so we can then begin to create a little bit of a fingerprint. We can create a little bit of a phenotype on, huh, when we see brainwaves that are too high or low in this one room, it tends to look like a certain flavor of inattention.” It tends to do that. And if the child is coming in with inattention, well, wait a second that fits. Right? 

 

And so that’s the way for us to measure, and that’s what we call – we call that brain mapping, measuring the brainwaves of the brain. 

 

Then we test – then we train by literally putting a little stethoscope. And I say it’s not really stethoscope but it’s just – we are not doing anything to the brain, we are just sensing the brain on that room. And then the child essentially plays videogames with their mind for – if they are doing it at home, it’s about 15 minutes a day. If it’s in the office, we are doing it for about 45 minutes about two or three times a week. 

 

And so what we do is we get to train that region that was too high, we get to train it to slowly begin to lower itself so that it can access lower – slower brainwaves. That’s it. 

 

And it doesn’t – we are not making it do one thing or the other. We just help it get unstuck. And then if it needs to go high, it can, but it doesn’t have to stay there. It can go back down. 

 

And so in about 12 weeks, 12 to 16 weeks, we see about a 50% improvement in the functions that are like attention or impulse control or any of those others, rather than have a child dependent on certain things for the rest of their life. So in essence, that’s what we do. 

 

Jill Stowell: And I like talking about it, getting unstuck because it’s so – we get into patterns and we sometimes have to have some help to break that pattern so that we can create a more effective one. 

 

And I will just tell you a little about we recently collaborated with a student to do this neurofeedback brain training and he was one of those kids whose brain was working so hard to pay attention, is what the brain map showed, but it really caused him in anxiety, which came across as withdrawal and lack of motivation. And then that was all compounded with remote schooling. 

 

But after completing the neurofeedback, we really saw a very encouraging improvement in engagement and mood and focus. And then at the same at the Learning Center, we were working with this student to develop the underlying skills that he needed to listen and read and think faster. And I really am excited for him to start school this year because even though it’s remote, I think it’s going to go great for him. And that’s awesome. That’s why we do this work. 

 

Dr. Giancarlo Licata: Yeah. Yes. And what it is, is it’s really about we can see and measure potential. That’s really what we are doing. Potential is no longer this kind of high in the sky thing, “Uh, you can be anything you want to be. You’re 5′2″ and you can be a professional NBA player.” Maybe. Maybe. But you may not have much potential in some other. 

 

But we can see potential and we can see that you have everything you need. It’s just that there are certain patterns that are stuck, and those patterns, we can help them get unstuck. You can access things that you feel more. The child feels more like themselves. They feel like the fuller version of themselves. And to be able to do that in a way that’s science-based and to be able to do in a way that’s more rigorous than what is done conventionally, before and after, measuring so many different types of auditory processing, visual processing, attention, and measuring them over time and doing neurocognitive tests. I mean it’s more rigorous than checking out a bunch of boxes and then saying, “Well, good luck! Let’s see how this goes.” 

 

Jill Stowell: Right. 

 

Dr. Giancarlo Licata: It’s profound. And what’s Stowell Learning Centers allows kids to do, it’s what we like to do too is we love to help measure and then help your child access their potential in a less floppy way. So yes, yes, it’s huge. It’s huge. 

 

Lauren Ma: I love that. Yeah. Yeah. I love that. We do have quite a few questions and it’s going along with this skill-based stuff. We have a few questions along those lines. 

 

So Amy is wondering, “What is your strategy for improving working memory for a child where their verbal comprehension and perceptual reasoning are very superior but working memory is just average?” 

 

I don’t know who wants to tackle that, but that’s the question. 

 

Jill Stowell: Verbal comprehension and tell me again, verbal comprehension and … 

 

Lauren Ma: So verbal comprehension and reasoning are great, but working memory is more of the struggle. 

 

Jill Stowell: I would – I feel like I don’t exactly have enough information to have a really good picture of exactly what we would do. But what we do in our assessment is we are looking at all of those factors, so long-term memory, working memory, attention, auditory processing, visual processing, reasoning, certainly verbal comprehension, and the academic pieces as well. 

 

But what I would want to look at is, is there something going on in the auditory or visual processing that is causing it, but maybe not get accurate information to think with. It could be. Simply, it could be a memory issue that they are not taking in enough information at one time. 

 

And so, we have a number of different ways that we attack that but we do processing skills training which is heavily based in developing working memory and processing speed, which if you wanted to know what it looks like, it looks like all different kinds of games and drills and all the activities are – they’re very different but they’re based in being able to build your working memory and your processing speed along with other critical underlying skills. And it’s intensive but it’s pretty fun. 

 

Dr. Giancarlo Licata: Yeah. And I think what Jill is also alluding to is that there are multiple types of working memory. And sometimes there’s working memory in what we think is working memory which is more short-term memory and oftentimes, they are super imposed so there’s a little bit of entanglement. So it’s rooms and hallways but there’s entanglement in some of them. 

 

And so again, sometimes it’s a little bit more testing but I’m sure the Stowell Learning Centers do and we do because it depends on that child. So since there is what we call standard working memory and there’s verbal memory and then there is the visual spatial memory. And usually whenever you have one, it’s coming along with some other things. 

 

And so again, however you got tested, I think it’s phenomenal that you are already asking that quality of question because you’re starting to think using a different operating system. You are starting to think like what are the right ingredients that I want to give my child so that they can make all the dishes that they can make rather than just how come my kid can’t make a good spaghetti. So what ingredients does my child have? And that’s an important question. 

 

So working memory, it really depends on what type of working memory, is it really that they don’t have great working or is it more of a short-term memory? Is it verbal, visual spatial, or is it a combination? That’s where it gets harder online to answer that simple question, but yeah. 

 

Lauren Ma: All right. Perfect. I know it’s definitely complex. When I first read the question, I was like, is she a parent of ours? She knows so many terms like … 

 

Dr. Giancarlo Licata: It’s a great question. That is the type of questions we want to start asking. Now, that’s a lot for a lot of us, parents. I mean it’s easy for us to talk about this because we spend all of our day everyday talking about this. But a parent who has a different profession, this is a whole new language. It’s a whole new vocabulary. And so, that’s OK. 

 

You don’t need to know all of it, but do you have somebody who is at least thinking that way that you can trust? Stowell Learning Centers is one of them. Vital Head and Spine is one of them. You may have others in your area, but we have people that fly in to see us. There are those people that work remotely with Stowell. You just know that that’s – at least if you’re starting to feel like, “Wait a second. I got to start thinking about this, I want to find professionals who are thinking this way,” that’s the beginning. 

 

Jill Stowell: That is. 

 

Dr. Giancarlo Licata: Yeah. 

 

Jill Stowell: Definitely. 

 

Lauren Ma: Awesome. Awesome. Along the lines of other professionals, we have a couple of recommendation questions. And if you don’t know off the top of your head, you can always let us know later. We can post them on the notes. 

 

But Susan is wondering if there are any recommendations for neurophysiologist. I don’t know where she lives but … 

 

Dr. Giancarlo Licata: Yeah. So in essence, I don’t – Jill, I’ll let you go – well, this is my thought. Do you mean a neuropsychologist? And then if you mean a neuropsychologist, we have – we recommend people here in Pasadena, California, but there are many others. But remember, I tend not to give great straight answers. I tend to try to help you with the context. 

 

The context is I need someone who is going to start – who can test using this new way of thinking, who tests for my child’s ingredients. And then I also may need others that can actually do the treatment or therapy or training for those things. And sometimes one person is great for testing but they have nothing to offer you as far as the actual training. Some places are both. Stowell Learning Centers is both. We are both. But also, in my practice, we tend to be great with four things; sleep, attention, concussions, and anxiety-like tendencies. That’s it. 

 

So we don’t try to do everything or we are not good at everything. And so, we are great at those things. And when someone comes to us with more complex issues, we usually then say, “Well, maybe you need a team around you. Maybe we will take care of this one part. Now that we have the right testing, you need certain ingredients. We will do these parts and maybe let’s recommend someone, two or three others to do the others.” 

 

So that’s where again, if you – the thinking about who is the tester, who is trainer, and some can do both but can they do both for everything that my child needs? That’s what we want to start to – that’s how we want to start to think in a more empowered way I think. 

 

Lauren Ma: And then she did respond, “Yes, neuropsychologist.” 

 

Dr. Giancarlo Licata: OK. Great. Yes. So, I don’t. I don’t. But yeah, Jill, maybe you do in general. But … 

 

Jill Stowell: Like you, we connect with professionals in our area and when we find like-minded professionals, we definitely refer to them. Out of the area, not so much, I’m so sorry to say. 

 

Dr. Giancarlo Licata: Yeah. 

 

Jill Stowell: But I think that’s really helpful what you’re saying about how to think about it. So … 

 

Lauren Ma: Great. Great. And we do have another therapy question. What kind of therapy do you recommend to help my 7-year-old with big emotions and executive function skills? 

 

Dr. Giancarlo Licata: Jill, do you want to go? I can go after you. 

 

Jill Stowell: Go ahead. 

 

Dr. Giancarlo Licata: OK. So I think this maybe a slight segue into the brain training in general. Across the country, there are probably about 500 or so people who do something called neurofeedback. And the challenges that probably 90% don’t start with a map. And so ideally, we would like to have a child get a map. They wear it. They could see the brainwaves. We know exactly what’s going on. 

 

Then out of that, it’s a smaller group of the neurofeedback world, and then of that group, there are different people that have different qualities. It’s a little bit of a Wild West but they have different qualifications to be able to help a child train up or down some of these rooms or hallways. 

 

And so, you may want to look around your area and see if someone is doing that, someone is able to get a brain map, someone who does brain mapping, someone who does neurofeedback. And there are different subcategories of neurofeedback, but again, our practice, we only take on four types of clients. We tend to be very, very good at those four and so – and we always keep focusing on getting better. But it’s a resource. It’s a tool. 

 

And so, we will have people that will fly down, get the brain map and then they fly home. And then we give them everything they need and they just wear a little band around their head with a little sensor they can put on with a little bit of gel and their child can play videogames for 15 minutes a day and they can train up or down some of these things. 

 

But big emotions is oftentimes a disregulation of feeling, and there can be multiple rooms that are involved with that. And so, it’s a little bit of a slippery answer but with the right map, we can tell you a lot more. And so, we are good at doing the testing and doing the training, but the big emotion part is sometimes a little bit outside of our wheelhouse. But there may be others in your area who is asking the question that maybe just for you, so you may want to look him up. 

 

Lauren Ma: Awesome. 

 

Jill Stowell: And I’ll tell you. Again, of course we don’t really have enough information to give you exact information about your child. But thinking about a 7-year-old who has kind of overwhelming emotions and you’re thinking executive function, well, I think – well, one of the things could that that child is operating in fight or flight. And when we are – and sometimes that goes back to retained primitive reflexes, which we are going to do a show on one of these days because it’s a big subject. 

 

But if your child is kind of just operating in fight or flight, they are not going to have good executive function because the rational brain isn’t even available while they are kind of in that hyper alert state. And it’s going to be very easy for them to be oversensitive, they fly off the handle. And so, these are definitely things that we deal with with our students. 

 

But let me just give you two things that you can just try to start doing. You can – well, yeah, a lot of things come to mind. But here’s one thing. When your child is in a pretty, not in a hyper alert state, but just kind of a nice time that you’re together, teach him how to do 5 – we call it 5-count breathing. Young kids, sometimes we do 3-count. But just breathe in for let’s say, 3 counts. Breathe in. Out. So breathe in through the nose, out through the mouth. If they go up to 4 or 5 counts, great. Don’t hold the breath. Just in, 5, out, 5 in through, out through the mouth. 

 

Do that. Just practice that. Practice it at different times of day when your child is doing fine. And that becomes a tool that he can use before things that tend to upset him, if it’s reading or school work or having to do chores. You start with your 5-count breath. Do three of them in a row. Start to settle the system down. 

Another thought is what’s called cross crawls. You could Google this and you will probably see it on YouTube, a demonstration of cross crawls. It’s through Brain Gym. And have your child cross elbow to the opposite knee back and forth like this. And you do it with them to keep them from going too fast and they just breathe slowly. Do it for about a minute and it will start to settle him down. 

 

And so if you know the triggers for him, do those things first. Use them as a brain break in school. Just – that is just settling the system a little bit and then he is going to be able to think more rationally. So those are a couple of thoughts. 

 

Dr. Giancarlo Licata: It’s wonderful. 

 

Jill Stowell: Let’s go back to you so we can kind of wrap up. 

 

Lauren Ma: Yeah. So this is – I know you talked a lot about professionals so the answer might be the same. I’ll take it down in a second. But Heather expresses that her son has actually Tourette syndrome and they are homeschooling. They’ve tried for 7 years to help him with his retention and attention skills. He struggles in Math. In general, just retention. But he loves music. And so he tends to have better attention when it’s something that he likes. So she is kind of just asking for maybe some other tips when they go to see the doctor. I don’t know if it applies the same other stuff you said, but if there’s anything additional for her situation, we would love to hear it. 

 

Dr. Giancarlo Licata: Yeah. I think the short answer for her maybe to find a neurofeedback specialist who has experience working with Tourettes. Tourettes will be a constant interruptor to his brain, to his brain. It’s a hundred times a second and oftentimes, it’s when it’s finally loud enough that it comes out. But the brain in small ways is just doing this overfiring. And so, it’s going to be near impossible to hold a certain train of thought or any constant attention because of that. And so it may not be a solution for Tourettes but it may turn that down enough to the point where it’s now functional. 

 

And again, I think like we don’t work with it but it’s something that I do know there are specialists that work with it in the neurofeedback world. Try it. Try it. Outside of that, I don’t know. I don’t know. 

 

Lauren Ma: All right. 

 

Dr. Giancarlo Licata: Yeah. 

 

Lauren Ma: Well, thank you for that. We do have a question. I’m not super familiar with this but maybe you guys are. Can people be HSP type, good use using sensory and problem-solving, 3D spatial use, et cetera, and be with ADHD that needs treating? Any thoughts on that one? 

 

Dr. Giancarlo Licata: I don’t know. I think what you’re asking – I’ll answer this. The brain reserves the right to have more than one room not working as great as we want. And all the combination of rooms and hallways that are not as great as we would like become the source of every diagnosis we give really. 

 

So yeah, you can have a lot of things not right. And that’s where I think Jill has been alluding to often. If you have someone who is looking at the different ways and can start training them individually or collectively together then the training becomes customized to the child because yeah, you could totally have. You can have multiple things all at once. 

 

In fact, anybody who has worked with children knows there’s usually more than one thing always happening at once. So again, I think Jill has been ahead of her time breaking down not just what – again, if it’s a metaphor of food, gosh, my kid has spaghetti problems. We have spaghetti problems. Well, if Jill breaks it down and says, “Well, what are the ingredients that you’re working with right here? Let’s see if we can fix the ingredients.” The plate of spaghetti maybe better or, “Oh, my child has whatever, pork chop problems.” Let’s break it down to the core ingredients. 

 

And so yes, yes, you could totally have multiple things. I’m sure they do. So then the question is, no, and then find the right tools to fit that child’s needs. 

 

Jill Stowell: In our experience, the encouraging thing is that as you start to work in one or two of those areas, it’s kind of like other areas begin to come in line as well. So that’s an encouraging thing. 

 

Dr. Giancarlo Licata: Oh, yeah. 

 

Jill Stowell: We have amazing brains. 

 

Lauren Ma: It’s true. It’s true. We do have a question about assessments. I don’t know if she is talking about functional assessments like we do or more of a clinical type of assessment. But Ronghi [0:35:32] [Phonetic] is wondering how much of these assessments can be done virtually? 

 

Dr. Giancarlo Licata: Jill, I’ll leave that to you. 

 

Jill Stowell: We do – there are certainly some things that we do that the testing world hasn’t found a way to do remotely yet, but we do remote screenings now and really have since March and have found it to be very, very effective. And I think that’s partly because what we are doing is a functional assessment. We really want to see how things are working in real life. So a lot can be done remotely. We have been really, really pleased with that. 

 

Lauren Ma: Yes. I can definitely attest to that. We’ve started so many students. At least, the Irvine branch with purely remotely, yeah. We did the full screening and they are like finishing up their stuff right now, which is really cool to see. 

 

We had a question about I think it’s a particular assessment I’m not familiar, what about the WISC-IV test? Are you familiar with that one? 

 

Jill Stowell: The WISC, yeah. I do not give that test. That is given by a psychologist, a school psychologist or a clinical psychologist. And I don’t know if that can be given remotely yet or not. 

 

Lauren Ma: OK. Perfect. Sorry. That was out of order. I should have given some context. She wasn’t asking about remote, just any opinions on it I guess, and its effective or I don’t know. Any opinions on the test in general. 

 

Dr. Giancarlo Licata: Remember – if I can comment on it. There are – at least we are talking – so tests become functional assessments. And functional is, can my child – how does my child – how are they able to access certain again, rooms and hallways? There are many rooms and hallways so there must be many functional tests. And there will be no one single test that measures every single room and hallway. The best attempt at it is one to two-day full battery where you’re literally in the office for one to two days straight taking tests, and that is what a neuropsychological test is trying to do. 

 

And oftentimes, the cost for that is much more so – much more, sometimes three, four, five times the price of the training for the individual things that you want to do. So there are many tests. There are many tests now. 

 

Again, for a parent who wants to navigate the world of tests, just understand, well, are they testing a certain levels of what we call intelligence? Are they looking at some of these core resources? 

 

I like Stowell’s philosophy. And if you read Jill Stowell’s book, if you can understand that that becomes your kind of hitchhiker’s guide to my child’s brain. It will help you kind of navigate and ask some better questions about which tests are good for what because yes, I’m aware of the intelligence skill for kids. I think it’s the Wechsler. I’m looking it up now because I couldn’t remember his name, the Wechsler Intelligence Scale. But there are many intelligence scales, and those intelligence scales are pretty much just broken down into smaller ingredients, smaller core resources. 

 

We use another company that’s called Cambridge Brain Sciences, and these you can do online and it’s 12-core functions of mental processing, and that’s really helpful too. There are many. That’s going to be the challenge is, is this one good or that one good? Is this one better or is that one better? Well, what are you trying to accomplish? Is a hammer better than a screwdriver? Well, what are you trying to do? 

 

And so, that’s again, that’s my another attempt to not give you a straight answer. [Laughs] 

 

Jill Stowell: But I tell you the one thing kind of like we said earlier where you don’t want ADHD, OK, I’ve got it, I’m stuck with it, that’s me. Well, with intelligence tests like the WISC, just know that you’ve got to really interpret it. And if all you do is you look at the composite score, OK, it gives you some information, but that’s not a true picture until you really look at all the different subtests. And most of the time, what happens is parents end up with a score that categorizes their child’s somewhere. And as a practitioner, if someone comes to me with a WISC, I’m going to be looking at all those different subtests to see where the child’s strengths and weaknesses are how they clamped together and things like that. So … 

 

Dr. Giancarlo Licata: Yeah. Absolutely. I mean we do the neurocognitive test. We also do the IVA-2 which is like a TOVA, which is just a big fancy way of saying we are measuring attention and impulse control, and it breaks those down into visual and auditory processing. And yes, we really want to know what the individual aspects of that child’s score are because that’s what we want to train. And then we train those up and then the scores go up. 

 

In fact, we expect the scores to go up. We believe on our part we failed if we didn’t help the scores go up. And so – but we need to have that interpretation and that interpretation is really, really important so yeah, I agree. 

 

Lauren Ma: Great. I realized that it’s WISC, the IV is for IV Roman numerals. OK. So that’s great. [Laughs]