It’s not ADHD, it’s Sluggish Cognitive Tempo

Have you heard of "Sluggish Cognitive Tempo" (SCT)?  It's apparently regarded by psychiatric professionals as a subtype of attention-deficit/hyperactivity disorder (ADHD). Until now, that is.

Medscape has reported  some research that concludes it is most likely to be a distinct attention disorder, although there is notable overlap with ADHD.

The researchers, Dr Catherine Saxbe and Dr Russell A. Barkley from the Medical University of South Carolina in the US, have based their findings on reviewing nearly three decades' worth of research on SCT and their own clinical experience. They're predicting that, given the evidence, SCT may "eventually be accepted as an identifiable attention disorder with its own diagnostic criteria that distinguish it from ADHD.".  Writing in the  Journal of Psychiatric Practice they claim that SCT may represent an exciting new frontier in psychiatry.

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Characteristics of Sluggish Cognitive Tempo

  • Like ADHD, SCT typically presents in childhood.
  • Being daydreamy, mentally foggy, and easily confused.
  • Staring frequently.
  • May have symptoms of hypoactivity, lethargy, slow movement, possibly sleepiness.
  • Children with SCT also appear to have slow processing speed and reaction times.

There are no officially endorsed criteria for SCT but the researchers believe that may change in the "foreseeable future," and that most doctors who see children with ADHD have probably come across someone who falls within the parameters of SCT.

First, there needs to be more research on the cognitive deficits, such as which areas of the brain are most active when the patient appears the most distracted ― in other words the researchers say, "where does the mind go?"

They're also hoping that is is renamed - after all who wants their child diagnosed with something with the word slug in it?

sad boy
copyright: SNJ

Does it matter?

But why does it matter? If your child has a diagnosis of ADHD and SCT is similiar, does separating them with a different, lesser known diagnosis mean anything?

Dr. Saxbe says it is important for several reasons:

  1. Because  SCT symptoms have not been shown to improve with stimulants such as ritalin, the treatment of choice for ADHD. At the moment it's thought atomoxetine is the most promising.
  2. Increased awareness of SCT will also enable parents to better understand their child's poor attention and tendency to daydream.
  3. That a more accurate diagnosis can lead to parents developing support networks of their own which are well known to increase awareness and help for other families.

If you have access, you can read more about SCT in the Journal of Abnormal Child Psychology . If you don't have access you should be able to at least read the abstracts.

Why medicate a child because they are not "ordinary"?

Of course there is the argument against medicalising and/or medicating personality types that are just part of the broad spectrum of humanity, but a type that is out of the stretch that is considered 'normal' (don't you hate the word normal?).

I firmly believe that many of the children with diagnoses of ADD, ADHD, Asperger's, Dyslexia and similar are our most promising and creative minds of the future. These are the quirky brains that invent, create, make us laugh and move the human race forward.

It's the personality type where genius cohabits with a slice of madness; the one that's often stalked by depression and difficulties making sense of the world the confusing way it is. These are my favourite type of people, the ones I feel most comfortable with.

After all, the world is only ruled by 'normal' (allegedly) people because they can think in straight lines and can organise themselves into political parties expounding rigid and often stagnant beliefs. The mad genius may join, but they will always be outsiders and stand out from the rest - and they're the ones who have the good ideas.

So why would we want to medicate them or try to change them?

There is only one good answer to this, in my view: so that they can survive and maybe even thrive in a society not created for them. So they can learn to focus and learn, if not understand, the rules long and well enough to to put their mad genius to good use.

And this is why an accurate diagnosis is necessary, whether it's ADHD, Asperger's or SCT - so these young people get the right therapy to enable them to maybe one day, change the world for the better.

What do you think?

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Tania Tirraoro

Founder, CEO at Special Needs Jungle
Founder of Special Needs Jungle. Parent of two young adults with autism. Tania is a member of the Whole School SEND Expert Reference Group for SEND Leadership, the Ofsted SEND Inspections Stakeholders Group, and sits on the Advisory Board of the Royal Holloway, University of London Centre of Gene and Cell Therapy.
She is also an experienced broadcast and print journalist & author. Tania also runs a PR, web & social media consultancy, SocialOro Media. She is a Rare Disease & chronic pain patient advocate with Ehlers Danlos syndrome.
Tania Tirraoro
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Yes, I agree, but I’d also point out that for those who have ASD or ADHD and are ‘geniuses’, there are at least as many who have significant learning disabilities. My son won’t ever go to university and it would take a miracle for him to be able to sit a GCSE. He’s never going to change the world. He is unlikely to be able to go into employment, even. Where does he fit in the world? Is he less valuable, less worthy, because he will never make a contribution to society? For me, the answer is no. He has… Read more »

I think as with the autism spectrum, there is an attention deficit spectrum and it would help in diagnosing which specific type of ADD a child has for treatment, whether the pharmacutical or holistic/diet approach or both. The book, The Out of Sync Child has already recognized how many subtypes there are of children who have abnormal processing. The lump term, Sensory Processing Disorder, is used for general purposes until a more specific diagnosis can be made, which is where I am with my son right now…

Vicky Hobbs

I was so encouraged by your comment. I was never diagnosed but I do seem to fit the description of SCT. As a child I was different. My teachers all thought I was actually bright and I had “Very high potential” on my school reports but unfortunately my marks were usually very low…with two exceptions, I was thought of as exceptionally gifted at Art and I loved reading. English Lit and Art were my subjects. But I was always getting lost at school, never knowing which class I was supposed to be in (lol), I was always accused of daydreaming,… Read more »

Michael

That really sounds like you are an INFP type. Especially with the daydreaming. Make a research on “Myer Briggs personality test”. The test provides you with a list of strength and weaknesses for your personality type. The test results are also very helpful with your job search. The test I made was on http://freestrengthstest.workuno.com/free-strengths-test.html

Hope that helps. Michael

Darwin

Just now hearing about this. Interesting reading.

Amy

I am so pleased to see more discussions and literature about SCT. I first discovered this “diagnosis” last year and asked my 10 year old’s Psychiatrist about it and he looked at me like I was crazy and told me that my so had ADHD. But he isn’t hyper….and the description COMPLETELY describes my son. He has been on Zoloft since age 4 (don’t judge), due to a childhood communication disorder (Selective Mutism), that is rare but debilitating. He also has OCD tendencies. He has been cured from the Selective Mutism for 3 years now, but he just never seemed… Read more »

Kelley

Today I learnt of this condition…It blew me away…Why?…Because what I read sounded like me when I was young, but also now I am older I still suffer from these debilitating conditions….I hate it…I could never understand why I would be listening to a teacher one minute and the next my mind would be anywhere but where it was supposed to be…No matter how hard I would try and concentrate, it would always wonder off…..Is there any help pages in the UK???…Or, I would be willing to answer questions etc to help with any investigation of this condition….I also have… Read more »

Jane

I relate to Kelly”s comment COMPLETELY!….I know I’ve had SCT all my life and it has been debilitating in every way.The most horribly frustrating part is being mid-sentence and forgetting my train of thought…what was the important point I was about to make?….my mind is lightening-fast at making associations and playing out possible scenarios and brilliant solutions of a current problem all at the same time while talking..then I get lost in my own thoughts…all the while…on the outside…people are looking at me…waiting for me to say something else..but only seeing a blank stare on my face…looking stupid 🙁 Also…I… Read more »

Gel

Wow. I can relate to the comments about knowing you have potential that hasn’t been fully realized, trying to focus but ending up “somewhere else”. I have this horrible driving habit (not as bad now) where I would tell myself to focus and concentrate so that I won’t miss my exit. And then I would realize a few minutes later that I missed my exit because I had gone off in my mind about how I was going to resolve this driving problem; my spontaneous problem-solving distracted me from taking the exit! I often laugh at myself (which I personally… Read more »

Kelley

Hi Tania Tirraoro….I have found a Facebook Page under the same name….But thats it….