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The PIFAM is a remediation tools for learnings difficulties

The Attentional and Metacognitive Functions Intervention Program (PIFAM) helps to provide strategies to children with learning difficulties to facilitate learning and academic success.







Finally, a tool that can provide strategies to children with attention deficits or hyperactivity disorders, and facilitate learning and academic success. Beyond the diagnosis, the PIFAM offers a remedy.




Although it is partcularly designed for students with an attention deficit disorder, with or without hyperactivity (ADD / ADHD), the PIFAM can also help children with less severe difficulties. This tool is intended for all students, between 10 and 14, who have attention or organization difficulties.

This program consists of 12 workshops of 90 minutes each, that provide the students skills that will be useful to school (concentration, memory), for homeworks (organization, planning) and social relationships (impulsivity, respect of others).

Program Objective: The development of behavioral and cognitive self-regulation skills and new ways of thinking and seeing the world. Current scientific evidences show that to intervening on certain mental functions result in significant improvement of the overall functioning of children with ADD / ADHD or other forms of executive function deficits.




The program aims to develop the following skills:

• The impulse control; The resistance to distraction • Mental flexibility and imagination
• Memory Strategies
• The ability to plan work
• The organization of their time and thoughts • Respect of oneself and others.

Developed and tested in clinic for over ten years by Dr. Francine Lussier, PhD., internationally reknown neuropsychologist. This tool has proven itself and obtained a success rate unprecedented. This is the first tool of its kind that actually addresses the problems of children with AD / HD.





Modular Attention



Recent work in the assessment of attention, both with adults and children, have attempted to isolate the different forms of attention, so that each one could be precisely evaluated (Manly and al., 2001), and for which intensive training could be provided (Sohlberg and Mateer, 2001); in particular for the selective attention and the divided attention. A consensus seems to be developing that both attention and executive processes interact closely because of their functional associations and their sharing of neural networks, based on neuroanatomical, cognitive, and psychometric researches (Robertson and Murre, 1999). Many authors note that the symptoms of inattention are accompanied by a number of deficits normally associated with higher cognitive functions such as the working memory, planning and anticipation, internalization of speech, self-regulation, and the flexibility of thinking (Barkley and al., 1995). These cognitive and metacognitive functions, known to be managed in the frontal lobe, involve executive functions.


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The treatment of attention deficit/hyperactivity disorder


With the introduction of Ritalin in the 1960s, the treatment of ADHD became, categorically, a medical model (Armstrong, 1995). Clinical studies showed that the use of stimulants for the central nervous system s in the treatment of ADHD resulted in a reduction of the main symptoms in 70 to 85% of cases. This success rate explains the popularity of the treatment. Since then, other medications have become available to treat ADHD. However, given the incidence of physiological and psychological side effects, as well as compliance issues and the ineffectiveness of medication in some children, caution is necessary. Moreover, the benefits disappear when the medication is permanently withdrawn. Faced with the limitations of the medical model, many researchers choose to create cognitive training programs that focus on the development of self-regulatory abilities and learning problem-solving strategies. One such model is built around the clinical neuropsychology intervention concept of brain plasticity, which aims at the restoration or reorganization of functions, based on either bottom-up or top-down strategies (Robertson and Murre, 1999; Seron, 1984).



Bottom-up

The bottom-up restoration principles have led to the development of direct intervention models which are characterized by intensive, repetitive training of the targeted functions (Robertson and Murre, 1999). The Attention Process Training p rogram (APT) of Sohlberg and Mateer (1987) and its adaptation for children with ADHD by Kerns (1999) are an example of this approach, as are cognitive remediation therapy, computer-assisted remediation, neurofeedback etc.


The principles of the top-down


The principles of the top-down approach for the restoration of functions are internally driven, and are associated with cognitive or metacognitive remediation primarily focused on the awareness of deficits and the development of self-regulation skills. The logic behind this approach is that the activation of higher level functions will affect the lower level functions which might eventually result in cortical reorganization (Robertson and Murre, 1999). Remediation programs for ADHD, based on modelling (see Box 1), internalized speech, and problem-solving strategies (Douglas and al., 1976; Meichenbaum & Goodman, 1971) use the top-down approach. Recently, the work of Pierre-Paul Gagné (1999; 2001; 2003; 2004; 2009) explored the possibilities of this intervention model and inspired the intervention program developed by the CENOP and the CRAN. Gagné’s model is based on the strength of the use of metaphors in a child’s imagination and he created characters representing the cognitive functions that are involved in learning.








Self-assessment
To encourage children to become aware of their own actions and reactions during each workshop, each child is asked to evaluate themselves at the end of the workshop using expressions such as : yuck, meh, ok, wow. When the impression of the facilitator is the same as the child’s impression (even if it was less than positive), the child will receive Reflecto-dollars to reward the accuracy of their self-assessment. However, if the self-assessment is different than the facilitator’s, the child will lose Reflecto-dollars.

The introductory activity in Workshop 1 describes the methodology, rules, and objectives of the workshops. Children are presented with the rules of the workshops. An agenda is presented at the beginning of each workshop, outlining the activities for that workshop.

In each workshop, the activities are designed to encourage the children to discover their strengths and their weaknesses. Each week, the children leave with an assignment and a challenge, designed to consolidate what they learned during the workshop. Parents are encouraged to actively support their child in their assignment and to remind them of their weekly challenge. A formal
commitment from from each participant is required during this workshop.

In the first workshop, the children are invited to discover and understand the various forms of intelligence. Brain functions are presented using concrete materials, analogies and activities. By completing a questionnaire, the participants identify their own strengths and weaknesses based on the characters they will be discovering in future workshops.









Caracteristics

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This program consists of 12 workshops of 90 minutes each, that provide the students skills that will be useful to school (concentration, memory), for homeworks (organization, planning) and social relationships (impulsivity, respect of others).

Although it is partcularly designed for students with an attention deficit disorder, with or without hyperactivity (ADD / ADHD), the PIFAM can also help children with less severe difficulties. This tool is intended for all students, between 10 and 14, who have attention or organization difficulties.

Program Objective: The development of behavioral and cognitive self-regulation skills and new ways of thinking and seeing the world. Current scientific evidences show that to intervening on certain mental functions result in significant improvement of the overall functioning of children with ADD / ADHD or other forms of executive function deficits.


This program is carried out in groups of 4 to 6 children. The groups are supervised by one or two speakers.