Change The Name Sluggish Cognitive Tempo to anything else

The name for Sluggish Cognitive Tempo (SCT) should be changed to something, anything else.  The diagnosis Sluggish Cognitive Tempo sounds like a playground insult. It is not as insulting as calling us mentally slow but it is pretty darn close. The truth is that there are many people with SCT that have very high IQs and that have managed to succeed in life and at work despite having sensory processing speed deficits. So little is known about this condition that an appropriate name is a challenge.

We do know that people with this condition have slower reaction times when given information in certain sensory forms. Some folks with SCT have auditory sensory reception issues and some people have visual sensory reception slowness and some have both. We know that people with this condition can be trained and that their reaction times can improve.

Studies have shown that reaction times can be improved with appropriate training in the elderly and also in people with traumatic brain injuries. We do not know, because this group has not been tested, if people with SCT can be trained to improve their reaction time. Judging from what I have seen in my clinical and personal life, reaction time does improve with brain training and reaction time exercises in people with symptoms of SCT.

How can you give a name to a diagnosis that has not been studied? If we knew more, a mpre appropriate name might emerge. People with SCT must be studied to determine the characteristics of this diagnosis. This has yet to be complered. We need to know more about reaction times to various sensory stimuli, symptoms response to medications such as Wellbutrin, Strattera, Intuniv, the stimulants and potentially new pharmaceuticals, symptom response to non-medical interventions such as cognitive and brain training and we need to know about co-occurring conditions (we know that people with SCT are much more likely to have anxiety and this can worsen their symptoms, they have very little co-occurring conduct disorders or oppositional symptoms). We need studies performed with functional MRI and other diagnostic studies that will inform researchers of the neurological processes that are amiss in this condition. In short, much work is yet to be completed.

I am not certain that you can rename a condition that you know so little about but I do know that Sluggish Cognitive Tempo is a poor name for any condition, no matter what the primary symptoms or primary neurological deficits are. Can we name it something else? Maybe Sensory Processing Speed Disorder would be better. What do you think? Can we come up with a better name, given what we know?

9 comments:

  1. Yes! I agree...... it is a terrible name.

    I've been following your blog for the last 3 weeks. It is packed with so much information. Thank you! Both my son and I are PI.

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  2. I agree it's a terrible name. I know people who have ADHD-PI and have PhDs.

    Russell Barkley has mentioned once that it was unlikely that the term ADHD would be changed because all the laws that protect people with ADHD would have to be changed too.

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  3. How about replacing the "H" in "AD/HD" with "SP", resulting in "AD/SPD": Attention Deficit/Sensory Processing Disorder

    I guess the overall problem with the naming is indeed that the underlying brain deficits (which neurotransmitters are involved, etc.) are yet unclear. Additionally it is not really known which set of cognitive deficits are at the core of this disorder (is e.g. erratic memory recall a common symptom to all PIs?).

    I think this rather diffuse picture of the disorder makes it hard to come up with a convincing name that hits the nail on the head. And if we don't know nothing for sure there's even less reason to name it potentially insulting.

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  4. Your concern for what a panel of incompetents whose knowledge of neuroscience is two decades behind the current standard is somewhat perplexing.

    I have what these fraudulent spin doctors call SLUGGISH COGNITIVE TEMPO ...

    And I make a living teaching people to master cognitive function.

    The SCT bit always makes for a good laugh when I throw it in at the end of a seminar or workshop.

    If you're waiting for these folks to cure you, good luck. People like me research real experts and treat ourselves.

    P.S. - Great blog.

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  5. Sluggish Cognitive Tempo sounds so negative. Something like Sensory Processing Deficiency sound a bit more hopeful and positive. A deficiency is generally viewed as something that can get better. Soccer Mom

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  6. Pete, I agree with you but the problem is that we are at the mercy of those incompetents. What Russell Barkley decides to say about SCT matters even if he know precious little about the condition. What they decide to name this condition matters a GREAT deal because parents and patients will NOT get help for a condition that does not resonate with them.

    Millions of kids with Inattentive ADD have been left to fend for themselves because parents and teachers refused to believe that they had any condition other that lack of motivation. A psychiatric diagnosis of ADHD made these parents laugh out loud. Their kids were so NOT hyperactive that they psychiatrist /teachers/counselors had to be wrong.

    Whatever the new name it has to:

    1. Resonate with patients and parents
    2. Not be conceived as derogatory right off the bat
    3. Be consistent with the major signs or symptoms experience by patients

    The name matters Pete. I don't like that it matters but it does. It would be better to call it something like "Jone's Syndrome" after some fictional Dr. Jones who has researched this to the hilt than to name it SCT. I would almost prefer that they wait to include this in the DSM V until more research is done .

    Pete, thanks for your email. I DO want you to tell us more about the cognitive functioning work that you are doing. Would you consider writing a guest post?

    Mathias and Anonymous, the problem with using the name Sensory Processing Disorder or Deficiency is that there is a condition called Sensory Processing Disorder that many children have. That condition causes kids and adults to be bothered by scratchy shirt tags, loud noises, motion sickness, etc depending on what sensory system is affected.

    SCT problems involve the reaction time required for the processing of visual, tactile, auditory and probably (but who knows because it has not been studied) proprioceptive and olfactory information.

    We do not know if there is a benefit to this delay. The information may be delayed in processing but the output may be comprehended in a more global manner (as opposed to a strictly linear manner). For all we know there is a cognitive reward for this delay. If this were the case then the name should be 'Thorough Cognitive Processing' or 'Complete Cognitive Processing'.

    My son sometimes seems to be just staring into space when the family is trying to solve a puzzle or problem and then out of nowhere he comes out with a totally novel and interesting solution. Maybe his processing was sluggish but it was also more complete. Just a thought.

    Tess

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  7. Who can you recommend in the Chicagoland area for my son to have tested for this disorder?

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  8. I DON'T CARE WHAT THEY CALL IT!

    As long as it receives a new name to get the "SCT" group out of the same category as ADHD I don't care what it is called.

    The hyperactivity portion dominates the research of ADHD and there is far to little awareness about SCT.

    I could at least tell someone that I am SCT they would ask what it was and then I could explain it but right now finding info on the sluggish portion of a hyperactive disorder is nearly impossible.

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