How I Talk to Parents About “Sluggish Cognitive Tempo”

Last year, I read an article in the New York Times about sluggish cognitive tempo (SCT), a possible new condition that’s being hotly debated by experts. The main symptoms of SCT are said to be lethargy, daydreaming and slow mental processing.

When I read the article, my initial reaction was, Who on earth came up with that terrible name?

But I decided to take a closer look. Terrible name or not, SCT does seem to describe some of the kids I’ve worked with.

The first thing I found is that one of the biggest proponents of SCT is Dr. Russell Barkley, a pioneer in our understanding of ADHD. Dr. Barkley sees SCT as a condition that affects attention in low-activity individuals. These children have issues like daydreaming and sleepiness, along with slow movement, sluggishness and passivity. With schoolwork, they may skip questions, not turn in assignments and forget to put their names on papers.

Dr. Barkley sees SCT as distinct from but overlapping with . He also has a somewhat better name for SCT—“concentration deficit disorder.”

As I learned about SCT, one of my students, Jeff, kept popping into my head. The clinical descriptions sounded so much like Jeff that I decided to reach out to his mom to get her thoughts. Here’s how our conversation went:

Me: Did you see this article in the New York Times about SCT? It offers a new way of thinking about the issues your son struggles with. There’s not really agreement in the research community, but these ideas are gaining traction. Mom: Yikes—I felt good reading the New York Times article. But I’ve heard a lot of skepticism as well. In fact, I just saw this article from Psychology Today, “No Child Left Undiagnosed: The Latest Ploy to Make Childhood a Disease.” Who should I pay attention to? Me: Both sides make important points. As I said, there is no agreement on whether SCT is real. There are top experts on both sides of the debate. But here’s my two cents for you and Jeff. There are reputable doctors who are closely studying children with some specific observable symptoms. Your son has those symptoms. To me, that means those doctors may have some insight into the issues Jeff struggles with. It doesn’t matter if SCT is called a real clinical disorder or not. The issues the doctors are studying are real for your son and for you. And if careful professionals have gained new insights, it’s worth looking into. Mom: Hmmm. That makes a lot of sense. I’m not alone, he isn’t unusual and perhaps there is an intervention I could consider at some point. As always, thank you.

Now, I always have reservations about pointing parents to approaches that aren’t more settled. The field of learning and thinking differences is littered with ideas that sound good but that don’t work or aren’t helpful. There are many approaches that are new and exciting but have little or no good research to support them.

But the professionals working on SCT are being appropriately cautious about the claims they’re making. (SCT has been discussed since the 1980s.) They aren’t presenting untested interventions. What they’re really doing is rethinking how issues could be related.

My hope for Jeff’s mom—and really for any parent—is that they keep an open mind. We know kids are struggling with attention issues, including sluggishness and low activity. Parents need to have good, critical conversations with doctors and professionals they trust about this. Using the ideas raised by SCT could help you and your doctor think through what might be done differently to support your child.

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