Overview
This lecture distinguishes Sluggish Cognitive Tempo (SCT) from ADHD, covering symptoms, family characteristics, and effective treatments for SCT.
SCT vs. ADHD: Core Differences
- SCT affects 30-50% of children diagnosed as inattentive type ADHD but is likely a distinct disorder.
- SCT symptoms (slow processing, lethargy, social withdrawal) are opposite to ADHD symptoms (impulsivity, hyperactivity).
- SCT children struggle with focused attention and may have long-term memory issues, unlike ADHD children.
- SCT children are socially reticent and prone to anxiety, with low rates of oppositional defiant disorder (ODD) and conduct disorder (CD).
- ADHD is a self-regulation and inhibition disorder; SCT is not.
- ADHD children often have more family issues (e.g., ADHD, anti-social behavior, substance abuse) than SCT children.
Impact on School and Social Life
- SCT is mainly a problem of accuracy in schoolwork; children complete assignments but make frequent errors.
- ADHD is a productivity disorder, with children often failing to complete work.
- SCT children are generally well-behaved outside school, have a few friends, and do not cause disruptions.
- Parents of SCT children mainly worry about school performance, not broader behavioral or social issues.
Treatment and Intervention
- Standard ADHD medications are mostly ineffective for SCT; lowest doses may be tried but rarely continued.
- SCT responds best to social skills training in natural settings (e.g., school), not clinics.
- Social skills groups can make 1 in 4 children worse due to deviancy training; clinicians should be cautious.
- Behavioral interventions may work even better for SCT than ADHD, as anxiety predicts positive response.
- Cognitive therapy fails for ADHD but may be worth exploring for SCT.
- Medications like Atomoxetine (Strattera) and Modafinil (Provigil) are speculative options for SCT; evidence is lacking.
Key Terms & Definitions
- SCT (Sluggish Cognitive Tempo) — A disorder with symptoms of slow processing, lethargy, and social withdrawal, distinct from ADHD.
- ADHD (Attention Deficit Hyperactivity Disorder) — A disorder characterized by impulsivity, hyperactivity, and self-regulation deficits.
- ODD (Oppositional Defiant Disorder) — A behavioral disorder with defiant and disruptive behaviors.
- CD (Conduct Disorder) — A disorder involving repetitive, aggressive, or antisocial behavior.
Action Items / Next Steps
- If working with SCT children, prioritize school-based interventions and social skills training.
- Do not apply standard ADHD resources or treatments directly to SCT cases.
- Monitor new research and interventions specific to SCT as the field develops.