Saturday, May 8, 2010

Perseveration in the Workplace

A horizontal slice of the head of an adult man...Image via Wikipedia
Perseveration (getting stuck in a groove) in the workplace:  The video at the link below. contrasts a normal person carrying on about sports ad infinitum and ad nauseum contrasted with an autistic person holding forth on parrots.  "Some perseverations are [considered] better than others,"   Square 8: Perseveration in the Workplace

As per my neuropsychiatric examination, I perseverate, too.  I took the WISC card sorting test and scored below normal.   The WISC card sorting test relies upon a number of intact cognitive functions including attention, working memory, and visual processing.  According to one study, it seems reasonable to infer that the brain responses elicited by those set-shifting events engage a widely distributed neural network of cortical and subcortical structures, reflecting the complex and dynamic interplay between the cerebral
representations of the eliciting stimulus and its associated task context along several time scales.

 Also, the P3b wave measured on the EEG is involved in this task as well. A P3B wave is a subset of the P300 wave, which is generated when the brain receives information that indicates that it needs to change these hypotheses, or update its mental state. This is very interesting because it is P3b that is also involved with auditory processing and in particular for me, the click test.  When I first took the audiology test with Maxine Young on differentiating between one click or two clicks, I failed that test royally.  As in didn't get a single question correct.  Deficits with the click tests are also correlated with this P3B wave.  Don't quite know what the connection is, if there is one, between perseveration and auditory processing disorder, but it is interesting to speculate on.  In vision therapy, we worked on audio-visual integration and audio-audio integration of counting beeps and flashes in various combinations.  Other interesting little factoids include: links with psychopathology, and cocaine addiction and alcoholism.  Training in standard musical chord progressions also influences the P3b wave.  There is some evidence that the locus coeruleus norepinephrine system might be responsible for generating the P3b.  Finally, there is speculation  that autism could just be due to dysregulation of the locus coeruleus.

Interestingly enough, mental illnesses such as Schizophrenia and Major Depression show degraded performance on the WISC card sorting test.  Although apparently major depression does not impact the WISC test as much as Schizophrenia does.

Another thought is the relationship between "special interests" that folks on the Autism spectrum have and perseveration.  When are people following their special interests and when are they just perseverating?  Also, looking at the "Gifted and Talented"'s overexcitabilities and passions for subjects.  When are they just being Gifties and when are they getting stuck or overly involved in their own little world.  Gifties also are noted for having a lot of determination and stick to it-iveness.  So when is determination perseverance and when is it perseveration?

Sometimes I wonder about this in terms of how much I devote myself to this blog!

Going back to the workplace.  Sometimes, I think that I can go off on a topic and stick on a topic that folks around me aren't that interested in.  Sometimes, I think perseveration may have combined with slow processing speed in that I am still on topic A when everyone else has moved to topic B.  Other times, I think maybe it's not  perseveration, per se.  but that I have gotten very excited about something and feel that it is very important to get my point across. 

I think perseveration has impacted my work sometimes when I have been diagnosing a problem.  I can see that in the past that sometimes I have retraced my steps repeatedly on a pathway that I have decided does not work.  But I have kept going back to it.

What I would like to get some idea about is how the different therapies that I have done such as vision therapy, Tomatis, Balametrics, and Interactive Metronome and the progress that I have made has impacted executive function.  Just getting the lower level senses to work properly should and does help, somewhat.  The vision therapy should have improved the visual processing piece of being able to look at the cards and understand the patterns.  All the therapies will have helped attention and working memory.  It would be nice to think that any problem I have had with perseveration was really a sensory integration problem and not a true executive function problem, but somehow, I don't think so.  At any rate, I do feel that I don't get stuck on things as much as I used to. 

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