Marburg concentration training (MKT) for children is a psychological or child psychiatric therapy method for treating a concentration disorder in childhood. The procedure is based on the use of self-instructional training and is used as a therapeutic method of cognitive-behavioral training for preschool and school-age children. Concentration training is intended to enable children to self-instruct on the one hand, and to facilitate everyday functions, such as doing homework, on the other. Self-instruction refers to a method in which children learn an inner monologue for planning and regulating their own behavior in order to specifically identify everyday problems, but also to determine the demands on themselves and to plan their own behavior. In addition, this method is used to reinforce feelings of success and to learn how to deal with frustration. In addition to self-instruction, relaxation techniques, for example autogenic training, and behavior modification are part of Marburg concentration training.
Indication (areas of application)
- ADHD (Attention Deficit/Hyperactivity Disorder) and ADD (Attention Deficit Disorder) – ADHD is characterized by a lack of persistence in cognitive pursuits and an erratic tendency. The behavior appears hyperactive and disorganized compared to the social norm. In addition to inattention and hyperactivity, marked impulsivity is also typical, although impulsivity and hyperactivity may be more often absent, especially in the female gender, in which case a diagnosis of pure attention deficit disorder (ADHD) should be made. To be diagnosed, the symptoms must first appear before the age of 7, be present for at least 6 months and be observable in several situations (classically: school and home environment).
- Combined disorders – Child and adolescent psychiatric disorders such as ADHD often occur in combination with other psychiatric disorders such as social behavior disorder. Through adequate therapy of a concentration disorder, among other things, with the help of the Marburg concentration training, other disturbance patterns can be accessible to cognitive behavioral therapy or other therapeutic measures.
Contraindications
Cognitive behavioral therapy (CBT) in combination with other methods such as remedial education, self-instructional training, parent training and conditioning programs (desired behavior is followed by immediate reward) constitute the basis of therapy of ADHD and ADD. Based on this, there are no absolute contraindications, but the therapy must be adapted to the intelligence level of the child. In the case of mental retardation, cognitive methods are often of very limited use and practical exercises as well as parent training and occupational therapy take a more important part of the therapy.
Before therapy
Before therapy, it is necessary to check whether a psychiatric disorder such as ADHD is diagnosed and whether combined disorder patterns are present. Furthermore, in the case of combined disorder patterns, an order of priority for therapy must be established, which therapy methods are to be used first and which measures are necessary in order to be able to carry out concentration training at all.
The procedure
The Marburg concentration training aims to reduce the symptoms of concentration deficit and impulsivity of ADHD. For this purpose, training is carried out with the affected children in several situations (at home and at school). The most important component of the Marburg concentration training is the self-instruction training, which can be divided into five phases:
- Model learning: the therapist performs a task himself as a model, while she or he speaks aloud to himself.
- External control: the child performs the same task by himself or herself while the therapist instructs him or her aloud. This is followed by the joint processing of the task by the therapist and the child.
- Thinking aloud: the child again performs the task himself, but the child instructs himself aloud. Initially, this requires assistance from the therapist.The child then speaks the instructions for the individual steps and performs the respective task, with the other children also performing the task. It is important here that the therapist praises and thereby reinforces successes of the children.
- Quiet self-instruction: following the child performs the task, instructing himself whispering. After solving each task, each child praises himself again aloud.
- Inner speech or self-instruction: last step of self-instruction training is to perform the task and think the instruction. The goal here is to generalize the self-instruction to other activities in everyday life. Thus, the child can apply the procedure in homework or in school lessons.
After therapy
The success of therapy can be monitored using various methods, such as questionnaires and psychological tests. If the symptoms do not improve sufficiently or if combined disorders are present, additional pharmacological therapy may be necessary. Various drugs are approved for ADHD, and an individual selection is necessary for each patient.