Can PC-based training boost working memory in ADHD preadolescents on medication? : a clinical intervention study (original) (raw)
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Applied Cognitive Psychology, 2009
This study evaluated the impact of two interventions-a training program and stimulant medication-on working memory (WM) function in children with attention deficit hyperactivity disorder (ADHD). Twenty-five children aged between 8 and 11 years participated in training that taxed WM skills to the limit for a minimum of 20 days, and completed other assessments of WM and IQ before and after training, and with and without prescribed drug treatment. While medication significantly improved visuo-spatial memory performance, training led to substantial gains in all components of WM across untrained tasks. Training gains associated with the central executive persisted over a 6month period. IQ scores were unaffected by either intervention. These findings indicate that the WM impairments in children with ADHD can be differentially ameliorated by training and by stimulant medication.
A Review of Working Memory Training in the Management of Attention Deficit Hyperactivity Disorder
Frontiers in Behavioral Neuroscience
Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders among children. Working memory deficits underlie many of the behavioural symptoms of ADHD. Alongside psychostimulant medications, strategies to improve working memory may play an important adjuvant role in the management of ADHD. In this study, we review the role of working memory deficits in ADHD, the evidence surrounding working memory training strategies in the management of the condition, and the factors affecting the success of these strategies in alleviating ADHD symptoms. More specifically, we review several non-pharmacological interventions that target working memory deficits in ADHD, with special emphasis on cognitive working memory training. We conclude that the development of evidence-based interventions such as computerised cognitive training (CCT) could provide an alternative or adjunct to the use of psychostimulants, especially in cases where side effects are a major ...
Background: Cogmed Working Memory Training (CWMT) has received considerable attention as a promising intervention for the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) in children. At the same time, methodological weaknesses in previous clinical trials call into question reported efficacy of CWMT. In particular, lack of equivalence in key aspects of CWMT (i.e., contingent reinforcement, time-on-task with computer training, parent– child interactions, supportive coaching) between CWMT and placebo versions of CWMT used in previous trials may account for the beneficial outcomes favoring CWMT. Methods: Eighty-five 7-to 11-year old school-age children with ADHD (66 male; 78%) were randomized to either standard CWMT (CWMT Active) or a well-controlled CWMT placebo condition (CWMT Placebo) and evaluated before and 3 weeks after treatment. Dependent measures included parent and teacher ratings of ADHD symptoms; objective measures of attention, activity level, and impulsivity; and psychometric indices of working memory and academic achievement (Clinical trial title: Combined cognitive remediation and behavioral intervention for the treatment of Attention-Deficit/Hyperactivity Disorder; http:// clinicaltrials.gov/ct2/show/NCT01137318). Results: CWMT Active participants demonstrated significantly greater improvements in verbal and nonverbal working memory storage, but evidenced no discernible gains in working memory storage plus processing/manipulation. In addition, no treatment group differences were observed for any other outcome measures. Conclusions: When a more rigorous comparison condition is utilized, CWMT demonstrates effects on certain aspects of working memory in children with ADHD; however, CWMT does not appear to foster treatment generalization to other domains of functioning. As such, CWMT should not be considered a viable treatment for children with ADHD.
The Effects of Working Memory Training on Adult ADHD Symptoms
Attention-Deficit/Hyperactivity Disorder (ADHD) is often regarded as a disorder of childhood and adolescence, but it affects millions of adults each year. For adults the symptoms of ADHD can include inattention, impulsivity and a poor working memory. Computerized cognitive working memory training has previously been used with children and adolescents with ADHD to see how it affects their symptoms with some success; however, this work had not been done yet with adults with ADHD. This study used a quantitative quasi- experimental design with an experimental group and a wait list control group to look at the effects of working memory training on ADHD symptoms on a sample of adults with ADHD. All participants met with this researcher for pretest and posttest measures, which consisted of two subtests from the Wechsler Memory Scales III (Spatial Span Board and Letter Number Sequencing) that were combined as one measure, and the overall ADHD score on the Attention of Variable’s Test (TOVA) as a second measure. The experimental group used a computerized working memory training program for a period of five weeks (or 25 sessions) in their homes. A MANOVA was used to look at within and between group differences on post test scores. A statistically significant improvement in working memory scores was seen in the experimental group from pretest to post-test. An improvement on TOVA scores was also seen, but not to a statistically significant degree.
Computerized Training of Working Memory in Children With ADHD-A Randomized, Controlled Trial
Journal of the American Academy of Child & Adolescent Psychiatry, 2005
Objective: Deficits in executive functioning, including working memory (WM) deficits, have been suggested to be important in attention-deficit/hyperactivity disorder (ADHD). During 2002 to 2003, the authors conducted a multicenter, randomized, controlled, double-blind trial to investigate the effect of improving WM by computerized, systematic practice of WM tasks. Method: Included in the trial were 53 children with ADHD (9 girls; 15 of 53 inattentive subtype), aged 7 to 12 years, without stimulant medication. The compliance criterion (>20 days of training) was met by 44 subjects, 42 of whom were also evaluated at follow-up 3 months later. Participants were randomly assigned to use either the treatment computer program for training WM or a comparison program. The main outcome measure was the span-board task, a visuospatial WM task that was not part of the training program. Results: For the span-board task, there was a significant treatment effect both postintervention and at follow-up. In addition, there were significant effects for secondary outcome tasks measuring verbal WM, response inhibition, and complex reasoning. Parent ratings showed significant reduction in symptoms of inattention and hyperactivity/impulsivity, both post-intervention and at follow-up. Conclusions:This study shows that WM can be improved by training in children with ADHD. This training also improved response inhibition and reasoning and resulted in a reduction of the parent-rated inattentive symptoms of ADHD.
Hospital-Based Modified Cogmed Working Memory Training for Youth With ADHD
Journal of Attention Disorders, 2021
Objective: This study evaluated a modified working memory training program, Cogmed, for ADHD youth. Method: Forty youth were randomized to modified Cogmed training (MCT) or treatment as usual (CON). MCT was delivered in an outpatient mental health clinic in 3 weekly 35-minute sessions with a dedicated coach for 10 weeks. Participants completed assessments at baseline, after the intervention, and again 3 months later. Results: After controlling for baseline, groups were comparable on working memory, academics, and ADHD symptoms. The MCT group was rated by parents and teachers as having fewer executive function challenges and youth endorsed better self-concept compared with the CON group. Conclusions: MCT was associated with some improvement, which could not be attributed to increased working memory capacity and may reflect other facets of the program. Results question the usefulness of Cogmed but highlight considerations for optimizing adherence, engagement, and the therapeutic allia...
Journal of Educational and Developmental Psychology
Commercial cognitive training programs have been proposed as a non-pharmacological treatment of ADHD-related outcomes, such as learning difficulties and academic achievement. Most of these programs focus on working memory, an essential cognitive ability sustaining nearly every conscious mental activity. In this article, we present and summarize the main studies assessing the effectiveness of such training programs on working memory. The reported studies have failed to show a positive far-transfer and long-term effect of cognitive training both in typically developing individuals and children with ADHD. In the end, we present emerging alternative approaches to the use of cognitive training to improve working memory functioning in children with ADHD.