Can working memory training work for ADHD? Development of central executive training and comparison with behavioral parent training.

Abstract

OBJECTIVE:

Working memory deficits have been linked experimentally and developmentally with attention-deficit/hyperactivity disorder (ADHD)-related symptoms/impairments. Unfortunately, substantial evidence indicates that extant working memory training programs fail to improve these symptoms/impairments. We hypothesized that this discrepancy may reflect insufficient targeting, such that extant protocols do not adequately engage the specific working memory components linked with the disorder's behavioral/functional impairments.

METHOD:

The current study describes the development, empirical basis, and initial testing of central executive training (CET) relative to gold-standard behavioral parent training (BPT). Children with ADHD ages 8-13 (M = 10.43, SD = 1.59; 21 girls; 76% Caucasian/non-Hispanic) were treated using BPT (n = 27) or CET (n = 27). Detailed data analytic plans for the pre/post design were preregistered. Primary outcomes included phonological and visuospatial working memory, and secondary outcomes included actigraphy during working memory testing and two distal far-transfer tasks. Multiple feasibility/acceptability measures were included.

RESULTS:

The BPT and CET samples did not differ on any pretreatment characteristics. CET was rated as highly acceptable by children and was equivalent to BPT in terms of feasibility/acceptability as evidenced by parent-reported high satisfaction, low barriers to participation, and large ADHD symptom reductions. CET was superior to BPT for improving working memory (Group × Time d = 1.06) as hypothesized. CET was also superior to BPT for reducing actigraph-measured hyperactivity during visuospatial working memory testing and both distal far-transfer tasks (Group × Time d = 0.74).

CONCLUSIONS:

Results provide strong support for continued testing of CET and, if replicated, would support recent hypotheses that next-generation ADHD cognitive training protocols may overcome current limitations via improved targeting. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

• Authors: Michael J Kofler, Dustin E Sarver, Kristin E Austin, Hillary S Schaefer, Elizabeth Holland, Paula A Aduen, Erica L Wells, Elia F Soto, Lauren N Irwin, Christopher Schatschneider, Christopher J Lonigan
• Journal: Journal of consulting and clinical psychology (J Consult Clin Psychol) Vol. 86 Issue 12 Pg. 964-979 (Dec 2018) ISSN: 1939-2117 [Electronic] United States
• PMID: 30507223 (Publication Type: Comparative Study, Journal Article)

Topics

• Adolescent
• Attention Deficit Disorder with Hyperactivity (psychology, therapy)
• Child
• Child Behavior (psychology)
• Executive Function
• Female
• Humans
• Learning
• Male
• Memory, Short-Term
• Parents
• Personal Satisfaction
• Psychotherapy (methods)