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      RCT of Working Memory Training in ADHD: Long-Term Near-Transfer Effects

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          Abstract

          Objective

          The aim of the study is to evaluate the long-term near-transfer effects of computerized working memory (WM) training on standard WM tasks in children with Attention-Deficit/Hyperactivity Disorder (ADHD).

          Method

          Sixty-seven children aged 10–12 years in Vestfold/Telemark counties (Norway) diagnosed with F90.0 Hyperkinetic disorder (ICD-10) were randomly assigned to training or control group. The training group participated in a 25-day training program at school, while the control group received treatment-as-usual. Participants were tested one week before intervention, immediately after and eight months later. Based on a component analysis, six measures of WM were grouped into composites representing Visual, Auditory and Manipulation WM.

          Results

          The training group had significant long-term differential gains compared to the control group on all outcome measures. Performance gains for the training group were significantly higher in the visual domain than in the auditory domain. The differential gain in Manipulation WM persisted after controlling for an increase in simple storage capacity.

          Conclusion

          Systematic training resulted in a long-term positive gain in performance on similar tasks, indicating the viability of training interventions for children with ADHD. The results provide evidence for both domain-general and domain-specific models. Far-transfer effects were not investigated in this article.

          Trial Registration: Controlled-Trials.com ISRCTN19133620

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          A developmental perspective on executive function.

          John R. Best, Patricia Miller (2010)
          This review article examines theoretical and methodological issues in the construction of a developmental perspective on executive function (EF) in childhood and adolescence. Unlike most reviews of EF, which focus on preschoolers, this review focuses on studies that include large age ranges. It outlines the development of the foundational components of EF-inhibition, working memory, and shifting. Cognitive and neurophysiological assessments show that although EF emerges during the first few years of life, it continues to strengthen significantly throughout childhood and adolescence. The components vary somewhat in their developmental trajectories. The article relates the findings to long-standing issues of development (e.g., developmental sequences, trajectories, and processes) and suggests research needed for constructing a developmental framework encompassing early childhood through adolescence. © 2010 The Authors. Child Development © 2010 Society for Research in Child Development, Inc.
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            Computerized training of working memory in children with ADHD--a randomized, controlled trial.

            Torkel Klingberg, Elisabeth Fernell, Pernille J Olesen … (2005)
            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. 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. For the span-board task, there was a significant treatment effect both post-intervention 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. 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.
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              Is working memory training effective?

              Zach Shipstead, Thomas Redick, Randall Engle (2012)
              Working memory (WM) is a cognitive system that strongly relates to a person's ability to reason with novel information and direct attention to goal-relevant information. Due to the central role that WM plays in general cognition, it has become the focus of a rapidly growing training literature that seeks to affect broad cognitive change through prolonged training on WM tasks. Recent work has suggested that the effects of WM training extend to general fluid intelligence, attentional control, and reductions in symptoms of ADHD. We present a theoretically motivated perspective of WM and subsequently review the WM training literature in light of several concerns. These include (a) the tendency for researchers to define change to abilities using single tasks, (b) inconsistent use of valid WM tasks, (c) no-contact control groups, and (d) subjective measurement of change. The literature review highlights several findings that warrant further research but ultimately concludes that there is a need to directly demonstrate that WM capacity increases in response to training. Specifically, we argue that transfer of training to WM must be demonstrated using a wider variety of tasks, thus eliminating the possibility that results can be explained by task specific learning. Additionally, we express concern that many of the most promising results (e.g., increased intelligence) cannot be readily attributed to changes in WM capacity. Thus, a critical goal for future research is to uncover the mechanisms that lead to transfer of training.
              Article 0 comments Cited 309 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Evelyn Kroesbergen: Role: Editor
                Journal
                Journal ID (nlm-ta): PLoS One
                Journal ID (iso-abbrev): PLoS ONE
                Journal ID (publisher-id): plos
                Journal ID (pmc): plosone
                Title: PLoS ONE
                Publisher: Public Library of Science (San Francisco, USA )
                ISSN (Electronic): 1932-6203
                Publication date Collection: 2013
                Publication date (Electronic): 9 December 2013
                Volume: 8
                Issue: 12
                Electronic Location Identifier: e80561
                Affiliations
                [1 ]Division of Mental Health and Addiction, Vestfold Hospital Trust, Tønsberg, Norway
                [2 ]Department of Psychology, University of Oslo, Oslo, Norway
                [3 ]Division of Child and Adolescent Psychiatry, Telemark Hospital Trust, Skien, Norway
                Langeveld Institute, Utrecht University, The Netherlands
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: AKA BKS JE. Performed the experiments: AKA BKS KTH. Analyzed the data: KTH JE. Contributed reagents/materials/analysis tools: BKS AKA JE. Wrote the paper: KTH JE BKS AKA.

                Article
                Publisher ID: PONE-D-13-18536
                DOI: 10.1371/journal.pone.0080561
                PMC ID: 3857172
                SO-VID: df430fa7-f59a-404a-86ce-967d45713b85
                Copyright statement: Copyright @ 2013
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 30 April 2013
                Date accepted : 2 October 2013
                Page count
                Pages: 9
                Funding
                Funding from a grant from the Centre for Child and Adolescent Mental Health, Eastern & Southern Norway and a grant from The Norwegian Resource Center for ADHD, Tourette and Narcolepsy. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Subject: Research Article

                ScienceOpen disciplines: Uncategorized
                Data availability:
                ScienceOpen disciplines: Uncategorized

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