Effects of a computerized working memory training program on working memory, attention, and academics in adolescents with severe LD and comorbid ADHD: a randomized controlled trial.

BACKGROUND Youths with coexisting learning disabilities (LD) and attention deficit hyperactivity disorder (ADHD) are at risk for poor academic and social outcomes. The underlying cognitive deficits, such as poor working memory (WM), are not well targeted by current treatments for either LD or ADHD. Emerging evidence suggests that WM might be improved by intensive and adaptive computerized training, but it remains unclear whether this intervention would be effective for adolescents with severe LD and comorbid ADHD. METHODS A total of sixty 12- to 17-year olds with LD/ADHD (52 male, 8 female, IQ > 80) were randomized to one of two computerized intervention programs: working memory training (Cogmed RM) or math training (Academy of Math) and evaluated before and 3 weeks after completion. The criterion measures of WM included auditory-verbal and visual-spatial tasks. Near and far transfer measures included indices of cognitive and behavioral attention and academic achievement. RESULTS Adolescents in the WM training group showed greater improvements in a subset of WM criterion measures compared with those in the math-training group, but no training effects were observed on the near or far measures. Those who showed the most improvement on the WM training tasks at school were rated as less inattentive/hyperactive at home by parents. CONCLUSIONS Results suggest that WM training may enhance some aspects of WM in youths with LD/ADHD, but further development of the training program is required to promote transfer effects to other domains of function.

[1]  Joni Holmes,et al.  Adaptive training leads to sustained enhancement of poor working memory in children. , 2009, Developmental science.

[2]  Patricia N. Pastor,et al.  Diagnosed attention deficit hyperactivity disorder and learning disability: United States, 2004-2006. , 2008, Vital and health statistics. Series 10, Data from the National Health Survey.

[3]  T. Klingberg,et al.  Increased prefrontal and parietal activity after training of working memory , 2004, Nature Neuroscience.

[4]  J C Dumville,et al.  The use of unequal randomisation ratios in clinical trials: a review. , 2006, Contemporary clinical trials.

[5]  Julian Elliott,et al.  The working memory rating scale: A classroom-based behavioral assessment of working memory , 2009 .

[6]  T. Klingberg,et al.  Computerized working memory training after stroke–A pilot study , 2007, Brain injury.

[7]  H. Forssberg,et al.  Computerized training of working memory in children with ADHD--a randomized, controlled trial. , 2005, Journal of the American Academy of Child and Adolescent Psychiatry.

[8]  B. Milner,et al.  Deficits on subject-ordered tasks after frontal- and temporal-lobe lesions in man , 1982, Neuropsychologia.

[9]  M. D’Esposito.  Working memory. , 2008, Handbook of clinical neurology.

[10]  G. Farkas,et al.  Kindergarten Children’s Growth Trajectories in Reading and Mathematics , 2011, Journal of learning disabilities.

[11]  B. Pennington,et al.  Etiology and neuropsychology of comorbidity between RD and ADHD: The case for multiple-deficit models , 2010, Cortex.

[12]  Susan E. Gathercole,et al.  Working memory assessments at school entry as longitudinal predictors of National Curriculum attainment levels , 2003, Educational and Child Psychology.

[13]  R. Tannock,et al.  Behavioral and Brain Functions , 2006 .

[14]  F. Castellanos,et al.  Neuroscience of attention-deficit/hyperactivity disorder: the search for endophenotypes , 2002, Nature Reviews Neuroscience.

[15]  R. Brickenkamp,et al.  D2 Test of Attention , 1998 .

[16]  H. Forssberg,et al.  Training of Working Memory in Children With ADHD , 2002 .

[17]  L. Fuchs,et al.  The Cognitive and Academic Profiles of Reading and Mathematics Learning Disabilities , 2012, Journal of learning disabilities.

[18]  K. Dahlin.  Effects of working memory training on reading in children with special needs , 2011 .

[19]  B. Pennington,et al.  Neuropsychological Analyses of Comorbidity Between Reading Disability and Attention Deficit Hyperactivity Disorder: In Search of the Common Deficit , 2005, Developmental neuropsychology.

[20]  Heungsun Hwang,et al.  Inattention, working memory, and academic achievement in adolescents referred for attention deficit/hyperactivity disorder (ADHD) , 2011, Child neuropsychology : a journal on normal and abnormal development in childhood and adolescence.

[21]  Jamie Zibulsky,et al.  Wide Range Achievement Test–Fourth Edition , 2014 .

[22]  T. Klingberg.  Training and plasticity of working memory , 2010, Trends in Cognitive Sciences.

[23]  B. Gibson,et al.  Child Neuropsychology: A Journal on Normal and Abnormal Development in Childhood and Adolescence , 2010 .

[24]  B. Pennington,et al.  A multiple deficit model of reading disability and attention-deficit/hyperactivity disorder: searching for shared cognitive deficits. , 2011, Journal of child psychology and psychiatry, and allied disciplines.

[25]  H. Gelhorn,et al.  The Co-occurrence of Reading Disorder and ADHD , 2012, Journal of learning disabilities.

[26]  W. Pelham,et al.  Normative Data on the IOWA Conners Teacher Rating Scale , 1989 .

[27]  A. Diamond,et al.  Genetic and neurochemical modulation of prefrontal cognitive functions in children. , 2004, The American journal of psychiatry.

[28]  Ralph L. Rosnow,et al.  Essentials of Behavioral Research: Methods and Data Analysis , 1984 .

[29]  Andy Field,et al.  Discovering statistics using SPSS, 2nd ed. , 2005 .

[30]  T. Robbins,et al.  Neuorpsychiatyric applications of CANTAB , 1996 .