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 6-month 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.
The purpose of this study was to explore the profiles of classroom behaviour relating to attention and executive functions in children with very poor working memory, and to test the hypothesis that inattentive behaviour and working memory problems co-occur. Teachers rated problem behaviours of 52 children with low working memory scores aged 5/6 and 9/10 years on teacher rating measures of attention and executive function behaviours. The majority of children with low working memory scores obtained atypically high ratings of cognitive problems/ inattentive symptoms, and were judged to have short attention spans, high levels of distractibility, problems in monitoring the quality of their work, and difficulties in generating new solutions to problems. These results extend previous findings that working memory problems and inattentive behaviour co-occur to a non-clinical sample. It is suggested that reduced working memory capacity may play a causal role in the problem behaviours of these children.
Background: Deficits in executive functions have been widely reported to characterise individuals with ADHD. The aim of this study was to evaluate the utility of a range of executive function measures for identifying children with ADHD. Method: Eighty-three children with ADHD and 50 normally-developing children without ADHD were assessed on measures of inhibition, set-shifting, planning, problem-solving, response inhibition, sustained attention and working memory. Measures of sensitivity, specificity, likelihood ratios and diagnostic odds ratios were calculated. Results: Executive function tasks effectively discriminated between children with and without ADHD. Measures of response inhibition and working memory contributed the most to the discriminant function. Conclusions: Cognitive measures of executive function can be used to help identify children with ADHD and could be useful as additional diagnostic tools for clinical practitioners.
Key Practitioner Message:• ADHD diagnoses are often based heavily upon symptoms assessed by behavioural checklists. These can lack diagnostic utility.• It is possible to enhance clinical diagnoses of ADHD by employing neuropsychological / cognitive tests of executive functioning; • Where there is little opportunity to undertake a full range of cognitive measures, brief tests of response inhibition and working memory can provide high levels of discrimination between individuals with and without ADHD.• Guidance from clinicians about the difficulties in executive functioning experienced by children with ADHD may prove helpful to teachers and parents.
The purpose of this study was to compare working memory (WM), executive function, academic ability, and problem classroom behaviors in children aged 8–11 years who were either identified via routine screening as having low WM, or had been diagnosed with ADHD. Standardized assessments of WM, executive function and reading and mathematics were administered to 83 children with ADHD, 50 children with low WM and 50 typically developing children. Teachers rated problem behaviors on checklists measuring attention, hyperactivity/impulsivity, oppositional behavior, and difficulties associated with executive function in the classroom. The ADHD and low WM groups had highly similar WM and executive function profiles, but were distinguished in two key respects: children with ADHD had higher levels of rated and observed impulsive behavior, and children with low WM had slower response times. Possible mechanisms for these common and distinct deficits are discussed.
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