Working memory and organizational skills problems in ADHD

Abstract

Background: This study tested model-driven predictions regarding working memory's role in the organizational problems associated with ADHD. Method: Children aged 8-13 (M = 10.33, SD = 1.42) with and without ADHD (N = 103; 39 girls; 73% Caucasian/Non-Hispanic) were assessed on multiple, counterbalanced working memory tasks. Parents and teachers completed norm-referenced measures of organizational problems (Children's Organizational Skills Scale; COSS). Results: Results confirmed large magnitude working memory deficits (d = 1.24) and organizational problems in ADHD (d = 0.85). Bias-corrected, bootstrapped conditional effects models linked impaired working memory with greater parent-and teacher-reported inattention, hyperactivity/impulsivity, and organizational problems. Working memory predicted organization problems across all parent and teacher COSS subscales (R 2 = .19-.23). Approximately 38%-57% of working memory's effect on organization problems was conveyed by working memory's association with inattentive behavior. Unique effects of working memory remained significant for both parent-and teacher-reported task planning, as well as for teacher-reported memory/materials management and overall organization problems. Attention problems uniquely predicted worse organizational skills. Hyperactivity was unrelated to parent-reported organizational skills, but predicted better teacher-reported task planning. Conclusions: Children with ADHD exhibit multisetting, broad-based organizational impairment. These impaired organizational skills are attributable in part to performance deficits secondary to working memory dysfunction, both directly and indirectly via working memory's role in regulating attention. Impaired working memory in ADHD renders it extraordinarily difficult for these children to consistently anticipate, plan, enact, and maintain goal-directed actions.

Reduced organizational skills in adults with ADHD are due to deficits in persistence, not in strategies

“…Furthermore, the connection between DOSQ’s Assiduity and ASRS’ hyperactivity-impulsivity matches previous findings suggesting that hyperactive symptoms may act to enhance one’s executive functioning (e.g., attention, overall arousal) when engaged in organizational-type activities ( Kofler et al, 2019 ). While hyperactivity (through the mechanism of motor engagement) has been identified as a potential enhancer of general executive functioning ( Kofler et al, 2018 ), this study clarifies that it is specifically assiduity that is particularly enhanced by such hyperactivity-impulsivity symptoms.…”

“…The term ‘organizational skills’ refers to a functional set of cognitive abilities which facilitate goal-oriented behaviour ( Clark, Prior & Kinsella, 2002 ). Previous research has identified working memory as a significant causal mechanism for the execution of organizational skills by conceptualizing working memory as both a domain-central executive and general executive function ( Kofler et al, 2011 ; Kofler et al, 2018 ). Despite its multiple conceptualizations, working memory generally refers to the cognitive process of temporary phonological and visuospatial information retention alongside simultaneous processing that is necessary for advanced cognition such as information encoding, learning, reason, and language ( Baddeley, 1992 ).…”

“…Congruent with this model, previous research has yielded consistent evidence that suggests impaired working memory is characteristic of ADHD and has a functional relationship with ADHD-typical hyperactive and inattentive behaviours ( Kofler et al, 2010 ; Rapport et al, 2009 ). In this context, the connection between organizational skills and ADHD is more apparent, as impaired working memory would inhibit the capacity to intake, integrate, and apply external information in ways necessary for goal-oriented behaviour such as organizational skills ( Kofler et al, 2018 ).…”

“…In addition, some research has shown positive relationships between the occurrence of hyperactive behaviours and the cognitive demand of a task, which suggests that hyperactive motor engagement may serve as a functional compensation for ADHD’s deficits in the executive functions necessary for organizational behaviour ( Kofler et al, 2018 ). Explanatory hypotheses largely identify this relationship as a compensatory function for working memory deficits; although, the proposed specificities of the process vary between dopaminergic cortical stimulation triggered by physiological arousal ( Kofler et al, 2018 ; Rapport et al, 2009 ), motor activated metabolic functions that regulate serotonin synthesis by enhancing pre-serotonin metabolite transportation ( Kofler et al, 2018 ; Patrick & Ames, 2015 ), and the externalization of working memory through external vocalizations which engage more efficient information processing through sensory encoding and the automatic phonological loop ( Kofler et al, 2018 ). Regardless of the working hypothesis being applied, this positive relationship suggests functional reversibility of the influential relationship between working memory and ADHD typical behaviours proposed by the functional working memory model of ADHD.…”

Keeping track of time : Daily time management, participation, and time-related interventions for children, adolescents, and young adults with neurodevelopmental disorders

“…Only one article was found investigating time-based prospective memory and the relation to time perception in children with ADHD (Mioni, Santon, executive functions, including time management (Faraone et al, 2015;Shaw et al, 2012). The consequences of time-related deficits in daily life are difficulties in automatizing routines, understanding the concept of time, achieving an overview of time, being on time for an appointment, starting and completing daily activities independently, planning and completing long-term projects, maintain goal-directed actions, understanding and using a calendar, and hurrying up if required (American Psychiatric Association, 2013; Barkley, 1997;Kofler et al, 2018;Langberg, Becker, Epstein, Vaughn, & Girio-Herrera, 2013). This difficulties affects all aspects of life: daily routines and homework, school work, and social relations (American Psychiatric Association, 2013; National Board of Health and Welfare, 2014).…”