Working memory deficits can be overcome: Impacts of training and medication on working memory in children with ADHD

Abstract

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.

Is working memory training effective? A meta-analytic review.

“…The narrative review by Shipstead et al (2010) made it clear that many studies that have examined the effects of working memory training have not always applied adequate methodological criteria that would allow training effects to be unambiguously demonstrated (e.g., Holmes et al, 2010;Mezzacappa & Buckner, 2010). However, the methodological requirements for an adequate study to demonstrate training effects on working memory are straightforward.…”

“…Several studies were excluded because they lack a control group, since as outlined in the introduction, such studies cannot provide any convincing support for the effects of an intervention (e.g., Holmes et al, 2010;Mezzacappa & Buckner, 2010). However, among the studies that were included in our review, many used only untreated control groups.…”

“…Therefore, theoretically, if one is able to train a domaingeneral working memory capacity successfully, far-transfer effects should be expected to occur to diverse skills and tasks that children may be struggling with (e.g., word decoding, arithmetic, attentional control, behavioral inhibition, and language abilities). This notion of transfer effects (see Holmes et al, 2010;Klingberg, 2010;Perrig, Hollenstein, & Oelhafen, 2009) also explains the potential practical importance of working memory training, since it should transfer to other "real world" tasks, such as performing an IQ test, or to improved attentional skills that might have general effects on cognitive development and school attainment.…”

“…-Did not have a control group or compares two types of WM training (no untreated control group); (Gibson, Gondoli, et al 2011Holmes, Gathercole, Place, Dunning et al 2010Mezzacappa & Buckner, 2010) -Different control groups for working memory and transfer measures (K. I. E. Dahlin, 2011) -Only used raƟng scales (Beck, Hanson, et al, 2010) -Did not report data on the targeted transfer measures Engvig, Fjell, et al 2010;Li, Schmiedek, et al 2008;Kinsella, Mullaly, et al 2009;Lundquist, Grundstr m, et al 2010;Løhaugen, Antonsen et al 2010;Owen, Hampshire et al 2010;Serino, Ciaramelli, et al 2007;Takeuchi, Sekiguchi et al 2010;Vogt, Kappos, et al 2009). …”

Will Working Memory Training Generalize to Improve Off-Task Behavior in Children with Attention-Deficit/Hyperactivity Disorder?

“…Enhanced performance on nontrained WM tasks was seen in both visuospatial and verbal WM, and persisted at 3 months and at 6 months after the end of the training period, suggesting that improvements after treatment are durable after an extent of time [31,33]. Holmes et al [37] recently compared the effect of WMT to the effects of stimulant medication on short-term memory and WM in 25 children with ADHD. The dose of medication was prescribed by the treatment provider of the children.…”