Research institution: Queens College, CUNY
Researchers: Anil Chacko, Ph.D.; Anne-Claude Bedard, Ph.D., David Marks, Ph.D.
Training program used in research: Cogmed RM
Status: Ongoing
The Problem: Evidence-based interventions for ADHD include stimulant medication, behavioral parent training (BPT), and behavioral classroom interventions (BCI). Although these interventions are the most effective interventions to treat ADHD in youth, they are not without notable limitations. These limitations include, first, the fact that acute effects of these interventions lack of normalization for treated youth with ADHD, and second, that there are little long-term improvements in functioning following use of these interventions. It appears that the current evidence-based interventions appear to provide acute/dose-dependent reductions in core symptoms of ADHD and related difficulties (e.g., oppositional problems) and key areas of impairment (e.g., parent-child relationships), but due to their inability to resolve underlying etiological or compensatory mechanisms (e.g., neurocognitive deficits), do not alter the often poor trajectories experienced by children with ADHD.
Given these neurocognitive deficits in ADHD and the limitations of many widely-used interventions for ADHD, further consideration must be placed on complementary approaches to ameliorating the difficulties of children with ADHD, particularly those that address suspected etiological deficiencies/compensatory mechanisms. For instance, since most behavioral or cognitive-behavioral interventions require participants to hold information on-line and assimilate treatment principles, the presence of underlying neurocognitive (e.g., working memory) deficits among youth with ADHD may preclude them from deriving benefit. These deficits may influence why psychosocial interventions for children with ADHD (e.g., cognitive interventions) have not been effective, why behavioral interventions do not generalize beyond settings where these interventions are actively implemented, and why they have limited long-term benefits. Such findings suggest that efforts to remediate and/or bolster underlying neurocognitive abilities may render youth with ADHD more responsive to psychosocial interventions. For instance, strategic sequencing of interventions, whereby neurocognitive remediation precedes behavioral intervention may enhance the efficacy of the latter intervention.
Objectives: The objective of this study is to evaluate whether a novel sequenced combination of a computerized working memory training program (Cogmed RM) targeting working memory deficits in children with ADHD in combination with BPT, a well-established, evidence-based intervention for ADHD can provide complementary and potentially augmentative benefits than what is observed with BPT alone.
