Working memory training for children with attention problems or hyperactivity: A school-based pilot study

Institution: Harvard University

Title: Computer Training of Working Memory for Children with ADHD: A School-Based Feasibility Pilot Study

Publication: School Mental Health

Researcher(s): Enrico Mezzacappa, M.D., John C. Buckner, Ph.D.

Program: Cogmed RM

Summary
The goal of this pilot investigation was to examine whether Cogmed Working Memory Training may be an effective intervention for economically disadvantaged students who struggle with ADHD symptoms. Nine, 2nd through 4th grade students identified by their teachers as struggling with symptoms of ADHD, received working memory training during the school day; training was provided for 40-45 minutes each day over a 5-week period.

Teachers completed ratings of each child’s ADHD symptoms before and after training using the ADHD Rating Scale, which inquires about the 18 symptoms of ADHD. Assessments of children’s verbal and visuo-spatial working memory were also obtained before and after training using well-established measures of these constructs, i.e., Digit Span Backwards to measure verbal working memory – and the Finger-Windows subtest of the Wide Range Assessment of Memory and Learning to measure visuo-spatial working memory. Because one child left the school during the study, follow-up data was obtained on 8 students.

Significant improvements were found on all three measures: teacher ratings of ADHD symptoms showed a significant decline after training, while children made significant gains on measures of visual and visuo-spatial working memory. The magnitude of the effects obtained would be considered large, with effect sizes ranging from .73 to 1.02. Average gains for the group were mirrored by changes at the individual level, as positive results were found for 7 of 8 students on 2 of the measures and for 6 of 8 students on the other. Although follow up ratings provided by teachers may have been biased because they were aware that students had received training, the assessments of working memory were not subject to observer bias and showed positive changes of comparable magnitude to those reported by teachers.

The authors are careful to note that conclusions drawn from this study are limited by the small sample size and the absence of an appropriate control group. However, the goals of the study were to both examine the viability of Cogmed Working Memory Training in an urban school setting and to obtain preliminary data on whether the training shows promise in this population. The answer obtained to both questions was positive and supports the value of conducting a larger controlled trial with disadvantaged students struggling with ADHD.

Although clearly preliminary, this study is important because it is the first to examine the feasibility of Cogmed Working Memory Training in an urban school environment and because it represents another set of positive results obtained by researchers who have no affiliation with Cogmed.