Is working memory training the priority for ADHD patients? | SharpBrains - 0 views
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Not all children benefit from medication, some experience intolerable side effects, and many continue to struggle despite the benefits provided by medication.
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Behavior therapy can be difficult for parents to consistently implement, and does not generally reduce behavior difficulties to normative levels.
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researchers have shown growing interest in whether cognitive training — generally done via computer — can induce more lasting changes in children’s ability to focus and attend. One approach that has shown promise in helping youth with ADHD, and which is now widely available, is Working Memory Training.
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In one, children with ADHD were randomly assigned to high intensity (HI) or low intensity (LI) WM training. The HI treatment involved performing computerized WM tasks, e.g., remembering the sequence in which lights appeared in different portions of a grid, recalling a sequence of numbers in reverse order, where the difficulty level was regularly adjusted to match the child’s performance by increasing or decreasing the items to be recalled.
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Each group trained 30–40 minutes per day, 5 days per week, for 5 weeks with training supervised by parents
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A subsequent study also used random assignment to HI vs. LI training, and observed the impact on children’s behavior in a controlled classroom setting.
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The authors conclude that their findings cast “…doubt on the claims that CWMT is an effective treatment in young children with ADHD.”
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parent reports indicated significant reductions in ADHD symptoms, particularly inattentive symptoms; these reductions remained evident at 3 months. However, no benefits in ADHD symptoms were evident in reports provided by children’s teachers.
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A significant limitation in the evidence-based for using CWMT to treat youth with ADHD is the absence of teacher reported benefits.
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some have suggested that CWMT should be regarded as no more than a ‘possibly efficacious’ treatment for ADHD and not considered a ‘first-line’ treatment like medication and behavior therapy.
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Results indicated significant reductions in off-task classroom behavior among children with ADHD who received HI training. This partially addresses concerns about failure to find teacher reported benefits in other studies.
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Results from these 2 randomized-controlled trials do not support CWMT as a first-line treatment for ADHD.
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What can we conclude from this work? Despite promising initial reports suggesting that CWMT is a potentially effective treatment for ADHD, these studies significantly undercut this conclusion. This does not mean that there is no utility to CWMT, however, particularly for individuals with demonstrated working memory deficits. If one’s treatment goal is to enhance working memory, CWMT may have real value. If the goal is to bring ADHD symptoms under control, however, these findings indicate that for most children with ADHD, CWMT would not currently be considered a reasonable substitute for medication and/or behavior therapy.
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What can we conclude from this work? Despite promising initial reports suggesting that CWMT is a potentially effective treatment for ADHD, these studies significantly undercut this conclusion. This does not mean that there is no utility to CWMT, however, particularly for individuals with demonstrated working memory deficits. If one's treatment goal is to enhance working memory, CWMT may have real value. If the goal is to bring ADHD symptoms under control, however, these findings indicate that for most children with ADHD, CWMT would not currently be considered a reasonable substitute for medication and/or behavior therapy.