CoChat
Sign Up
Cited by 176Attention Deficit Hyperactivity DisorderCognitive Abilities and TestingDevelopmental and Educational Neuropsychology

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

Open access
Green, Chloe T., Long, Debra L., Green, David, Iosif, Ana-Maria, Dixon, J. Faye, Miller, Meghan R., Fassbender, Catherine, Schweitzer, Julie B.·2012·Neurotherapeutics
DOI 10.1007/s13311-012-0124-yPMC PMC3441930
Open this paper in CoChat — free accountOpen PDF

Abstract

Computerized working memory and executive function training programs designed to target specific impairments in executive functioning are becoming increasingly available, yet how well these programs generalize to improve functional deficits in disorders, such as attention-deficit/hyperactivity disorder (ADHD), beyond the training context is not well-established. The aim of this study was to examine the extent to which working memory (WM) training in children with ADHD would diminish a core dysfunctional behavior associated with the disorder, "off-task" behavior during academic task performance. The effect of computerized WM training (adaptive) was compared to a placebo condition (nonadaptive) in a randomized, double-blind, placebo-controlled design in 26 children (18 males; age, 7 to 14 years old) diagnosed with ADHD. Participants completed the training in approximately 25 sessions. The Restricted Academic Situations Task (RAST) observational system was used to assess aspects of off-task behavior during the completion of an academic task. Traditional measures of ADHD symptoms (Conners' Parent Rating Scale) and WM ability (standardized WM tests) were also collected. WM training led to significant reductions in off-task ADHD-associated behavior on the RAST system and improvement on WM tests. There were no significant differences between groups in improvement on parent rating scales. Findings lend insight into the generalizability of the effects of WM training and the relation between deficits in WM and off-task behavioral components of ADHD. These preliminary data suggest WM training may provide a mechanism for indirectly altering academic performance in children with ADHD.

AI snapshot

Written from the paper’s full text.

TL;DR

In a randomized, double-blind, placebo-controlled trial with 26 children diagnosed with ADHD, adaptive computerized working memory training reduced observed off-task behavior during an academic task and improved a standardized working memory index. Parent-rated ADHD symptoms improved over time in both the training and placebo groups, with no significant between-group difference.

Key findings

  • On the Restricted Academic Situations Task, the adaptive training group’s off-task behavior fell from 26.2 ± 11.8 to 13.9 ± 6.7, while the placebo group stayed near baseline (22.7 ± 9.5 to 22.7 ± 9.0); the group-by-time difference was 12.3 points ± 4.6 SE, p = 0.01.
  • “Plays with object” behavior decreased in the active group from 9 of 12 children (75%) to 1 of 12 (8%), compared with 8 of 14 (57%) to 7 of 14 (50%) in placebo; the interaction estimate was 3.4, p = 0.04. No significant training effects appeared for fidgets, out-of-seat, or vocalizes.
  • WISC-IV Working Memory Index scores improved in the active group from 95.9 ± 10.6 to 102.3 ± 9.1, but not in placebo (90.0 ± 10.1 to 88.0 ± 13.5); the between-group difference in improvement was 8.4 ± 3.3 SE, p = 0.02.
  • Conners’ Parent Rating Scale ADHD Index scores declined in both groups (placebo 78.1 ± 8.3 to 70.9 ± 8.3; active 72.5 ± 7.5 to 67.0 ± 12.2), with no significant group difference (estimated difference −1.3 ± 4.0 SE, p = 0.74).

Methods

  • Randomized, double-blind, placebo-controlled design: 32 children were pre-screened, 30 were randomized, and 26 completed the study (12 active training, 14 placebo), ages 7 to 14 years, all diagnosed with ADHD.
  • Participants used Cogmed working memory tasks for approximately 25 sessions, completing 90 trials per day; the active condition adjusted difficulty to each child’s span, while the placebo condition kept difficulty low and nonadaptive. Both groups received coaching and feedback.
  • Outcomes included the RAST observational academic task, WISC-IV Working Memory Index, and Conners’ Parent Rating Scale-Revised. Analyses used generalized linear models with group, time, their interaction, medication use as a covariate, and a random effect for child.

Limitations

  • The paper states that more children in the active group were taking prescribed ADHD medication (8 vs 2, p = 0.01), so an interaction between medication and training could not be ruled out; one active-group participant discontinued medication during the study.
  • The paper also notes that the placebo group may have received more positive feedback, the sample was modest, dropout was slightly higher in training (3 vs 1), teacher ratings were insufficient for analysis, and subtype or comorbidity effects could not be examined.
  • The text acknowledges that improvement on the WISC-IV Working Memory Index was not unexpected because its subtests resemble the training exercises, and it calls for larger replications and longer-term comparative studies.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1007/s13311-012-0124-y

Cites

17 of 17 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 38 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Working memory training produced significant improvement on standardized working memory tests relative to placebo in children with ADHD.

    “WM training led to significant reductions in off-task ADHDassociated behavior on the RAST system and improvement on WM tests.”
    • Also stated in: § Nontrained WMT · plain
      “this interaction was driven by a significant improvement on WM tests in the treatment group that was not present in the placebo group (difference in improvement between active and placebo=8.4±3.3SE; p00.02).”
    Quote in the paperSubstantial claim
  • Findingown data

    Parent ratings on the CPRS-R ADHD Index did not improve significantly more in the working memory training group than in the placebo group.

    “There were no significant differences between groups in improvement on parent rating scales.”
    • Also stated in: § Rating Scales · hedged
      “parent ratings on the CPRS-R ADHD Index decreased significantly with time for both the placebo and the active training condition, but the improvement was similar in the 2 groups (estimated difference0-1.3;±4.0 SE; p00.74).”
    Quote in the paperSubstantial claim
  • Findingown data

    There were no significant training effects on fidgeting.

    “There were no significant training effects on fidgeting, with both groups maintaining the observed pre-intervention levels (difference in improvement 0.9; ±3.9 SE; p00.81).”
    Quote in the paperNot a substantial claim
  • Findingown data

    In this study, the active working memory training group showed a significantly greater reduction in playing with objects on the Restricted Academic Situations Task from pre- to post-intervention than the placebo group (difference 3.4, SE 1.5, F=4.99, p=0.04).

    “Plays with objects 8 (57 %) | 7 (50 %) | 9 (75 %) | 1 (8 %) | 3.4±1.5 SE | 4.99 | 0.04”
    Quote in the paperSubstantial claim
  • Findingown data

    Our sample had a low rate of oppositional behavior.

    “yet because we did not have a high rate of oppositional behavior in our sample”
    Quote in the paperSubstantial claim
  • The quote only partly states this claim. 1
  • May combine two claims. 22
  • Classified as probably not a substantial claim. 16

  • The quote only partly states this claim.

    Findingown data

    Adaptive computerized working memory training, compared with a nonadaptive placebo, produced significant reductions in off-task behavior on the RAST in children diagnosed with ADHD.

    “WM training led to significant reductions in off-task ADHDassociated behavior on the RAST system and improvement on WM tests.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In this study, both the placebo and active treatment groups improved on the Conners' Parent Rating Scale long form, with no significant difference between the groups.

    “Although prior studies have found that WM training led to significant improvements on the CPRS-R [33,38] short form, we found that both our placebo and active treatment group improved, without significant differences between the groups, when we administered the CPRS long form.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In this study, the active working memory training group improved on the Wechsler Intelligence Scale for Children-IV Working Memory Index from pre- to post-intervention, while the placebo group did not, with a significant between-group difference (8.4, SE 3.3, F=6.67, p=0.02).

    “WISC WMI composite ‡ 90.0±10.1 SD 88.0±13.5 SD 95.9±10.6 SD 102.3±9.1 SD 8.4±3.3 SE | 6.67 | 0.02”
    • Also stated in: § Discussion · plain
      “The training did lead to improvement on the WISC-IV WMI, a widely used standardized WM measure.This improvement was only observed in the training group.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    There were no significant baseline differences or training-related changes for out-of-seat and vocalizes behaviors.

    “There were no significant differences in either baseline levels or changes as a result of training for both out-of-seat and vocalizes behaviors.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Training had its largest effect on the off-task category, the behavior with the highest rate, measured by looking away from worksheets.

    “Training had the greatest effect on the category in which the highest rate of behavior occurred, specifically, the offtask category, which is measured by whether the child looks away from the worksheets.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Working memory deficits may contribute to inefficient learning, behavioral problems, executive dysfunction, and eventual underachievement in children with ADHD.

    “These WM deficits may contribute significantly to inefficient learning, behavioral problems, executive dysfunction, and the eventual underachievement that children with ADHD often experience [25][26][27][28][29].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [25][26][27][28][29]

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Children with ADHD show moderate-to-marked working memory impairment, affecting both initiation and storage limits, especially in the visuospatial domain.

    “Neuropsychological testing reveals moderate-to-marked impairment in WM in children with ADHD, both in initiating WM and in the limits of storage, particularly in the visuospatial domain [16][17][18][19][20][21][22][23][24].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [16][17][18][19][20][21][22][23][24]

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Prior research in typically developing adults indicates that working memory training directly changes activity in prefrontal and posterior parietal brain regions and dopamine receptor binding.

    “initial research in typically developing adults suggests that WMT directly affects functioning of brain regions, such as the prefrontal cortex (PFC) and posterior parietal lobe [5][6][7][8][9][10], as well as dopamine (a neurotransmitter altered in ADHD) receptor binding [11].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [5][6][7][8][9][10]

      Not checked in the free run.

    • cites [11] McNab, 2009, Changes in cortical dopamine D1 receptor binding associated with cognitive training, Science (New York) source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    The training effect on off-task behavior is important because inattention is often considered a primary problem in inattentive and combined ADHD subtypes and is linked to academic functioning.

    “The influence of training on these categories, particularly the off-task category, is significant because inattention is often considered to be a primary issue in both the inattentive and combined subtypes of ADHD, and is related to academic functioning.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Improvements on nontrained working memory tasks after training appear in both visuospatial and verbal domains and persist at 3 and 6 months.

    “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].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [31] Holmes, 2009, Adaptive training leads to sustained enhancement of poor working memory in children, Dev Sci source

      Not checked in the free run.

    • cites [33] Klingberg, 2005, Computerized training of working memory in children with ADHD–a randomized, controlled trial, J Am Acad Child and Adolesc Psychiatry source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Dropout was somewhat greater in the training arm (n=3) than in the placebo arm (n=1).

    “we noted a slightly higher dropout rate for the training (n03) versus placebo (n01) groups.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationreasoning

    These brain systems support executive function and learning and could underlie transfer to untrained behavior.

    “Both PFC and dopamine are associated with the general category of executive functioning and learning, and may be responsible for the generalization to nontrained behavior.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    The earlier samples had more comorbid disorders and inattentive subtype cases than ours.

    “For example, those samples included participants with a higher preponderance of comorbid disorders and the inattentive subtype, whereas our sample did not.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [38] Beck, 2010, A controlled trial of working memory training for children and adolescents with ADHD, J Clin Child Adolesc Psychol source

      Not checked in the free run.

    • cites [33] Klingberg, 2005, Computerized training of working memory in children with ADHD–a randomized, controlled trial, J Am Acad Child and Adolesc Psychiatry source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In the Beck et al. study, many participants were prescribed stimulant medication, similar to our study.

    “However, we do note that the Beck et al. [38] study was similar to ours in that many of their participants were prescribed stimulant medication.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [38] Beck, 2010, A controlled trial of working memory training for children and adolescents with ADHD, J Clin Child Adolesc Psychol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Methylphenidate and similar stimulants act on dopamine reward circuitry that is disrupted in ADHD and may explain the broad effects of stimulant treatment.

    “Stimulant treatment, such as methylphenidate, is known to act directly on brain regions associated with disrupted dopamine reward pathways in ADHD [62,63] and may be responsible for the global effects seen with stimulant treatment in ADHD.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [62] Volkow, 1998, Dopamine transporter occupancies in the human brain induced by therapeutic doses of oral methylphenidate, Am J Psychiatry source

      Not checked in the free run.

    • cites [63] Volkow, 2009, Evaluating dopamine reward pathway in ADHD: clinical implications, JAMA source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    Other sample differences from Beck et al. and Klingberg et al. could have influenced how well the parent rating scales detected change.

    “Other differences between our sample and those of Beck et al. [38] and Klingberg et al. [33] may have also affected the sensitivity to detect change on the parent rating scales.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [38] Beck, 2010, A controlled trial of working memory training for children and adolescents with ADHD, J Clin Child Adolesc Psychol source

      Not checked in the free run.

    • cites [33] Klingberg, 2005, Computerized training of working memory in children with ADHD–a randomized, controlled trial, J Am Acad Child and Adolesc Psychiatry source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    The groups had similar full-scale IQ, with active training mean 107.0 and placebo mean 105.4.

    “The groups had similar full scale IQ, as assessed by the Wechsler Abbreviated Scale of Intelligence, with a mean of 107.0±12.3SD) for the active treatment group and a mean of 105.4±14.2SD) for the placebo group.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    The subtests that comprise the Working Memory Index, Letter-Number Sequencing and Digit Span, are similar to the training exercises, so improvement on this measure was not unexpected.

    “Subtests that comprise the WMI, the Letter-Number Sequencing and Digit Span, are similar to the training exercises, and thus, improvement on this measure was not unexpected.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Cogmed training has been linked in healthy adults to greater prefrontal and parietal activity and to increased dopamine D1 receptor binding.

    “The training program (i.e., Cogmed) that we used is associated with increases in PFC and parietal lobe activity, and in dopamine D1 receptor binding in healthy adults [11].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [11] McNab, 2009, Changes in cortical dopamine D1 receptor binding associated with cognitive training, Science (New York) source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    The off-task and plays-with-object categories may have overlapped.

    “There may have been some overlap between the off-task and plays with objects categories, although it is conceivable that a child could hold or touch a nontask related object while maintaining attention to the worksheets.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Medication use was included as a covariate in all analyses and had no significant effect on any RAST behavior or working memory index.

    “Furthermore, medication use was included as a covariate in all statistical analyses, but it did not have a significant effect on any of the RAST behaviors or WMI.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductnone given

    The placebo group probably got more positive feedback than the training group.

    “Participants in the placebo condition likely received more positive feedback than did participants in the training condition.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    The similar active and placebo versions controlled for nonspecific training effects and allowed improvement to be attributed exclusively to working memory training.

    “These similar versions controlled for nonspecific effects of the training procedure and enabled us to attribute any improvement in ADHD-related behaviors and WM exclusively, due to the effect of training WM.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    Correct responses earn rewards during training, which may affect the basal ganglia, but both groups received such rewards.

    “The training also includes delivery of rewards for correct performance, which likely acts on the basal ganglia, although both training and placebo groups would have received rewards.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Holmes et al. found that working memory training improved verbal and visuospatial working memory and short-term memory, while stimulant medication improved only visuospatial working memory.

    “The authors found that the training improved verbal and visuospatial WM and short-term memory functioning, whereas stimulant medication only resulted in improvement in visuospatial WM.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [37] Holmes, 2010, Working memory deficits can be overcome: impacts of training and medication on working memory in children with ADHD, Appl Cogn Psychol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationnone given

    The off-task measure may be most closely related to attention.

    “This measure might be most related to attention.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Participants and researchers remained blind to group assignment throughout the study.

    “Throughout the study, both the participants and researchers remained blind to the condition assigned to the participant.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Our sample size was modest.

    “Our sample size was also quite modest and replications in larger samples are warranted.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    A single treated child was taking medication before the study, stopped during training, and remained off it at post-testing.

    “1 participant in the treatment condition was on medication at pre-testing and discontinued medication during the treatment and at post-testing.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Participants were assigned to adaptive training or nonadaptive placebo using a computerized random number sequence.

    “participants were randomly assigned to either the treatment (adaptive WM training) or to the control placebo (nonadaptive) condition using a computerized generated random number sequence.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    The coach had no role in random assignment, outcome or screening testing, or data analysis.

    “The coach, who had contact with participants during the study, was not involved in the random assignment, in testing on any outcome or screening measures, or in the data analytic components of the study.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Teacher ratings showed no significant changes in that trial or in an earlier study that included teacher ratings.

    “However, there were no significant changes in teacher ratings in this study, nor were there any changes in a previous study that included teacher ratings [33].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [33] Klingberg, 2005, Computerized training of working memory in children with ADHD–a randomized, controlled trial, J Am Acad Child and Adolesc Psychiatry source

      Not checked in the free run.

32 of 32

  • The paper relies on this without support.

    The RAST quantifies off-task behavior during academic task performance that may not be salient in teacher observations.

    “The RAST quantifies the frequency and type of the off-task behavior of a child during academic task performance that may not be salient in teacher observations.”

  • The paper relies on this without support.

    The use of a laboratory measure permits objective outcomes not susceptible to measurement and informant bias encountered in a classroom.

    “The use of a laboratory measure permitted us to obtain objective outcomes that are not susceptible to the measurement and informant bias that would be encountered in a classroom situation.”

  • The paper relies on this without support.

    The RAST is sensitive to moment-to-moment off-task behavior that a teacher or parent may be unlikely to detect.

    “The RAST is sensitive to moment-to-moment offtask behavior that a teacher or parent may be unlikely to detect.”
3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Helsinki Declaration citation points to an ADHD handbook

    Minor

    The study cites reference 58 for the Declaration of Helsinki, but reference 58 is an ADHD handbook.

  • Male participant count differs between abstract and table

    Minor

    The abstract reports 18 males among the 26 children, but Table 1 lists 17 boys in total (9 in the placebo group and 8 in treatment).

  • Significance rule conflicts with reported interpretation

    Minor

    The methods say a predictor is significant when its significance level exceeds 0.05, yet the results call an interaction with p = 0.01 significant. The stated rule and its application cannot both be correct.

  • Statistical-method citation points to a pharmacology article

    Minor

    The methods cite reference 61 for the generalized linear models approach, but the listed reference is an article about dopamine transporter occupancy rather than that statistical method.

4 of 4

Cites

Flagged first, then by citations

Research works printed but not linked: 47

  1. Chronis, 2006, Evidence-based psychosocial treatments for children and adolescents with attention-deficit/hyperactivity disorder, Clin Psychol Rev, 26, 486, 10.1016/j.cpr.2006.01.002 · DOI
  2. Anastopoulos, 1992, Parenting stress among families of children with attention deficit hyperactivity disorder, J Abnorm Child Psychol, 20, 503, 10.1007/BF00916812 · DOI
  3. Abikoff, 2009, ADHD psychosocial treatments: generalization reconsidered, J Atten Disord, 13, 207, 10.1177/1087054709333385 · DOI
  4. Hale, 2007, Atypical brain activation during simple & complex levels of processing in adult ADHD: an fMRI study, J Atten Disord, 11, 125, 10.1177/1087054706294101 · DOI · Paper page
  5. Krauel, 2007, Impact of emotional salience on episodic memory in attention-deficit/hyperactivity disorder: a functional magnetic resonance imaging study, Biol Psychiatry, 61, 1370, 10.1016/j.biopsych.2006.08.051 · DOI · Paper page
  6. Schweitzer, 2000, Alterations in the functional anatomy of working memory in adult attention deficit hyperactivity disorder, Am J Psychiatry, 157, 278, 10.1176/appi.ajp.157.2.278 · DOI · Paper page
  7. Sheridan, 2007, Efficiency of the prefrontal cortex during working memory in attention-deficit/hyperactivity disorder, J Am Acad Child Adolesc Psychiatry, 46, 1357, 10.1097/chi.0b013e31812eecf7 · DOI · Paper page
  8. McNab, 2009, Changes in cortical dopamine D1 receptor binding associated with cognitive training, Science (New York), 323, 800, 10.1126/science.1166102 · DOI · Paper page
  9. Baddeley, 1996, The fractionation of working memory, Proc Natl Acad Sci, 26, 13468, 10.1073/pnas.93.24.13468 · DOI
  10. Alloway, 2010, Examining the link between working memory behaviour and academic attainment in children with ADHD, Dev Med Child Neurol, 52, 632, 10.1111/j.1469-8749.2009.03603.x · DOI
  11. Gropper, 2009, A pilot study of working memory and academic achievement in college students with ADHD, J Atten Disord, 12, 574, 10.1177/1087054708320390 · DOI · Paper page
  12. McLean, 2004, Characteristic neurocognitive profile associated with adult attention-deficit/hyperactivity disorder, Psychol Med, 34, 681, 10.1017/S0033291703001296 · DOI
  13. Karatekin, 1998, Working memory in childhood-onset schizophrenia and attention-deficit/hyperactivity disorder, Psychiatry Res, 80, 165, 10.1016/S0165-1781(98)00061-4 · DOI
  14. Kempton, 1999, Executive function and attention deficit hyperactivity disorder: stimulant medication and better executive function performance in children, Psychol Med, 29, 527, 10.1017/S0033291799008338 · DOI
  15. Kuntsi, 2001, Psychological mechanisms in hyperactivity: I. Response inhibition deficit, working memory impairment, delay aversion, or something else?, J Child Psychol Psychiatry, 42, 199, 10.1111/1469-7610.00711 · DOI · Paper page
  16. Schweitzer, 2006, Working memory deficits in adults with ADHD: is there evidence for subtype differences?, Behav Brain Funct, 2, 43, 10.1186/1744-9081-2-43 · DOI
  17. Gathercole, 2000, Working memory deficits in children with low achievements in the national curriculum at 7 years of age, Br J Educ Psychol, 70, 177, 10.1348/000709900158047 · DOI
  18. Rapport, 1999, Attention-deficit/hyperactivity disorder and scholastic achievement: a model of dual developmental pathways, J Child Psychol Psychiatry, 40, 1169, 10.1111/1469-7610.00534 · DOI
  19. Jarvis, 2003, Verbal and non-verbal working memory and achievements on national curriculum tests at 11 and 14 years of age, Educ Child Psychol, 20, 123, 10.53841/bpsecp.2003.20.3.123 · DOI
  20. Biederman, 2009, Are cognitive deficits in attention deficit/hyperactivity disorder related to the course of the disorder? A prospective controlled follow-up study of grown up boys with persistent and remitting course, Psychiatry Res, 170, 177, 10.1016/j.psychres.2008.09.010 · DOI
  21. Kremen, 2007, Genetics of verbal working memory processes: a twin study of middle-aged men, Neuropsychology, 21, 569, 10.1037/0894-4105.21.5.569 · DOI
  22. Holmes, 2009, Adaptive training leads to sustained enhancement of poor working memory in children, Dev Sci, 12, F9, 10.1111/j.1467-7687.2009.00848.x · DOI · Paper page
  23. Kurtz, 2009, Predictors of change in life skills in schizophrenia after cognitive remediation, Schizophr Res, 107, 267, 10.1016/j.schres.2008.10.014 · DOI
  24. Olesen, 2004, Increased prefrontal and parietal activity after training of working memory, Nat Neurosci, 7, 75, 10.1038/nn1165 · DOI · Paper page
  25. Schweitzer, 2004, Effect of methylphenidate on executive functioning in adults with attention-deficit/hyperactivity disorder: normalization of behavior but not related brain activity, Biol Psychiatry, 56, 597, 10.1016/j.biopsych.2004.07.011 · DOI · Paper page
  26. Westerberg, 2007, Changes in cortical activity after training of working memory — a single-subject analysis, Physiol Behav, 92, 186, 10.1016/j.physbeh.2007.05.041 · DOI · Paper page
  27. Olson, 2009, Some surprising findings on the involvement of the parietal lobe in human memory, Neurobiol Learn Mem, 91, 155, 10.1016/j.nlm.2008.09.006 · DOI
  28. Wager, 2003, Neuroimaging studies of working memory: a meta-analysis, Cogn Affect Behav Neurosci, 3, 255, 10.3758/CABN.3.4.255 · DOI · Paper page
  29. Hoekzema, 2010, Enhanced neural activity in frontal and cerebellar circuits after cognitive training in children with attention-deficit/hyperactivity disorder, Hum Brain Map, 31, 1942, 10.1002/hbm.20988 · DOI
  30. Volkow, 2007, Depressed dopamine activity in caudate and preliminary evidence of limbic involvement in adults with attention-deficit/hyperactivity disorder, Arch Gen Psychiatry, 64, 932, 10.1001/archpsyc.64.8.932 · DOI · Paper page
  31. Milich, 1982, Independent dimensions of hyperactivity and aggression: a validation with playroom observation data, J Abnorm Psychol, 91, 183, 10.1037/0021-843X.91.3.183 · DOI
  32. Milich, 1986, Playroom observations of activity level and sustained attention: two-year stability, J Consult Clin Psychol, 54, 272, 10.1037/0022-006X.54.2.272 · DOI
  33. Roberts, 1990, A behavioral observation method for differentiating hyperactive and aggressive boys, J Abnorm Child Psychol, 18, 131, 10.1007/BF00910726 · DOI
  34. Loney, 2005, Validation of three dimensions of childhood psychopathology in young clinic-referred boys, J Atten Disord, 8, 169, 10.1177/1087054705279298 · DOI
  35. Breen, 1989, Cognitive and behavioral differences in AdHD boys and girls, J Child Psychol Psychiatry, 30, 711, 10.1111/j.1469-7610.1989.tb00783.x · DOI · Paper page
  36. Schweitzer, 1995, Self-control in boys with attention deficit hyperactivity disorder: effects of added stimulation and time, J Child Psychol Psychiatry, 36, 671
  37. Breslau, 2009, The impact of early behavior disturbances on academic achievement in high school, Pediatrics, 123, 1472, 10.1542/peds.2008-1406 · DOI
  38. Raggi, 2006, Interventions to address the academic impairment of children and adolescents with ADHD, Clin Child Fam Psychol Rev, 9, 85, 10.1007/s10567-006-0006-0 · DOI · Paper page
  39. Hinshaw, 1992, Academic underachievement, attention deficits, and aggression: comorbidity and implications for intervention, J Consult Clin Psychol, 60, 893, 10.1037/0022-006X.60.6.893 · DOI
  40. Barkley, 2006, Young adult outcome of hyperactive children: adaptive functioning in major life activities, J Am Acad Child and Adolesc Psychiatry, 45, 192, 10.1097/01.chi.0000189134.97436.e2 · DOI · Paper page
  41. Polderman, 2010, A systematic review of prospective studies on attention problems and academic achievement, Acta psychiatrica Scandinavica, 122, 271, 10.1111/j.1600-0447.2010.01568.x · DOI · Paper page
  42. Barkley, 1989, The response of aggressive and nonaggressive ADHD children to two doses of methylphenidate, J Am Acad Child Adolesc Psychiatry, 28, 873, 10.1097/00004583-198911000-00011 · DOI
  43. Zeger, 1986, Longitudinal data analysis for discrete and continuous outcomes, Biometrics, 42, 121, 10.2307/2531248 · DOI
  44. Volkow, 1998, Dopamine transporter occupancies in the human brain induced by therapeutic doses of oral methylphenidate, Am J Psychiatry, 155, 1325, 10.1176/ajp.155.10.1325 · DOI · Paper page
  45. Johansen, 2009, Origins of altered reinforcement effects in ADHD, Behav Brain Funct, 5, 7, 10.1186/1744-9081-5-7 · DOI · Paper page
  46. Swanson, 2003, Compliance with stimulants for attention-deficit/hyperactivity disorder: issues and approaches for improvement, CNS Drugs, 17, 117, 10.2165/00023210-200317020-00004 · DOI · Paper page
  47. Weiss, 2006, Effectiveness outcomes in attention-deficit/hyperactivity disorder, J Clin Psychiatry, 67, 38

Cited by

Sorted by citations

Authors
Green, C. T., Long, D. L., Green, D., Iosif, A.-M., Dixon, J. F., Miller, M. R., Fassbender, C., & Schweitzer, J. B.
Affiliations
  • University of California Davis Medical Center (US)
  • University of California, Davis (US)
Corresponding author
Schweitzer, Julie B.
ORCID
Venue
Neurotherapeutics
Publisher
Elsevier BV
Published
2012-07
Volume
9
Issue
3
Pages
639-648
ISSN
1878-7479 (ISSN-L)
DOI
10.1007/s13311-012-0124-y
PMC
PMC3441930
OpenAlex
W2139151413
Semantic Scholar
a478996bf10cfd333f894dd13065979382b37f16
Cited by
176
References
17
Citations by year
2026: 2 · 2025: 3 · 2024: 3 · 2023: 7 · 2022: 6 · 2021: 9 · 2020: 15 · 2019: 13 · 2018: 11 · 2017: 20 · 2016: 20 · 2015: 27 · 2014: 24 · 2013: 12 · 2012: 3
FWCI
15.03
Type
journal article
Language
en
Open access
Licence
Locations
  • Neurotherapeutics (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Mental Health (R01MH121416)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Abilities and Testing
  • Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
Keywords
working memory training, attention deficit hyperactivity disorder, off-task behavior, executive function, computerized cognitive training, children, academic performance
MeSH terms
Attention Deficit Disorder with Hyperactivity, Child, Child Behavior Disorders, Double-Blind Method, Female, Humans, Male, Memory, Short-Term, Neuropsychological Tests, Teaching, Outcome Assessment, Health Care, Statistics, Nonparametric

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-06.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-06.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review