Can working memory training work for ADHD? Development of central executive training and comparison with behavioral parent training.
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OBJECTIVE: Working memory deficits have been linked experimentally and developmentally with attention-deficit/hyperactivity disorder (ADHD)-related symptoms/impairments. Unfortunately, substantial evidence indicates that extant working memory training programs fail to improve these symptoms/impairments. We hypothesized that this discrepancy may reflect insufficient targeting, such that extant protocols do not adequately engage the specific working memory components linked with the disorder's behavioral/functional impairments. METHOD: The current study describes the development, empirical basis, and initial testing of central executive training (CET) relative to gold-standard behavioral parent training (BPT). Children with ADHD ages 8-13 (M = 10.43, SD = 1.59; 21 girls; 76% Caucasian/non-Hispanic) were treated using BPT (n = 27) or CET (n = 27). Detailed data analytic plans for the pre/post design were preregistered. Primary outcomes included phonological and visuospatial working memory, and secondary outcomes included actigraphy during working memory testing and two distal far-transfer tasks. Multiple feasibility/acceptability measures were included. RESULTS: The BPT and CET samples did not differ on any pretreatment characteristics. CET was rated as highly acceptable by children and was equivalent to BPT in terms of feasibility/acceptability as evidenced by parent-reported high satisfaction, low barriers to participation, and large ADHD symptom reductions. CET was superior to BPT for improving working memory (Group × Time d = 1.06) as hypothesized. CET was also superior to BPT for reducing actigraph-measured hyperactivity during visuospatial working memory testing and both distal far-transfer tasks (Group × Time d = 0.74). CONCLUSIONS: Results provide strong support for continued testing of CET and, if replicated, would support recent hypotheses that next-generation ADHD cognitive training protocols may overcome current limitations via improved targeting. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Conclusions from ADHD cognitive training studies have been highly limited because most protocols have not shown large enough improvements in the trained/targeted cognitive abilities to realistically expect detectable downstream behavior changes, even if the causal models are correct.
“In contrast, conclusions from ADHD cognitive training studies have been highly limited because most protocols have not shown large enough improvements in the trained/targeted cognitive abilities to realistically expect detectable downstream behavior changes, even if the causal models are correct (for review see 119) – although newer neurocognitive training protocols appear to be showing more”
From Working memory and inhibitory control deficits in children with ADHD: an experimental evaluation of competing model predictions (2024) · cites this paper as [120]
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“A critical distinction between CET and extant, capacity-based protocols (Rapport et al., 2013) is that CET’s algorithms dynamically adjust multiple parameters to incrementally increase demands on central executive processes.”
InfluentialSelf-citationKasper, L. J., Alderson, R. M., & Hudec, K. L. (2012) · Clinical Psychology Review · doi:10.1016/j.cpr.2012.07.001 · Cited by 414 · cited 6× · see citing works
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“These possibilities are undermined at least partially, however, based on experimental evidence that manipulating working memory demands can provocate and rarefy objectively-assessed ADHD inattentive (Kofler et al., 2010) and hyperactive behavior (Rapport et al., 2009).”
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“These possibilities are undermined at least partially, however, based on experimental evidence that manipulating working memory demands can provocate and rarefy objectively-assessed ADHD inattentive (Kofler et al., 2010) and hyperactive behavior (Rapport et al., 2009).”
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Self-citation
- Authors
- Kofler, M. J., Sarver, D. E., Austin, K. E., Schaefer, H. S., Holland, E., Aduen, P. A., Wells, E. L., Soto, E. F., Irwin, L. N., Schatschneider, C., & Lonigan, C. J.
- Affiliations
- Florida State University (US)
- University of Mississippi Medical Center (US)
- Tufts University (US)
- Western Washington University (US)
- University of Virginia (US)
- Corresponding author
- Kofler, Michael J.
- ORCID
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2018-12
- Volume
- 86
- Issue
- 12
- Pages
- 964-979
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- PMC
- PMC6287280
- OpenAlex
- W2903128041
- Cited by
- 46
- References
- 27
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 6 · 2023: 8 · 2022: 11 · 2021: 4 · 2020: 2 · 2019: 4 · 2018: 2
- FWCI
- 2.36
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- University of Virginia
- National Institutes of Health (R34 MH102499-01)
- 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
- attention deficit hyperactivity disorder, working memory training, behavioral parent training, cognitive training, children, hyperactivity, visuospatial working memory, phonological working memory, far transfer, actigraphy, treatment acceptability, feasibility
- MeSH terms
- Adolescent, Attention Deficit Disorder with Hyperactivity, Child, Child Behavior, Female, Humans, Learning, Male, Memory, Short-Term, Parents, Personal Satisfaction, Psychotherapy, Executive Function
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