Cited by 1,225Attention Deficit Hyperactivity DisorderCognitive Abilities and TestingDevelopmental and Educational Neuropsychology

Training of Working Memory in Children With ADHD

Klingberg, Torkel, Forssberg, Hans, Westerberg, Helena·2002·Journal of Clinical and Experimental Neuropsychology

Abstract

Working memory (WM) capacity is the ability to retain and manipulate information during a short period of time. This ability underlies complex reasoning and has generally been regarded as a fixed trait of the individual. Children with attention deficit hyperactivity disorder (ADHD) represent one group of subjects with a WM deficit, attributed to an impairment of the frontal lobe. In the present study, we used a new training paradigm with intensive and adaptive training of WM tasks and evaluated the effect of training with a double blind, placebo controlled design. Training significantly enhanced performance on the trained WM tasks. More importantly, the training significantly improved performance on a nontrained visuo-spatial WM task and on Raven's Progressive Matrices, which is a nonverbal complex reasoning task. In addition, motor activity--as measured by the number of head movements during a computerized test--was significantly reduced in the treatment group. A second experiment showed that similar training-induced improvements on cognitive tasks are also possible in young adults without ADHD. These results demonstrate that performance on WM tasks can be significantly improved by training, and that the training effect also generalizes to nontrained tasks requiring WM. Training improved performance on tasks related to prefrontal functioning and had also a significant effect on motor activity in children with ADHD. The results thus suggest that WM training potentially could be of clinical use for ameliorating the symptoms in ADHD.

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Crossref · 10.1076/jcen.24.6.781.8395

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  • Klingberg et al. (2002) had very small groups (7 children each) and was severely underpowered.

    “However, there are some obvious weaknesses in this study: the group sizes (7 children per group) are tiny – this study is, like many other studies in this area, severely underpowered.”
  • In Klingberg et al. (2002), observed differences might stem from unequal task duration between groups rather than adaptive working memory training.

    “Another problem with the design of this study is that any differences found as a result of training may reflect differences in the duration of the computerized tasks performed by the two groups, rather than being effects of adaptive working memory training per se.”
  • The largest effect size for working memory training on nonverbal ability came from the earliest study (d = 2.18; Klingberg et al., 2002), which had only 7 subjects per group.

    “The largest effect size for working memory training on nonverbal ability came from the earliest study (d = 2.18; Klingberg et al., 2002), which included only 7 subjects in each of the training and control groups.”
  • While some studies show subsequent improvement in ADHD symptoms, others do not.

    “However, while some studies [84,85] show subsequent improvement in ADHD symptoms, others do not (e.g. [86], reviewed in e.g. [87]).”

    From Linking ADHD to the Neural Circuitry of Attention (2017) · cites this paper as [84]

  • Training individuals with ADHD on one specific cognitive domain, e.g. working memory, has been found to result in improved performance on the trained and similar tasks.

    “Training individuals with ADHD on one specific cognitive domain, e.g. working memory, has been found to result in improved performance on the trained and similar tasks [84–86].”

    From Linking ADHD to the Neural Circuitry of Attention (2017) · cites this paper as [84]

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Authors
Klingberg, T., Forssberg, H., & Westerberg, H.
Affiliations
Karolinska Institutet (SE)
Venue
Journal of Clinical and Experimental Neuropsychology
Published
2002-09
Volume
24
Issue
6
Pages
781-791
ISSN
  • 0165-0475 (ISSN-L)
  • 1380-3395
  • 1744-411X
OpenAlex
W2163254754
Cited by
1,225
References
37
Citations by year
2026: 15 · 2025: 35 · 2024: 30 · 2023: 31 · 2022: 44 · 2021: 52 · 2020: 65 · 2019: 75 · 2018: 62 · 2017: 79 · 2016: 75 · 2015: 98 · 2014: 84 · 2013: 91 · 2012: 90
FWCI
8.41
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Clinical and Experimental Neuropsychology (publishedVersion)
  • PubMed (publishedVersion)
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, children, adaptive training, transfer of training, visuospatial working memory, Raven's Progressive Matrices, nonverbal reasoning, prefrontal cortex, motor activity, head movement
MeSH terms
Adolescent, Adult, Attention Deficit Disorder with Hyperactivity, Child, Cognition, Double-Blind Method, Female, Humans, Male, Memory, Neuropsychological Tests, Task Performance and Analysis, Treatment Outcome

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