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A Controlled Trial of Working Memory Training for Children and Adolescents with ADHD
Abstract
This study assessed the efficacy of a 5-week, intensive working memory training program for 52 children and adolescents (ages 7-17) who had Attention-Deficit/Hyperactivity Disorder (ADHD) and other comorbid diagnoses. This study provided a treatment replication since the waitlist control group also completed training and was included in the follow-up data analyses. Parents and teachers completed paper-and-pencil measures of working memory, executive functioning, and ADHD symptoms at baseline, posttreatment, and 4-month follow-up. Parent ratings indicated that participants improved on inattention, overall number of ADHD symptoms, initiation, planning/organization, and working memory. Teacher ratings approached significance at posttreatment and at 4-month follow-up on and Initiate scale. Working memory training appears promising as an intervention in improving executive functioning and ADHD symptoms.
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“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.”
From Will Working Memory Training Generalize to Improve Off-Task Behavior in Children with Attention-Deficit/Hyperactivity Disorder? (2012) · cites this paper as [38]
In the citing paper
“A recent study of 52 children with ADHD in a wait list, controlled trial found significant improvement on parent-rated measures of executive functioning, the Behavior Rating Inventory of Executive Function (BRIEF), immediately after training and at a 4-month follow-up [38].”
From Will Working Memory Training Generalize to Improve Off-Task Behavior in Children with Attention-Deficit/Hyperactivity Disorder? (2012) · cites this paper as [38]
In the citing paper
“For example, those samples included participants with a higher preponderance of comorbid disorders and the inattentive subtype, whereas our sample did not.”
From Will Working Memory Training Generalize to Improve Off-Task Behavior in Children with Attention-Deficit/Hyperactivity Disorder? (2012) · cites this paper as [38]
In the citing paper
“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.”
From Will Working Memory Training Generalize to Improve Off-Task Behavior in Children with Attention-Deficit/Hyperactivity Disorder? (2012) · cites this paper as [38]
In the citing paper
“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.”
From Will Working Memory Training Generalize to Improve Off-Task Behavior in Children with Attention-Deficit/Hyperactivity Disorder? (2012) · cites this paper as [38]
In the citing paper
“Moreover, these improvements were also observed in terms of parent-rated symptoms of inattention and hyperactivity/impulsivity and many gains were maintained for three months (e.g., Klingberg et al., 2005; see also Beck et al., 2010).”
From Executive control training from middle childhood to adolescence (2014) · cites this paper as Beck et al., 2010
In the citing paper
“Although improvements in planning/organizing skills have been shown by other computerized neurocognitive training programs as well [39,59], this serious game is unique because it elicits its effects by promoting behavioral strategies instead of training executive functions by offering repeated cognitive exercises.”
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“Moreover, these improvements were also observed in terms of parent-rated symptoms of inattention and hyperactivity/impulsivity and many gains were maintained for three months (e.g., Klingberg et al., 2005; see also Beck et al., 2010).”
BackgroundCogmed working memory training: Does the evidence support the claims?
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“Children (ADHD) Beck et al. (2010) No-contact 51 Parent ratings”
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“, 2005), no significant differential impact of CWMT Active versus Placebo was observed for parentreported ADHD symptoms; however, our results comport with those of prior controlled trials (Beck et al., 2010; Gray et al., 2012; Klingberg et al., 2005), which did not find effects of CWMT on teacher-rated ADHD symptoms.”
BackgroundResultPalmer, S. L., Armstrong, C. L., Onar‐Thomas, A., Wu, S., Wallace, D., Bonner, M. J., Schreiber, J. E., Swain, M. A., Chapieski, L., Mabbott, D., et al. (2013) · Journal of Clinical Oncology · doi:10.1200/jco.2012.47.4775 · Cited by 241
“Additional studies report evidence of improved cognitive processes among populations experiencing learning difficulties.(26,27) Of the variables tested, AgeDx, risk status, and baseline performance were found to be significantly associated with change in PS.”
BackgroundTaking working memory training from the laboratory into schools
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“This pattern of association of parent and teacher ratings has been observed in randomised controlled trials evaluating changes in inattention in daily life after completing a WM training program [10,30,39], but there is currently no consensus in the literature on what the discrepancy reflects.”
BackgroundMethodTraining the brain: fact and fad in cognitive and behavioral remediation.
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Neuronal effects following working memory training.
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“…improvements during the training, it is informative to examine the long-term effects of training, using a follow-up measurement several months after the training is completed (e.g., Klingberg et al., 2005; Holmes et al., 2009b; Beck et al., 2010; Jolles et al., 2010; Jaeggi et al., 2011).”
Academic Outcomes 2 Years After Working Memory Training for Children With Low Working Memory
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“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.”
BackgroundMethodResultInfluentialBul, K. C., Kato, P. M., Van der Oord, S., Danckaerts, M., Vreeke, L. J., Willems, A., van Oers, H. J., Van Den Heuvel, R., Birnie, D., Van Amelsvoort, T. A., et al. (2016) · Journal of Medical Internet Research · doi:10.2196/jmir.5173 · Cited by 158
“Although improvements in planning/organizing skills have been shown by other computerized neurocognitive training programs as well [39,59], this serious game is unique because it elicits its effects by promoting behavioral strategies instead of training executive functions by offering repeated cognitive exercises.”
BackgroundWorking memory training in survivors of pediatric cancer: a randomized pilot study
Hardy, K. K., Willard, V. W., Allen, T. M., & Bonner, M. J. (2012) · Psycho-Oncology · doi:10.1002/pon.3222 · Cited by 170
“Moreover, our findings are consistent with the parent-rated improvements in attention that have been reported in trials of CogmedRM with other populations [27,31].”
ResultWorking memory and autism: A review of literature
Kercood, S., Grskovic, J. A., Banda, D. R., & Begeske, J. (2014) · Research in Autism · doi:10.1016/j.rasd.2014.06.011 · Cited by 181
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“Other studies on WM training often have not found significant effects on teacher ratings of ADHD behavior (e.g., Beck et al., 2010; Klingberg et al., 2005).”
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Few Effects of Far Transfer of Working Memory Training in ADHD: A Randomized Controlled Trial
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“Interestingly, except for Van der Oord et al. (2012) and Beck et al. (2010), no other studies involved parents.”
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“Given that both clearly supportive studies of CWMT (Beck et al., 2010; Klingberg et al., 2005) focused on youth from higher socioeconomic status, and that socioeconomic status and its correlates are often associated with adherence to psychosocial and pharmacological intervention (Chacko et al.”
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“Such training has been shown to improve WM performance in healthy children and adults (Olesen et al., 2004; Jaeggi et al., 2008; Thorell et al., 2009; Bergman Nutley et al., 2011) and in children with attention-deficit hyperactivity disorder (ADHD) (Klingberg et al., 2002, 2005; Beck et al., 2010; Holmes et al., 2010;…”
BackgroundInfluentialPhysical Exercise Alleviates ADHD Symptoms: Regional Deficits and Development Trajectory
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“2011), attention regulation (Arnsten and Pliszka 2011), working memory (Beck et al. 2010; Martinussen et al. 2005), planning (Chamberlain et al.”
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“…& Backman, 2012; McNab et al., 2009; Olesen, Westerberg, & Klingberg, 2004), children with ADHD (Beck, Hanson, Puffenberger, Benninger, & Benninger, 2010; Green et al., 2012; Holmes et al., 2010; Klingberg et al., 2002, 2005; Mezzacappa & Buckner, 2010), children with poor WM (Holmes,…”
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“18 Several studies have replicated these findings, 19,20 but concerns with regard to transfer issues (i.e., whether positive training effects generalize to other, non-trained EFs and to the child’s self-control behaviors in daily life) have been raised.”
Longitudinal trends in diagnosis at child and adolescent mental health centres in Madrid, Spain
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“Notably, changes in functional magnetic resonance imaging (fMRI)–measured neural activity have been reported following training in working memory (Olesen, Westerberg, & Klingberg, 2004; Westerberg & Klingberg, 2007), as have been encouraging clinical results in school-age children and adolescents with ADHD (Beck et al…”
BackgroundResultEarly childhood memory and attention as predictors of academic growth trajectories.
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Fragile X Syndrome and Targeted Treatment Trials
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“…closely to attentional processes, and neuroimaging studies even indicate activation of similar regions in the parietal and prefrontal lobes as controlled attention (Castellanos and Tannock 2002; Kane and Engle 2002; Olesen et al. 2004; Martinussen et al. 2005; Klingberg 2009; Beck et al. 2010).”
Training Self-Control: A Domain-General Translational Neuroscience Approach
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“Moving forward, computerized working memory training has also emerged as a potential way to improve children’s behavioral self-regulation skills (Beck et al. 2010; Green et al. 2012), although the effects have not typically generalized to non-executive tasks (for review, see Shipstead et al.”
BackgroundVeloso, A. S., Vicente, S., & Filipe, M. G. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.02983 · Cited by 92
“Of the nine studies that performed follow-up sessions, seven concluded that the gains observed at the end of the intervention weremaintained throughout time (Beck et al., 2010; Johnstone et al., 2012; Egeland et al., 2013; van der Oord et al., 2014; van der Donk et al., 2015; Bigorra et al., 2016; Hannesdottir et al.,…”
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Idiopathic focal epilepsies: the “lost tribe”
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Working Memory Training is Associated with Long Term Attainments in Math and Reading
Söderqvist, S., & Nutley, S. B. (2015) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.01711 · Cited by 92
“It has been shown thatWM capacity can be improved through intensive computerized training, such as Cogmed WM Training (CWMT) and these effects have been shown to transfer to improvements in attention (Klingberg et al., 2005; Beck et al., 2010; Gropper et al., 2014).”
The development and malleability of executive control abilities
Hsu, N. S., Novick, J. M., & Jaeggi, S. M. (2014) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2014.00221 · Cited by 78
“For example, two studies showed improvements to neuropsychological outcomes and parent-rated ADHD symptoms relative to both wait-list control and placebo treatment conditions (Klingberg et al., 2005; Beck et al., 2010).”
MethodResultExecutive Functioning Theory and Autism
Geurts, H. M., de Vries, M., & van den Bergh, S. F. W. M. (2013) · Springer eBooks · doi:10.1007/978-1-4614-8106-5_8 · Cited by 80
Contribution of Rating Scales to Intervention for Executive Dysfunction
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Cogmed Working Memory Training Product Review
Roche, J. D., & Johnson, B. D. (2014) · Journal of Attention Disorders · doi:10.1177/1087054714524275 · Cited by 77
“Research has demonstrated Cogmed may improve inattention and hyperactive symptoms (e.g., Beck et al., 2010; Brehmer et al., 2012; Cogmed, 2013; Green et al., 2012; Klingberg et al., 2005; Klingberg et al., 2002b), reading comprehension (K. Dahlin, 2011), and mathematic ability (K. I. E. Dahlin,…”
BackgroundA preliminary study of the effects of working memory training on brain function
Stevens, M. C. G., Gaynor, A. M., Bessette, K. L., & Pearlson, G. D. (2015) · Brain Imaging and Behavior · doi:10.1007/s11682-015-9416-2 · Cited by 80
“It is possible that individual ADHD patient differences in striatal dysfunction might explain inconsistent clinical improvement in previous ADHD WM training clinical trials (Beck et al. 2010; Chacko et al. 2013; Dahlin 2013; Egeland et al. 2013; Gibson et al. 2011; Gray et al. 2012; Green et al. 2012; Gropper et al. 2…”
BackgroundResultInfluentialExploring N -Back Cognitive Training for Children With ADHD
Jones, M. R., Katz, B., Buschkuehl, M., Jaeggi, S. M., & Shah, P. (2020) · Journal of Attention Disorders · doi:10.1177/1087054718779230 · Cited by 64
Dovis, S., Van der Oord, S., Wiers, R. W., & Prins, P. J. M. (2013) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-013-9729-9 · Cited by 67
“Finally, there is evidence suggesting that improvement of working memory in children with ADHD is associated with a reduction of ADHD symptoms (Beck et al. 2010; Klingberg et al. 2005; Van der Oord et al. 2012).”
BackgroundWorking Memory Training in College Students With ADHD or LD
Gropper, R. J., Gotlieb, H., Kronitz, R., & Tannock, R. (2014) · Journal of Attention Disorders · doi:10.1177/1087054713516490 · Cited by 67
“Previous studies have found training-related reduction in ADHD symptoms, as measured by parent-completed rating scales (Beck et al., 2010; Holmes et al., 2009; Klingberg et al., 2005; Klingberg et al., 2002).”
BackgroundResultADHD Symptomatology and Risky Health, Driving, and Financial Behaviors in College
Graziano, P. A., Reid, A. M., Slavec, J., Paneto, A., McNamara, J. P. H., & Geffken, G. R. (2014) · Journal of Attention Disorders · doi:10.1177/1087054714527792 · Cited by 66
Improving Clinical Practices for Children With Language and Learning Disorders
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Training Cognition in ADHD: Current Findings, Borrowed Concepts, and Future Directions
Rutledge, K. J., van den Bos, W., McClure, S. M., & Schweitzer, J. B. (2012) · Neurotherapeutics · doi:10.1007/s13311-012-0134-9 · Cited by 75
Robinson, K. E., Kaizar, E. E., Catroppa, C., Godfrey, C., & Yeates, K. O. (2014) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsu031 · Cited by 71
Hadwin, J. A., & Richards, H. J. (2016) · Frontiers in Psychology · doi:10.3389/fpsyg.2016.00047 · Cited by 75
Nonpharmacologic Treatments for Attention-Deficit/Hyperactivity Disorder: A Systematic Review
Goode, A. P., Coeytaux, R. R., Maslow, G., Davis, N. O., Hill, S., Namdari, B., LaPointe, N. M. A., Befus, D., Lallinger, K. R., Bowen, S., et al. (2018) · PEDIATRICS · doi:10.1542/peds.2018-0094 · Cited by 64
Ferreira-Brito, F., Fialho, M., Virgolino, A., Neves, I., Miranda, A. C., Sousa-Santos, N., Caneiras, C. S. G., Carriço, L. M., Verdelho, A., & Santos, O. (2019) · Journal of Biomedical Informatics · doi:10.1016/j.jbi.2019.103287 · Cited by 72
Rennie, B. J., Beebe-Frankenberger, M. E., & Swanson, H. L. (2014) · Journal of Clinical and Experimental Neuropsychology · doi:10.1080/13803395.2014.921284 · Cited by 62
Rivero, T. S., Núñez, L., Pires, E. U., & Bueno, O. F. A. (2015) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2015.00151 · Cited by 53
“In relation to scales, studies reported enhancement in abilities related to inhibition and metacognition (27), initiation, planning/organization and working memory (35), attentional control (28), motivation on task (9), and schooling skills, such as reading comprehension and passage copying (37).”
BackgroundMethodInfluentialPhillips, N. L., Parry, L., Mandalis, A., & Lah, S. S. (2015) · Child Neuropsychology · doi:10.1080/09297049.2015.1085500 · Cited by 50
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“trained functions regarding attention (33–35) and working memory training (30,36,37,56).”
BackgroundSmith, S. D., Vitulano, L. A., Katsovich, L., Li, S., Moore, C. C., Li, F., Grantz, H., Zheng, X., Eicher, V. W., Gülöksüz, S. A., et al. (2016) · Journal of Attention Disorders · doi:10.1177/1087054716647490 · Cited by 50
“, blinded raters) have not typically been found (Beck et al., 2010; Chacko et al., 2014; Klingberg et al., 2005; van Dongen-Boomsma et al., 2014).”
InfluentialKirk, H., Gray, K. M., Ellis, K., Taffe, J. R., & Cornish, K. M. (2017) · American Journal on Intellectual and Developmental Disabilities · doi:10.1352/1944-7558-122.2.97 · Cited by 61
Brain Training in Children and Adolescents: Is It Scientifically Valid?
Rossignoli-Palomeque, T., Pérez-Hernández, E., & González-Marqués, J. (2018) · Frontiers in Psychology · doi:10.3389/fpsyg.2018.00565 · Cited by 60
“Another attempt to prove the benefits of behavioral ADHD symptoms (FT) through WM training has been conducted by Beck et al. (2010).”
BackgroundInfluentialNeuroeconomics: Implications for Understanding and Treating Addictive Behavior
Jarmolowicz, D. P., Reed, D. D., & Bickel, W. K. (2015) · Palgrave Macmillan UK eBooks · doi:10.1057/9781137362650_10 · Cited by 47
He, F., Qi, Y., Zhou, Y., Cao, A., Yue, X., Fang, S., & Zheng, Y. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1054831 · Cited by 49
Current evidence does not support the claims made for CogMed working memory training.
Hulme, C., & Melby‐Lervåg, M. (2012) · Journal of Applied Research in Memory and Cognition · doi:10.1016/j.jarmac.2012.06.006 · Cited by 56
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“Recent studies of those with ADHD, which can also present as comorbidity with SUD [117], have demonstrated clinically significant effects of WM training, particularly in lowering inattention and impulsivity [118–120].”
BackgroundThe Efficacy of Computerized Cognitive Training in Adults With ADHD
Stern, A., Malik, E., Pollak, Y., Bonne, O. B., & Maeir, A. (2014) · Journal of Attention Disorders · doi:10.1177/1087054714529815 · Cited by 50
“CCT is widely used in the last few years, and it was used in several of the studies mentioned above (Beck et al., 2010; Chacko et al., 2014; Green et al., 2012; Johnstone et al., 2012; Klingberg et al., 2005; Klingberg et al., 2002; Rabiner et al., 2010; Shalev et al., 2007; Steiner et al., 2011;…”
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“, 3–6 months after training) indicate that training gains are maintained over time (Beck et al., 2010; Dahlin, 2011; Holmes et al., 2010; Løhaugen et al., 2011).”
BackgroundBombonato, C., Lucchese, B. D., Ruffini, C., Lieto, M., Brovedani, P., Sgandurra, G., Cioni, G., & Pecini, C. (2023) · Neuropsychology Review · doi:10.1007/s11065-022-09574-z · Cited by 57
“…6 reported an intensive and high frequency weekly intervention plan (5 times a week, from 5 to 7 weeks), with sessions of short duration (20—40 min) (Beck et al., 2010; Bigorra et al., 2016a, b; Dovis et al., 2015; Egeland et al., 2013; Kirk et al., 2017; Klingberg et al., 2005), while the…”
BackgroundMethodResultInfluentialMokhtari, S., Mokhtari, A., Bakizadeh, F., Moradi, A., & Shalbafan, M. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-04554-w · Cited by 42
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Randomized Controlled Trial of Working Memory Intervention in Congenital Heart Disease
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TENI: A comprehensive battery for cognitive assessment based on games and technology
Tenorio Delgado, M., Arango Uribe, P., Aparicio Alonso, A., & Rosas Díaz, R. (2016) · Child Neuropsychology · doi:10.1080/09297049.2014.977241 · Cited by 34
“These programs include some forms of dynamic assessment and have robust evidence of positive impact (i.e., Beck, Hanson, Puffenberger, Benninger, & Benninger, 2010; Preis, Chatil, Cermá ć ová, Cimermannová, & Flescher, 2013).”
BackgroundThe OutSMARTers Program for Children With ADHD
Hannesdottir, D. K., Ingvarsdottir, E., & Bjornsson, A. S. (2014) · Journal of Attention Disorders · doi:10.1177/1087054713520617 · Cited by 45
“The gain in working memory has been shown to be maintained significantly after the training period ends (Beck et al., 2010).”
BackgroundA Quantitative Signature of Self-Control Repair
Bickel, W. K., Landes, R. D., Kurth-Nelson, Z. L., & Redish, A. D. (2014) · Clinical Psychological Science · doi:10.1177/2167702614528162 · Cited by 39
The Crucial Role of Working Memory in Intellectual Functioning
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A Review of Working Memory Training in the Management of Attention Deficit Hyperactivity Disorder
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An iPad-Based Tool for Improving the Skills of Children with Attention Deficit Disorder
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“reinforcement [15].”
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The role of working memory in childhood education: Five questions and answers
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“6.0 Visual Verbal 4.5 3.0 1.5 0.0 5 y r s 8 y r s 1 0 y r s 1 3 y r s 1 6 y r s 2 2 y r s 3 5 y r s 4 5 y r s 5 5 y r s 6 5 y r s Figure 2: The development of working memory capacity (Adapted from Alloway 2011) (Note: The y-axis represents the number of chunks recalled.”
BackgroundInfluential
Metadata
- Authors
- Beck, S. J., Hanson, C. A., Puffenberger, S. S., Benninger, K. L., & Benninger, W. B.
- Affiliations
- The Ohio State University (US)
- University of Toledo (US)
- Corresponding author
- Beck, Steven J.
- Venue
- Journal of Clinical Child & Adolescent Psychology
- Publisher
- Informa UK Limited
- Published
- 2010-11-11
- Volume
- 39
- Issue
- 6
- Pages
- 825-836
- ISSN
- 1537-4416 (ISSN-L)
- 1537-4424
- OpenAlex
- W2044837895
- Cited by
- 311
- References
- 43
- Citations by year
- 2026: 7 · 2025: 6 · 2024: 7 · 2023: 16 · 2022: 10 · 2021: 9 · 2020: 15 · 2019: 24 · 2018: 15 · 2017: 28 · 2016: 31 · 2015: 40 · 2014: 40 · 2013: 24 · 2012: 23
- FWCI
- 13.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Child & Adolescent Psychology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Abilities and Testing
- Keywords
- working memory training, attention deficit hyperactivity disorder, children and adolescents, executive function, ADHD symptoms, inattention, comorbidities, waitlist control
- MeSH terms
- Adolescent, Attention Deficit Disorder with Hyperactivity, Child, Faculty, Female, Follow-Up Studies, Humans, Male, Memory, Short-Term, Parents, Space Perception, Teaching, Verbal Learning, Visual Perception, Comorbidity, Cognitive Behavioral Therapy, Treatment Outcome, Executive Function
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