A randomized clinical trial of Cogmed Working Memory Training in school‐age children with ADHD : a replication in a diverse sample using a control condition
Open accessAbstract
Background: Cogmed Working Memory Training ( CWMT ) has received considerable attention as a promising intervention for the treatment of Attention‐Deficit/Hyperactivity Disorder ( ADHD ) in children. At the same time, methodological weaknesses in previous clinical trials call into question reported efficacy of CWMT . In particular, lack of equivalence in key aspects of CWMT (i.e., contingent reinforcement, time‐on‐task with computer training, parent–child interactions, supportive coaching) between CWMT and placebo versions of CWMT used in previous trials may account for the beneficial outcomes favoring CWMT . Methods: Eighty‐five 7‐ to 11‐year old school‐age children with ADHD (66 male; 78%) were randomized to either standard CWMT ( CWMT Active) or a well‐controlled CWMT placebo condition ( CWMT Placebo) and evaluated before and 3 weeks after treatment. Dependent measures included parent and teacher ratings of ADHD symptoms; objective measures of attention, activity level, and impulsivity; and psychometric indices of working memory and academic achievement (Clinical trial title: Combined cognitive remediation and behavioral intervention for the treatment of Attention‐Deficit/Hyperactivity Disorder; http://clinicaltrials.gov/ct2/show/NCT01137318 ). Results: CWMT Active participants demonstrated significantly greater improvements in verbal and nonverbal working memory storage, but evidenced no discernible gains in working memory storage plus processing/manipulation. In addition, no treatment group differences were observed for any other outcome measures. Conclusions: When a more rigorous comparison condition is utilized, CWMT demonstrates effects on certain aspects of working memory in children with ADHD ; however, CWMT does not appear to foster treatment generalization to other domains of functioning. As such, CWMT should not be considered a viable treatment for children with ADHD .
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In many ways our findings are similar to those of previous placebo controlled (single) EF training studies in children with ADHD (but only one of these studies corrected for multiple testing).
“In many ways our findings are similar to those of previous placebo controlled (single) EF training studies in children with ADHD [21], [84], [85], [86], [23] (but note that only one of these studies [21] corrected for multiple testing).”
The present results show considerable cognitive and neural plasticity in children suffering from ADHD, indicating that individual benefits of well-tailored cognitive interventions may be considerable.
“The present results nonetheless show considerable cognitive and neural plasticity in children suffering from ADHD (Jolles and Crone, 2012; Rapport et al., 2013; Chacko et al., 2014), indicating that the individual benefits of well-tailored cognitive interventions may be considerable.”
From Executive control training from middle childhood to adolescence (2014) · cites this paper as Chacko et al., 2014
Recent reviews and meta-analyses suggest that the effects of working memory training in children with ADHD may not be that far reaching.
“Despite these and other encouraging findings, recent reviews and meta-analyses suggest that the effects of working memory training in children with ADHD may not be that far reaching (Rapport et al., 2013; Chacko et al., 2014).”
From Executive control training from middle childhood to adolescence (2014) · cites this paper as Chacko et al., 2014
A well-controlled recent study on the effects of CogMed training in 7- to 11-year-old children with ADHD did not show beneficial effects beyond working memory improvements.
“In fact, a well-controlled recent study on the effects of CogMed training in 7- to 11-year-old children with ADHD did not show beneficial effects beyond working memory improvements (Chacko et al., 2014; see also Holmes et al., 2009b).”
From Executive control training from middle childhood to adolescence (2014) · cites this paper as Chacko et al., 2014
Computerized training programs for ADHD show some evidence for short-term effects on targeted working memory outcomes as measured by neurocognitive tests similar to the ones practiced in the games, but have not shown compelling evidence that these effects generalize beyond neurocognitive outcomes to important domains of daily life functioning.
“Although these programs show some evidence for short-term effects on targeted working memory outcomes as measured by neurocognitive tests similar to the ones practiced in the games, they have not shown compelling evidence that these effects generalize beyond neurocognitive outcomes to important domains of functioning in the daily lives of children with ADHD (so-called “far-transfer effects”) [27-”
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- Authors
- Chacko, A., Bedard, A. C., Marks, D. J., Feirsen, N., Uderman, J. Z., Chimiklis, A., Rajwan, E., Cornwell, M., Anderson, L., Zwilling, A., & Ramon, M.
- Affiliations
- Queens College, CUNY (US)
- Icahn School of Medicine at Mount Sinai (US)
- NYU Langone Health (US)
- The Graduate Center, CUNY (US)
- Department of Psychology Queens College City University of New York Flushing NY USA
- Corresponding author
- Chacko, A.
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 2013-10-07
- Volume
- 55
- Issue
- 3
- Pages
- 247-255
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- PMC
- PMC3944087
- OpenAlex
- W1979335377
- Cited by
- 244
- References
- 21
- Citations by year
- 2026: 9 · 2025: 14 · 2024: 9 · 2023: 18 · 2022: 8 · 2021: 15 · 2020: 23 · 2019: 35 · 2018: 21 · 2017: 28 · 2016: 18 · 2015: 33 · 2014: 12 · 2013: 1
- FWCI
- 15.35
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R34MH088845)
- 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, ADHD treatment, working memory, placebo-controlled intervention, cognitive remediation, elementary school students, treatment generalization, impulsivity, academic performance
- MeSH terms
- Attention Deficit Disorder with Hyperactivity, Child, Female, Humans, Male, Memory, Short-Term, Placebos, Cognitive Behavioral Therapy, Treatment Outcome
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