A Pilot Study of the Efficacy of a Computerized Executive Functioning Remediation Training With Game Elements for Children With ADHD in an Outpatient Setting: Outcome on Parent- and Teacher-Rated Executive Functioning and ADHD Behavior
Abstract
Objective: This pilot study tested the short- and long-term efficacy (9 weeks follow-up) of an executive functioning (EF) remediation training with game elements for children with ADHD in an outpatient clinical setting, using a randomized controlled wait-list design. Furthermore, in a subsample, that is, those treated with methylphenidate, additive effects of the EF training were assessed. Method: A total of 40 children (aged 8-12 years) were randomized to the EF training or wait-list. The training consisted of a 25-session training of inhibition, cognitive flexibility, and working memory. Treatment outcome was assessed by parent- and teacher-rated EF, ADHD, oppositional deviant disorder, and conduct disorder symptoms. Results: Children in the EF training showed significantly more improvement than those in the wait-list condition on parent-rated EF and ADHD behavior in the total sample and in the subsample treated with methylphenidate. Effects were maintained at follow-up. Conclusion: This pilot study shows promising evidence for the efficacy of an EF training with game elements.
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A previous waitlist-controlled study of BGB showed promising results on reduction of symptoms of ADHD and improvement of EF.
“A previous waitlist-controlled study of BGB [31] showed promising results on reduction of symptoms of ADHD and improvement of EF.”
Some have argued that EF training studies only find Time effects on parent-ratings but not on teacher-ratings because teachers, in contrast to parents, are only minimally involved in training and thus may be less biased than parents.
“Some have argued that EF training studies only find Time effects on parent-ratings but not on teacher-ratings because teachers, in contrast to parents, are only minimally involved in training and thus may be less biased than parents (e.g., by their expectancies of the training outcome) [31].”
A previous study investigating BGB [31] found no improvement on parent- and teacher-rated ADHD and EF behavior in a wait-list control group, whilst they did find improvement in the trained group.
“a previous study investigating BGB [31] found no improvement on parent- and teacher-rated ADHD and EF behavior in a wait-list control group, whilst they did find improvement in the group that was trained.”
Serious games are characterized by high-intensity immediate reinforcement, which appears to improve task performance, especially within ADHD populations.
“These games are characterized by a high-intensity immediate reinforcement and this appears to improve task performance, especially within ADHD populations [39,40].”
This serious game is unique because it elicits its effects by promoting behavioral strategies instead of training executive functions by offering repeated cognitive exercises.
“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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- Authors
- van der Oord, S., Ponsioen, A. J. G. B., Geurts, H. M., Brink, E. L. T., & Prins, P. J. M.
- Affiliations
- Leuven University, Belgium
- Lucertis, Outpatient Children’s Psychiatric Clinic, Beverwijk/Zaandam, Netherlands
- University of Amsterdam (NL)
- Venue
- Journal of Attention Disorders
- Publisher
- SAGE Publications
- Published
- 2012-08-09
- Volume
- 18
- Issue
- 8
- Pages
- 699-712
- ISSN
- 1087-0547 (ISSN-L)
- 1557-1246
- OpenAlex
- W1993435970
- Semantic Scholar
- b9059fba8d4dc55b3e2fee8659f64255d1f24030
- Cited by
- 148
- References
- 25
- Citations by year
- 2026: 15 · 2025: 12 · 2024: 8 · 2023: 10 · 2022: 10 · 2021: 10 · 2020: 14 · 2019: 10 · 2018: 13 · 2017: 10 · 2016: 9 · 2015: 12 · 2014: 4 · 2013: 8 · 2012: 1
- FWCI
- 5.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Attention Disorders (publishedVersion)
- PubMed (publishedVersion)
- UvA-DARE (University of Amsterdam) (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- 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 › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Keywords
- executive function training, attention deficit hyperactivity disorder, children, computer-based training, game-based intervention, inhibition, cognitive flexibility, working memory, methylphenidate, conduct disorder, outpatient care, treatment efficacy
- MeSH terms
- Ambulatory Care, Attention Deficit Disorder with Hyperactivity, Child, Child Behavior Disorders, Female, Humans, Inhibition, Psychological, Male, Memory, Short-Term, Methylphenidate, Parents, Pilot Projects, Play and Playthings, Reinforcement, Psychology, Waiting Lists, Cognitive Behavioral Therapy, Treatment Outcome, Executive Function, Watchful Waiting
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