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Cited by 272Attention Deficit Hyperactivity DisorderDevelopmental and Educational NeuropsychologyCognitive Abilities and Testing

Improving Executive Functioning in Children with ADHD: Training Multiple Executive Functions within the Context of a Computer Game. A Randomized Double-Blind Placebo Controlled Trial

Open access
Dovis, Sebastiaan, Van der Oord, Saskia, Wiers, Reinout W., Prins, Pier J. M.·2015·PLOS ONE
DOI 10.1371/journal.pone.0121651PMC PMC4386826
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Abstract

INTRODUCTION: Executive functions (EFs) training interventions aimed at ADHD-symptom reduction have yielded mixed results. Generally, these interventions focus on training a single cognitive domain (e.g., working memory [WM], inhibition, or cognitive-flexibility). However, evidence suggests that most children with ADHD show deficits on multiple EFs, and that these EFs are largely related to different brain regions. Therefore, training multiple EFs might be a potentially more effective strategy to reduce EF-related ADHD symptoms. METHODS: Eighty-nine children with a clinical diagnosis of ADHD (aged 8-12) were randomized to either a full-active-condition where visuospatial WM, inhibition and cognitive-flexibility were trained, a partially-active-condition where inhibition and cognitive-flexibility were trained and the WM-training task was presented in placebo-mode, or to a full placebo-condition. Short-term and long-term (3-months) effects of this gamified, 25-session, home-based computer-training were evaluated on multiple outcome domains. RESULTS: During training compliance was high (only 3% failed to meet compliance criteria). After training, only children in the full-active condition showed improvement on measures of visuospatial short-term-memory (STM) and WM. Inhibitory performance and interference control only improved in the full-active- and the partially-active condition. No Treatment-condition x Time interactions were found for cognitive-flexibility, verbal WM, complex-reasoning, nor for any parent-, teacher-, or child-rated ADHD behaviors, EF-behaviors, motivational behaviors, or general problem behaviors. Nonetheless, almost all measures showed main Time-effects, including the teacher-ratings. CONCLUSIONS: Improvements on inhibition and visuospatial STM and WM were specifically related to the type of treatment received. However, transfer to untrained EFs and behaviors was mostly nonspecific (i.e., only interference control improved exclusively in the two EF training conditions). As such, in this multiple EF-training, mainly nonspecific treatment factors - as opposed to the specific effects of training EFs-seem related to far transfer effects found on EF and behavior. TRIAL REGISTRATION: trialregister.nl NTR2728. Registry name: improving executive functioning in children with ADHD: training executive functions within the context of a computer game; registry number: NTR2728.

Verified 2026-10-06 · 1 reference not checked yet

AI snapshot

Written from the paper’s full text.

TL;DR

This randomized double-blind placebo-controlled trial tested a gamified, home-based multiple executive-function training (Braingame Brian) in 89 children aged 8–12 with ADHD combined-type. Only trained EF domains showed specific improvements, while far transfer to untrained EFs and behavior was mostly nonspecific, with broad time effects even in placebo.

Key findings

  • Compliance was high: 30/31 (96.7%) in full-active, 28/28 in partially-active, and 28/30 (93.3%) in placebo met the 25-session/5-week compliance criterion; overall only 3% failed to meet compliance criteria.
  • Only the full-active condition improved on visuospatial short-term memory and working memory: CBTT-forward showed a significant Treatment × Time interaction pre- to post-test after Bonferroni correction (p = .002); full-active vs placebo contrasts were F(1,59) = 11.03, p < .01, ηp² = .16 pre–post and F(1,59) = 8.35, p < .01, ηp² = .12 pre–follow-up.
  • Inhibitory performance and interference control improved only in the full-active and partially-active conditions: Stop task full-active vs placebo pre–post F(1,59) = 5.73, p < .05, ηp² = .09; partially-active vs placebo pre–post F(1,56) = 4.22, p < .05, ηp² = .07; Stroop full-active vs placebo pre–follow-up F(1,59) = 6.53, p < .05, ηp² = .10. After Bonferroni correction, only CBTT-forward remained significant.
  • No Treatment-condition × Time interactions were found for cognitive flexibility, verbal WM, complex reasoning, or any parent-, teacher-, or child-rated ADHD behaviors, EF behaviors, motivational behaviors, or general problem behaviors. Nonetheless, almost all measures showed main Time effects, including teacher ratings (e.g., parent DBDRS Inattention pre–post F(1,86) = 66.21, p < .001, ηp² = .44; teacher DBDRS Inattention pre–post F(1,86) = 19.27, p < .001, ηp² = .18).

Methods

  • Multicenter (14 sites), double-blind, placebo-controlled, multi-arm parallel-group trial in the Netherlands. Eighty-nine children aged 8–12 with DSM-IV-TR ADHD combined-type, clinical-range parent and teacher DBDRS scores, PDISC-IV ADHD combined-type, IQ ≥ 80, and no autism spectrum disorder or conduct disorder were randomized by minimization to full-active (WM, inhibition, cognitive flexibility trained), partially-active (inhibition and cognitive flexibility trained; WM in placebo mode), or full placebo.
  • Intervention: “Braingame Brian,” a gamified, home-based computerized EF training of 25 sessions over 5 weeks, with each session including WM, inhibition, and cognitive-flexibility tasks; training-mode adjusted difficulty, while placebo-mode did not.
  • Outcomes assessed at pre-test, post-test, and 3-month follow-up: performance measures (Stop task SSRT, Stroop, Corsi Block Tapping forward/backward, Digit span, Trail Making Test, Raven) and rating scales (DBDRS parent/teacher, BRIEF, SPSRQ-C, PedsQL, HSQ). Analyses used intent-to-treat with stochastic regression imputation, repeated-measures MANOVAs with Bonferroni corrections, simple contrasts, within-group paired t-tests, and reliable change indices for responders.

Limitations

  • Stated: no wait-list control condition was used, so the authors cannot determine the extent to which findings relate to multiple testing, passage of time, or nonspecific treatment factors. They also note that stochastic regression imputation can increase the probability of type I errors.
  • Stated: the study only investigated overall group differences, children were allocated irrespective of individual EF deficits, far-transfer domains were limited to direct performance measures and indirect behavior ratings, and no direct behavior measures were included; effects of inhibition versus cognitive-flexibility training were not separated.
  • Evident from the text: the placebo condition still required sustained attention and may have constituted some cognitive training; the cognitive-flexibility outcome (TMT global switch cost) may not match the trained local switch cost; and Bonferroni corrections with small subgroups may have reduced power to detect interactions.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1371/journal.pone.0121651

Cites

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Statistics

Claims the paper makes

0 of 81 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Almost all measures showed main Time-effects, including the teacher-ratings.

    “Nonetheless, almost all measures showed main Time-effects, including the teacher-ratings.”
    Quote in the paperNot a substantial claim
  • Findingown data

    After training, only children in the full-active condition showed improvement on measures of visuospatial short-term-memory (STM) and WM.

    “After training, only children in the full-active condition showed improvement on measures of visuospatial short-term-memory (STM) and WM.”
    Quote in the paperSubstantial claim
  • Findingown data

    Inhibitory performance and interference control only improved in the full-active and the partially-active conditions.

    “Inhibitory performance and interference control only improved in the full-active- and the partially-active condition.”
    Quote in the paperSubstantial claim
  • Findingown data

    In the 3x3 repeated measures MANOVA with the main scores of the EF tasks (Stoptask SSRT, STROOP interference, CBTT-fwd, CBTT-bkw, Digit recall, TMT) and Raven as dependent variables, there was a main effect of Time, F(14,334)=6.74, p<.001, ηp2=.22.

    “A 3x3 (Treatment condition x Time [pre-test, post-test, follow-up]) repeated measures MANOVA with the main scores of the EF tasks (Stoptask [SSRT], STROOP [interference score], CBTT-fwd [total score], CBTT-bkw [total score], Digit recall [scaled score], TMT [scaled contrast score]) and the Raven (total score) as dependent variables (scores on all seven tasks were analyzed simultaneously), showed a”
    Quote in the paperNot a substantial claim
  • Findingown data

    In the same MANOVA, there was a non-significant trend towards an interaction between Treatment condition and Time, F(28,676)=1.59, p=.027, ηp2=.06 (after Bonferroni correction only p-values < .0125 were considered significant).

    “and a non-significant trend towards an interaction between Treatment condition and Time, F (28,676) = 1.59, p = .027, η p 2 = .06 (after Bonferroni correction only p-values < .0125 were considered significant).”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim. 37
  • May combine two claims. 45

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    During training, compliance was high (only 3% failed to meet compliance criteria).

    “During training compliance was high (only 3% failed to meet compliance criteria).”
    • Also stated in: § Process Measures · plain
      “Overall, compliance to treatment was high, given that this was a home-based intervention that included a substantial portion of participants with ODD (see Fig 2).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    No Treatment-condition x Time interactions were found for cognitive-flexibility, verbal WM, complex-reasoning, nor for any parent-, teacher-, or child-rated ADHD behaviors, EF-behaviors, motivational behaviors, or general problem behaviors.

    “No Treatment-condition x Time interactions were found for cognitive-flexibility, verbal WM, complex-reasoning, nor for any parent-, teacher-, or child-rated ADHD behaviors, EF-behaviors, motivational behaviors, or general problem behaviors.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Within the full-active condition, children improved significantly from Start Index to Max Index on the Inhibition training, the Cognitive flexibility training, and all five levels of the WM training.

    “Within the full-active condition, paired t-tests showed a significant difference (improvement) between the Start Index and Max Index for the Inhibition training, t (30) = -18.66, p < .001, the Cognitive flexibility training, t (30) = -19.14, p < .001, and for all the levels of the WM training (level 1, t (30) = -7.25, p < .001; level 2, t (30) = -7.90, p < .001; level 3, t (30) = -7.19, p < .001,”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Of the 31 participants in full-active, 30 (96.7%) met compliance criteria; all 28 in partially-active met criteria; of 30 in placebo, 28 (93.3%) met criteria.

    “Of the 31 participants assigned to the full-active condition, 30 (96.7%) met compliance criteria (25 training days within 5 weeks). All of the 28 participants assigned to the partially-active condition met compliance criteria. Of the 30 participants assigned to the placebo condition, 28 (93.3%) met compliance criteria.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Within the partially-active condition, children improved significantly from Start Index to Max Index on both the Inhibition training and the Cognitive flexibility training.

    “Within the partially-active condition (where WM was in placebo-mode), paired t-tests showed significant difference (improvement) between the Start Index and the Max Index for both the Inhibition training, t (27) = -15.86, p < .001, and the Cognitive flexibility training, t (27) = -22.89, p < .001.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Eight participants (9%) of the total sample were lost to post-test and follow-up testing.

    “Eight participants (9%) of our total sample (i.e., 3 children in the full-active condition, 2 children in the partially-active condition, and 3 children in the placebo condition) were lost to post-test and follow-up testing (see Fig 2).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    However, this difference was no longer significant after Bonferroni correction: as only p-values < .0063 were considered significant.

    “However, this difference was no longer significant after Bonferroni correction: as only p-values < .0063 (.05/8) were considered significant.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    After Bonferroni correction (p < .0024), parents reported a significant improvement on all general problem behavior indices (effect sizes ranged from medium to large), and teachers reported a significant improvement on the ODD scale of the DBDRS (medium effect size).

    “After Bonferroni correction (p < .0024 [.05/21]) results indicate the following: after training, parents reported a significant improvement on all general problem behavior indices (effect sizes ranged from medium to large), and teachers reported a significant improvement on the ODD scale of the DBDRS (medium effect size).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    After Bonferroni correction (p < .0024), between pre- and post-test there was a significant Treatment condition x Time interaction for CBTT-fwd (p = .002), and a non-significant trend for the Stoptask (p = .037) and the CBTT-bkw (p = .039).

    “After Bonferroni correction (p < .0024 [.05/21]) results indicate the following: Between the pre- and post-test there was a significant Treatment condition x Time interaction for the CBTT-fwd (p = .002), and a non-significant trend for the Stoptask (p = .037) and the CBTT-bkw (p = .039; see Table 2).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    However, these differences were no longer significant after Bonferroni correction: as only p-values < .0063 were considered significant.

    “However, these differences were no longer significant after Bonferroni correction: as only p-values < .0063 (.05/8) were considered significant.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    No Treatment-condition x Time interactions (with or without Bonferroni corrections) were found for cognitive flexibility, verbal STM and WM, non-verbal complex reasoning, or child-rated psychosocial health, nor for any parent- or teacher-rated ADHD symptoms, EF behaviors, motivational behaviors, or general problem behaviors.

    “However, no Treatment-condition x Time interactions (with or without Bonferroni corrections) were found for cognitive flexibility, verbal STM and WM, non-verbal complex reasoning, or child-rated psychosocial health, nor for any parent- or teacher-rated ADHD symptoms, EF behaviors, motivational behaviors, or general problem behaviors.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Performance on the Stoptask, the STROOP and the CBTT-bkw also significantly improved between pre-test and follow-up in the full-active condition (there was a trend for performance on the CBTT-fwd, p = .003).

    “Performance on the Stoptask, the STROOP and the CBTT-bkw also significantly improved between pre-test and follow-up (there was a trend for performance on the CBTT-fwd, p = .003).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Between pre-test and follow-up there was a non-significant trend towards a Treatment condition x Time interaction for the CBTT-fwd (p = .013) and the STROOP (p = .07).

    “Between the pre-test and follow-up there was a non-significant trend towards a Treatment condition x Time interaction for the CBTT-fwd (p = .013) and the STROOP (p = .07; see Table 2).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In the placebo condition none of the differences were significant (although there was a trend for STROOP performance between pre- and post-test, p = .043).

    “In the placebo condition none of the differences were significant (although there was a trend for STROOP performance between pre- and post-test, p = .043; see Table 4).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The pattern of treatment responder results strongly resembles the pattern of the mean results.

    “The pattern of these results strongly resembles the pattern of the mean results (see Table 5; in addition see Table A in S2 Appendix).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    After Bonferroni correction (p < .0042), compared to the pre-test, both parents and teachers reported a significant decrease in ADHD symptoms at the post-test and at the follow-up (effect sizes of parent-ratings were large; effect sizes of teacher-ratings ranged from medium to large).

    “After Bonferroni correction (p < .0042 [.05/12]) results indicate that: compared to the pre-test, both parents and teachers reported a significant decrease in ADHD symptoms at the post-test and at the follow-up (effect sizes of parent-ratings were large; effect sizes of teacher-ratings ranged from medium to large).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Almost all measures showed significant Time-effects, including the teacher-ratings (effect sizes ranged from medium to large).

    “Nonetheless, almost all measures showed significant Time-effects, including the teacher-ratings (effect sizes ranged from medium to large).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    After Bonferroni correction only the Treatment x Time interactions for the CBTT-fwd remained significant (as only p-values < .0063 were considered significant).

    “However, after Bonferroni correction only the Treatment x Time interactions for the CBTT-fwd remained significant (as only p-values < .0063 [.05/8] were considered significant).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingreasoning

    Although we used more stringent compliance criteria than most previous studies (completing 100% of the training sessions versus 80%), in our study only 3% of the participants failed to meet compliance criteria, whereas in previous studies 15-23% failed to meet compliance criteria.

    “Although we used more stringent compliance criteria than most previous studies (i.e., completing 100% of the training sessions versus completing 80% of the training sessions), in our study only 3% of the participants failed to meet compliance criteria, whereas in previous studies 15–23% failed to meet compliance criteria.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    After Bonferroni correction (p < .0014), parents reported a significant improvement (with large effect sizes) on almost all scales of the BRIEF (only improvement on the Organization of Materials scale was no longer significant after Bonferroni correction) and on the Impulsivity/Fun Seeking scale of the SPSRQ-C (medium effect size; improvement on the Punishment Sensitivity scale [p = .022] and the

    “After Bonferroni correction (p < .0014 [.05/36]) results indicate the following: after training, parents reported a significant improvement (with large effect sizes) on almost all scales of the BRIEF (EF behavior; only improvement on the Organization of Materials scale was no longer significant after Bonferroni correction) and on the Impulsivity/Fun Seeking scale of the SPSRQ-C (motivational”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Theories of ADHD suggest that deficits in executive functioning are at the core of the ADHD-syndrome and play a pivotal role in explaining the problems children with ADHD encounter in daily life.

    “Theories of ADHD suggest that deficits in executive functioning are at the core of the ADHD-syndrome, and play a pivotal role in explaining the problems children with ADHD encounter in daily life [1], [2], [3], [4].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [1] RA Barkley, 2006, A handbook for diagnosis and treatment

      Not checked in the free run.

    • cites [2] JT Nigg, 2006, Understanding what goes wrong and why

      Not checked in the free run.

    • cites [3] MD Rapport, 2001, A conceptual model of child psychopathology: implications for understanding attention deficit hyperactivity disorder and treatment efficacy, J Clin Child Psychol source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Executive functions allow individuals to regulate their behavior, thoughts and emotions, and thereby enable self-control via dorsal frontostriatal brain circuits.

    “Via dorsal frontostriatal brain circuits, executive functions (EF) allow individuals to regulate their behavior, thoughts and emotions, and thereby enable self-control [5].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [5] S Durston, 2011, Differentiating frontostriatal and fronto-cerebellar circuits in attention-deficit/hyperactivity disorder, Biol Psychiatry source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    Eighty-nine children with a clinical diagnosis of ADHD aged 8-12 were randomized to three treatment conditions.

    “Eighty-nine children with a clinical diagnosis of ADHD (aged 8–12) were randomized to either a full-active-condition where visuospatial WM, inhibition and cognitive-flexibility were trained, a partially-active-condition where inhibition and cognitive-flexibility were trained and the WM-training task was presented in placebo-mode, or to a full placebo-condition.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    No important changes to methods were made after trial commencement.

    “No important changes to methods were made after trial commencement (the trial started April 2011 and ended January 2013).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Bonferroni corrections for multiple testing were applied to the MANOVAs and contrasts.

    “Bonferroni corrections for multiple testing were applied to these MANOVAs: only p-values < .0125 [.05/4] were considered significant.”
    • Also stated in: § Statistical Analyses · plain
      “Bonferroni corrections for multiple testing were applied to these contrasts, in which the amount of dependent variables corrected for was defined per repeated measures MANOVA”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    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.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [31] Oord S Van Der, 2014, 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, J Atten Disord source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    Sample size was determined by a prospective power analysis for univariate testing based on effect sizes of two previous EF-treatment studies.

    “Sample size was determined by a prospective power analyses for univariate testing (using G*Power) based on the effect sizes of two previous EF-treatment studies [86], [45].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [86] T Klingberg, 2005, Computerized training of working memory in children with ADHD—a randomized, controlled trial, J Am Acad Child Adolesc Psychiatry source

      Not checked in the free run.

    • cites [45] PJM Prins, 2011, Does computerized working memory training with game elements enhance motivation and training efficacy in children with ADHD?, Cyberpsychol Behav Soc Netw source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Experimenters were blind to condition at each test-session.

    “At each test-session experimenters were blind to condition.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Most EF-training studies focus on the effects of WM training, whereas very few studies investigate the unique effects of response inhibition and/or cognitive flexibility training in children with ADHD.

    “To date, most EF-training studies focus on the effects of WM training (e.g., see [15]), whereas very few studies investigate the unique effects (i.e. without WM training) of response inhibition- and/or cognitive flexibility training in children with ADHD.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [15] A Chacko, 2013, Cogmed Working Memory Training for Youth with ADHD: A Closer Examination of Efficacy Utilizing Evidence-Based Criteria, J Clin Child Adolesc Psychol source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    If a coach received information revealing the treatment condition, he/she was replaced and could no longer have contact with the family or the teacher.

    “If a coach did receive information revealing the treatment condition, he/she was replaced and could no longer have contact with the family or the teacher.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Coaches were blind to treatment condition.

    “a coach (a research assistant blind to the treatment condition) made weekly calls”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The study was approved by the faculty's IRB.

    “This study was approved by the faculty’s IRB (the Ethics Review Board of the Faculty of Social and Behavioral Sciences of the university of Amsterdam).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Only Kray et al. investigated effects of a cognitive flexibility training in children with ADHD; they found placebo-controlled effects on untrained EF performance (interference control), but did not investigate effects on behavior.

    “Only Kray et al. [23] investigated effects of a cognitive flexibility training in children with ADHD; they found placebo-controlled effects on untrained EF performance (i.e., interference control), but they did not investigate effects on behavior.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [23] J Kray, 2012, Can task-switching training enhance executive control functioning in children with attention deficit/-hyperactivity disorder?, Front Hum Neurosci source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Written informed consent was obtained from parents.

    “After obtaining written informed consent from the parents (on behalf of the participating children), parents and teachers completed the DBDRS.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    No important changes to outcome measures were made after trial commencement.

    “No important changes to outcome measures were made after trial commencement.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Including baseline demographics and clinical characteristics as covariates in the main analyses did not change the pattern of results.

    “Also, including these baseline demographics and clinical characteristics (i.e., Gender, Age, FSIQ, DBDRS parent and teacher ratings, ODD diagnosis, ADHD medication use, Computergame experience, and Dyslexia) as covariates in the main analyses did not change the pattern of our results.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Children with ADHD are less stimulated by reinforcement (reward) than typically developing children, probably due to a dopaminergic deficit.

    “Motivational models [34], [35], [36], [37], and subsequent research (for an overview see [38], [39]; also see [40], [41], [42], [43]) suggest that children with ADHD are less stimulated by reinforcement (i.e. reward) than typically developing children (probably due to a dopaminergic deficit)”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [34] M Haenlein, 1987, Attention deficit disorder with hyperactivity: a specific hypothesis of reward dysfunction, J Am Acad Child Adolesc Psychiatry source

      Not checked in the free run.

    • cites [35] JA Sergeant, 1999, Handbook of disruptive behavior disorders

      Not checked in the free run.

    • cites [36] T Sagvolden, 2005, A dynamic developmental theory of attention-deficit/hyperactivity disorder (ADHD) predominantly hyperactive/impulsive and combined subtypes, Behav Brain Sci source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    Once a research assistant completed a startup session with a family, he/she could not test or have further contact with that family or the teacher (to preserve blinding).

    “Once a research assistant completed a startup session with a particular family, he/she could not test or have further contact with that family or the teacher (to preserve blinding).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Gamification of an EF training or task has been found to optimize both motivation and training-effects in children with ADHD.

    “However, gamification of an EF training or task (e.g., by using game mechanics and visuals) has been found to optimize both motivation and training-effects in children with ADHD [40], [45], [46].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [40] S Dovis, 2012, Can motivation normalize working memory and task persistence in children with attention-deficit/hyperactivity disorder? The effects of money and computer-gaming, J Abnorm Child Psychol source

      Not checked in the free run.

    • cites [45] PJM Prins, 2011, Does computerized working memory training with game elements enhance motivation and training efficacy in children with ADHD?, Cyberpsychol Behav Soc Netw source

      Not checked in the free run.

    • cites [46] R Shaw, 2005, Inhibition, ADHD, and computer games: the inhibitory performance of children with ADHD on computerized tasks and games, J Atten Disord source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Gaming increases the release of striatal dopamine, promoting long-term potentiation of neural connections within the striatum, which is suggested to improve motivation and one's ability to learn.

    “Gaming increases the release of striatal dopamine [47], [48], promoting long-term potentiation of neural connections within the striatum [49], which is suggested to improve motivation and one’s ability to learn [50] (e.g., during EF training).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [47] MJ Koepp, 1998, Evidence for striatal dopamine release during a video game, Nature source

      Not checked in the free run.

    • cites [48] S Kühn, 2011, The neural basis of video gaming, Transl Psychiatry source

      Not checked in the free run.

    • cites [49] JN Reynolds, 2001, A cellular mechanism of reward-related learning, Nature source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Impairments in EF are related to associated problems such as deficient academic functioning.

    “and with associated problems such as deficient academic functioning [12], [13]”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [12] J Biederman, 2004, Impact of executive function deficits and attention-deficit/hyperactivity disorder (ADHD) on academic outcomes in children, J Consult Clin Psychol source

      Not checked in the free run.

    • cites [13] C Titz, 2014, Working memory and executive functions: effects of training on academic achievement, Psychol Res source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    The study was a multicenter (14 sites), double-blind, placebo-controlled, multi-arm parallel-group study conducted in the Netherlands.

    “This was a multicenter (14 sites), double-blind, placebo-controlled, multi-arm parallel-group study conducted in the Netherlands (trial register: http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2728; registry name: improving executive functioning in children with ADHD: training executive functions within the context of a computer game; registry number: NTR2728).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    An Intent-To-Treat approach using single imputations was used to compare treatment effects.

    “An Intent-To-Treat (ITT) approach, using single imputations, was used to compare treatment effects of the three treatment conditions.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    Participants were randomized to one of three treatment conditions using randomization by minimization on the basis of age, gender, IQ, medication-use, and parent- and teacher-rated inattention and hyperactivity/impulsivity symptoms.

    “were independently allocated to one of the three treatment conditions using the process of randomization by minimization [82] on the basis of age, gender, IQ, medication-use (yes/no), and parent- and teacher-rated inattention and hyperactivity/impulsivity symptoms (using the 6-months DBDRS).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [82] DG Altman, 2005, Treatment allocation by minimisation, BMJ source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In studies [85] and [86], only incongruent trials were used as outcome measure and baseline response times to congruent trials were not controlled for, making it impossible to calculate the interference score.

    “but they only used the incongruent trials as outcome measure; baseline response times to congruent trials were not controlled for, making it impossible to calculate the interference score)”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [85] T Klingberg, 2002, Training of working memory in children with ADHD, J Clin Exp Neuropsychol source

      Not checked in the free run.

    • cites [86] T Klingberg, 2005, Computerized training of working memory in children with ADHD—a randomized, controlled trial, J Am Acad Child Adolesc Psychiatry source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationcitation

    The hypothesis that gamification explains the compliance difference is consistent with previous findings of increased time-on-training when EF training was gamified and with the finding that gaming increases the release of striatal dopamine, which is associated with increased motivation to continue playing and performing.

    “This hypothesis is consistent with previous findings of increased time-on-training when EF training was gamified [45] (also see [40]), and with the finding that gaming increases the release of striatal dopamine [47], [48], which is associated with increased motivation to continue playing and performing [50].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [45] PJM Prins, 2011, Does computerized working memory training with game elements enhance motivation and training efficacy in children with ADHD?, Cyberpsychol Behav Soc Netw source

      Not checked in the free run.

    • cites [40] S Dovis, 2012, Can motivation normalize working memory and task persistence in children with attention-deficit/hyperactivity disorder? The effects of money and computer-gaming, J Abnorm Child Psychol source

      Not checked in the free run.

    • cites [47] MJ Koepp, 1998, Evidence for striatal dopamine release during a video game, Nature source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    There is evidence that video game playing can enhance various cognitive skills (e.g., attention).

    “For example, there is evidence that video game playing can enhance various cognitive skills (e.g., attention; see [88]).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [88] CS Green, 2003, Action video game modifies visual selective attention, Nature source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Evidence suggests that decreased negative parental discipline mediates the effect of ADHD treatment (e.g., medication and behavior therapy) on teacher-rated ADHD behavior.

    “Evidence suggests that decreased negative parental discipline mediates the effect of ADHD treatment (e.g., medication and behavior therapy) on teacher-rated ADHD behavior [91].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [91] SP Hinshaw, 2007, Moderators and mediators of treatment outcome for youth with ADHD: understanding for whom and how interventions work, J Ped Psychol source

      Not checked in the free run.

  • May combine two claims.

    Premisenone given

    In most placebo controlled studies differential far transfer to untrained EF tasks has been limited, and differential effects on parent- or teacher-rated behavior are generally not found.

    “Further, in most placebo controlled studies differential far transfer to untrained EF tasks has been limited, and differential effects on parent- or teacher-rated behavior (e.g., ADHD or EF) are generally not found.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    It may be that parents' positive attitude towards this particular game enhanced its positive effects.

    “Nonetheless, it may be that parents’ positive attitude towards this particular game enhanced its positive effects.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationreasoning

    Sharing the joy of achievement in the game with parents could have enhanced the child's appraisal of the game's positive feedback and its effect on self-esteem beyond that of commercial video games.

    “For example, sharing the joy of achievement in the game with his/her parents could have enhanced the child’s appraisal of the game’s positive feedback and its effect on his/her self-esteem beyond that of commercial video games (as many parents don’t encourage children to indulge in commercial gaming).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    The shorter placebo condition in Klingberg et al. suggests a difference in parent involvement between the conditions, which may have interacted with the outcome of parent-rated ADHD behavior (e.g., through expectancy effects or inequality of parent-child interactions).

    “This suggests a difference in parent involvement between the conditions, which may have interacted with the outcome of parent-rated ADHD behavior (e.g., through expectancy effects or inequality of parent-child interactions; see [15]).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [15] A Chacko, 2013, Cogmed Working Memory Training for Youth with ADHD: A Closer Examination of Efficacy Utilizing Evidence-Based Criteria, J Clin Child Adolesc Psychol source

      Not checked in the free run.

    • Rests on an assumption: The placebo condition used in Klingberg et al. was considerably shorter in time than the training condition.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

    Interpretationown data

    If children were more motivated to comply with treatment than in other EF training studies, which is consistent with the relatively high compliance rate in our study, there may have been less need for parents to discipline their children during training.

    “If children were more motivated to comply with treatment than in other EF training studies, which is consistent with the relatively high compliance rate in our study, there may have been less need for parents to discipline their children during training.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation

    Such near transfer effects may not be surprising since many outcome measures are very similar to the training tasks themselves and improvement may be the result of a learned strategy instead of improved cognitive capacity.

    “However, such near transfer effects may not be surprising since many of these outcome measures are very similar to the training tasks themselves and improvement may be the result of a learned strategy instead of improved cognitive capacity [87].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [87] TW Thompson, 2013, Failure of working memory training to enhance cognition or intelligence, PloS one source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing). May combine two claims.

    Premisecitation

    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].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [31] Oord S Van Der, 2014, 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, J Atten Disord source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    The gamification of BGB may also have impacted classroom functioning by enhancing children's motivation to comply with treatment.

    “Furthermore, the gamification of BGB may also have impacted classroom functioning by enhancing children’s motivation to comply with treatment.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    There is a link between parental praise and children's self-esteem, and self-esteem has been found to mediate the relationship between ADHD and classroom functioning.

    “Although there is a link between parental praise and children’s self-esteem [89], and self-esteem has been found to mediate the relationship between ADHD and classroom functioning [90], future research should investigate this further.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [89] RB Felson, 1989, Children’s Self-Esteem and Parental Support, J Marriage Fam source

      Not checked in the free run.

    • cites [90] B Shaw-Zirt, 2005, Adjustment, social skills, and self-esteem in college students with symptoms of ADHD, J Atten Disord source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Most previous placebo controlled EF training studies find differential treatment effects on outcome measures of trained EFs, although Kray et al. found no significant differences on cognitive flexibility.

    “Most of these studies find differential treatment effects on outcome measures of trained EFs (although Kray et al. [23], as in the present study, found no significant differences on cognitive flexibility).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [23] J Kray, 2012, Can task-switching training enhance executive control functioning in children with attention deficit/-hyperactivity disorder?, Front Hum Neurosci source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    The improvement on teacher-rated ADHD behavior seems unrelated to specific EF training effects, and the only nonspecific treatment factor that clearly distinguishes our study from previous studies appears to be the use of relatively strong gamification.

    “It seems unrelated to specific EF training effects, and the only nonspecific treatment factor that clearly distinguishes our study from previous studies appears to be the use of relatively strong gamification (i.e., teachers were not more involved than in previous studies).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationown data

    Although the improvement on teacher-rated ADHD behavior was unrelated to specific effects of the EF training (as it was also found in the placebo condition), it is still a remarkable finding.

    “Although this improvement was unrelated to specific effects of the EF training (as it was also found in the placebo condition), it is still a remarkable finding.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation

    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).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [21] A Chacko, 2014, 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, J Child Psychol Psychiatry source

      Not checked in the free run.

    • cites [84] CT Green, 2012, Will working memory training generalize to improve off-task behavior in children with attention-deficit/hyperactivity disorder?, Neurotherapeutics source

      Not checked in the free run.

    • cites [85] T Klingberg, 2002, Training of working memory in children with ADHD, J Clin Exp Neuropsychol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationown data

    The far transfer in the placebo condition might not be explained only by nonspecific treatment effects; it may be the result of actual cognitive training in the placebo condition.

    “The fact that far transfer was also found in the placebo condition might not (only) be explained by nonspecific treatment effects (e.g., effects of expectancies, self-fulfilling prophecies, attribution, gamification, or improved parent-child interactions), but may be the result of actual cognitive training in the placebo condition.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    The null effect on cognitive flexibility may be due to the difference between the switch-cost that was trained and the switch-cost used as the outcome measure.

    “This may be the result of the difference between the switch-cost (the index of cognitive flexibility) that was trained, and the switch-cost that was used as outcome measure of cognitive flexibility.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    The placebo tasks required focusing attention for a substantial amount of time, which could be sufficient to improve cognitive control and behavior.

    “it could be argued that the requisite of the placebo tasks to focus attention for a substantial amount of time was sufficient to improve cognitive control (e.g., attention) and the behavior of our participants.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    The domains of far transfer investigated in this study were limited to direct measures of performance and indirect measures of behavior.

    “the domains of far transfer that were investigated in this study were limited to direct measures of performance and indirect measures of behavior (e.g., behavior as rated by parents, teachers or children).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    The very limited improvement on EF performance in the placebo condition and the lack of effects from other activities requiring prolonged focused attention appear inconsistent with the idea that placebo tasks improved cognitive control.

    “However, this appears inconsistent with the very limited improvement on EF performance in the placebo condition, and the lack of effects resulting from other activities that require prolonged focused attention (e.g., paying attention in school, playing [educational] video games).”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    The scaled contrast score on the TMT measures global switch-cost, the difference between a block of switch-trials and blocks of non-switch trials.

    “Our outcome measure (the scaled contrast score on the TMT) measures global switch-cost (i.e., the difference between a block of switch-trials and blocks of non-switch trials)”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    The outcome measure of cognitive flexibility was in fact a measure of far transfer.

    “Therefore, it could be argued that our outcome measure of cognitive flexibility was in fact a measure of far transfer.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Evidence suggests that global and local switch-cost tap somewhat different cognitive processes and can be differentiated on a neural level.

    “evidence suggests that they tap somewhat different cognitive processes and can be differentiated on a neural level [94], [95].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [94] TS Braver, 2003, Neural Mechanisms of Transient and Sustained Cognitive Control during Task Switching, Neuron source

      Not checked in the free run.

    • cites [95] HA White, 2006, Training attention-switching ability in adults with ADHD, J Atten Disord source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    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.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [31] Oord S Van Der, 2014, 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, J Atten Disord source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    A recent placebo-controlled WM training study [84] found no specific treatment effects on parent-rated behavior, did not investigate teacher-rated behavior, but found specific effects on aspects of experimenter-observed off-task behavior during an academic task.

    “a recent placebo-controlled WM training study [84] found no specific treatment effects on parent-rated behavior (teacher-rated behavior was not investigated), but found specific effects on aspects of experimenter-observed off-task behavior during an academic task.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [84] CT Green, 2012, Will working memory training generalize to improve off-task behavior in children with attention-deficit/hyperactivity disorder?, Neurotherapeutics source

      Not checked in the free run.

71 of 71

  • The paper relies on this without support.

    The placebo condition used in Klingberg et al. was considerably shorter in time than the training condition.

    “However, the placebo condition used in Klingberg et al. was considerably shorter in time than the training condition.”

  • The paper relies on this without support.

    Klingberg et al. did not include children with comorbid ODD.

    “Another notable feature of the study of Klingberg et al. is that they did not include children with comorbid ODD.”

  • The paper relies on this without support.

    Most previous studies also used an external reward system, a structured schedule for implementing the intervention, weekly contact with a coach, and performance feedback during training.

    “Since most previous studies also used an external reward system, a structured schedule for implementing the intervention, weekly contact with a coach, and performance feedback during training”

  • The authors state this as an assumption.

    The absence of comorbid ODD in the Klingberg et al. study is an unlikely explanation for their distinctive findings on parent-rated ADHD.

    “Therefore, the absence of comorbid ODD in the Klingberg et al. study seems an unlikely explanation for their distinctive findings on parent-rated ADHD. This assumption is further substantiated by the findings we presented in Table A”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Consistentχ²(4) = 1.26reported p = .868 · recomputed p = .868

    “χ2(4) = 1.26, p = .868”

  • Consistentt(30) = -18.66reported p < .001 · recomputed p < .001

    “t (30) = -18.66, p < .001”

  • Consistentt(30) = -19.14reported p < .001 · recomputed p < .001

    “t (30) = -19.14, p < .001”

  • Consistentt(30) = -7.25reported p < .001 · recomputed p < .001

    “t (30) = -7.25, p < .001”

  • Consistentt(30) = -7.9reported p < .001 · recomputed p < .001

    “t (30) = -7.90, p < .001”

  • Consistentt(30) = -7.19reported p < .001 · recomputed p < .001

    “t (30) = -7.19, p < .001”

  • Consistentt(30) = -9.21reported p < .001 · recomputed p < .001

    “t (30) = -9.21, p < .001”

  • Consistentt(30) = -7.72reported p < .001 · recomputed p < .001

    “t (30) = -7.72, p < .001”

  • Consistentt(27) = -15.86reported p < .001 · recomputed p < .001

    “t (27) = -15.86, p < .001”

  • Consistentt(27) = -22.89reported p < .001 · recomputed p < .001

    “t (27) = -22.89, p < .001”

  • ConsistentF(14, 334) = 6.74reported p < .001 · recomputed p < .001

    “F (14,334) = 6.74, p < .001”

  • ConsistentF(14, 162) = 1.41reported p = .154 · recomputed p = .154

    “F (14,162) = 1.41, p = .154”

  • ConsistentF(28, 676) = 1.59reported p = .027 · recomputed p = .028

    “F (28,676) = 1.59, p = .027”

  • ConsistentF(8, 232) = 6.22reported p < .001 · recomputed p < .001

    “F (8,232) = 6.22, p < .001”

  • ConsistentF(4, 56) = 5.06reported p = .009 · recomputed p = .001

    “F (4,56) = 5.06, p = .009”

    The paper states a correction for multiple tests

  • ConsistentF(8, 232) = 3.9reported p < .001 · recomputed p < .001

    “F (8,232) = 3.90, p < .001”

  • ConsistentF(8, 220) = 3.49reported p = .001 · recomputed p < .001

    “F (8,220) = 3.49, p = .001”

  • ConsistentF(4, 53) = 1.44reported p = .235 · recomputed p = .234

    “F (4,53) = 1.44, p = .235”

  • ConsistentF(8, 220) = 1.07reported p = .388 · recomputed p = .385

    “F (8,220) = 1.07, p = .388”

  • ConsistentF(8, 224) = 9.79reported p < .001 · recomputed p < .001

    “F (8,224) = 9.79, p < .001”

  • ConsistentF(4, 54) = 1.76reported p = .151 · recomputed p = .150

    “F (4,54) = 1.76, p = .151”

  • ConsistentF(8, 224) = 2reported p = .048 · recomputed p = .048

    “F (8,224) = 2.00, p = .048”

  • ConsistentF(8, 340) = 13.32reported p < .001 · recomputed p < .001

    “F (8,340) = 13.32, p < .001”

  • ConsistentF(8, 166) = 0.33reported p = .953 · recomputed p = .954

    “F (8,166) = .33, p = .953”

  • ConsistentF(16, 688) = 0.77reported p = .718 · recomputed p = .721

    “F (16,688) = .77, p = .718”

  • ConsistentF(30, 318) = 4.91reported p < .001 · recomputed p < .001

    “F (30,318) = 4.91, p < .001”

  • ConsistentF(30, 146) = 1.08reported p = .368 · recomputed p = .369

    “F (30,146) = 1.08, p = .368”

  • ConsistentF(60, 644) = 0.72reported p = .942 · recomputed p = .944

    “F (60,644) = .72, p = .942”

  • ConsistentF(14, 334) = 5.15reported p < .001 · recomputed p < .001

    “F (14,334) = 5.15, p < .001”

  • ConsistentF(14, 162) = 1.83reported p = .038 · recomputed p = .038

    “F (14,162) = 1.83, p = .038”

  • ConsistentF(28, 676) = 1.1reported p = .337 · recomputed p = .331

    “F (28,676) = 1.10, p = .337”

31 of 31

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Placebo responder percentage cannot represent a count of children

    Minor

    Table 5 reports 14.6% of placebo children as Stroop responders before versus after training. With 30 children assigned to placebo, no whole-number responder count can yield 14.6% when rounded to one decimal place.

  • Teacher-rated ADHD interaction is reported despite a claim of none

    Minor

    The discussion says there were no treatment-by-time interactions for teacher-rated ADHD symptoms even without Bonferroni correction. Table 2 marks the teacher-rated hyperactivity/impulsivity post-test-to-follow-up interaction with *, which its note defines as p < .05.

2 of 2

Cites

Flagged first, then by citations

2 of the 96 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. RA Barkley, 1987, 3, 157

Cited by

Sorted by citations

Related

Authors
Dovis, S., Van der Oord, S., Wiers, R. W., & Prins, P. J. M.
Affiliations
University of Amsterdam (NL)
Corresponding author
Dovis, Sebastiaan
ORCID
Venue
PLOS ONE
Publisher
Public Library of Science (PLoS)
Published
2015-04-06
Volume
10
Issue
4
Pages
e0121651
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0121651
PMC
PMC4386826
OpenAlex
W2041411601
Semantic Scholar
8f4b071523be4820d22b4d168bc6d7a121350536
Cited by
272
References
96
Citations by year
2026: 27 · 2025: 33 · 2024: 18 · 2023: 26 · 2022: 27 · 2021: 20 · 2020: 31 · 2019: 28 · 2018: 20 · 2017: 26 · 2016: 12 · 2015: 2 · 2013: 1 · 2012: 1
FWCI
16.22
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • UvA-DARE (University of Amsterdam) (submittedVersion, cc-by)
  • Lirias (KU Leuven) (submittedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Funders
Janssen Pharmaceuticals
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
attention deficit hyperactivity disorder, executive function training, visuospatial working memory, inhibition, cognitive flexibility, far transfer, children, home-based exercise
MeSH terms
Attention Deficit Disorder with Hyperactivity, Child, Computer-Assisted Instruction, Double-Blind Method, Female, Humans, Male, Patient Compliance, Treatment Outcome, Video Games, Executive Function

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-06.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-06.

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