Computerized training of working memory in children with ADHD--a randomized, controlled trial.
OBJECTIVE
Deficits in executive functioning, including working memory (WM) deficits, have been suggested to be important in attention-deficit/hyperactivity disorder (ADHD). During 2002 to 2003, the authors conducted a multicenter, randomized, controlled, double-blind trial to investigate the effect of improving WM by computerized, systematic practice of WM tasks.


METHODS
Included in the trial were 53 children with ADHD (9 girls; 15 of 53 inattentive subtype), aged 7 to 12 years, without stimulant medication. The compliance criterion (>20 days of training) was met by 44 subjects, 42 of whom were also evaluated at follow-up 3 months later. Participants were randomly assigned to use either the treatment computer program for training WM or a comparison program. The main outcome measure was the span-board task, a visuospatial WM task that was not part of the training program.


RESULTS
For the span-board task, there was a significant treatment effect both post-intervention and at follow-up. In addition, there were significant effects for secondary outcome tasks measuring verbal WM, response inhibition, and complex reasoning. Parent ratings showed significant reduction in symptoms of inattention and hyperactivity/impulsivity, both post-intervention and at follow-up.


CONCLUSIONS
This study shows that WM can be improved by training in children with ADHD. This training also improved response inhibition and reasoning and resulted in a reduction of the parent-rated inattentive symptoms of ADHD.
Klingberg
Torkel
T
Unit of Neuropediatrics, Department Women and Children's Health, Karolinska Institute, 17176 Stockholm, Sweden. torkel.klingberg@kbh.ki.se
Fernell
Elisabeth
E
Olesen
Pernille J
PJ
Johnson
Mats
M
Gustafsson
Per
P
Dahlström
Kerstin
K
Gillberg
Christopher G
CG
Forssberg
Hans
H
Westerberg
Helena
H
D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology / Q000534:rehabilitation*; D002648:Child; D003194:Computer-Assisted Instruction; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000453:epidemiology / Q000628:therapy*; D012984:Software; D013663:Teaching / Q000379:methods*