title: Interventions to improve executive functioning and working memory in school-aged children with AD(H)D: a randomised controlled trial and stepped-care approach.
abstract: BACKGROUND
  Deficits in executive functioning are of great significance in attention-deficit/hyperactivity disorder (ADHD). One of these executive functions, working memory, plays an important role in academic performance and is often seen as the core deficit of this disorder. There are indications that working memory problems and academic performance can be improved by school-oriented interventions but this has not yet been studied systematically. In this study we will determine the short- and long-term effects of a working memory--and an executive function training applied in a school situation for children with AD(H)D, taking individual characteristics, the level of impairment and costs (stepped-care approach) into account.
  
  
  METHODS
  The study consists of two parts: the first part is a randomised controlled trial with school-aged children (8-12 yrs) with AD(H)D. Two groups (each n = 50) will be randomly assigned to a well studied computerized working memory training 'Cogmed', or to the 'Paying attention in class' intervention which is an experimental school-based executive function training. Children will be selected from regular -and special education primary schools in the region of Amsterdam, the Netherlands. The second part of the study will determine which specific characteristics are related to non-response of the 'Paying attention in class' intervention. School-aged children (8-12 yrs) with AD(H)D will follow the experimental school-based executive function training 'Paying attention in class' (n = 175). Academic performance and neurocognitive functioning (primary outcomes) are assessed before, directly after and 6 months after training. Secondary outcome measures are: behaviour in class, behaviour problems and quality of life.
  
  
  CONCLUSIONS
  So far, there is limited but promising evidence that working memory - and other executive function interventions can improve academic performance. Little is know about the applicability and generalization effects of these interventions in a classroom situation. This study will contribute to this lack of information, especially information related to real classroom and academic situations. By taking into account the costs of both interventions, level of impairment and individual characteristics of the child (stepped-care approach) we will be able to address treatment more adequately for each individual in the future.
  
  
  BACKGROUND
  Nederlands Trial Register NTR3415.
authors: Department of Child and Adolescent Psychiatry, Academic Medical Centre Amsterdam, University of Amsterdam, Amsterdam, The Netherlands. m.vanderdonk@debascule.com
authors: Marthe L A
authors: ML
authors: van der Donk
authors: Anne-Claire
authors: AC
authors: Hiemstra-Beernink
authors: Ariane C
authors: AC
authors: Tjeenk-Kalff
authors: Aryan V
authors: AV
authors: van der Leij
authors: Ramón J L
authors: RJ
authors: Lindauer
mesh_terms: D001288:Attention; D001289:Attention Deficit Disorder with Hyperactivity / Q000523:psychology / Q000628:therapy*; D002648:Child; D004522:Educational Status; D056344:Executive Function; D006801:Humans; D008570:Memory, Short-Term; D009483:Neuropsychological Tests; D011613:Psychotherapy / Q000379:methods