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

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 effic...

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Bibliographic Details
Published in:Journal of child psychology and psychiatry Vol. 55; no. 3; pp. 247 - 255
Main 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.
Format: Journal Article
Language:English
Published: Oxford Blackwell Publishing Ltd 01.03.2014
Wiley-Blackwell
Blackwell
Subjects:
Academic achievement
Activity level
ADHD
Attention Deficit Disorder with Hyperactivity - physiopathology
Attention Deficit Disorder with Hyperactivity - therapy
Attention deficit disorders. Hyperactivity
Attention Deficit Hyperactivity Disorder
Behavior disorders
Biological and medical sciences
Child
Child clinical studies
Child psychology
Children
Clinical research
Clinical trials
Coaching
Cognitive Behavioral Therapy - methods
cognitive training
Cognitive-behavioral factors
Efficacy
Female
Humans
Hyperactivity
Impulsivity
Intervention
Male
Manipulation
Medical sciences
Memory
Memory, Short-Term - physiology
Outcome Measures
Outcomes of Treatment
Parent Child Relationship
Parent-child relations
Parenthood education
Parents & parenting
Placebos
Psychology. Psychoanalysis. Psychiatry
Psychometrics
Psychopathology. Psychiatry
Reinforcement
Replication (Evaluation)
Short Term Memory
Storage
Teacher Evaluation
Teachers
Training
treatment
Treatment Outcome
Verbal memory
Working memory
Human
ADHD
Memory
Treatment efficiency
Controlled therapeutic trial
Cognition
Treatment
School age
Cognitive remediation
Attention disorder with hyperactivity
Working memory
Child
cognitive training
treatment
working memory
ISSN:0021-9630, 1469-7610, 1469-7610
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Summary: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.
Bibliography:istex:411D00CC788B11FA5AE9B1E24B02443D2ECC988A
Table S1. Observed means and standard deviations for outcome measures by CWMT treatment group by assessment period
National Institute of Mental Health - No. R34MH088845
ArticleID:JCPP12146
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ISSN:0021-9630
1469-7610
1469-7610
DOI:10.1111/jcpp.12146