10 research outputs found

    Working Memory Training in Post-Secondary Students with ADHD: A Randomized Controlled Study

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    <div><p>Objectives</p><p>To determine whether standard-length computerized training enhances working memory (WM), transfers to other cognitive domains and shows sustained effects, when controlling for motivation, engagement, and expectancy.</p><p>Methods</p><p>97 post-secondary students (59.8% female) aged 18–35 years with Attention-Deficit/Hyperactivity Disorder, were randomized into standard-length adaptive Cogmed WM training (CWMT; 45-min/session), a shortened-length adaptive version of CWMT (15 min/session) that controlled for motivation, engagement and expectancy of change, or into a no training group (waitlist-control group). All three groups received weekly telephone calls from trained coaches, who supervised the CWMT and were independent from the research team. All were evaluated before and 3 weeks post-training; those in the two CWMT groups were also assessed 3 months post-training. Untrained outcome measures of WM included the WAIS-IV Digit Span (auditory-verbal WM), CANTAB Spatial Span (visual-spatial WM) and WRAML Finger Windows (visual-spatial WM). Transfer-of-training effects included measures of short-term memory, cognitive speed, math and reading fluency, complex reasoning, and ADHD symptoms.</p><p>Results</p><p>Performance on 5/7 criterion measures indicated that shortened-length CWMT conferred as much benefit on WM performance as did standard-length training, with both CWMT groups improving more than the waitlist-control group. Only 2 of these findings remained robust after correcting for multiple comparisons. Follow-up analyses revealed that post-training improvements on WM performance were maintained for at least three months. There was no evidence of any transfer effects but the standard-length group showed improvement in task-specific strategy use.</p><p>Conclusions</p><p>This study failed to find robust evidence of benefits of standard-length CWMT for improving WM in college students with ADHD and the overall pattern of findings raise questions about the specificity of training effects.</p><p>Trial Registration</p><p>ClinicalTrials.gov <a href="https://clinicaltrials.gov/ct2/show/NCT01657721?term=NCT01657721&rank=1" target="_blank">NCT01657721</a></p></div

    CONSORT Diagram.

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    <p>CONSORT Diagram.</p

    Types of post and follow-up treatment effects for Criterion, Near transfer and Far transfer measures.

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    <p><sup>a</sup> Withstood Bonferroni correction</p><p>Types of post and follow-up treatment effects for Criterion, Near transfer and Far transfer measures.</p

    Hypothetical Effects.

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    <p>Hypothetical Effects.</p

    Descriptive Statistics for Criterion, Near-transfer and Far-transfer measures at pre- and post-test (intent to treat).

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    <p>* Survived Bonferroni correction for multiple comparisons</p><p>Descriptive Statistics for Criterion, Near-transfer and Far-transfer measures at pre- and post-test (intent to treat).</p

    Participant Characteristics.

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    <p><sup>a</sup>. Raw scores</p><p><sup>b</sup>. Standardized scores</p><p><sup>c</sup>. Z-score</p><p><sup>d</sup>. Percentile Rank</p><p><sup>e</sup>. T-score. NOTE: ASRS = ADHD Self-Report Scale; WASI = Wechsler Abbreviated Scale of Intelligence; TOWRE = Test of Word Reading Efficiency; WAIS = Wechsler Adult Intelligence Scale; CANTAB = Cambridge Neuropsychological Testing Automated Battery; WRAML = Wide Range Assessment of Memory and Learning; BDEFS = Barkley Deficits in Executive Functioning Scale.</p><p>Participant Characteristics.</p

    Congruency effects in the single-trial Stroop tasks.

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    <p>This Figure shows confidence intervals (p = .05) of the Congruency effects (as the respective differences in performance parameters between incongruent minus congruent conditions) from Colour- (left) and Counting-Stroop (right). Reaction-times were significantly slower in incongruent trials of both Stroop-Tests in all four groups (as the respective confidence intervals indicated by vertical bars around the respective mean do not include zero), and did not reveal any group-differences (as no mean lie outside the confidence intervals of comparison, see line A, above). Accuracy was significantly lower in incongruent trials of the Counting Stroop similarly for all groups (different from zero and negative in all groups, and all confidence intervals overlap with the respective means), but in the Colour Stroop interference liability on accuracy was present only in the pure ADHD and CTD groups, while Controls and children with ADHD+TIC did not show reduced accuracy in incongruent trials and showed less congruency effect as compared to both other groups (line B). The combined Speed-Accuracy parameter (line C, mean difference incongruent minus congruent trials of z-standardized reaction-time and accuracy scores) showed in the Colour Stroop (left) elevated interference load in the pure ADHD and pure CTD groups than in the controls and comorbid ADHD+TIC groups only, but no significant group differences in the Counting-Stroop (right).</p

    Stroop-Task description.

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    <p>Items of Colour- and Counting-Stroop. Correct responses are “blue”, “yellow”, “green” and “red” for the Colour-Stroop and “3, “1”, “4” and “2” for the Counting-Stroop. Responses were given on a custom-made trapezoid four-choice response pad.</p

    Colour discrimination and attention.

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    <p>The comorbidity of ADHD+CTD is characterized by additive effects on colour discrimination and attention. The Farnsworth-Munsell 100 hue colour discrimination test (above) revealed for ADHD and CTD additive effects on error scores (confidence intervals with p = .05) of the blue-yellow (left) and red-green (right) axis. Difficulties with sustained attention in the Frankfurt Attention Inventory as indicated by the number (FAIR-L, below left, confidence intervals with p = .05) and proportion (FAIR-Q, below right) of attentively processed items during the 6 min testing are present in children with ADHD but not CTD.</p
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