Journal of the American Academy of Child & Adolescent Psychiatry
Volume 44, Issue 2 , Pages 177-186, February 2005

Computerized Training of Working Memory in Children With ADHD-A Randomized, Controlled Trial

Drs. Klingberg, Fernell, Forssberg, and Westerberg and Ms. Olesen are with the Unit of Neuropediatrics, Department Women and Children's Health, Karolinska Institute, Stockholm Institute, Stockholm; Drs. Johnson and Gillberg are with the Department of Child and Adolescent Psychiatry, Göteborg University, Sweden; Dr. Gustafsson is with the Division of Child and Adolescent Psychiatry, Faculty of Health Sciences, Linköping University, Sweden; Dr. Dahlström is with the Department of Neuropediatrics, Huddinge University Hospital, Sweden

Accepted 14 September 2004.

ABSTRACT 

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.

Method

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.

Key Words:  attention-deficit/hyperactivity disorder , intervention , working memory , response inhibition

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 This study was supported by the Swedish Research Foundation (Vetenskapsrådet), the Wallenberg Global Learning Network, and Cogmed Cognitive Medical Systems AB. The authors thank Anna-Karin Adler, Gunilla Berglund, and Sven östlund for performing the neuropsychological testing, Jonas Beckeman and David Skoglund for their significant contribution to task design, Maria Andersson for managing the patient calls, and Johan Bring for statistical analyses.Disclosure: Drs. Forssberg and Klingberg and Ms. Westerberg own stock in Cogmed. Ms. Olesen had a consultancy agreement with Cogmed. The other authors have no financial relationships to disclose.

PII: S0890-8567(09)61427-1

doi:10.1097/00004583-200502000-00010

Journal of the American Academy of Child & Adolescent Psychiatry
Volume 44, Issue 2 , Pages 177-186, February 2005