A Randomized Controlled Trial of an Integrated Brain, Body, and Social Intervention for Children With ADHD

Abstract

Objective This study evaluated the efficacy of an Integrated Brain, Body, and Social (IBBS) intervention for children with ADHD. Treatment consisted of computerized cognitive remediation training, physical exercises, and a behavior management strategy. Method Ninety-two children aged 5 to 9 years with ADHD were randomly assigned to 15 weeks of IBBS or to treatment-as-usual. Primary outcome measures included blinded clinician ratings of ADHD symptoms and global clinical functioning. Secondary outcome measures consisted of parent and teacher ratings of ADHD and neurocognitive tests. Results No significant treatment effects were found on any of our primary outcome measures. In terms of secondary outcome measures, the IBBS group showed significant improvement on a verbal working memory task; however, this result did not survive correction for multiple group comparisons. Conclusion These results suggest that expanding cognitive training to multiple domains by means of two training modalities does not lead to generalized improvement of ADHD symptomatology.

Attention and executive functions computer training for attention-deficit/hyperactivity disorder (ADHD): results from a randomized, controlled trial

“…Despite the methodological differences between our trials, our results are similar in finding no effect on the majority of cognitive outcome measures, severity of symptoms and executive functions behaviors. We did find an exploratory effect on the ability to plan, while Smith et al [18] did not include such a measure. Overall these results indicate that ACTIVATE™ is not very useful for children with ADHD in general.…”

“…ACTIVATE™ has been tested previously as part of a multifaceted intervention [18] in a randomized, controlled trial with children with ADHD or subthreshold ADHD in a school group setting. Despite the methodological differences between our trials, our results are similar in finding no effect on the majority of cognitive outcome measures, severity of symptoms and executive functions behaviors.…”

“…The search for a new intervention has resulted in a range of different approaches to cognitive training being driven by different theoretical frameworks. For instance, studies on working memory training have lead the field [8,9,13], followed by attention and some executive functions training [14][15][16][17][18]. The focus of most cognitive training approaches has been to achieve improvement both on the directly trained functions like attention or working memory measured by tests dissimilar to the intervention (near transfer) and, more importantly, to other untrained cognitive functions and symptoms (far transfer).…”

“…ACTIVATE™ has been previously tested in a different setting, where it was incorporated as a part of a multifaceted intervention program, the Integrated Brain, Body, and Social (IBBS) intervention for children with ADHD or subthreshold ADHD. In that trial ACTIVATE™ was combined with physical exercises and a class behavioral intervention three times a week with very modest outcome [18]. That trial was a school based multifaceted intervention and we were interested to investigate the effect of the cognitive training component of ACTIVATE™ solely in a more intensive home-based setting in children with ADHD only.…”

Updates in technology-based interventions for attention deficit hyperactivity disorder

“…The intervention group improved in their executive functions (inhibition, switching, updating), general psychopathology and motor abilities compared with the control group. In their multisite study, Smith et al [ 87 ] combined computerized cognitive training and physical exercises in their intervention, which was delivered in a classroom setting by teachers and therapists. Their behaviour ratings at the end of the study did not differ from the control group which received psychosocial and or pharmacological interventions.…”