Impaired Memory for Instructions in Children with Attention-Deficit Hyperactivity Disorder Is Improved by Action at Presentation and Recall

Abstract

Children with attention deficit hyperactivity disorder (ADHD) often fail to comply with teacher instructions in the classroom. Using action during presentation or recall can enhance typically developing children’s abilities to complete multi-step instruction sequences. In this study, we tested the ability to following instructions in children with ADHD under different conditions to explore whether they show the same beneficial effects of action. A total of 24 children with ADHD and 27 typically developing children either listened to or viewed demonstrations of instructions during encoding, and then either verbally repeated or physically performed the sequences during recall. This resulted in four conditions: spoken-verbal, spoken-enacted, demonstration-verbal, and demonstration-enacted. Children with ADHD were significantly impaired in all conditions of the following instructions task relative to the typically developing group. Both groups showed an enacted-recall advantage, with superior recall by physical performance than oral repetition. Both groups also benefitted from demonstration over spoken presentation, but only when the instructions were recalled verbally. These findings suggest that children with ADHD struggle to complete multi-step instructions, but that they benefit from action-based presentation and recall in the same way as typically developing children. These findings have important implications for educators, suggesting that motor-based methods of instruction-delivery might enhance classroom learning both for children with and without developmental disorders.

Exploring the effects of demonstration and enactment in facilitating recall of instructions in working memory

“…Recall of action-object pairs was superior following demonstration of instructions, relative to verbal presentation, replicating the findings of previous working memory studies (Waterman et al, 2017;Yang, Allen, & Gathercole, 2016a;Yang et al, 2017). A positive effect of self-enactment during encoding was also found, though this was qualified by an interaction with presentation type and was only observed in the verbal presentation condition.…”

“…Yang, Allen, Yu, and Chan (2016b) extended this to the use of video demonstration (see also Yang, Jia, Zheng, Allen, & Ye, 2018) finding that this facilitated adults' recall performance, compared to auditory presentation of verbal instruction sequences. This was further observed in both children with attentiondeficit hyperactivity disorder (ADHD) and age-matched typical controls (Yang, Allen, Holmes, & Chan, 2017). Thus, it is apparent that visual demonstration can benefit FI performance in working memory.…”

Forward and backward recall of serial actions: Exploring the temporal dynamics of working memory for instruction

“…As in Experiment 1, and consistent with the starting hypothesis, the enacted-recall advantage was obtained in demonstrated instructions and the magnitude (η p 2 = 0.40) was smaller compared with spoken instructions (η p 2 = 0.69). Moreover, cross-experiment analysis indicated superior memory following demonstrated than spoken instructions, replicating previous findings (Lui et al, 2017;Yang et al, 2017;Yang et al, 2015).…”

“…Third, across three experiments, an advantage in recall accuracy for enacted over verbal recall was found, replicating a growing body of findings (Allen & Waterman, 2015;Gathercole et al, 2008;Koriat et al, 1990;Lui et al, 2017;T. Yang et al, 2014;Yang et al, 2017) and indicating it to be a highly robust finding. Serial position curves indicate that the first item was recalled equally well for both recall types, but memory performance for subsequent items dropped more rapidly when oral repetition was required (as in Allen & Waterman, 2015).…”

“…During retrieval, recall by physical action substantially improves recall accuracy relative to spoken repetition (Allen & Waterman, 2015;Gathercole et al, 2008;Jaroslawska, Gathercole, Allen, et al, 2016a;Koriat, Ben-Zur, & Nussbaum, 1990;Yang et al, 2014). These action-based effects have been found in FI studies with healthy populations (Allen & Waterman, 2015;Gathercole et al, 2008;Waterman et al, 2017;Yang et al, 2014;Yang et al, 2016) and clinical groups with lower working memory capacity (Charlesworth, Allen, Morson, Burn, & Souchay, 2014;Lui et al, 2017;Wojcik et al, 2011;Yang, Allen, Holmes, & Chan, 2017). Such effects indicate a superiority of action/visual-motor-based representations relative to verbalonly storage.…”