Utilizing Cognitive Training to Improve Working Memory, Attention, and Impulsivity in School-Aged Children with ADHD and SLD

Abstract

Students’ use of working memory (WM) is a key to academic success, as many subject areas and various tasks school-aged children encounter require the ability to attend to, work with, and recall information. Children with poor WM ability typically struggle with academic work compared to similar-aged peers without WM deficits. Further, WM has been shown to be significantly correlated with inattention and disorganization in those with ADHD, and WM deficits have also been identified as a potential underpinning of specific learning disorder (SLD). As an intervention technique, the use of computerized cognitive training has demonstrated improved attention and working memory skills in children with WM deficits, and children that have completed cognitive training protocols have demonstrated performance improvements in reading and math. The current study aimed to examine the effectiveness of cognitive training (conducted in a clinical setting) for students diagnosed with ADHD and SLD. Using paired-samples t-tests and a psychometric network modeling technique, results from data obtained from a sample of 43 school-aged children showed (1) that attention and working memory improved following cognitive training and (2) that cognitive training might be related to cognitive structural changes found pre- to post-training among the variables being measured. Implications for clinical practice and school-based interventions are discussed.

Teacher perceptions of working memory and executive function improvements following school-day cognitive training

“…As a necessary element to testing our primary hypothesis, we engaged students in CCT. Similar to what has been found in previous work (de Oliveira Rosa et al, 2020; Gathercole et al, 2019; Wiest et al, 2020; Wiest et al, 2022), results demonstrated that students who completed training notably improved on both measures of WM (i.e., verbal and symbolic). Teacher perceptions regarding students who did not receive training were generally consistent with this project's primary hypothesis.…”

“…Importantly, the current results also have implications for school practice (on a broader level) as they suggest that CCT may be an effective strategy that can be implemented as part of a Response-to-Intervention (RTI) program for specific students. In fact, there may be a protective function associated with CCT as other studies (e.g., Alloway et al, 2013;Buschkuehl & Jaeggi, 2010;Gathercole et al, 2012;Wiest, et al, 2020;Wiest et al, 2022) have shown that WM is malleable and can be positively impacted by training. Thus, there is the possibility that CCT may be used with students (in general) as a costeffective intervention to improve a critical ability that is foundational to academic performance in preventing the emergence of academic concerns.…”

“…Fifty students were selected so that the training group would be comprised of 25 randomly selected participants; this allowed the research staff to maintain a no more than 1:3 (staff-to-student) ratio during the cognitive training. Smaller samples (and training groups) such as this are not entirely uncommon in cognitive training literature (see de Oliveira Rosa et al, 2020; Chein & Morrison, 2010; Rabiner et al, 2010), particularly if working with clinical samples (e.g., Wiest et al, 2014, 2020, 2022). The participating students were from grades third through sixth and ranged from 7 to 13 years of age, with a mean age of 10.4 years.…”

“…Specifically, studies examining the efficacy of CCT for WM have shown increased levels of attention and visual and auditory WM following training protocols (de Oliveira-Rosa et al, 2020; Gray et al, 2012; Jones et al, 2020). Further, work has used CCT to demonstrate the benefits with school-age children within educational and clinical settings (Wiest et al, 2020, 2022), showing maintained improvements over various time periods (Gathercole et al, 2019; Rabiner et al, 2010).…”

“…While early conceptualizations of WM considered it to be genetically fixed (Cowan, 2010;Kremen et al, 2007), much evidence now demonstrates the plasticity of WM and how it can be improved through intervention (Alloway et al, 2013;Buschkuehl & Jaeggi, 2010;Gathercole et al, 2012;Klingberg, 2010Klingberg, , 2012Klingberg et al, 2002Klingberg et al, , 2005Morrison & Chein, 2011). Research has provided evidence documenting WM skill changes due to training (Alloway et al, 2013;Klingberg, 2010;Klingberg et al, 2002Klingberg et al, , 2005Wiest et al, 2020Wiest et al, , 2022.…”