Feasibility and Efficacy of Executive Working Memory Training for Adolescents with Attention-Deficit/Hyperactivity Disorder

In a recent randomized, placebo-controlled study, researchers evaluated the feasibility, tolerability, and behavioral effects of a novel executive working memory (EWM) training program in adolescents with attention-deficit/hyperactivity disorder (ADHD).

The study aimed to assess whether targeting EWM processes, specifically those related to flexibility and stability in working memory, could improve ADHD symptoms, offering an alternative to traditional working memory training, which has shown inconsistent results.

This trial included adolescents, aged 12 to 18, diagnosed with ADHD (N = 62). Participants were randomized into either the EWM training or placebo group, with 20 sessions conducted remotely during 4–5 weeks. The primary outcome measures focused on improvements in performance on EWM tasks, while secondary outcomes assessed the tolerability of the intervention, participant retention, and responsiveness to adaptive task difficulty.

The researchers observed that participants in the EWM training group exhibited medium-sized improvements on several key measures, including enhanced accuracy in the shifting and filtering EWM tasks and faster reaction times in the shifting and updating tasks. These improvements were statistically significant and suggest that the EWM training was effective in engaging relevant cognitive processes for ADHD management. The intervention was also well-tolerated, with participants reporting strong motivation and mood throughout the program. High retention rates and successful adaptation to increasing task difficulty further indicated the feasibility of the approach.

“The results suggest that these EWM processes show promise as training targets for ADHD,” the study authors concluded. “The subsequent NIMH R33-funded extension clinical trial will seek to replicate and extend these findings.”

Reference

Sullivan AJ, Anderson J, Beatty M, et al. A randomized clinical trial to evaluate feasibility, tolerability, and preliminary target engagement for a novel executive working memory training in adolescents with ADHD. Behav Res Ther. 2024:181:104615. doi:10.1016/j.brat.2024.104615