Abstract
ObjectivesTo determine whether standard-length computerized training enhances working memory (WM), transfers to other cognitive domains and shows sustained effects, when controlling for motivation, engagement, and expectancy.Methods97 post-secondary students (59.8% female) aged 18–35 years with Attention-Deficit/Hyperactivity Disorder, were randomized into standard-length adaptive Cogmed WM training (CWMT; 45-min/session), a shortened-length adaptive version of CWMT (15 min/session) that controlled for motivation, engagement and expectancy of change, or into a no training group (waitlist-control group). All three groups received weekly telephone calls from trained coaches, who supervised the CWMT and were independent from the research team. All were evaluated before and 3 weeks post-training; those in the two CWMT groups were also assessed 3 months post-training. Untrained outcome measures of WM included the WAIS-IV Digit Span (auditory-verbal WM), CANTAB Spatial Span (visual-spatial WM) and WRAML Finger Windows (visual-spatial WM). Transfer-of-training effects included measures of short-term memory, cognitive speed, math and reading fluency, complex reasoning, and ADHD symptoms.ResultsPerformance on 5/7 criterion measures indicated that shortened-length CWMT conferred as much benefit on WM performance as did standard-length training, with both CWMT groups improving more than the waitlist-control group. Only 2 of these findings remained robust after correcting for multiple comparisons. Follow-up analyses revealed that post-training improvements on WM performance were maintained for at least three months. There was no evidence of any transfer effects but the standard-length group showed improvement in task-specific strategy use.ConclusionsThis study failed to find robust evidence of benefits of standard-length CWMT for improving WM in college students with ADHD and the overall pattern of findings raise questions about the specificity of training effects.Trial RegistrationClinicalTrials.gov NCT01657721
Highlights
Computer-based cognitive training has emerged as a novel, non-invasive treatment option for training working memory (WM)
97 post-secondary students (59.8% female) aged 18–35 years with Attention-Deficit/Hyperactivity Disorder, were randomized into standard-length adaptive Cogmed WM training (CWMT; 45-min/session), a shortened-length adaptive version of CWMT (15 min/session) that controlled for motivation, engagement and expectancy of change, or into a no training group
Performance on 5/7 criterion measures indicated that shortened-length CWMT conferred as much benefit on WM performance as did standard-length training, with both CWMT groups improving more than the waitlist-control group
Summary
Computer-based cognitive training has emerged as a novel, non-invasive treatment option for training working memory (WM). There are marked individual differences in WM capacity and these differences have been found to correlate positively with individual differences in high-level cognitive abilities, such as reading, mathematics, reasoning, sustaining attention, and fluid intelligence [2]. Given the documented associations between WM, high-level cognitive abilities, a variety of cognitive training paradigms have been developed with the goal of improving working memory. It is important to acknowledge that most of the evidence of associations between WM and other cognitive and academic outcomes, as well as between WM and ADHD, is correlational in nature. WM may be linked indirectly to these variables and not necessarily part of the causal pathway, in which case WM training would not be expected to transfer to other cognitive abilities or behavioral symptoms of ADHD [7,8]. Whether WM capacity itself can be improved is an issue of both theoretical and clinical importance
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