A randomized clinical trial of Cogmed Working Memory Training in school-age children with ADHD: a replication in a diverse sample using a control condition
Background Cogmed Working Memory Training (CWMT) has received considerable attention as a promising intervention for the treatment of Attention‐Deficit/Hyperactivity Disorder (ADHD) in children. At the same time, methodological weaknesses in previous clinical trials call into question reported effic...
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| Veröffentlicht in: | Journal of child psychology and psychiatry 2014-03, Vol.55 (3), p.247-255 |
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| creator | Chacko, A. Bedard, A.C. Marks, D.J. Feirsen, N. Uderman, J.Z. Chimiklis, A. Rajwan, E. Cornwell, M. Anderson, L. Zwilling, A. Ramon, M. |
| description | Background
Cogmed Working Memory Training (CWMT) has received considerable attention as a promising intervention for the treatment of Attention‐Deficit/Hyperactivity Disorder (ADHD) in children. At the same time, methodological weaknesses in previous clinical trials call into question reported efficacy of CWMT. In particular, lack of equivalence in key aspects of CWMT (i.e., contingent reinforcement, time‐on‐task with computer training, parent–child interactions, supportive coaching) between CWMT and placebo versions of CWMT used in previous trials may account for the beneficial outcomes favoring CWMT.
Methods
Eighty‐five 7‐ to 11‐year old school‐age children with ADHD (66 male; 78%) were randomized to either standard CWMT (CWMT Active) or a well‐controlled CWMT placebo condition (CWMT Placebo) and evaluated before and 3 weeks after treatment. Dependent measures included parent and teacher ratings of ADHD symptoms; objective measures of attention, activity level, and impulsivity; and psychometric indices of working memory and academic achievement (Clinical trial title: Combined cognitive remediation and behavioral intervention for the treatment of Attention‐Deficit/Hyperactivity Disorder; http://clinicaltrials.gov/ct2/show/NCT01137318).
Results
CWMT Active participants demonstrated significantly greater improvements in verbal and nonverbal working memory storage, but evidenced no discernible gains in working memory storage plus processing/manipulation. In addition, no treatment group differences were observed for any other outcome measures.
Conclusions
When a more rigorous comparison condition is utilized, CWMT demonstrates effects on certain aspects of working memory in children with ADHD; however, CWMT does not appear to foster treatment generalization to other domains of functioning. As such, CWMT should not be considered a viable treatment for children with ADHD. |
| doi_str_mv | 10.1111/jcpp.12146 |
| format | Article |
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Cogmed Working Memory Training (CWMT) has received considerable attention as a promising intervention for the treatment of Attention‐Deficit/Hyperactivity Disorder (ADHD) in children. At the same time, methodological weaknesses in previous clinical trials call into question reported efficacy of CWMT. In particular, lack of equivalence in key aspects of CWMT (i.e., contingent reinforcement, time‐on‐task with computer training, parent–child interactions, supportive coaching) between CWMT and placebo versions of CWMT used in previous trials may account for the beneficial outcomes favoring CWMT.
Methods
Eighty‐five 7‐ to 11‐year old school‐age children with ADHD (66 male; 78%) were randomized to either standard CWMT (CWMT Active) or a well‐controlled CWMT placebo condition (CWMT Placebo) and evaluated before and 3 weeks after treatment. Dependent measures included parent and teacher ratings of ADHD symptoms; objective measures of attention, activity level, and impulsivity; and psychometric indices of working memory and academic achievement (Clinical trial title: Combined cognitive remediation and behavioral intervention for the treatment of Attention‐Deficit/Hyperactivity Disorder; http://clinicaltrials.gov/ct2/show/NCT01137318).
Results
CWMT Active participants demonstrated significantly greater improvements in verbal and nonverbal working memory storage, but evidenced no discernible gains in working memory storage plus processing/manipulation. In addition, no treatment group differences were observed for any other outcome measures.
Conclusions
When a more rigorous comparison condition is utilized, CWMT demonstrates effects on certain aspects of working memory in children with ADHD; however, CWMT does not appear to foster treatment generalization to other domains of functioning. As such, CWMT should not be considered a viable treatment for children with ADHD.</description><identifier>ISSN: 0021-9630</identifier><identifier>EISSN: 1469-7610</identifier><identifier>DOI: 10.1111/jcpp.12146</identifier><identifier>PMID: 24117656</identifier><identifier>CODEN: JPPDAI</identifier><language>eng</language><publisher>Oxford: Blackwell Publishing Ltd</publisher><subject>ADHD ; Attention Deficit Disorder with Hyperactivity - physiopathology ; Attention Deficit Disorder with Hyperactivity - therapy ; Attention deficit disorders. Hyperactivity ; Attention Deficit Hyperactivity Disorder ; Behavior disorders ; Biological and medical sciences ; Child ; Child clinical studies ; Child psychology ; Children ; Clinical trials ; Cognitive Behavioral Therapy - methods ; cognitive training ; Efficacy ; Female ; Humans ; Hyperactivity ; Intervention ; Male ; Medical sciences ; Memory ; Memory, Short-Term - physiology ; Outcome Measures ; Outcomes of Treatment ; Parent Child Relationship ; Parents & parenting ; Placebos ; Psychology. Psychoanalysis. Psychiatry ; Psychometrics ; Psychopathology. Psychiatry ; Replication (Evaluation) ; Short Term Memory ; Teacher Evaluation ; Training ; treatment ; Treatment Outcome ; Working memory</subject><ispartof>Journal of child psychology and psychiatry, 2014-03, Vol.55 (3), p.247-255</ispartof><rights>2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.</rights><rights>2015 INIST-CNRS</rights><rights>The Journal of Child Psychology and Psychiatry © 2014 Association for Child and Adolescent Mental Health</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5716-ebc8970192bd6c4350d7f625eadde436c9a0553a0649c3845d815f3c857d2c823</citedby><cites>FETCH-LOGICAL-c5716-ebc8970192bd6c4350d7f625eadde436c9a0553a0649c3845d815f3c857d2c823</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjcpp.12146$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjcpp.12146$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,27901,27902,30976,30977,45550,45551</link.rule.ids><backlink>$$Uhttp://eric.ed.gov/ERICWebPortal/detail?accno=EJ1032151$$DView record in ERIC$$Hfree_for_read</backlink><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28226617$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24117656$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chacko, A.</creatorcontrib><creatorcontrib>Bedard, A.C.</creatorcontrib><creatorcontrib>Marks, D.J.</creatorcontrib><creatorcontrib>Feirsen, N.</creatorcontrib><creatorcontrib>Uderman, J.Z.</creatorcontrib><creatorcontrib>Chimiklis, A.</creatorcontrib><creatorcontrib>Rajwan, E.</creatorcontrib><creatorcontrib>Cornwell, M.</creatorcontrib><creatorcontrib>Anderson, L.</creatorcontrib><creatorcontrib>Zwilling, A.</creatorcontrib><creatorcontrib>Ramon, M.</creatorcontrib><title>A randomized clinical trial of Cogmed Working Memory Training in school-age children with ADHD: a replication in a diverse sample using a control condition</title><title>Journal of child psychology and psychiatry</title><addtitle>J Child Psychol Psychiatr</addtitle><description>Background
Cogmed Working Memory Training (CWMT) has received considerable attention as a promising intervention for the treatment of Attention‐Deficit/Hyperactivity Disorder (ADHD) in children. At the same time, methodological weaknesses in previous clinical trials call into question reported efficacy of CWMT. In particular, lack of equivalence in key aspects of CWMT (i.e., contingent reinforcement, time‐on‐task with computer training, parent–child interactions, supportive coaching) between CWMT and placebo versions of CWMT used in previous trials may account for the beneficial outcomes favoring CWMT.
Methods
Eighty‐five 7‐ to 11‐year old school‐age children with ADHD (66 male; 78%) were randomized to either standard CWMT (CWMT Active) or a well‐controlled CWMT placebo condition (CWMT Placebo) and evaluated before and 3 weeks after treatment. Dependent measures included parent and teacher ratings of ADHD symptoms; objective measures of attention, activity level, and impulsivity; and psychometric indices of working memory and academic achievement (Clinical trial title: Combined cognitive remediation and behavioral intervention for the treatment of Attention‐Deficit/Hyperactivity Disorder; http://clinicaltrials.gov/ct2/show/NCT01137318).
Results
CWMT Active participants demonstrated significantly greater improvements in verbal and nonverbal working memory storage, but evidenced no discernible gains in working memory storage plus processing/manipulation. In addition, no treatment group differences were observed for any other outcome measures.
Conclusions
When a more rigorous comparison condition is utilized, CWMT demonstrates effects on certain aspects of working memory in children with ADHD; however, CWMT does not appear to foster treatment generalization to other domains of functioning. As such, CWMT should not be considered a viable treatment for children with ADHD.</description><subject>ADHD</subject><subject>Attention Deficit Disorder with Hyperactivity - physiopathology</subject><subject>Attention Deficit Disorder with Hyperactivity - therapy</subject><subject>Attention deficit disorders. Hyperactivity</subject><subject>Attention Deficit Hyperactivity Disorder</subject><subject>Behavior disorders</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child clinical studies</subject><subject>Child psychology</subject><subject>Children</subject><subject>Clinical trials</subject><subject>Cognitive Behavioral Therapy - methods</subject><subject>cognitive training</subject><subject>Efficacy</subject><subject>Female</subject><subject>Humans</subject><subject>Hyperactivity</subject><subject>Intervention</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Memory</subject><subject>Memory, Short-Term - physiology</subject><subject>Outcome Measures</subject><subject>Outcomes of Treatment</subject><subject>Parent Child Relationship</subject><subject>Parents & parenting</subject><subject>Placebos</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychometrics</subject><subject>Psychopathology. Psychiatry</subject><subject>Replication (Evaluation)</subject><subject>Short Term Memory</subject><subject>Teacher Evaluation</subject><subject>Training</subject><subject>treatment</subject><subject>Treatment Outcome</subject><subject>Working memory</subject><issn>0021-9630</issn><issn>1469-7610</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqNkl9v0zAUxSMEYmXwwjvIEkJCSBl2HDvOHpCqbGxMA4o02KPl2k7rzomDnWyUr8KXxaFd-fOA8MO1rPO7R_daJ0keI3iA4nm1kl13gDKU0zvJJNYyLSiCd5MJhBlKS4rhXvIghBWEkGLC7id7WY5QQQmdJN-nwItWucZ80wpIa1ojhQW9N7G6GlRu0UTh0vkr0y7AO904vwYXXkQwvk0Lglw6Z1Ox0EAujVVet-DG9EswPTo9OgQCeN3ZaNob1468AMpcax80CKLprAZDGJ0EkK7tvbPjrcxIP0zu1cIG_Wh77yef3hxfVKfp-YeTt9X0PJWkQDTVc8nKAqIymysqc0ygKmqaES2U0jmmshSQECwgzUuJWU4UQ6TGkpFCZZJleD95vfHthnlcVuo4h7C886YRfs2dMPxPpTVLvnDXHJd5DlkRDV5sDbz7MujQ88YEqa0VrXZD4IgQWDJKCPsPFCIctypoRJ_9ha7c4Nv4ExzlZckwYoxE6uWGkt6F4HW9mxtBPsaDj_HgP-MR4ae_b7pDb_MQgedbQISYgzpmQ5rwi2NZRikaN36y4bQ3cicfnyGIM0RQ1NFGvzFWr_8xEj-rZrPb4dJNjwm9_rrrEf6K0wIXhF--P-GzqvrMqnzGP-IfPYHrrQ</recordid><startdate>201403</startdate><enddate>201403</enddate><creator>Chacko, A.</creator><creator>Bedard, A.C.</creator><creator>Marks, D.J.</creator><creator>Feirsen, N.</creator><creator>Uderman, J.Z.</creator><creator>Chimiklis, A.</creator><creator>Rajwan, E.</creator><creator>Cornwell, M.</creator><creator>Anderson, L.</creator><creator>Zwilling, A.</creator><creator>Ramon, M.</creator><general>Blackwell Publishing Ltd</general><general>Wiley-Blackwell</general><general>Blackwell</general><scope>BSCLL</scope><scope>7SW</scope><scope>BJH</scope><scope>BNH</scope><scope>BNI</scope><scope>BNJ</scope><scope>BNO</scope><scope>ERI</scope><scope>PET</scope><scope>REK</scope><scope>WWN</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201403</creationdate><title>A randomized clinical trial of Cogmed Working Memory Training in school-age children with ADHD: a replication in a diverse sample using a control condition</title><author>Chacko, A. ; Bedard, A.C. ; Marks, D.J. ; Feirsen, N. ; Uderman, J.Z. ; Chimiklis, A. ; Rajwan, E. ; Cornwell, M. ; Anderson, L. ; Zwilling, A. ; Ramon, M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5716-ebc8970192bd6c4350d7f625eadde436c9a0553a0649c3845d815f3c857d2c823</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>ADHD</topic><topic>Attention Deficit Disorder with Hyperactivity - physiopathology</topic><topic>Attention Deficit Disorder with Hyperactivity - therapy</topic><topic>Attention deficit disorders. Hyperactivity</topic><topic>Attention Deficit Hyperactivity Disorder</topic><topic>Behavior disorders</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Child clinical studies</topic><topic>Child psychology</topic><topic>Children</topic><topic>Clinical trials</topic><topic>Cognitive Behavioral Therapy - methods</topic><topic>cognitive training</topic><topic>Efficacy</topic><topic>Female</topic><topic>Humans</topic><topic>Hyperactivity</topic><topic>Intervention</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Memory</topic><topic>Memory, Short-Term - physiology</topic><topic>Outcome Measures</topic><topic>Outcomes of Treatment</topic><topic>Parent Child Relationship</topic><topic>Parents & parenting</topic><topic>Placebos</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychometrics</topic><topic>Psychopathology. Psychiatry</topic><topic>Replication (Evaluation)</topic><topic>Short Term Memory</topic><topic>Teacher Evaluation</topic><topic>Training</topic><topic>treatment</topic><topic>Treatment Outcome</topic><topic>Working memory</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chacko, A.</creatorcontrib><creatorcontrib>Bedard, A.C.</creatorcontrib><creatorcontrib>Marks, D.J.</creatorcontrib><creatorcontrib>Feirsen, N.</creatorcontrib><creatorcontrib>Uderman, J.Z.</creatorcontrib><creatorcontrib>Chimiklis, A.</creatorcontrib><creatorcontrib>Rajwan, E.</creatorcontrib><creatorcontrib>Cornwell, M.</creatorcontrib><creatorcontrib>Anderson, L.</creatorcontrib><creatorcontrib>Zwilling, A.</creatorcontrib><creatorcontrib>Ramon, M.</creatorcontrib><collection>Istex</collection><collection>ERIC</collection><collection>ERIC (Ovid)</collection><collection>ERIC</collection><collection>ERIC</collection><collection>ERIC (Legacy Platform)</collection><collection>ERIC( SilverPlatter )</collection><collection>ERIC</collection><collection>ERIC PlusText (Legacy Platform)</collection><collection>Education Resources Information Center (ERIC)</collection><collection>ERIC</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of child psychology and psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chacko, A.</au><au>Bedard, A.C.</au><au>Marks, D.J.</au><au>Feirsen, N.</au><au>Uderman, J.Z.</au><au>Chimiklis, A.</au><au>Rajwan, E.</au><au>Cornwell, M.</au><au>Anderson, L.</au><au>Zwilling, A.</au><au>Ramon, M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><ericid>EJ1032151</ericid><atitle>A randomized clinical trial of Cogmed Working Memory Training in school-age children with ADHD: a replication in a diverse sample using a control condition</atitle><jtitle>Journal of child psychology and psychiatry</jtitle><addtitle>J Child Psychol Psychiatr</addtitle><date>2014-03</date><risdate>2014</risdate><volume>55</volume><issue>3</issue><spage>247</spage><epage>255</epage><pages>247-255</pages><issn>0021-9630</issn><eissn>1469-7610</eissn><coden>JPPDAI</coden><abstract>Background
Cogmed Working Memory Training (CWMT) has received considerable attention as a promising intervention for the treatment of Attention‐Deficit/Hyperactivity Disorder (ADHD) in children. At the same time, methodological weaknesses in previous clinical trials call into question reported efficacy of CWMT. In particular, lack of equivalence in key aspects of CWMT (i.e., contingent reinforcement, time‐on‐task with computer training, parent–child interactions, supportive coaching) between CWMT and placebo versions of CWMT used in previous trials may account for the beneficial outcomes favoring CWMT.
Methods
Eighty‐five 7‐ to 11‐year old school‐age children with ADHD (66 male; 78%) were randomized to either standard CWMT (CWMT Active) or a well‐controlled CWMT placebo condition (CWMT Placebo) and evaluated before and 3 weeks after treatment. Dependent measures included parent and teacher ratings of ADHD symptoms; objective measures of attention, activity level, and impulsivity; and psychometric indices of working memory and academic achievement (Clinical trial title: Combined cognitive remediation and behavioral intervention for the treatment of Attention‐Deficit/Hyperactivity Disorder; http://clinicaltrials.gov/ct2/show/NCT01137318).
Results
CWMT Active participants demonstrated significantly greater improvements in verbal and nonverbal working memory storage, but evidenced no discernible gains in working memory storage plus processing/manipulation. In addition, no treatment group differences were observed for any other outcome measures.
Conclusions
When a more rigorous comparison condition is utilized, CWMT demonstrates effects on certain aspects of working memory in children with ADHD; however, CWMT does not appear to foster treatment generalization to other domains of functioning. As such, CWMT should not be considered a viable treatment for children with ADHD.</abstract><cop>Oxford</cop><pub>Blackwell Publishing Ltd</pub><pmid>24117656</pmid><doi>10.1111/jcpp.12146</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of child psychology and psychiatry, 2014-03, Vol.55 (3), p.247-255 |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | ADHD Attention Deficit Disorder with Hyperactivity - physiopathology Attention Deficit Disorder with Hyperactivity - therapy Attention deficit disorders. Hyperactivity Attention Deficit Hyperactivity Disorder Behavior disorders Biological and medical sciences Child Child clinical studies Child psychology Children Clinical trials Cognitive Behavioral Therapy - methods cognitive training Efficacy Female Humans Hyperactivity Intervention Male Medical sciences Memory Memory, Short-Term - physiology Outcome Measures Outcomes of Treatment Parent Child Relationship Parents & parenting Placebos Psychology. Psychoanalysis. Psychiatry Psychometrics Psychopathology. Psychiatry Replication (Evaluation) Short Term Memory Teacher Evaluation Training treatment Treatment Outcome Working memory |
| title | A randomized clinical trial of Cogmed Working Memory Training in school-age children with ADHD: a replication in a diverse sample using a control condition |
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