Skip to main content

Advertisement

SpringerLink
Log in

A pilot study of combined working memory and inhibition training for children with AD/HD

  • Original Article
  • Published:
ADHD Attention Deficit and Hyperactivity Disorders

Abstract

Building on recent favourable outcomes using working memory (WM) training, this study examined the behavioural and physiological effect of concurrent computer-based WM and inhibition training for children with attention-deficit hyperactivity disorder (AD/HD). Using a double-blind active-control design, 29 children with AD/HD completed a 5-week at-home training programme and pre- and post-training sessions which included the assessment of overt behaviour, resting EEG, as well as task performance, skin conductance level and event-related potentials (ERPs) during a Go/Nogo task. Results indicated that after training, children from the high-intensity training condition showed reduced frequency of inattention and hyperactivity symptoms. Although there were trends for improved Go/Nogo performance, increased arousal and specific training effects for the inhibition-related N2 ERP component, they failed to reach standard levels of statistical significance. Both the low- and high-intensity conditions showed resting EEG changes (increased delta, reduced alpha and theta activity) and improved early attention alerting to Go and Nogo stimuli, as indicated by the N1 ERP component, post-training. Despite limitations, this preliminary work indicates the potential for cognitive training that concurrently targets the interrelated processes of WM and inhibition to be used as a treatment for AD/HD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Notes

  1. Given the exploratory nature of this study and the small number of participants involved, we felt that it was also appropriate to report post-hoc tests on the other variables that relate to the primary hypotheses, even though the trends for an interaction did not reach the standard levels of significance. Accordingly, these results need to be interpreted with some caution.

References

  • Achenbach TM, Conners CK, Quay HC, Verhulst FC, Howell CT (1989) Replication of empirically derived syndromes as a basis for taxonomy of child/adolescent psychopathology. J Abnorm Child Psychol 17:299–323

    Article  CAS  PubMed  Google Scholar 

  • APA (1994) Diagnostic and statistical manual of mental disorders. American Psychiatric Association, Washington, DC

    Google Scholar 

  • Barkley RA (1997) Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD. Psychol Bull 121:65–94

    Article  CAS  PubMed  Google Scholar 

  • Barkley RA (1999) Response inhibition in Attention-Deficit Hyperactivity Disorder. Ment Retard Dev Disabil Res Rev 5:177–184

    Article  Google Scholar 

  • Barry RJ, Sokolov EN (1993) Habituation of phasic and tonic components of the orienting reflex. Int J Psychophysiol 15:39–42

    Article  CAS  PubMed  Google Scholar 

  • Barry RJ, Clarke AR, Johnstone SJ (2003a) A review of electrophysiology in attention-deficit/hyperactivity disorder: I. Qualitative and quantitative electroencephalography. Clin Neurophysiol 114:171–183

    Article  PubMed  Google Scholar 

  • Barry RJ, Johnstone SJ, Clarke AR (2003b) A review of electrophysiology in attention-deficit/hyperactivity disorder: II. Event-related potentials. Clin Neurophysiol 114:184–198

    Article  PubMed  Google Scholar 

  • Brandeis D, Van Leeuwen TH, Rubia K et al (1998) Neuroelectric mapping reveals precursor of stop failures in children with attention deficits. Behav Brain Res 94:111–125

    Article  CAS  PubMed  Google Scholar 

  • Broyd SJ, Johnstone SJ, Barry RJ et al (2005) The effect of methylphenidate on response inhibition and the event-related potential of children with attention deficit/hyperactivity disorder. Int J Psychophysiol 58:47–58

    Article  PubMed  Google Scholar 

  • Clark JM (1996) Contributions of inhibitory mechanisms to unified theory in neuroscience and psychology. Brain Cogn 30:127–152

    Article  CAS  PubMed  Google Scholar 

  • Clarke AR, Barry RJ, Bond D, McCarthy R, Selikowitz M (2002) Effects of stimulant medications on the EEG of children with attention-deficit/hyperactivity disorder. Psychopharmacology 164:277–284

    Article  CAS  PubMed  Google Scholar 

  • Clarke AR, Barry RJ, McCarthy R, Selikowitz M, Johnstone SJ (2007) Effects of stimulant medications on the EEG of girls with attention-deficit/hyperactivity disorder. Clin Neurophysiol 118:2700–2708

    Article  CAS  PubMed  Google Scholar 

  • Conners CK (1997) Conners parent rating scale revised. Abbott Laboratories, Chicago

    Google Scholar 

  • Dimoska A, Johnstone SJ, Barry RJ, Clarke AR (2003) Inhibitory motor control in children with attention-deficit/hyperactivity disorder: Event-related potentials in the stop-signal paradigm. Biol Psychiatry 54:1345–1354

    Article  PubMed  Google Scholar 

  • Duffy E (1962) Activation and behavior. Wiley, New York

    Google Scholar 

  • Geurts HM, Verte S, Oosterlaan J, Roeyers H, Sergeant JA (2005) ADHD subtypes: do they differ in their executive functioning profile? Arch Clin Neuropsychol 20:457–477

    Article  PubMed  Google Scholar 

  • Hasher L, Zacks RT (1988) Working memory, comprehension, and aging: a review and a new view. In: Bower GH (ed) The psychology of learning and motivation. Academic Press, San Diego

    Google Scholar 

  • Jodo E, Kayama Y (1992) Relation of a negative ERP component to response inhibition in a Go/No-go task. Electroencephalogr Clin Neurophysiol 82:477–482

    Article  CAS  PubMed  Google Scholar 

  • Johnstone SJ, Barry RJ (1996) Auditory event-related potentials to a two-tone discrimination paradigm in attention deficit hyperactivity disorder. Psychiatry Res 64:179–192

    Article  CAS  PubMed  Google Scholar 

  • Johnstone SJ, Pleffer CB, Barry RJ, Clarke AR, Smith JL (2005) Development of inhibitory processing during the Go/NoGo task: a behavioral and event-related potential study of children and adults. J Psychophysiol 19:11–23

    Article  Google Scholar 

  • Johnstone SJ, Barry RJ, Clarke AR (2007) Behavioural and ERP indices of response inhibition during a Stop-signal task in children with two subtypes of Attention-Deficit Hyperactivity Disorder. Int J Psychophysiol 66:37–47

    Article  PubMed  Google Scholar 

  • Kida N, Oda S, Matsumura M (2005) Intensive baseball practice improves the Go/No go reaction time, but not the simple reaction time. Cogn Brain Res 22:257–264

    Article  Google Scholar 

  • Kimko HC, Cross JT, Abernethy DR (1999) Pharmacokinetics and clinical effectiveness of methylphenidate. Clin Pharmacokinet 37:457–470

    Article  CAS  PubMed  Google Scholar 

  • Klingberg T, Forssberg H, Westerberg H (2002) Training of working memory in children with ADHD. J Clin Exp Neuropsychol 24:781–791

    Article  PubMed  Google Scholar 

  • Klingberg T, Fernell E, Olesen PJ et al (2005) Computerized training of working memory in children with ADHD—a randomized, controlled trial. J Am Acad Child Adolesc Psychiatry 44:177–186

    Article  PubMed  Google Scholar 

  • Kotwal DB, Burns WJ, Montgomery DD (1996) Computer-assisted cognitive training for ADHD: a case study. Behav Modif 20:85–96

    Article  Google Scholar 

  • Lawrence CA, Barry RJ, Clarke AR et al (2005) Methylphenidate effects in attention deficit/hyperactivity disorder: electrodermal and ERP measures during a continuous performance task. Psychopharmacology 183:81–91

    Article  CAS  PubMed  Google Scholar 

  • Lazzaro I, Gordon E, Li W et al (1999) Simultaneous EEG and EDA measures in adolescent attention deficit hyperactivity disorder. Int J Psychophysiol 34:123–134

    Article  CAS  PubMed  Google Scholar 

  • Magee CA, Clarke AR, Barry RJ, McCarthy R, Selikowitz M (2005) Examining the diagnostic utility of EEG power measures in children with attention deficit/hyperactivity disorder. Clin Neurophysiol 116:1033–1040

    Article  PubMed  Google Scholar 

  • Mannuzza S, Klein RG, Moulton Iii JL (2008) Lifetime criminality among boys with attention deficit hyperactivity disorder: a prospective follow-up study into adulthood using official arrest records. Psychiatry Res 160:237–246

    Article  PubMed  Google Scholar 

  • McNab F, Leroux G, Strand F et al (2008) Common and unique components of inhibition and working memory: an fMRI, within-subjects investigation. Neuropsychologia 46:2668–2682

    Article  PubMed  Google Scholar 

  • Mitchell P (2007) Attention deficit hyperactivity disorder in children and adolescents in New South Wales—2007. Final report of the Special Review. Sydney, Clinical Excellence Commission

  • Naatanen R, Picton T (1987) The N1 wave of the human electric and magnetic response to sound: a review and an analysis of the component structure. Psychophysiology 24:375–425

    Article  CAS  PubMed  Google Scholar 

  • Neale MD (1999) Neale analysis of reading ability. ACER, Melbourne

    Google Scholar 

  • Nieuwenhuis S, Yeung N, Van Den Wildenberg W, Ridderinkhof KR (2003) Electrophysiological correlates of anterior cingulate function in a go/no-go task: effects of response conflict and trial type frequency. Cogn Affect Behav Neurosci 3:17–26

    Article  PubMed  Google Scholar 

  • Oosterlaan J, Sergeant JA (1996) Inhibition in ADHD, aggressive, and anxious children: a biologically based model of child psychopathology. J Abnorm Child Psychol 24:19–36

    Article  CAS  PubMed  Google Scholar 

  • Pennington BF, Ozonoff S (1996) Executive functions and developmental psychopathology. J Child Psychol Psychiatry 37:51–87

    Article  CAS  PubMed  Google Scholar 

  • Pliszka SR, Liotti M, Woldorff MG (2000) Inhibitory control in children with attention-deficit/hyperactivity disorder: event-related potentials identify the processing component and timing of an impaired right-frontal response-inhibition mechanism. Biol Psychiatry 48:238–246

    Article  CAS  PubMed  Google Scholar 

  • Quay HC (1997) Inhibition and attention deficit hyperactivity disorder. J Abnorm Child Psychol 25:7–13

    Article  CAS  PubMed  Google Scholar 

  • Raven JC (1989) Standard progressive matrices Australian manual. Australian Council for Education Research, Victoria

    Google Scholar 

  • Roberts RJ, Pennington BF (1996) An interactive framework for examining prefrontal cognitive processes. Dev Neuropsychol 12:105–126

    Article  Google Scholar 

  • Roodenrys S (2006) Working memory function in attention deficit hyperactivity disorder. In: Packiam Alloway T, Gathercole SE (eds) Working memory and neurodevelopmental condition. Psychology Press, Hove

    Google Scholar 

  • Rubia K, Overmeyer S, Taylor E et al (1999) Hypofrontality in attention deficit hyperactivity disorder during higher-order motor control: a study with functional MRI. Am J Psychiatry 156:891–896

    CAS  PubMed  Google Scholar 

  • Satterfield JH, Dawson ME (1971) Electrodermal correlates of hyperactivity in children. Psychophysiology 8:191–197

    Article  CAS  PubMed  Google Scholar 

  • Satterfield JH, Schell AM, Backs RW, Hidaka KC (1984) A cross-sectional and longitudinal study of age effects of electrophysiological measures in hyperactive and normal children. Biol Psychiatry 19:973–990

    CAS  PubMed  Google Scholar 

  • Semlitsch HV, Anderer P, Schuster P, Presslich OA (1986) A solution for reliable and valid reduction of ocular artifacts, applied to the P300 ERP. Psychophysiology 23:695–703

    Article  CAS  PubMed  Google Scholar 

  • Sergeant J (2000) The cognitive-energetic model: an empirical approach to Attention-Deficit Hyperactivity Disorder. Neurosci Biobehav Rev 24:7–12

    Article  CAS  PubMed  Google Scholar 

  • Smith JL, Johnstone SJ, Barry RJ (2003) Aiding diagnosis of attention-deficit/hyperactivity disorder and its subtypes: discriminant function analysis of event-related potential data. J Child Psychol Psychiatry 44:1067–1075

    Article  PubMed  Google Scholar 

  • Smith JL, Johnstone SJ, Barry RJ (2004) Inhibitory processing during the Go/NoGo task: an ERP analysis of children with attention-deficit/hyperactivity disorder. Clin Neurophysiol 115:1320–1331

    Article  PubMed  Google Scholar 

  • Smith JL, Johnstone SJ, Barry RJ (2007) Response priming in the Go/NoGo task: the N2 reflects neither inhibition nor conflict. Clin Neurophysiol 118:343–355

    Article  PubMed  Google Scholar 

  • Swanson JM, Elliott GR, Greenhill LL et al (2007) Effects of stimulant medication on growth rates across 3 years in the MTA follow-up. J Am Acad Child Adolesc Psychiatry 46:1015–1027

    Article  PubMed  Google Scholar 

  • Verbruggen F, Logan GD (2008) Automatic and controlled response inhibition: associative learning in the Go/No-Go and stop-signal paradigms. J Exp Psychol Gen 137:649–672

    Article  PubMed  Google Scholar 

  • Westwood PS (1979) South Australian spelling test. Education Department of South Australia Adelaide

  • Young SE, Friedman NP, Miyake A et al (2009) Behavioral disinhibition: liability for externalizing spectrum disorders and its genetic and environmental relation to response inhibition across adolescence. J Abnorm Psychol 118:117–130

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The research was supported by a small internal grant from the University of Wollongong.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Brain and Behaviour Research Institute and School of Psychology, University of Wollongong, Wollongong, NSW, 2522, Australia

    Stuart J. Johnstone, Steven Roodenrys, Elise Phillips, Annele J. Watt & Sharlene Mantz

Authors
  1. Stuart J. Johnstone
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Steven Roodenrys
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Elise Phillips
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Annele J. Watt
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sharlene Mantz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stuart J. Johnstone.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Johnstone, S.J., Roodenrys, S., Phillips, E. et al. A pilot study of combined working memory and inhibition training for children with AD/HD. ADHD Atten Def Hyp Disord 2, 31–42 (2010). https://doi.org/10.1007/s12402-009-0017-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12402-009-0017-z

Keywords

Search

Navigation