A Review of Working Memory Training in the Management of Attention Deficit Hyperactivity Disorder

Abstract

Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders among children. Working memory deficits underlie many of the behavioural symptoms of ADHD. Alongside psychostimulant medications, strategies to improve working memory may play an important adjuvant role in the management of ADHD. In this study, we review the role of working memory deficits in ADHD, the evidence surrounding working memory training strategies in the management of the condition, and the factors affecting the success of these strategies in alleviating ADHD symptoms. More specifically, we review several non-pharmacological interventions that target working memory deficits in ADHD, with special emphasis on cognitive working memory training. We conclude that the development of evidence-based interventions such as computerised cognitive training (CCT) could provide an alternative or adjunct to the use of psychostimulants, especially in cases where side effects are a major issue.

Keywords: ADHD (attention deficit hyperactivity disorder); computerised cognitive training (CCT); neurodevelopmental disorders; working memory (WM); working memory training (WMT).

Figure 1

(A) Proposed mechanism of cognitive ability enhancement using working memory training, as explained by von Bastian et al. (2013). (B) An association-test map displaying brain regions that were consistently reported in 1091 studies investigating working memory. Working memory training engages executive and dorsal attentional networks. This involves brain regions like dorsolateral prefrontal cortex (DLPFC), anterior cingulate (AC), inferior frontal gyrus (IFG), and parietal regions. Map prepared using Neurosynth meta-analysis of the term working memory (Yarkoni et al., 2011). Similar neural networks show decreased signals in attention deficit hyperactivity disorder (ADHD) patients performing working memory tasks.