Development of a Multi-faceted Cognitive Training Program for Children With Attention Deficit Hyperactivity Disorder (ADHD)
Condition: Attention Deficit Hyperactivity Disorder
MeSH terms: Hyperkinesis; Attention Deficit Disorder with Hyperactivity
Study type: Interventional

Summary: 
      After decades of Attention Deficit Hyperactivity Disorder (ADHD) intervention research, only
      two intervention approaches (i.e., psychopharmacology, behavioral treatment) have a
      "well-established" evidence-base supporting their efficacy for children with ADHD. Both of
      these interventions have inherent limitations. Recently multiple studies have demonstrated
      that cognitive training may improve neuropsychological and behavioral functioning in children
      with ADHD. The magnitude of treatment effects for cognitive training has been comparable to
      treatment effects for behavioral treatment for ADHD (i.e., small to moderate effect sizes). A
      limitation of existing cognitive training programs that may limit their efficacy is that each
      has employed a unifaceted approach. Each intervention program has targeted a single cognitive
      domain (e.g., working memory). This is problematic since as a group, children with ADHD have
      multiple areas of cognitive deficit (i.e., working memory, attention, response inhibition,
      delay aversion, intra-individual variability) and thus a unifaceted intervention does not
      address the multifaceted array of cognitive dysfunction in children with ADHD. Also, because
      individuals with ADHD each have unique patterns of cognitive deficits, a unifaceted cognitive
      training approach may target areas which are non-deficient and miss areas of significant
      deficit in individual patients depending on their ideographic cognitive profile. The primary
      goal of the proposed research is to develop and test a multifaceted cognitive training
      intervention that addresses a comprehensive array of ADHD-related cognitive deficits thereby
      ensuring that children's unique areas of cognitive deficit are targeted. During Phase I (R21
      grant), software and a manual will be developed consisting of four training tasks targeting
      response inhibition, verbal working memory, attention, and delay aversion. Each task will
      possess advancing levels of difficulty. On each task, children will receive feedback on
      performance accuracy as well as on intra-individual variability in reaction times. The
      software will be pilot tested in Phase I to determine performance thresholds and intervention
      duration. Also, focus groups will be conducted to obtain patient perceptions of each task's
      difficulty and interest level. In Phase II (R33 grant), a preliminary randomized clinical
      trial will be conducted in order to obtain initial estimates of treatment efficacy. Pre-,
      post-, and follow up outcomes will be collected on a wide range of neuropsychological,
      behavioral, and academic measures. Effect size estimates across outcomes will be used to
      guide sample size determinations for future clinical trials of multifaceted cognitive
      training.
    


Intervention name(s): Multifaceted cognitive training
Intervention type(s): Other
Intervention description(s): Four computerized training tasks
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Outcomes Assessor)
Primary purpose: Treatment
Keywords: ADHD; cognitive training