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Research

Research

Our ADHD Treatment app is built on the science of neuro-cognitive training, the benefits of which have long been touted in academic journals, in some cases as early as 1980.

We continue to stay up to date on the latest findings which make their way into our app with every subsequent iteration. Several of the key studies ADHD Treatment is based on that have been published over the last 30 years are located below.

Just click on the ‘Read more’ link to be brought to the PDF of the paper if you care to dig in a little further.

Neuro-Cognitive Training

Enhancing Cognition with Video Games: A Multiple Game Training Study
Previous evidence points to a causal link between playing action video games and enhanced cognition and perception. However, benefits of playing other video games are under-investigated. We examined whether playing non-action games also improves cognition. Hence, we compared transfer effects of an action and other non-action types that required different cognitive demands.

Five groups of non-gamer participants were instructed to play one game each on a mobile device (iPhone/iPod Touch) for one hour a day/five days a week over four weeks (20 hours). Games included action, spatial memory, match-3, hidden- object, and an agent-based life simulation. Participants performed four behavioral tasks before and after video game training to assess for transfer effects. Tasks included an attentional blink task, a spatial memory and visual search dual task, a visual filter memory task to assess for multiple object tracking and cognitive control, as well as a complex verbal span task. Action game playing eliminated attentional blink and improved cognitive control and multiple-object tracking. Match-3, spatial memory and hidden object games improved visual search performance while the latter two also improved spatial working memory. Complex verbal span improved after match-3 and action game training.

Cognitive improvements were not limited to action game training alone and different games enhanced different aspects of cognition. We conclude that training specific cognitive abilities frequently in a video game improves performance in tasks that share common underlying demands. Overall, these results suggest that many video game-related cognitive improvements may not be due to training of general broad cognitive systems such as executive attentional control, but instead due to frequent utilization of specific cognitive processes during game play. Thus, many video game training related improvements to cognition may be attributed to near-transfer effects.

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Will Working Memory Training Generalize to Improve Off-Task Behavior in Children with ADHD?
Computerized working memory and executive function training programs designed to target specific impairments in executive functioning are becoming increasingly available, yet how well these programs generalize to improve functional deficits in disorders, such as attention-deficit/hyperactivity disorder (ADHD), beyond the training context is not well-established. The aim of this study was to examine the extent to which working memory (WM) training in children with ADHD would diminish a core dysfunctional behavior associated with the disorder, “off-task” behavior during academic task performance.

The effect of computerized WM training (adaptive) was compared to a placebo condition (nonadaptive) in a randomized, double-blind, placebo-controlled design in 26 children (18 males; age, 7 to 14 years old) diagnosed with ADHD. Participants completed the training in approximately 25 sessions. The Restricted Academic Situations Task (RAST) observational system was used to assess aspects of off-task behavior during the completion of an academic task. Traditional measures of ADHD symptoms (Conners’ Parent Rating Scale) and WM ability (standardized WM tests) were also collected.

WM training led to significant reductions in off-task ADHD-associated behavior on the RAST system and improvement on WM tests. There were no significant differences between groups in improvement on parent rating scales. Findings lend insight into the generalizability of the effects of WM training and the relation between deficits in WM and off-task behavioral components of ADHD. These preliminary data suggest WM training may provide a mechanism for indirectly altering academic performance in children with ADHD.

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Computer-Based Attention Training in the Schools for Children With ADHD: A Preliminary Trial
This study examined the efficacy of 2 computer-based training systems to teach children with attention deficit/hyperactivity disorder (ADHD) to attend more effectively.

A total of 41 children with ADHD from 2 middle schools were randomly assigned to receive 2 sessions a week at school of either neurofeedback (NF) or attention training through a standard computer format (SCF), either immediately or after a 6-month wait (waitlist control group). Parents, children, and teachers completed questionnaires pre- and postintervention.

Primary parents in the NF condition reported significant (P < .05) change on Conners’s Rating Scales—Revised (CRS-R) and Behavior Assessment Scales for Children (BASC) subscales; and in the SCF condition, they reported significant (P < .05) change on the CRS-R Inattention scale and ADHD index, the BASC Attention Problems Scale, and on the Behavioral Rating Inventory of Executive Functioning (BRIEF). This randomized control trial provides preliminary evidence of the effectiveness of computer-based interventions for ADHD and supports the feasibility of offering them in a school setting.

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A Randomized Trial of Two Promising Computer-Based Interventions for Students with Attention Difficulties
Few studies have examined whether attention can be improved with training, even though attention difficulties adversely affect academic achievement. The present study was a randomized-controlled trial evaluating the impact of Computerized Attention Training (CAT) and Computer Assisted Instruction (CAI) on attention and academic performance in 77 inattentive first graders.

Students receiving either intervention were more likely than controls to show a moderate decline in teacher rated attention problems in first grade. Students receiving CAI also showed gains in reading fluency and in teacher ratings of academic performance. Intervention effects for attention were absent by second grade largely because attention problems declined in all groups. However, post hoc analyses indicated potential longer-term benefits for children with 6 or more inattentive symptoms at baseline. Persistent attention problems were associated with poorer academic performance in multiple domains.

Results provide initial evidence that CAT and CAI can improve children’s attention in the classroom – and support additional studies to determine whether more clinically significant benefits are attainable.

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Improving Fluid Intelligence with Training on Working Memory
Fluid intelligence (Gf) refers to the ability to reason and to solve new problems independently of previously acquired knowledge. Gf is critical for a wide variety of cognitive tasks, and it is considered one of the most important factors in learning. Moreover, Gf is closely related to professional and educational success, especially in complex and demanding environments. Although performance on tests of Gf can be improved through direct practice on the tests themselves, there is no evidence that training on any other regimen yields increased Gf in adults. Furthermore, there is a long history of research into cognitive training showing that, although performance on trained tasks can increase dramatically, transfer of this learning to other tasks remains poor. Here, we present evidence for transfer from training on a demanding working memory task to measures of Gf.

This transfer results even though the trained task is entirely different from the intelligence test itself. Furthermore, we demonstrate that the extent of gain in intelligence critically depends on the amount of training: the more training, the more improvement in Gf. That is, the training effect is dosage-dependent. Thus, in contrast to many previous studies, we conclude that it is possible to improve Gf without practicing the testing tasks themselves, opening a wide range of applications.

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Computerized Training of Working Memory in Children with ADHD–A Randomized, Controlled Trial
Deficits in executive functioning, including working memory (WM) deficits, have been suggested to be important in attention-deficit/hyperactivity disorder (ADHD). During 2002 to 2003, the authors conducted a multicenter, randomized, controlled, double-blind trial to investigate the effect of improving WM by computerized, systematic practice of WM tasks.

Included in the trial were 53 children with ADHD (9 girls; 15 of 53 inattentive subtype), aged 7 to 12 years, without stimulant medication. The compliance criterion (>20 days of training) was met by 44 subjects, 42 of whom were also evaluated at follow-up 3 months later. Participants were randomly assigned to use either the treatment computer program for training WM or a comparison program.

The main outcome measure was the span-board task, a visuospatial WM task that was not part of the training program. For the span-board task, there was a significant treatment effect both post-intervention and at follow-up. In addition, there were significant effects for secondary outcome tasks measuring verbal WM, response inhibition, and complex reasoning. Parent ratings showed significant reduction in symptoms of inattention and hyperactivity/impulsivity, both post-intervention and at follow-up.

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Training The Brain: Cognitive Therapy as an Alternative to ADHD Drugs
To medicate or not? Millions of parents must decide when their child is diagnosed with attention-deficit hyperactivity disorder (ADHD)–a decision made tougher by controversy. Studies increasingly show that while medication may calm a child’s behavior, it does not improve grades, peer relationships or defiant behavior over the long term. Consequently, researchers have focused attention on the disorder’s neurobiology.

Recent studies support the notion that many children with ADHD have cognitive deficits, specifically in working memory–the ability to hold in mind information that guides behavior. The cognitive problem manifests behaviorally as inattention and contributes to poor academic performance. Such research not only questions the value of medicating ADHD children, it also is redefining the disorder and leading to more meaningful treatment that includes cognitive training.

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Changes After EEG Biofeedback and Cognitive Retraining in Adults with Mild Traumatic Brain Injury and ADHD
Adults diagnosed with mild traumatic brain injury (mTBI) or Attention Deficit Hyperactivity Disorder (ADHD) were treated with EEG Biofeedback and cognitive retraining. Psychological and neuropsychological tests were completed at pre-treatment and post-treatment and compared to a normal control group that did not receive training, but tested on two occasions.

The results found significant improvement on full scale attention and full scale response accuracy of a continuous performance task in the mTBI and ADHD groups compared to the control group. A self report showed a significant decline in symptoms in the mTBI and ADHD groups compared to the control group. Errors on a problem solving task decreased only in the mTBI group. The treatment model used in this study showed significant improvement in the sustained attention of individuals diagnosed with mTBI and ADHD after twenty treatment sessions.

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Computerized Cognitive Training for Severely Emotionally Disturbed Children with ADHD
An experiment was conducted to investigate the influence of Captain’s Log (a computerized cognitive-training system) on the behaviors and performance capabilities of 4 severely emotionally disturbed children with Attention Deficit Hyperactivity Disorder (ADHD), ages 7 to 11.

Behavioral scales, spectral electroencephalograms, and intelligence and performance tests were assessed pre-and posttreatment. A behavioral point system and monitoring of progress on computer tasks were used throughout treatment to evaluate ongoing improvements. There were 64 training sessions administered over a 16-week period. Outcome of treatment was determined by computer advancement, changes in behavioral points, and pre-and postmeasures.

Results support the expectation that children who were most successful in the training would demonstrate the highest levels of generalization of those skills that were the focus of treatment.

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Computer-Assisted Cognitive Training for ADHD
A computer-assisted cognitive training program was used to treat a 13-year-old Caucasian male with attention deficit hyperactivity disorder. The subject was administered a cognitive training computer program, Captain’s Log, for 35 sessions. Pre/post differences on the Conners Parent Rating Scale revealed a decrease on all subscales. The scores on the Conners Teacher Rating Scale were less conclusive. Electrophysiological testing on the A620 EEG/Neurofeedback revealed a reduction in EMG, theta, and beta wave amplitudes. However, the theta/beta ratio increased. A 7-month follow-up revealed that most of the acquired gains were maintained, but at a slightly lower level.

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Effects of Two Treatment Techniques on Delay and Vigilance Tasks with ADHD Children
In this study, we examined the effects of two treatment techniques under on-medication and off-medication conditions on the hyperactive behavior patterns of children. Three groups of subjects were compared: a control group, a behavior modification group, and a cognitive training group. The Gordon Diagnostic System was used to assess the subjects at the initial screening, during treatment without medication, and during treatment with medication. The two medication conditions were counterbalanced during the second and third testing sessions.

Results showed that when the cognitive intervention was combined with medication, there was a significant improvement in the subjects’ ability to delay impulsive responding. However, no significant effects were seen for sustained vigilance for either the behavioral or cognitive groups. Parents rated children in the cognitive group significantly higher than those in the control group.

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Psychology of Computers: XIV. Cognitive Rehabilitation Through Computer Games
To test the hypothesis that computer games may be an efficient therapeutic tool in a cognitive rehabilitation program (CRP), 40 boys and girls (aged 8–14 yrs) with attention problems with or without minimal brain damage were compared with 20 matched controls before and after a 12-hr training program on the game Super Breakout.

Experimental Ss showed improvement on scanning and tracking variables, in spite of the nature of their particular dysfunctions. Recommendations are presented regarding the nature and content of the cognitive tasks in a CRP.

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Effects of Cognitive Training on Academic and On-Task Behavior of Hyperactive Children
A cognitive traning program that taught both self-instructional and self-management skills was used with three 7- to 8-year-old hyperactive children. A multiple baseline across individuals design was used to evaluate the effects of training on on-task behavior and math accuracy. There were significant changes in math accuracy for all subjects, and two subjects showed significant improvements in on-task behavior. Evidence suggesting generalization to untrained behaviors was shown by an increase in self-correction or oral reading for all subjects. The results suggest that cognitive training specifically designed to promote generalization of classroom tasks can improve the classroom behavior and academic achievement of hyperactive children.

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