TY - JOUR
T1 - Improving working memory in children with attention-deficit/hyperactivity disorder
T2 - The separate and combined effects of incentives and stimulant medication
AU - Strand, Michael T.
AU - Hawk, Larry W.
AU - Bubnik, Michelle
AU - Shiels, Keri
AU - Pelham, William E.
AU - Waxmonsky, James G.
N1 - Funding Information:
Acknowledgments We thank Dominica Vito for coordination of the project and Mark Kutgowski for computer programming. This research was supported by grant R01MH069434 to LWH from the National Institute of Mental Health. KS is now at the Kennedy Krieger Institute. WEP and JGW are now at the Center for Children and Families, Florida International University.
PY - 2012/10
Y1 - 2012/10
N2 - Working memory (WM) is considered a core deficit in Attention-Deficit/ Hyperactivity Disorder (ADHD), with numerous studies demonstrating impaired WM among children with ADHD. We tested the degree to which WM in children with ADHD was improved by performance-based incentives, an analog of behavioral intervention. In two studies, WM performance was assessed using a visuo-spatial n-back task. Study 1 compared children (ages 9-12 years) with ADHD-Combined type (n024) to a group of typically developing (TD) children (n032). Study 1 replicated WM deficits among children with ADHD. Incentives improved WM, particularly among children with ADHD. The provision of incentives reduced the ADHD-control group difference by approximately half but did not normalize WM. Study 2 examined the separate and combined effects of incentives and stimulant medication among 17 children with ADHD-Combined type. Both incentives and a moderate dose of long-acting methylphenidate (MPH; ̃0.3 mg/kg t.i.d. equivalent) robustly improved WM relative to the no-incentive, placebo condition. The combination of incentives and medication improved WM significantly more than either incentives or MPH alone. These studies indicate that contingencies markedly improve WM among children with ADHD-Combined type, with effect sizes comparable to a moderate dose of stimulant medication. More broadly, this work calls attention to the role of motivation in studying cognitive deficits in ADHD and in testing multifactorial models of ADHD.
AB - Working memory (WM) is considered a core deficit in Attention-Deficit/ Hyperactivity Disorder (ADHD), with numerous studies demonstrating impaired WM among children with ADHD. We tested the degree to which WM in children with ADHD was improved by performance-based incentives, an analog of behavioral intervention. In two studies, WM performance was assessed using a visuo-spatial n-back task. Study 1 compared children (ages 9-12 years) with ADHD-Combined type (n024) to a group of typically developing (TD) children (n032). Study 1 replicated WM deficits among children with ADHD. Incentives improved WM, particularly among children with ADHD. The provision of incentives reduced the ADHD-control group difference by approximately half but did not normalize WM. Study 2 examined the separate and combined effects of incentives and stimulant medication among 17 children with ADHD-Combined type. Both incentives and a moderate dose of long-acting methylphenidate (MPH; ̃0.3 mg/kg t.i.d. equivalent) robustly improved WM relative to the no-incentive, placebo condition. The combination of incentives and medication improved WM significantly more than either incentives or MPH alone. These studies indicate that contingencies markedly improve WM among children with ADHD-Combined type, with effect sizes comparable to a moderate dose of stimulant medication. More broadly, this work calls attention to the role of motivation in studying cognitive deficits in ADHD and in testing multifactorial models of ADHD.
UR - https://www.scopus.com/pages/publications/84866743512
UR - https://www.scopus.com/pages/publications/84866743512#tab=citedBy
U2 - 10.1007/s10802-012-9627-6
DO - 10.1007/s10802-012-9627-6
M3 - Article
C2 - 22477205
AN - SCOPUS:84866743512
SN - 0091-0627
VL - 40
SP - 1193
EP - 1207
JO - Journal of Abnormal Child Psychology
JF - Journal of Abnormal Child Psychology
IS - 7
ER -
