a Department of Applied Psychology , New York University , NY , USA.
b Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education , University of Toronto , Canada.
Child Neuropsychol. 2018 May;24(4):427-450. doi: 10.1080/09297049.2017.1282450. Epub 2017 Feb 23.
The present study examines the potential of sequencing a neurocognitive intervention with behavioral parent training (BPT) to improve executive functions (EFs), psychiatric symptoms, and multiple indices of functional impairment in school-age children aged 7 to 11 years who have been diagnosed with attention-deficit/hyperactivity disorder (ADHD). Specifically, in a randomized controlled trial design, 85 children were assigned to either Cogmed Working Memory Training (CWMT) followed by an empirically supported, manualized BPT intervention, or to a placebo version of CWMT followed by the same BPT intervention. Working memory maintenance (i.e., attention control/short-term memory), working memory processing and manipulation, ADHD and oppositional defiant disorder (ODD) symptoms, impairment in parent-child dynamics, familial impairment, and overall functional compromise were evaluated as outcomes. The results suggest specific effects of the combined CWMT and BPT program on verbal and nonverbal working memory storage and nonverbal working memory processing and manipulation but no incremental benefits in regard to ADHD symptoms, ODD symptoms, and functional outcomes. The present findings do not support the hypothesis regarding the complementary and augmentative benefits of sequenced neurocognitive and BPT interventions for the treatment of ADHD. These results, the study's limitations, and future directions for research are further discussed.
本研究考察了对神经认知干预进行测序，结合行为家长培训（BPT），以改善 7 至 11 岁被诊断患有注意力缺陷多动障碍（ADHD）的学龄儿童的执行功能（EFs）、精神症状和多个功能障碍指标的潜力。具体来说，在一项随机对照试验设计中，85 名儿童被分配到 Cogmed 工作记忆训练（CWMT）后接受经过实证支持的、规范化的 BPT 干预，或接受 CWMT 的安慰剂版本后接受相同的 BPT 干预。工作记忆维持（即注意力控制/短期记忆）、工作记忆处理和操作、ADHD 和对立违抗性障碍（ODD）症状、亲子动态受损、家庭受损以及整体功能受损被评估为结果。结果表明，CWMT 和 BPT 联合计划对言语和非言语工作记忆存储以及非言语工作记忆处理和操作具有特定影响，但在 ADHD 症状、ODD 症状和功能结果方面没有额外的益处。目前的研究结果不支持关于序列神经认知和 BPT 干预在 ADHD 治疗中的互补和增强益处的假设。本研究进一步讨论了这些发现、研究的局限性以及未来的研究方向。
