Can Working Memory Training Help Children with ADHD in Saudi Arabia?

What you need to know

• A computerized working memory training program called Cogmed was tested with Saudi children who have ADHD.
• Most children were able to complete the training, and those who did showed improvements in working memory and related skills.
• Parents reported high satisfaction with the program and felt it helped address their children’s challenges.

Working Memory Difficulties in ADHD

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) often struggle with working memory, which is the ability to temporarily hold and manipulate information in your mind. Working memory is crucial for many everyday tasks like following instructions, solving problems, and controlling attention. When working memory is impaired, it can lead to difficulties in school, social interactions, and daily functioning.

Traditionally, ADHD has been treated primarily with medication in Saudi Arabia. However, there is growing interest in non-medication approaches that can help improve cognitive skills like working memory in children with ADHD. One such approach that has shown promise in other countries is computerized working memory training.

What is Cogmed Working Memory Training?

Cogmed Working Memory Training (CWMT) is a computer-based program designed to improve working memory skills. It involves game-like tasks that challenge a child’s ability to remember and manipulate visual and verbal information. As the child practices, the difficulty of the tasks automatically adjusts to match their skill level.

The standard CWMT program involves:

• 25 training sessions
• 30-45 minutes per session
• 5 sessions per week for 5 weeks

Children complete the training at home on a computer, with some guidance from a parent or coach.

Testing Cogmed in Saudi Arabia

While CWMT has been studied in many countries, it had not previously been tested in Saudi Arabia. Researchers wanted to know:

1. Is it feasible to implement CWMT with Saudi children who have ADHD?
2. Will Saudi children engage with and complete the training?
3. Does CWMT lead to improvements in working memory and related skills for these children?
4. How do parents perceive the program?

To answer these questions, they conducted a study with 29 Saudi children diagnosed with ADHD, aged 7-15 years old.

How the Study Worked

The children were given access to the Cogmed software and asked to complete the standard 5-week training program at home. Researchers tracked:

• How many sessions each child completed
• How much time they spent training
• Changes in their performance on working memory tasks
• Improvements in related skills like following instructions and math
• Parent feedback on the program

Children who completed at least 80% of the training sessions (20 out of 25) were considered “compliant” with the program.

Key Findings

Feasibility and Engagement

• 62% of children (18 out of 29) were able to complete at least 80% of the training program
• On average, children spent about 39 minutes per day actively training
• There were no significant differences in age, ADHD symptoms, or family background between children who did or didn’t complete the program

This suggests that CWMT is feasible to implement with Saudi children who have ADHD, with good levels of engagement for most participants.

Improvements in Skills

All children showed some improvements in working memory performance over the course of training. However, those who completed more of the program showed greater gains:

• Larger increases in working memory capacity
• More improvement in the ability to follow instructions
• Greater gains in math-related skills

These findings indicate that consistent engagement with CWMT can lead to meaningful improvements in cognitive skills for Saudi children with ADHD.

Parent Perspectives

21 parents provided feedback after the program. Overall, they reported:

• High satisfaction with the training (90% were very or extremely satisfied)
• Feeling the program addressed their child’s challenges well (81% said very or extremely well)
• Willingness to continue using techniques from the program (90% likely or extremely likely)
• Likelihood of recommending the program to others (90% likely or extremely likely)

Many parents noted improvements in their child’s attention. Some did mention that the daily sessions felt a bit long for their child.

What This Means for Families and Clinicians

This study provides encouraging initial evidence that computerized working memory training could be a helpful intervention for Saudi children with ADHD:

1. It’s feasible to implement, with most children able to engage consistently.
2. It leads to improvements in working memory and related cognitive skills.
3. Parents view it positively and find it helpful for addressing their children’s challenges.

For families, CWMT could offer an additional treatment option beyond medication, especially given some parents’ concerns about long-term medication use. The at-home nature of the training also makes it convenient and accessible.

For clinicians in Saudi Arabia, this study introduces a potential new tool for supporting children with ADHD. It may be particularly valuable for children who don’t respond well to medication or whose families prefer non-medication approaches.

Limitations and Next Steps

While promising, this was a small initial study without a control group. Larger, controlled studies are needed to more definitively establish the benefits of CWMT for Saudi children with ADHD. Future research should also examine:

• Long-term effects: Do the cognitive improvements last?
• Real-world impacts: Does CWMT lead to better academic performance or reduced ADHD symptoms in daily life?
• Comparison to other treatments: How does CWMT compare to or combine with medication and behavioral therapies?

Conclusions

• Cogmed Working Memory Training appears to be a feasible and potentially beneficial intervention for Saudi children with ADHD.
• Consistent engagement with the program leads to improvements in working memory and related cognitive skills.
• Parents view the program positively, suggesting it could be a well-accepted treatment option.
• More research is needed to fully establish the effectiveness of CWMT compared to other interventions for ADHD in Saudi Arabia.

This study opens the door for further exploration of computerized cognitive training as a treatment option for ADHD in Saudi Arabia, potentially expanding the resources available to support these children and their families.