Can Working Memory Training Help Children with Borderline Intellectual Functioning and ADHD or Autism?

What you need to know

• This study examined whether computerized working memory training could improve cognitive abilities in children with borderline intellectual functioning (IQ 70-85) and ADHD or autism.

• The adaptive training did not lead to significantly greater improvements compared to a non-adaptive control version.

• However, children in both groups showed improvements over time on measures of working memory, other cognitive skills, and behavior.

• Structured cognitive training may provide benefits for this population, even if not specifically targeting working memory.

Working Memory and Its Importance

Working memory refers to our ability to temporarily hold and manipulate information in our minds. It plays a crucial role in many everyday tasks, from following instructions to solving problems. Children with borderline intellectual functioning (BIF) and conditions like attention-deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) often struggle with working memory. These challenges can negatively impact their academic performance, social skills, and overall quality of life.

Given the importance of working memory, researchers have been exploring ways to improve this cognitive ability, especially in children who face developmental challenges. One approach that has gained attention is computerized working memory training.

The Study: Testing Working Memory Training

Researchers in the Netherlands conducted a study to examine whether a specific type of computerized working memory training could help children with BIF and either ADHD or ASD. They were particularly interested in whether an adaptive version of the training, which automatically adjusts difficulty based on the child’s performance, would be more effective than a non-adaptive version.

The study included 72 children aged 10-13 years with BIF (IQ between 70 and 85) and a diagnosis of ADHD, ASD, or both. The children were randomly assigned to one of two groups:

1. Experimental group: Received adaptive working memory training
2. Control group: Received non-adaptive (placebo) working memory training

Both groups used a computerized training program called Cogmed for 5 weeks, completing 25 sessions of about 30-45 minutes each. The adaptive version increased in difficulty as children improved, while the non-adaptive version stayed at a constant, lower level of difficulty.

The researchers assessed the children’s cognitive abilities and behavior before the training, immediately after completing the training, and again 6 months later. They used various tests to measure working memory, attention, academic skills, and behavioral symptoms.

Key Findings

The main results of the study were:

1. No significant difference between groups: Contrary to the researchers’ expectations, children who received the adaptive training did not show significantly greater improvements in working memory or other measures compared to those who received the non-adaptive training.

2. Overall improvements: Both groups showed improvements over time on many measures, including:

   • Working memory tasks
   • Other cognitive skills (e.g., attention, reading, math)
   • Behavioral symptoms of ADHD and ASD (as rated by parents and investigators)

3. Sustained effects: Many of the improvements were still present at the 6-month follow-up assessment.

Interpreting the Results

While the lack of difference between the adaptive and non-adaptive training groups was unexpected, the overall improvements seen in both groups are encouraging. There are several possible explanations for these findings:

1. Structured learning environment: Both versions of the training provided a structured, engaging activity that required focus and effort. This alone may have been beneficial for the children, regardless of the specific working memory demands.

2. Motivation and self-efficacy: Completing the training program may have boosted children’s confidence in their abilities and motivation to engage in challenging tasks.

3. Practice effects: Simply practicing cognitive tasks regularly may lead to improvements, even if the tasks don’t specifically target working memory.

4. Non-specific benefits: The training may have helped children develop general skills like sustained attention and frustration tolerance, which could contribute to improvements across various domains.

5. Placebo effect: The expectation of improvement and the extra attention received during the study may have influenced outcomes.

Implications and Future Directions

While this study didn’t find evidence for the superiority of adaptive working memory training, it suggests that structured cognitive activities may be beneficial for children with BIF and ADHD or ASD. The improvements seen in both groups indicate that these children can make cognitive gains with consistent practice and support.

Future research could explore:

1. Comparing training to a no-intervention control group to better understand the specific effects of the training.

2. Investigating whether longer or more intensive training periods lead to greater improvements.

3. Examining how to integrate cognitive training into daily life and existing therapies or educational programs.

4. Identifying which specific elements of cognitive training are most helpful for different individuals.

5. Studying the long-term effects of such interventions on academic performance and quality of life.

Conclusions

• Computerized working memory training, whether adaptive or non-adaptive, may lead to improvements in cognitive skills and behavior for children with borderline intellectual functioning and ADHD or ASD.

• The structured nature of the training, rather than its specific focus on working memory, may be a key factor in its benefits.

• More research is needed to determine the most effective ways to support cognitive development in this population and to understand how cognitive training can best be integrated into comprehensive treatment approaches.