(PS11-B28) Central Executive and Inhibitory Control Training Effects for Adhd-related Organizational Impairments

Objective: Organizational deficits are prominent in ADHD and, if untreated, portend adverse educational, psychosocial, and occupational outcomes for children with ADHD into adulthood. Core ADHD-related neurocognitive systems (i.e., working memory, inhibitory control) have been proposed as causal mechanisms underlying ADHD-related functional impairments, including organizational problems (Abikoff et al., 2013). Indeed, central executive (or the working component of working memory) training (CET) as well as inhibitory control training (ICT) neurocognitive protocols have demonstrated significant improvements in ADHD-related executive dysfunction, core behavioral symptoms, and functional outcomes (REFS REMOVED FOR MASKED REVIEW). The present study is the first to examine the far-transfer treatment effects of CET and ICT for improving ADHD-related organizational problems.

Method: A carefully phenotyped sample of 73 children diagnosed with ADHD (ages 8-13, M=10.15, SD=1.43; 20 girls; 73% White/Non-Hispanic) participated in a preregistered randomized controlled trial of CET or ICT (both 10-week computerized treatments). Parent- and teacher-rated organizational skills from the COSS (Abikoff & Gallagher, 2009) Task Planning, Organized Action, and Memory/Materials Management subscales were collected at pre- and post-treatment, and parent ratings were collected at 2-4 months follow-up. Mixed-model ANOVAs with post-hocs were used to compare group effects on child organizational skills.

Results: Parent-reported organizational skills at immediate post-treatment and at 2-4 months follow-up were significant for the main effects of Time and Subscale, and the Subscale x Time interactions (all p < .004). The Treatment x Time interaction was significant per teacher report (p=.01). At the time of this writing, I remained masked to treatment group, thus I do not know whether the Treatment x Time interaction indicates that CET or ICT is superior for improving teacher-reported organizational skills. A priori planned posthoc analyses indicate one of the treatments showed significant pre-post improvements on all 3 parent (d=0.50-0.62) and all 3 teacher (d=0.46-0.95) subscales, whereas the other showed improvements only on parent-reported Memory Materials/Management (d=0.67). Unmasking of treatment groups and analyses of follow-up data will occur prior to presenting findings at the conference.

Conclusions: Results provide support for the far-transfer effects of CET and ICT on organizational skills for children with ADHD. Findings are also consistent with model-driven conceptualizations that ADHD-related organizational problems are at least, in part, caused by working memory or inhibitory control deficits (Rapport et al., 2008; Abikoff et al., 2013). Further research is needed on the neurocognitive mechanisms underpinning ADHD-related organizational problems and intervention.