Working memory (WM) is the cognitive system responsible for the temporary storage and manipulation of information and plays an important role in both learning and focusing attention. Considerable research has documented that many children and adults with ADHD have WM deficits and that this contributes to difficulties associated with the disorder. For an excellent introduction to the role of WM deficits in ADHD, click here.

A simple example illustrates the importance of WM for particular academic tasks. Try adding 3 and 9 in your head. That was probably easy for you. Now trying adding 33 and 99. That was probably more difficult. Finally, try adding 333 and 999. This is quite challenging for most adults even though each calculation required is trivially easy. The challenge occurred because you need to store information – the sum of 3+9 in the one’s column and then ten’s column – as you process the remaining part of the problem, i.e., 3+9 in the hundred’s column, and this taxed your WM. If your WM capacity was exceeded, you could not complete the problem successfully.

This simple problem also illustrates the difference between short-term memory (STM) and WM. Short-term memory simply involves retaining information in mind for short periods of time, e.g., remembering that the problem you need to solve is 333+999. Working memory, in contrast, involves mentally manipulating – or ‘working’ with – retained information and comes into play in a wide range of learning activities. For example, to answer questions about a science chapter, a child not only has to correctly retain factual information but must mentally work with that information to answer questions about it. Thus, when a child’s WM capacity is low relative to peers, academic performance is likely to be compromised in multiple areas.

Because WM deficits play an important role in the struggles experienced by many individuals with ADHD, it is important to consider how different interventions address this aspect of the disorder. In this study, the authors were interested in comparing the impact of Working Memory Training and stimulant medication treatment on the WM performance of children diagnosed with ADHD.

Participants were 25 8-11 year-old children with ADHD (21 boy and 4 girls) who were being treated with stimulant medication. Children’s memory performance was assessed on 4 occasions using the Automated Working Memory Assessment (AWMA), a computerized test that measures verbal short-term memory, verbal working memory, visuo-spatial short-term memory, and visuo-spatial working memory.

At time 1, the assessment was conducted when children had been off medication for at least 24 hours. The second assessment occurred an average of 5 months later and when children were on medication. The third assessment occurred after children had completed 5 weeks of Cogmed Working Memory Training using the standard training protocol (see below). The final assessment occurred approximately 6 months after training had ended. This design enabled the researchers to make the following comparisons:

- WM performance on medication vs. off medication (T1 vs T2)
- WM performance on medication vs. after training (T2 vs. T3)
- WM performance immediately after training ended vs. 6 months following training (T3 vs. T4)

This final comparison provided information on whether any benefits provided by the training had endured.

In addition to measuring STM and WM at each time point, measures of IQ were collected at times 1, 2, and 3.

- Working Memory Training -

WM training was conducted using the standard Cogmed training protocol with each child completing 20-25 training sessions within a 25 day period. The training requires the storage and manipulation of sequences of verbal, e.g., repeating back a sequence of digits in reverse order, and/or visuo-spatial information, e.g., recalling the location of objects on different portions of the computer screen.

Difficulty level is calibrated on a trial by trial basis so the child is always working at a level that closely matches their performance. For example, if a child successfully recalled three digits in reverse order, on the next trial he had to recall four. When a trial was failed, the next trial was made easier by reducing the number of items to be recalled. This method of ‘adaptive training’ is thought to be a key element because it requires the child to ’stretch’ their WM capacity to move through the program.

- Results -

- Impact of Short-Term Memory and Working Memory -

Medication vs. no medication – When tested on medication, Read the rest of this entry »

Working memory is our ability to store and manipulate information for a brief time. It is typically measured by dual-tasks, where the individual has to remember an item while simultaneously processing a sometimes unrelated piece of information. A widely used working memory task is the reading span task where the individual reads a sentence, verifies it, and then recalls the final word. Individual differences in working memory performance are closely related to a range of academic skills such as reading, spelling, comprehension, and mathematics. Crucially, there is emerging research that working memory predicts learning outcomes independently of IQ. One explanation for the importance of working memory in academic attainment is that because it appears to be relatively unaffected by environmental influences, such as parental educational level and financial background, it measures a student’s capacity to acquire knowledge rather than what they have already learned.

However little is known about the consequences of low working memory capacity per se, independent of other associated learning difficulties. In particular, it is not known either what proportion of students with low working memory capacities has significant learning difficulties or what their behavioral characteristics are. The aim of a recent study published in Child Development (reference below) was to provide the first systematic large-scale examination of the cognitive and behavioral characteristics of school-aged students who have been identified solely on the basis of very low working memory scores.

In screening of over 3000 school-aged students in mainstream schools, 1 in 10 was identified as having working memory difficulties. There were several key findings regarding their cognitive skills. The first is that the majority of them performed below age-expected levels in reading and mathematics. This suggests that Read the rest of this entry »

Neurofeedback – also known as EEG Biofeedback – is an approach for treating ADHD in which individuals are provided real-time feedback on their brainwave patterns and taught to alter their typical EEG pattern to one that is consistent with a focused, attentive state. This is typically done by collecting EEG data from individuals as they focus on stimuli presented on a computer screen. Their ability to control the stimuli, for example, keeping the smile on a smiley face, is contingent on maintaining the particular EEG state being trained. According to neurofeedback proponents, learning how to do this during training generalizes to real world situations and this results in improved attention and reduced hyperactive/impulsive behavior.

Neurofeedback treatment for ADHD has been controversial in the field for many years and remains so today. Although a number of published studies have reported positive results many prominent ADHD researchers believe that problems with the design of these studies preclude concluding that neurofeedback is an effective treatment. These limitations have included the absence of random assignment, the lack of appropriate control groups, raters who are not ‘blind’ to children’s treatment status, and small samples. For additional background, you can find a recent review I wrote on existing research support for neurofeedback treatment of ADHD – along with links to extensive reviews of several recently published studies -: How Strong is the Research Support for Neurofeedback in Attention Deficits?

- Results from a New Study of Neurofeedback -

Recently, a study of neurofeedback treatment for ADHD was published that addresses several limitations that have undermined prior research [Gevensleben, et al., (2009). Is neurofeedback an efficacious treatment for ADHD? A randomized controlled clinical trial. Journal of Child Psychology and Psychiatry.]

The study was conducted in Germany and began with 102 children aged 8 to 12. All had been carefully diagnosed with ADHD and approximately over 90% had never received medication treatment. About 80% were boys. Children were randomly assigned to Read the rest of this entry »

We sometimes neglect to mention a very basic yet powerful method of cognitive and emotional development, for children and adults alike: Play.

Dr. David Elkind, author of The Power of Play: Learning That Comes Naturally, discusses the need to build a more “playful culture” in this great article brought to you thanks to our collaboration with Greater Good Magazine.

- Alvaro

——————–

Can We Play?

– By Dr. David Elkind

Play is rapidly disappearing from our homes, our schools, and our neighborhoods. Over the last two decades alone, children have lost eight hours of free, unstructured, and spontaneous play a week. More than 30,000 schools in the United States have eliminated recess to make more time for academics. From 1997 to 2003, children’s time spent outdoors fell 50 percent, according to a study by Sandra Hofferth at the University of Maryland. Hofferth has also found that the amount of time children spend in organized sports has doubled, and the number of minutes children devote each week to passive leisure, not including watching television, has increased from 30 minutes to more than three hours. It is no surprise, then, that childhood obesity is now considered an epidemic.

But the problem goes well beyond obesity. Decades of research has shown that play is crucial to physical, intellectual, and social-emotional development at all ages. This is especially true of the purest form of play: the unstructured, self-motivated, imaginative, independent kind, where children initiate their own games and even invent their own rules.

Read the rest of this entry »

After many months of work (and we hope many new neurons and stronger synapses in our brains), we have just released our inaugural report on the emerging Brain Fitness Software Market, the first to define the brain fitness and training software market and analyze the size and trends of its four customer segments. We estimate the size of the US brain fitness software market at $225M in2007, up from $100m in 2005 (50% CAGR). The two segments that fueled the market growth: consumers (grew from $5m to $80m, 300% CAGR) and healthcare & insurance providers (grew from $36m to $65m, 35% CAGR).

Highlights from The State of the Brain Fitness Software Market 2008 report include:

1) 2007 was a seminal year for the US Brain Fitness software market, which reached $225 million in revenues – up from an estimated $100 million in 2005.

2) Over 20 companies are offering tools to assess and train cognitive skills to four customer segments: consumers; healthcare and insurance providers; K12 school systems; and Fortune 1000 companies, the military, and sports teams.

3) The Nintendo Brain Age/ Brain Training phenomenon has driven much of the growth. The consumer segment grew from a few million in 2005 to an estimated $80 million in 2007.

4) There is major confusion in the market, so education will be key. Users and buyers need help to navigate the maze of products and claims.

Read the rest of this entry »

The CDC has reported a joint initiative with the Alzheimer’s Association to create the Healthy Brain Initiative: A National Public Health Roadmap for Cognitive Health. Some quotes from their announcement:

• “In order to maintain and improve the cognitive performance of all adults, the Centers for Disease Control and Prevention (CDC) and the Alzheimer’s Association today released the first-ever National Public Health Road Map to Maintaining Cognitive Health (Road Map) at the 2nd Alzheimer’s Association International Conference on Prevention of Dementia in Washington, DC.”
• “The Road Map highlights the importance of maintaining and improving cognitive health to the overall health of the nation. The Road Map is both a call to action and a guide for implementing a coordinated approach to raising the public’s awareness about cognitive health and increasing the nation’s commitment to understanding both the risks for cognitive decline and ways of maintaining brain health.”
• “Efforts to maintain and improve public health have focused mostly
  ‘below the neck,’ addressing diseases and conditions affecting the heart
  and other bodily organs,” said Harry Johns, Alzheimer’s Association
  President and CEO. “The National Public Health Road Map to Maintaining
  Cognitive Health shifts the focus ‘above the neck’ to draw attention to
  maintaining the health of our brains, which arguably is the most important
  organ in our bodies.”

We hope the message gets well-heard!

Related posts:

• The Dana Guide to Brain Health book review
• Easy Steps to Improve Your Brain Health Now