Which 'Working' Components of Working Memory aren't Working in Youth with ADHD?

Abstract

Despite replicated evidence for working memory deficits in youth with ADHD, no study has comprehensively assessed all three primary 'working' subcomponents of the working memory system in these children. Children ages 8-13 with (n = 45) and without (n = 41) ADHD (40% female; M_age = 10.5; 65% Caucasian/Non-Hispanic) completed a counterbalanced battery of nine tasks (three per construct) assessing working memory reordering (maintaining and rearranging information in mind), updating (active monitoring of incoming information and replacing outdated with relevant information), and dual-processing (maintaining information in mind while performing a secondary task). Detailed analytic plans were preregistered. Bayesian t-tests indicated that, at the group level, children with ADHD exhibited significant impairments in working memory reordering (BF₁₀ = 4.64 × 10⁵; d = 1.34) and updating (BF₁₀ = 9.49; d = 0.64), but not dual-processing (BF₀₁ = 1.33; d = 0.37). Overall, 67%-71% of youth with ADHD exhibited impairment in at least one central executive working memory domain. Reordering showed the most ADHD-related impairment, with 75% classified as below average or impaired, and none demonstrating strengths. The majority of children with ADHD (52%-57%) demonstrated average or better abilities in the remaining two domains, with a notable minority demonstrating strengths in updating (8%) and dual-processing (20%). Notably, impairments in domain-general central executive working memory, rather than individual subcomponents, predicted ADHD severity, suggesting that common rather than specific working memory mechanisms may be central to understanding ADHD symptoms. These impairment estimates extend prior work by providing initial evidence that children with ADHD not only exhibit heterogeneous profiles across cognitive domains but also exhibit significant heterogeneity within subcomponents of key cognitive processes.