Elizabeth S M Chan, Fatou Gaye, Alissa M Cole, Leah J Singh, Michael J Kofler
{"title":"注意力缺陷多动障碍的中央管理培训:对家庭和学校组织技能的影响。一项随机对照试验。","authors":"Elizabeth S M Chan, Fatou Gaye, Alissa M Cole, Leah J Singh, Michael J Kofler","doi":"10.1037/neu0000918","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The current randomized controlled trial (RCT) was the first to examine the benefits of central executive training (CET, which trains the <i>working</i> components of working memory [WM]) for reducing organizational skills difficulties relative to a carefully matched neurocognitive training intervention (inhibitory control training [ICT]).</p><p><strong>Method: </strong>A carefully phenotyped sample of 73 children with attention-deficit/hyperactivity-impulsivity disorder (ADHD; ages 8-13, <i>M</i> = 10.15, <i>SD</i> = 1.43; 20 girls; 73% White/Non-Hispanic) participated in a preregistered RCT of CET versus ICT (both 10-week treatments). Parent-rated task planning, organized actions, and memory/materials management data were collected at pretreatment, posttreatment, and 2-4 month follow-up; teacher ratings were obtained at pretreatment and 1-2 month follow-up.</p><p><strong>Results: </strong>CET was superior to ICT for improving organizational skills based on teacher report (Treatment × Time interaction: <i>d</i> = 0.61, <i>p</i> = .01, BF₁₀ = 31.61). The CET group also improved significantly based on parent report, but this improvement was equivalent in both groups (main effect of time: <i>d</i> = 0.48, <i>p</i> < .001, BF₁₀ = 3.13 × 10⁷; Treatment × Time interaction: <i>d</i> = 0.29, <i>p</i> = .25, BF₀₁ = 3.73). Post hocs/preregistered planned contrasts indicated that CET produced significant and clinically meaningful (number needed to treat = 3-8) pre/post gains on all three parent (d = 0.50 -0.62) and all three teacher (<i>d</i> = 0.46 -0.95) subscales, with gains that were maintained at 1-2 month (teacher report) and 2-4 month follow-up (parent report) for five of six outcomes.</p><p><strong>Conclusions: </strong>Results provide strong initial evidence that CET produces robust and lasting downstream improvements in school-based organizational skills for children with ADHD based on teacher report. These findings are generally consistent with model-driven predictions that ADHD-related organizational problems are secondary outcomes caused, at least in part, by underdeveloped working memory abilities. (PsycInfo Database Record (c) 2023 APA, all rights reserved).</p>","PeriodicalId":19205,"journal":{"name":"Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.6000,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10615842/pdf/","citationCount":"0","resultStr":"{\"title\":\"Central executive training for ADHD: Impact on organizational skills at home and school. A randomized controlled trial.\",\"authors\":\"Elizabeth S M Chan, Fatou Gaye, Alissa M Cole, Leah J Singh, Michael J Kofler\",\"doi\":\"10.1037/neu0000918\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>The current randomized controlled trial (RCT) was the first to examine the benefits of central executive training (CET, which trains the <i>working</i> components of working memory [WM]) for reducing organizational skills difficulties relative to a carefully matched neurocognitive training intervention (inhibitory control training [ICT]).</p><p><strong>Method: </strong>A carefully phenotyped sample of 73 children with attention-deficit/hyperactivity-impulsivity disorder (ADHD; ages 8-13, <i>M</i> = 10.15, <i>SD</i> = 1.43; 20 girls; 73% White/Non-Hispanic) participated in a preregistered RCT of CET versus ICT (both 10-week treatments). Parent-rated task planning, organized actions, and memory/materials management data were collected at pretreatment, posttreatment, and 2-4 month follow-up; teacher ratings were obtained at pretreatment and 1-2 month follow-up.</p><p><strong>Results: </strong>CET was superior to ICT for improving organizational skills based on teacher report (Treatment × Time interaction: <i>d</i> = 0.61, <i>p</i> = .01, BF₁₀ = 31.61). The CET group also improved significantly based on parent report, but this improvement was equivalent in both groups (main effect of time: <i>d</i> = 0.48, <i>p</i> < .001, BF₁₀ = 3.13 × 10⁷; Treatment × Time interaction: <i>d</i> = 0.29, <i>p</i> = .25, BF₀₁ = 3.73). Post hocs/preregistered planned contrasts indicated that CET produced significant and clinically meaningful (number needed to treat = 3-8) pre/post gains on all three parent (d = 0.50 -0.62) and all three teacher (<i>d</i> = 0.46 -0.95) subscales, with gains that were maintained at 1-2 month (teacher report) and 2-4 month follow-up (parent report) for five of six outcomes.</p><p><strong>Conclusions: </strong>Results provide strong initial evidence that CET produces robust and lasting downstream improvements in school-based organizational skills for children with ADHD based on teacher report. These findings are generally consistent with model-driven predictions that ADHD-related organizational problems are secondary outcomes caused, at least in part, by underdeveloped working memory abilities. (PsycInfo Database Record (c) 2023 APA, all rights reserved).</p>\",\"PeriodicalId\":19205,\"journal\":{\"name\":\"Neuropsychology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2023-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10615842/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neuropsychology\",\"FirstCategoryId\":\"102\",\"ListUrlMain\":\"https://doi.org/10.1037/neu0000918\",\"RegionNum\":3,\"RegionCategory\":\"心理学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/7/13 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"NEUROSCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neuropsychology","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1037/neu0000918","RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/7/13 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"NEUROSCIENCES","Score":null,"Total":0}
Central executive training for ADHD: Impact on organizational skills at home and school. A randomized controlled trial.
Objective: The current randomized controlled trial (RCT) was the first to examine the benefits of central executive training (CET, which trains the working components of working memory [WM]) for reducing organizational skills difficulties relative to a carefully matched neurocognitive training intervention (inhibitory control training [ICT]).
Method: A carefully phenotyped sample of 73 children with attention-deficit/hyperactivity-impulsivity disorder (ADHD; ages 8-13, M = 10.15, SD = 1.43; 20 girls; 73% White/Non-Hispanic) participated in a preregistered RCT of CET versus ICT (both 10-week treatments). Parent-rated task planning, organized actions, and memory/materials management data were collected at pretreatment, posttreatment, and 2-4 month follow-up; teacher ratings were obtained at pretreatment and 1-2 month follow-up.
Results: CET was superior to ICT for improving organizational skills based on teacher report (Treatment × Time interaction: d = 0.61, p = .01, BF₁₀ = 31.61). The CET group also improved significantly based on parent report, but this improvement was equivalent in both groups (main effect of time: d = 0.48, p < .001, BF₁₀ = 3.13 × 10⁷; Treatment × Time interaction: d = 0.29, p = .25, BF₀₁ = 3.73). Post hocs/preregistered planned contrasts indicated that CET produced significant and clinically meaningful (number needed to treat = 3-8) pre/post gains on all three parent (d = 0.50 -0.62) and all three teacher (d = 0.46 -0.95) subscales, with gains that were maintained at 1-2 month (teacher report) and 2-4 month follow-up (parent report) for five of six outcomes.
Conclusions: Results provide strong initial evidence that CET produces robust and lasting downstream improvements in school-based organizational skills for children with ADHD based on teacher report. These findings are generally consistent with model-driven predictions that ADHD-related organizational problems are secondary outcomes caused, at least in part, by underdeveloped working memory abilities. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
期刊介绍:
Neuropsychology publishes original, empirical research; systematic reviews and meta-analyses; and theoretical articles on the relation between brain and human cognitive, emotional, and behavioral function.