Abstract
Working memory (WM) is considered a core deficit in Attention-Deficit/ Hyperactivity Disorder (ADHD), with numerous studies
demonstrating impaired WM among children with ADHD. We tested the degree to which WM in children with ADHD was improved by
performance-based incentives, an analog of behavioral intervention. In two studies, WM performance was assessed using a visuo-spatial
n-back task. Study 1 compared children (ages 9–12 years) with ADHD–Combined type (n = 24) to a group of typically developing (TD) children (n = 32). Study 1 replicated WM deficits among children with ADHD. Incentives improved WM, particularly among children with
ADHD. The provision of incentives reduced the ADHD-control group difference by approximately half but did not normalize WM.
Study 2 examined the separate and combined effects of incentives and stimulant medication among 17 children with ADHD-Combined
type. Both incentives and a moderate dose of long-acting methylphenidate (MPH; ~0.3 mg/kg t.i.d. equivalent) robustly improved
WM relative to the no-incentive, placebo condition. The combination of incentives and medication improved WM significantly
more than either incentives or MPH alone. These studies indicate that contingencies markedly improve WM among children with
ADHD–Combined type, with effect sizes comparable to a moderate dose of stimulant medication. More broadly, this work calls
attention to the role of motivation in studying cognitive deficits in ADHD and in testing multifactorial models of ADHD.
demonstrating impaired WM among children with ADHD. We tested the degree to which WM in children with ADHD was improved by
performance-based incentives, an analog of behavioral intervention. In two studies, WM performance was assessed using a visuo-spatial
n-back task. Study 1 compared children (ages 9–12 years) with ADHD–Combined type (n = 24) to a group of typically developing (TD) children (n = 32). Study 1 replicated WM deficits among children with ADHD. Incentives improved WM, particularly among children with
ADHD. The provision of incentives reduced the ADHD-control group difference by approximately half but did not normalize WM.
Study 2 examined the separate and combined effects of incentives and stimulant medication among 17 children with ADHD-Combined
type. Both incentives and a moderate dose of long-acting methylphenidate (MPH; ~0.3 mg/kg t.i.d. equivalent) robustly improved
WM relative to the no-incentive, placebo condition. The combination of incentives and medication improved WM significantly
more than either incentives or MPH alone. These studies indicate that contingencies markedly improve WM among children with
ADHD–Combined type, with effect sizes comparable to a moderate dose of stimulant medication. More broadly, this work calls
attention to the role of motivation in studying cognitive deficits in ADHD and in testing multifactorial models of ADHD.
- Content Type Journal Article
- Pages 1-15
- DOI 10.1007/s10802-012-9627-6
- Authors
- Michael T. Strand, Department of Psychology, University at Buffalo, SUNY, Buffalo, NY, USA
- Larry W. Hawk, Department of Psychology, University at Buffalo, SUNY, Buffalo, NY, USA
- Michelle Bubnik, Department of Psychology, University at Buffalo, SUNY, Buffalo, NY, USA
- Keri Shiels, Department of Psychology, University at Buffalo, SUNY, Buffalo, NY, USA
- William E. Pelham, Department of Psychology, University at Buffalo, SUNY, Buffalo, NY, USA
- James G. Waxmonsky, Department of Psychiatry, University at Buffalo, SUNY, Buffalo, NY, USA
- Journal Journal of Abnormal Child Psychology
- Online ISSN 1573-2835
- Print ISSN 0091-0627