Neuropsychology, Vol 37(8), Nov 2023, 859-871; doi:10.1037/neu0000918
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 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)