Computerized cognitive training programs aim to help adults with ADHD improve cognitive skills like working memory through regular practice on computer-based mental exercises. However, recent research suggests the benefits of these programs for reducing ADHD symptoms and improving daily functioning are quite limited so far. More study is needed to determine if tailored approaches can help adults manage persistent attention deficits.
Key points
Rationale
ADHDpersists into adulthood for many individuals, with prevalence around 4-5% in ages 18-44 years (Young & Goodman, 2016).
Adults withADHD exhibit deficits in executive functions(EFs) like working memory compared to controls (Alderson et al., 2013).
Given these cognitive impairments, research has focused on computerized cognitive training (CCT) interventions aiming to improve EFs and working memory in ADHD (Shah et al., 2017).
Method
The literature wassystematically searchedto identify RCTs of CCT interventions for adults with ADHD.
Included studies had to have a mean age over 18 years and include adults with a primary ADHD diagnosis.
Eligible CCT interventions targeted cognition like EFs orworking memory. Two independent reviewers extracted outcome data on overall cognition and ADHD symptom severity for meta-analysis.
Risk of bias was assessed using theCochrane Risk of Bias 2 tool.
Sample
Across 9 included studies, there were 285 total participants (151 CCT, 134 control). Mean ages ranged from 21.1 to 41.6 years. Between 25-69% of participants were female. Most studies did not exclude pharmacotherapy use.
Statistical measures
Random-effects meta-analyses were conducted to synthesize overall cognitive outcomes, ADHD symptom severity, and cognitive domains like EFs, cognitive speed, and working memory.
Effect sizeswere calculated as Hedge’s g, with 95% confidence intervals. Heterogeneity was assessed using I2 and tau2 statistics.
Results
Insights and depth
This meta-analysis provides initial evidence that CCT may improve cognitive performance to a small degree in adults with ADHD.
However, the lack of symptoms or functional improvements indicates limited clinical meaningfulness so far. Variability in CCT methods and outcome measures likely reduced power to detect effects.
More research is needed to identify the optimal CCT program type and duration for enhancing cognition and daily functioning in adult ADHD.
Strengths
Limitations
Implications
These results provide tentative evidence that CCT may improve somecognitive skills in adults with ADHD.
However, inadequate study quality and small samples limit the strength of this conclusion. Clinicians should consider potential modest cognitive benefits but not assume CCT will improve ADHD symptoms or daily functioning yet.
Researchers need to conduct more high-quality, adequately poweredRCTssystematically comparing different CCT programs. Identifying active ingredients and optimal duration is critical. Far transfer to symptom and functional outcomes should be evaluated.
Conclusion
In conclusion, this meta-analysis represents an initial synthesis of CCT trials for adult ADHD.
The findings suggest potential but limited benefits of CCT for cognitive performance at this stage.
More rigorous research is critically needed to clarify if tailored CCT programs can meaningfully improve cognition and symptoms for adults with ADHD.
Given the chronic daily impairments associated with adult ADHD, developing evidence-based non-pharmacological interventions is an important public health priority.
This review highlights the need for further research to unlock the full potential of CCT in this population.
References
Alderson, R. M., Kasper, L. J., Hudec, K. L., & Patros, C. H. (2013). Attention-deficit/hyperactivity disorder (ADHD) and working memory in adults: A meta-analytic review.Neuropsychology,27(3), 287–302.https://doi.org/10.1037/a0032371
Klingberg, T., Forssberg, H., & Westerberg, H. (2002). Training of working memory in children with ADHD.Journal of Clinical and Experimental Neuropsychology, 24(6), 781–791.https://doi.org/10.1076/jcen.24.6.781.8395
Shah, T. M., Weinborn, M., Verdile, G., Sohrabi, H. R., & Martins, R. N. (2017). Enhancing cognitive functioning in healthly older adults: A systematic review of the clinical significance of commercially available computerized cognitive training in preventing cognitive decline.Neuropsychology Review,27(1), 62–80.https://doi.org/10.1007/s11065-016-9338-9
Young, J. L., & Goodman, D. W. (2016). Adult attention-deficit/hyperactivity disorder diagnosis, management, and treatment in the DSM-5 era.The Primary Care Companion for CNS Disorders,18(6), 1–18.https://doi.org/10.4088/PCC.16r02000
Learning check
Saul McLeod, PhD
BSc (Hons) Psychology, MRes, PhD, University of Manchester
Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.
Olivia Guy-Evans, MSc
BSc (Hons) Psychology, MSc Psychology of Education
Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.
