1. Working Memory (WM) training A randomised placebo-controlled treatment study in young ADHD children M. Boomsma 1,2, M.M. Lansbergen 1,2, Drs. S. Roos 2, Prof. dr. J.K. Buitelaar 1,2, D.I.E. Slaats-Willemse 1,2 1 Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Psychiatry, Nijmegen, 2 Karakter University Centre for Child and Adolescent Psychiatry, Nijmegen, The Netherlands. Correspondence: M.boomsma@psy.umcn.nl Methods & Materials Research in progress Approved protocol by Ethical Committee Oct 2008 Planned date of start Jan 2009 References Background Karakter Aims Workpackage 5.3 WM is the ability to retain and manipulate information during short periods of time and to make a response based on that internal representation. It is an important factor for many cognitive skills, including problem solving, and reasoning ability (Westerberg et al., 2007). Convincing evidence has been found for an impaired working memory in ADHD (Martinussen et al., 2005). The Cogmed WM training program (Cogmed, Sweden, Stockholm) has been proven to be successful in children with ADHD without any side-effects (Klingberg et al., 2002, Klingberg et al., 2005). Although there is mounting evidence for the efficacy of this training, a better methodological design and research in the younger range of age in ADHD is necessary for possible clinical relevance. The proposed study will critically evaluate the efficacy of the Dutch version of Cogmed WM training in reducing symptoms of ADHD and improving neurocognitive and neural performance in young children with ADHD. Cogmed WM training During five weeks each child will train for 15 minutes a day on a personal computer at home. The training program consists of performing WM tasks implemented in a computer program. The children will perform a variable amount of trials depending on the level of the child. In the WM training, difficulty level is automatically adjusted on a trial-by-trial basis to match the WM span of the child. The difficulty level will always be on the boarder of ability of the child. The control version of WM training is identical to the WM training that will be used in the treatment condition, but with a lower WM load (i.e., less number of items to be remembered) and without adaptation to the level of performance during the training. Design Double-blind randomized placebo-controlled treatment study. Participants 100 non-medicated children with ADHD (age 4,6-7,4 and IQ ≥ 80). Intervention 50 children receive 25 sessions Cogmed WM training and 50 children receive 25 sessions of the control version of Cogmed WM training. Before and after the WM training, all children will undergo a neurocognitive and neurophysiologic assessment (EEG, ERP). The post-assessment will be done within a month after the last session. Three months after the last session there will be a follow-up. Neuropsychological test battery 1.Working Memory 2.Executive functioning a.Response inhibition b.Attention c.Cognitive flexibility/set shifting All the pictures are Cogmed copyright and with permission used for this purpose Klingberg, T., Forssberg, H., & Westerberg, H. (2002). Training of working memory in children with ADHD. J.Clin.Exp.Neuropsychol., 24, 781-791. Klingberg, T., Fernell, E., Olesen, P. J., Johnson, M., Gustafsson, P., Dahlstrom, K. et al. (2005). Computerized training of working memory in children with ADHD--a randomized, controlled trial. J.Am.Acad.Child Adolesc.Psychiatry, 44, 177-186. Westerberg, H. & Klingberg, T. (2007c). Changes in cortical activity after training of working memory--a single-subject analysis. Physiol Behav., 92, 186-192. Martinussen, R., Hayden, J., Hogg-Johnson, S., & Tannock, R. (2005a). A meta-analysis of working memory impairments in children with attention-deficit/hyperactivity disorder. J.Am.Acad.Child Adolesc.Psychiatry, 44, 377-384.