Working Memory Training and ADD/ADHD

Mark Katz, a San Diego clin­i­cal psy­chol­o­gist with decades of expe­ri­ence help­ing ADD/ ADHD kids and adults, and for­mer Board Mem­ber of CHADD, and I had a very good meet­ing with a few school super­in­ten­dents on Saturday.

We dis­cussed the research state-of-the-art, cur­rent ADD/ ADHD inter­ven­tions and the future of pre­ven­tion-dri­ven interventions.

Some high­lights from our talk:

- More and more researchers are com­ing to see that the label “Atten­tion deficit” was prob­a­bly not the most for­tu­nate one. Kids and adults with ADD/ ADHD can pay atten­tion, when they are engaged in cer­tain tasks, so the under­ly­ing prob­lem is not a deficit of attention.

- ADD/ ADHD is not a prob­lem of know­ing, but a prob­lem of doing. The bot­tle­neck may reside in exec­u­tive func­tions such as so-called work­ing mem­o­ry. The prob­lem is exe­cu­tion, inter­nal­ized behav­ior, not con­cep­tu­al knowledge.

- For more infor­ma­tion on Exec­u­tive func­tions, you can check the excel­lent review in the Amer­i­can Jour­nal of Psy­chi­a­try, of Dr. Elkhonon Gold­berg’s book The Exec­u­tive Brain

- Work­ing mem­o­ry is the abil­i­ty to hold dif­fer­ent things on line and manip­u­late them in real time in order to solve a prob­lem, com­plete a task…

- When asked if “work­ing mem­o­ry” and “short-term mem­o­ry” are the same, Mark explained that they refer to sim­i­lar con­cepts, if not the same, but that researchers stopped using the term “short-term” mem­o­ry many years ago, to make it clear that it is an active, not pas­sive, skill. In fact, he added, maybe it should be called “work­ing atten­tion” rather than “work­ing memory”.

- We dis­cussed the for­tu­nate trend that many schools are migrat­ing towards a pub­lic health mod­el in help­ing kids with learn­ing dis­abil­i­ties and ADD/ ADHD, focus­ing on more pre­ven­tion at ear­ly ages than on reac­tive inter­ven­tions to major problems.

- Work­ing mem­o­ry may be trained by tar­get­ed cog­ni­tive train­ing pro­grams sup­port­ed such as RoboMemo, a pro­gram that I came to know last year after a good Sci­en­tif­ic Amer­i­can arti­cle that high­light­ed their clin­i­cal study with kids with ADD/ ADHD pub­lished in the Jour­nal of Child and Ado­les­cent Psychiatry.