Effect of Neurocognitive Training for Children With ADHD at Improving Academic Engagement in Two Learning Settings

Abstract

Objective: This preliminary study investigated effectiveness of neurocognitive training on academic engagement (AET) for children with ADHD. The training approach targeted working memory, inhibitory control, and attention/relaxation (via brain electrical activity). Method: A reversal design with a 2-week follow-up was used to assess the effectiveness of the treatment on two children with diagnosed ADHD in two learning settings. Direct observation was used to collect academic-related behavior. Results: Improvements in on-task expected behavior (ONT-EX) and general AET, as well as reductions in off-task motor activity (OFF-MA) and off-task passive behavior (OFF-PB) were observed for both students over baselines and across the settings. Moreover, differences in behavioral change were found between participants and settings. Conclusion: These findings support using the treatment for improving academic performance of children with ADHD. Future studies may investigate influences of contextual differences, nontreatment variables, or adult’s feedback during the training session on treatment effectiveness.

Keywords

ADHD neurocognitive training EEG neurofeedback academic engagement learning settings

Get full access to this article

View all access options for this article.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Barb

Siegle

Young

Huppert

(2018). Augmenting CBT with real-time fMRI amygdala neurofeedback training increases early response to therapy. Biological Psychiatry, 83(9), S188-S188.

Barry

R. J.

Clarke

A. R.

Johnstone

S. J.

(2003). A review of electrophysiology in attention-deficit/hyperactivity disorder: I. Qualitative and quantitative electroencephalography. Clinical Neurophysiology, 114, 171-183. doi:10.1016/S1388-2457(02)00362-0

Beauchaine

T. P.

Neuhaus

Gatzke-Kopp

L. M.

Reid

M. J.

Chipman

Olliges

. . . Webster-Stratton

(2015). Electrodermal Responding predicts responses to, and may be altered by, preschool intervention for ADHD. Journal of Consulting & Clinical Psychology, 83, 293-303. doi:10.1037/a0038405

Chacko

Kofler

Jarrett

(2014). Improving outcomes for youth with ADHD: A conceptual framework for combined neurocognitive and skill-based treatment approaches. Clinical Child and Family Psychology Review, 17, 368-384. doi:10.1007/s10567-014-0171-5

Cohen

(1992). A power primer. Psychological Bulletin, 112, 155-159. doi:10.1037/0033-2909.112.1.155

Cortese

Ferrin

Brandeis

Holtmann

Aggensteiner

Daley

. . . Sonuga-Barke

E. J. S.

(2016). Neurofeedback for attention-deficit/hyperactivity disorder: Meta-analysis of clinical and neuropsychological outcomes from randomized controlled trials. Journal of the American Academy of Child & Adolescent Psychiatry, 55, 444-455. doi:10.1016/j.jaac.2016.03.007

den Dunnen

St Pierre

Stewart

S. L.

Johnson

Cook

Leschied

A. W

. (2012). Predicting residential treatment outcomes for emotionally and behaviorally disordered youth: The role of pretreatment factors. Residential Treatment for Children & Youth, 29, 13-31.

DuPaul

G. J.

Joshua

M. L.

(2015). Educational impairments in children with ADHD. In Barkley

R. A.

(Ed.), Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (4th ed., pp. 311-349). New York, NY: The Guilford Press.

10.

DuPaul

G. J.

Weyandt

L. L.

Janusis

G. M.

(2011). ADHD in the classroom: Effective intervention strategies. Theory Into Practice, 50, 35-42.

11.

Egeland

Johansen

S. N.

Ueland

(2009). Differentiating between ADHD sub-types on CCPT measures of sustained attention and vigilance. Scandinavian Journal of Psychology, 50, 347-354. doi:10.1111/j.1467-9450.2009.00717.x

12.

Fowler

(2010). Increasing on-task performance for students with ADHD. Education Digest: Essential Readings Condensed for Quick Review, 76(2), 44-50.

13.

Frid

Lavner

Rabinowitz

(2012, Nov). Analysis of finger tapping parameters in people with ADHD. Paper presented at the IEEE 27th Convention of Electrical and Electronics Engineers, Israel. Retrieved from http://ezproxy.uow.edu.au/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=edseee&AN=edseee.6377064&site=eds-live

14.

Hart

K. C.

Massetti

G. M.

Fabiano

G. A.

Pariseau

M. E.

Pelham

W. E.

Jr. (2011). Impact of group size on classroom on-task behavior and work productivity in children with ADHD. Journal of Emotional and Behavioral Disorders, 19, 55-64.

15.

Hattie

(2009). Visible learning: A synthesis of over 800 meta-analyses relating to achievement. London, England: Routledge.

16.

Hodgson

Hutchinson

A. D.

Denson

(2014). Nonpharmacological treatments for ADHD: A meta-analytic review. Journal of Attention Disorders, 18, 275-282. doi:10.1177/1087054712444732

17.

Imeraj

Antrop

Sonuga-Barke

Deboutte

Deschepper

Bal

Roeyers

(2013). The impact of instructional context on classroom on-task behavior: A matched comparison of children with ADHD and non-ADHD classmates. Journal of School Psychology, 51, 487-498. doi:10.1016/j.jsp.2013.05.004

18.

Jarrett

M. A.

(2013). Treatment of comorbid attention-deficit/hyperactivity disorder and anxiety in children: Processes of change. Psychological Assessment, 25, 545-5558. doi:10.1037/a0031749

19.

Jiang

Johnstone

S. J.

(2015). A preliminary multiple case report of neurocognitive training for children with AD/HD in China. SAGE Open, 5(2), 1-13. doi:10.1177/2158244015586811

20.

Johnstone

S. J.

(2013). Computer gaming and ADHD: Potential positive influences on behavior. IEEE Technology and Society Magazine, 32(1), 20-22. doi:10.1109/mts.2013.2249355

21.

Johnstone

S. J.

Blackman

Bruggemann

J. M.

(2012). EEG from a single-channel dry-sensor recording device. Clinical EEG and Neuroscience, 43, 112-120. doi:10.1177/1550059411435857

22.

Johnstone

S. J.

Roodenrys

S. J.

Blackman

Johnston

Loveday

Mantz

Barratt

M. F.

(2012). Neurocognitive training for children with and without AD/HD. Attention Deficit and Hyperactivity Disorders, 4(1), 11-23. doi:10.1007/s12402-011-0069-8

23.

Johnstone

S. J.

Roodenrys

S. J.

Johnson

Bonfield

Bennett

S. J.

(2017). Game-based combined cognitive and neurofeedback training using focus pocus reduces symptom severity in children with diagnosed AD/HD and subclinical AD/HD. International Journal of Psychophysiology, 116, 32-44. doi:10.1016/j.ijpsycho.2017.02.015

24.

Johnstone

S. J.

Roodenrys

S. J.

Phillips

E. A.

Watt

A. J.

Mantz

(2010). A pilot study of combined working memory and inhibition training for children with AD/HD. Attention Deficit and Hyperactivity Disorders, 2(1), 31-42. doi:10.1007/s12402-009-0017-z

25.

Jurbergs

Palcic

J. L.

Kelley

M. L.

(2010). Daily behavior report cards with and without home-based consequences: Improving classroom behavior in low income, African American children with ADHD. Child & Family Behavior Therapy, 32, 177-195.

26.

Kleinstäuber

Lambert

M. J.

Hiller

(2017). Early response in cognitive-behavior therapy for syndromes of medically unexplained symptoms. BMC Psychiatry, 17, 195-195. doi:10.1186/s12888-017-1351-x

27.

Kofler

M. J.

Rapport

M. D.

Alderson

R. M.

(2008). Quantifying ADHD classroom inattentiveness, its moderators, and variability: A meta-analytic review. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 49(1), 59-69. doi:10.1111/j.1469-7610.2007.01809.x

28.

Langberg

J. M.

Molina

B. S. G.

Arnold

L. E.

Epstein

J. N.

Altaye

Hinshaw

S. P.

. . . Hechtman

(2011). Patterns and predictors of adolescent academic achievement and performance in a sample of children with attention-deficit/hyperactivity disorder. Journal of Clinical Child & Adolescent Psychology, 40, 519-531.

29.

Lauth

G. W.

Heubeck

B. G.

Mackowiak

(2006). Observation of children with attention-deficit hyperactivity (ADHD) problems in three natural classroom contexts. British Journal of Educational Psychology, 76, 385-404. doi:10.1348/000709905X43797

30.

Linardon

Brennan

de la Piedad Garcia

(2016). Rapid response to eating disorder treatment: A systematic review and meta-analysis. International Journal of Eating Disorders, 49, 905-919. doi:10.1002/eat.22595

31.

Liu

C.-Y.

Huang

W.-L.

Kao

W.-C.

Gau

S. S.-F.

(2017). Influence of disruptive behavior disorders on academic performance and school functions of youths with attention-deficit/hyperactivity disorder. Child Psychiatry & Human Development, 48, 870-880. doi:10.1007/s10578-017-0710-7

32.

Lofthouse

Arnold

L. E.

Hersch

Hurt

DeBeus

(2012). A review of neurofeedback treatment for pediatric ADHD. Journal of Attention Disorders, 16, 351-372. doi:10.1177/1087054711427530

33.

Mayer

Wyckoff

S. N.

Strehl

(2013). One size fits all? Slow cortical potentials neurofeedback: A review. Journal of Attention Disorders, 17, 393-409. doi:10.1177/1087054712468053

34.

Parker

Whear

Ukoumunne

O. C.

Bethel

Thompson-Coon

Stein

Ford

(2015). School exclusion in children with psychiatric disorder or impairing psychopathology: A systematic review. Emotional and Behavioural Difficulties, 20, 229-251. doi:10.1080/13632752.2014.945741

35.

Parker

Hagan-Burke

(2007). Useful effect size interpretations for single case research. Behavior Therapy, 38, 95-105. doi:10.1016/j.beth.2006.05.002

36.

Pingault

J.-B.

Côté

S. M.

Vitaro

Falissard

Genolini

Tremblay

R. E.

(2014). The developmental course of childhood inattention symptoms uniquely predicts educational attainment: A 16-year longitudinal study. Psychiatry Research, 219, 707-709. doi:10.1016/j.psychres.2014.06.022

37.

Price

A. T.

Martella

R. C.

Marchand-Martella

N. E.

Cleanthous

C. C.

(2002). A comparison of immediate feedback delivered via an FM headset versus delayed feedback on the inappropriate verbalizations of a student with ADHD. Education & Treatment of Children, 25, 159-171.

38.

Rapport

M. D.

Kofler

M. J.

Alderson

R. M.

Timko

T. M.

Jr. DuPaul

G. J.

(2009). Variability of attention processes in ADHD: Observations from the classroom. Journal of Attention Disorders, 12, 563-573.

39.

Rapport

M. D.

Orban

S. A.

Kofler

M. J.

Friedman

L. M.

(2013). Do programs designed to train working memory, other executive functions, and attention benefit children with ADHD? A meta-analytic review of cognitive, academic, and behavioral outcomes. Clinical Psychology Review, 33, 1237-1252. doi:10.1016/j.cpr.2013.08.005

40.

Rapport

M. D.

Orban

S. A.

Kofler

M. J.

Friedman

L. M.

Bolden

(2015). Executive function training for children with ADHD. In Barkley

R. A.

(Ed.), Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (4th ed., pp. 1131-1171). New York, NY: The Guilford Press.

41.

Rapport

M. D.

Scanlan

S. W.

Denney

C. B.

(1999). Attention-deficit/hyperactivity disorder and scholastic achievement: A model of dual developmental pathways. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 40, 1169-1183.

42.

Rodriguez

Järvelin

M.-R.

Obel

Taanila

Miettunen

Moilanen

. . . Olsen

(2007). Do inattention and hyperactivity symptoms equal scholastic impairment? Evidence from three European cohorts. BMC Public Health, 7, 327-327.

43.

Rogers

J. M.

Aminov

Wilson

P. H.

Johnstone

S. J.

(2016). Retest reliability of a single-channel, wireless EEG device. International Journal of Psychophysiology, 106, 87-96.

44.

Rogers

Tannock

(2013). Are classrooms meeting the basic psychological needs of children with ADHD symptoms? A self-determination theory perspective. Journal of Attention Disorders. doi:10.1177/1087054713508926

45.

Rothbart

M. K.

Posner

M. I.

(2015). The developing brain in a multitasking world. Developmental Review, 35(Suppl. C), 42-63. doi:10.1016/j.dr.2014.12.006

46.

Sarver

D. E.

Rapport

M. D.

Kofler

M. J.

Raiker

J. S.

Friedman

L. M.

(2015). Hyperactivity in attention-deficit/hyperactivity disorder (ADHD): Impairing deficit or compensatory behavior? Journal of Abnormal Child Psychology, 43, 1219-1232. doi:10.1007/s10802-015-0011-1

47.

Schneider

Goldstein

Parker

(2008). Social skills interventions for children with autism: A meta-analytic application of percentage of all non-overlapping data (PAND). Evidence-Based Communication Assessment and Intervention, 2, 152-162. doi:10.1080/17489530802505396

48.

Seli

Smallwood

Cheyne

J. A.

Smilek

(2015). On the relation of mind wandering and ADHD symptomatology. Psychonomic Bulletin & Review, 22, 629-636. doi:10.3758/s13423-014-0793-0

49.

Sergeant

J. A.

(2005a). The dynamic developmental theory of ADHD: Reflections from a cognitive energetic model standpoint. Behavioral and Brain Sciences, 28, 442-443. doi:10.1017/s0140525x05380071

50.

Sergeant

J. A.

(2005b). Modeling attention-deficit/hyperactivity disorder: A critical appraisal of the cognitive-energetic model. Biological Psychiatry, 57, 1248-1255. doi:10.1016/j.biopsych.2004.09.010

51.

Steiner

N. J.

Frenette

E. C.

Rene

K. M.

Brennan

R. T.

Perrin

E. C.

(2014). In-school neurofeedback training for ADHD: Sustained improvements from a randomized control trial. Pediatrics, 133, 483-492. doi:10.1542/peds.2013-2059

52.

Steiner

N. J.

Sheldrick

R. C.

Gotthelf

Perrin

E. C.

(2011). Computer-based attention training in the schools for children with attention deficit/hyperactivity disorder: A preliminary trial. Clinical Pediatrics, 50, 615-622. doi:10.1177/0009922810397887

53.

Swanson

J. M.

Kraemer

H. C.

Hinshaw

S. P.

Arnold

L. E.

Conners

C. K.

Abikoff

H. B.

(2001). Clinical relevance of the primary findings of the MTA: Success rates based on severity of ADHD and odd symptoms at the end of treatment. Journal of the American Academy of Child & Adolescent Psychiatry, 40, 168-179.

54.

Vile Junod

R. E.

DuPaul

G. J.

Jitendra

A. K.

Volpe

R. J.

Cleary

K. S

. (2006). Classroom observations of students with and without ADHD: Differences across types of engagement. Journal of School Psychology, 44, 87-104. doi:10.1016/j.jsp.2005.12.004

55.

Wechsler

(2003). Wechsler Intelligence Scale for Children–Fourth Edition. San Antonio, TX: Psychological Corporation.