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Are Expensive Computer Training Programs for ADHD Worth It?

July 9, 2014

I was reviewing some science-y research –as opposed to fantasy-esque research– when I came across this article:

ADHD study: Expensive training programs don’t help grades, behavior

This did not come as a huge surprise to me, as last year The National Association of School Psychologists published an excellent review of current research in their professional newsletter, NASP Communiqué. In “The Effectiveness of Computer-Based Training Programs,” Dr. Walcott and her associate, Ms. Phillips, examine the research to date on computer programs designed to improve symptoms associated with Attention Deficit Disorders, such as working memory and processing speed. These include such popular programs as CogMed, Jungle Memory, Braintrain, and Mindsparke. Such programs are heavily marketed and even note that they are “evidence backed.” But… are they?

In a word, no. How do I feel about such programs? In a word, meh.

As Dr. Walcott and Ms. Phillips conclude,

The current body of research suggests that while CCT [Computer-based Training] programs can significantly improve children’s functioning on program tasks and other closely related EF tasks, there is not resounding empirical support for long-term EF  [Executive Functioning] improvements or a transfer of effects to other areas that should, theoretically, be positively impacted by underlying improvements in EF.

In other words, students may improve on computer tasks (sort of like a practice effect) and students may also experience improved performance on similar tasks, but research has not demonstrated any robust transfer effects or ability to generalize these improvements. All of this is to say the the real world impact of these expensive programs is yet to be substantiated. Are expensive computer training programs for ADHD worth it?

spark adhd

I would be remiss not to mention exercise as a proven remedy for improving cognition.

So, in three words: save your moola.

The good news is that research, as Dr. Walcott and Ms. Phillips point out, currently demonstrates that the brain is plastic, meaning we can grow our brains and we can change. No one is saying that children with EF and/or ADHD deficits cannot improve on weaknesses. I have certainly observed, and research has shown, that ADHD symptoms attenuate over time. That is, although executive functioning may be underdeveloped during school years, with adulthood many abilities (and coping skills) come online.

Now, if you are a practitioner or parent who has used these CTT programs, I would love to hear from you– how and why did this work for you?

I could write a dissertation on all the effective interventions for ADHD/ EF, but to date, one of the best real-world interventions I have seen for students with ADHD and EF weaknesses are those posited by Drs. Peg Dawson and Richard Guare. If you do not already own Smart but Scattered, I urge to stop reading right now and point your browser to Amazon. This book, along with others by these authors (they have done some great guides for clinicians), do a marvelous job outlining what I believe to be an excellent approach to ADHD/ EF. It’s my opinion, and just my opinion, that one of the best ways to remediate cognitive weaknesses is by teaching metacognitive skills that students can employ to implement micro-level coping skills. Metacognition simply means being able to monitor one’s own thinking and behavior– it implies an awareness. Microskills are those little skills one utilizes to manage the day-to-day executive functioning, such as keeping track of time or keeping assignments prioritized.

My second favorite intervention is exercise and improving the mind-body connection. It’s unfortunate that we can’t mandate more outdoors time in an IEP, but schools are certainly trying. The book I urge you to pick up is “Spark” by John Ratey, M.D. I have seem entire schools adopt Dr. Ratey’s program to miraculous effect.

In conclusion, let’s approach increasing student’s ‘screen time with caution. Instead, let’s explore common-sense and less expensive alternatives: direct instruction skill-building with experienced adults and quality time moving.

References

Walcott, C. M., & Phillips, M.E. (2013). The Effectiveness of Computer-Based Training ProgramsCommuniqué, 41, 1, 28-29.

3 Responses to “Are Expensive Computer Training Programs for ADHD Worth It?”

  1. Peter Freer says:

    I agree, most all brain training programs fail significantly when applied to ADHD children. However, it should be made clear that a different type of brain training does make significant improvement in the behavior and grades of school age ADHD children. As a matter of fact, neurofeedback has been elevated to Level 1 Best Support Intervention by the American Academy of Pediatrics.

    Play Attention (www.playattention.com) is an advancement of neurofeedback. It has had two randomized, controlled studies performed by the prestigious Tufts University School of Medicine that produced remarkable performance based outcomes. Additionally, a six month follow up study was performed to determine whether those outcomes were maintained. They were. All three studies were published in peer reviewed journals.

    Two salient issues are relative to Ms. Grappo’s assertion that brain training produces no significant results and the aforementioned studies of Play Attention. The first is that the studies pitted Play Attention against brain training games. Play Attention produced significant changes in the students’ behaviors and educational outcomes. Brain training games did not. Play Attention students did not require additional increases in medication. Brain training students did by an average of 13mg over the period of testing. Play Attention’s results lasted. Brain training games did not produce a significantly measurable outcome in the 6 month follow up. So, indeed this would verify that brain training games, as determined in these studies and previously published studies, do not not produces significant outcomes for ADHD children.

    The second salient issue is that not all brain training is created equal. As noted, Play Attention which integrates feedback technology with behavioral shaping and cognitive training, does make significant changes. Thus, it is imperative that one doesn’t lump all brain training into a category that is then dismissed arbitrarily.

    • Rebecca Grappo says:

      Thank you very much for your own insights. We appreciate your feedback and different point of view. Thank you for reading it and taking the time to comment!

    • Thank you for your most articulate and thoughtful response, Peter. I see you are the CEO and founder of Play Attention, so I am sure you are very familiar this program. I will certainly review the data you mention. I think neurofeedback is a different animal than the basic cognitive training programs that I discuss here. Neurofeedback is indeed an effective intervention for many challenges. You are correct we should not toss out neurofeedback with the brain training bath water!

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