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

Many parents spend thousands of dollars on computer-based training programs that claim to help children with ADHD succeed in the classroom and in peer relationships while reducing hyperactivity and inattentiveness. But a University of Central Florida researcher says parents are better off saving their hard-earned cash.

Psychology professor Mark Rapport's research team spent two years analyzing the data from 25 studies and found that those programs are not producing significant or clinically meaningful long-term improvements in children's cognitive abilities, academic performance or behavior.

"Parents are desperate for help," said Rapport, who runs the Children's Learning Clinic IV at UCF. "If they can afford it, they are willing to spend the money, and some parents even enroll their children in private schools because they offer these programs. But there is no empirical evidence to show those investments are worthwhile."

Rapport initiated the study because many parents of children who have been evaluated at his clinic asked him whether they should invest in the programs. The study is featured in the December issue of Clinical Psychology Review.

His team analyzed published studies sponsored by the companies themselves as well as all independent published studies in the literature – and he drew his conclusions based on analyzing "blinded" studies, meaning studies in which researchers and independent raters used objective measures and did not know which children were assigned to the cognitive training programs as opposed to an inactive placebo condition.

Working memory represents one of the most important core deficits in children with ADHD, and improvements in are associated with improved academic performance, behavior, peer relationships and other intellectual abilities. Surprisingly, although a majority of the cognitive training programs claimed to train this important aspect of brain functioning, closer examination of their training exercises revealed that they actually train short-term memory.

Short-term memory stores information in mind for a brief interval, whereas working memory uses the stored information for accomplishing a wide range of cognitive tasks, such as reading comprehension, mental math, and multitasking.

Rapport said his conclusions do not mean that the computer-based programs cannot become a helpful tool for children with ADHD. If programs can be designed to focus on working memory, it is worth evaluating whether they can help children's , and behavior, he said.

Rapport, who is a fellow of the American Psychological Association, began teaching at UCF in 2000. Early in his career, he worked as a school psychologist in Pinellas County. He was often frustrated that many of the techniques that he and schoolteachers tried would fail to help children with ADHD. As a researcher at three universities prior to coming to UCF, Rapport studied behavioral and pharmacological treatments for children with ADHD.

The Children's Learning Clinic offers free assessments for typically developing boys ages 8 to 12, as well as for who are experiencing difficulties with attention, learning, memory or concentration and those suspected of having ADHD. The clinic's free evaluations include intelligence, academic achievement, activity level and memory assessments.

Co-authors on this study include UCF doctoral students Sarah Orban and Lauren Friedman and Michael J. Kofler, a professor with the University of Virginia's Department of Human Services.

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