Nearest transfer effects of working memory training: A comparison of two programs focused on working memory updating

Brain activations elicited during task-switching generalize beyond the task: A partial least squares correlation approach to combine fMRI signals and cognition

An underlying hypothesis for broad transfer from cognitive training is that the regional brain signals engaged during the training task are related to the transfer tasks. However, it is unclear whether the brain activations elicited from a specific cognitive task can generalize to performance of other tasks, esp. in normal aging where cognitive training holds much promise. In this large dual-site functional magnetic resonance imaging (fMRI) study, we aimed to characterize the neurobehavioral correlates of task-switching in normal aging and examine whether the task-switching-related fMRI-blood-oxygen-level-dependent (BOLD) signals, engaged during varieties of cognitive control, generalize to other tasks of executive control and general cognition. We therefore used a hybrid blocked and event-related fMRI task-switching paradigm to investigate brain regions associated with multiple types of cognitive control on 129 non-demented older adults (65-85 years). This large dataset provided a unique opportunity for a data-driven partial least squares-correlation approach to investigate the generalizability of multiple fMRI-BOLD signals associated with task-switching costs to other tasks of executive control, general cognition, and demographic characteristics. While some fMRI signals generalized beyond the scanned task, others did not. Results indicate right middle frontal brain activation as detrimental to task-switching performance, whereas inferior frontal and caudate activations were related to faster processing speed during the fMRI task-switching, but activations of these regions did not predict performance on other tasks of executive control or general cognition. However, BOLD signals from the right lateral occipital cortex engaged during the fMRI task positively predicted performance on a working memory updating task, and BOLD signals from the left post-central gyrus that were disengaged during the fMRI task were related to slower processing speed in the task as well as to lower general cognition. Together, these results suggest generalizability of these BOLD signals beyond the scanned task. The findings also provided evidence for the general slowing hypothesis of aging as most variance in the data were explained by low processing speed and global low BOLD signal in older age. As processing speed shared variance with task-switching and other executive control tasks, it might be a possible basis of generalizability between these tasks. Additional results support the dedifferentiation hypothesis of brain aging, as right middle frontal activations predicted poorer task-switching performance. Overall, we observed that the BOLD signals related to the fMRI task not only generalize to the performance of other executive control tasks, but unique brain predictors of out-of-scanner performance can be identified.

Role of executive functions in the relations of state- and trait-math anxiety with math performance

The detrimental effect of math anxiety on math performance is thought to be mediated by executive functions. Previous studies have primarily focused on trait-math anxiety rather than state-math anxiety and have typically examined a single executive function rather than comprehensively evaluating all of them. Here, we used a structural equation modeling approach to concurrently determine the potential mediating roles of different executive functions (i.e., inhibition, switching, and updating) in the relationships between both state- and trait-math anxiety and math performance. A battery of computer-based tasks and questionnaires were administered to 205 university students. Two relevant results emerged. First, confirmatory factor analysis suggests that math anxiety encompassed both trait and state dimensions and, although they share substantial variance, trait-math anxiety predicted math performance over and above state-math anxiety. Second, working memory updating was the only executive function that mediated the relationship between math anxiety and math performance; neither inhibition nor switching played mediating roles. This calls into question whether some general proposals about the relationship between anxiety and executive functions can be extended specifically to math anxiety. We also raise the possibility that working memory updating or general cognitive difficulties might precede individual differences in math anxiety.

Can we enhance working memory? Bias and effectiveness in cognitive training studies

Meta-analyses have found that working memory (WM) can be improved with cognitive training; however, some authors have suggested that these improvements are mostly driven by biases in the measurement of WM, especially the use of similar tasks for assessment and training. In the present meta-analysis, we investigated whether WM, fluid intelligence, executive functions, and short-term memory can be improved by cognitive training and evaluated the impact of possible sources of bias. We performed a risk of bias assessment of the included studies and took special care in controlling for practice effects. Data from 52 independent comparisons were analyzed, including cognitive training aimed at different cognitive functions. Our results show small improvements in WM after training (SMD = 0.18). Much larger effects were observed when the analysis was restricted to assessment tasks similar to those used for training (SMD = 1.15). Fluid intelligence was not found to improve as a result of training, and improvements in WM were not related to changes in fluid intelligence. Our analyses did however indicate that cognitive training can improve specific executive functions. Contrary to expectations, a set of meta-regressions indicated that characteristics of the training programme, such as dosage and type of training, do not have an impact on the effectiveness of training. The risk of bias assessment revealed some concerns in the randomization process and possible selective reporting among studies. Overall, our results identified various potential sources of bias, with the most significant being the choice of assessment tasks.

The mechanisms of far transfer from cognitive training: specifying the role of distraction suppression

Cognitive training aims to produce a durable transfer to untrained abilities (i.e., far transfer). However, designing effective programs is difficult, because far transfer mechanisms are not well understood. Greenwood and Parasuraman (Neuropsychol 30(6):742-755. https://doi.org/10.1037/neu0000235 , 2016) proposed that the ability to ignore distractions is key in promoting far transfer. While the authors identified working-memory training based on the N-back task as an effective way to train distraction suppression, a recent meta-analysis concluded that this form of training rarely produces far transfer. Such inconsistency casts doubt onto the importance of distraction suppression in far transfer and calls for further examination of the role of this ability in cognitive training effectiveness. We propose here to conceptualize distraction suppression in the light of the load theory of attention, which distinguishes two mechanisms of distractor rejection depending on the level and type of information load involved: perceptual selection and cognitive control. From that standpoint, N-back training engages a single suppression mechanism, namely cognitive control, because it mainly involves low perceptual load. In the present study, we compared the efficacy of N-back training in producing far transfer to that of a new response-competition training paradigm that solicits both distraction suppression mechanisms. Response-competition training was the only one to produce far transfer effects relative to an active control training. These findings provided further support to Greenwood and Parasuraman's hypothesis and suggest that both selection perception and cognitive control need to be engaged during training to increase the ability to suppress distraction, hence to promote far transfer.

Experimental investigation of training schedule on home-based working memory training in healthy older adults

Introduction

The efficacy of working memory training (WMT) for cognitive enhancement in healthy older adults has been extensively investigated. Typically, WMT results in improved performance on the training task, but limited or no transfer of improvement to other cognitive tasks. Accordingly, there is a need to identify optimal intervention parameters to maximize training and transfer task effects of WMT. The current study aimed to investigate the effect of training schedule on training and transfer task performance of WMT in healthy older adults. A secondary aim was to examine the feasibility of participants performing the intervention online at home, unsupervised, and using their personal devices.

Methods

Participants (N = 71; mean age: 66 years) completed sixteen WMT or active-control sessions over eight (distributed) or four (intensive) weeks. Adaptive verbal and spatial n-back tasks were used as the WMT tasks. We tested near transfer effects to a digit-span task and far transfer effects to an abstract relational reasoning task.

Results

Participants successfully performed the cognitively demanding intervention using their own devices, online at home, and with minimal contact with the researcher. We observed a significant improvement in WMT task performance in the WMT group relative to active-controls, but no evidence of near or far transfer. Similar training effects were observed irrespective of the intensity of the training schedule.

Discussion

Our results suggest that comparable benefits could be observed when using less intensive schedules that may be more easily accommodated into everyday life.

Artificial Cognitive Systems Applied in Executive Function Stimulation and Rehabilitation Programs: A Systematic Review

This article presents a systematic review of studies on cognitive training programs based on artificial cognitive systems and digital technologies and their effect on executive functions. The aim has been to identify which populations have been studied, the characteristics of the implemented programs, the types of implemented cognitive systems and digital technologies, the evaluated executive functions, and the key findings of these studies. The review has been carried out following the PRISMA protocol; five databases have been selected from which 1889 records were extracted. The articles were filtered following established criteria, to give a final selection of 264 articles that have been used for the purposes of this study in the analysis phase. The findings showed that the most studied populations were school-age children and the elderly. The most studied executive functions were working memory and attentional processes, followed by inhibitory control and processing speed. Many programs were commercial, customizable, gamified, and based on classic tasks. Some more recent initiatives have begun to incorporate user-machine interfaces, robotics, and virtual reality, although studies on their effects remain scarce. The studies recognize multiple benefits of computerized neuropsychological stimulation and rehabilitation programs for executive functions in different age groups, but there is a lack of studies in specific population sectors and with more rigorous research designs.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13369-022-07292-5.

Near transfer to an unrelated N-back task mediates the effect of N-back working memory training on matrix reasoning

The extent to which working memory training improves performance on untrained tasks is highly controversial. Here we address this controversy by testing the hypothesis that far transfer may depend on near transfer using mediation models in three separate randomized controlled trials (RCTs). In all three RCTs, totalling 460 individuals, performance on untrained N-back tasks (near transfer) mediated transfer to Matrix Reasoning (representing far transfer) despite the lack of an intervention effect in RCTs 2 and 3. Untrained N-back performance also mediated transfer to a working memory composite, which showed a significant intervention effect (RCT 3). These findings support a model of N-back training in which transfer to untrained N-back tasks gates further transfer (at least in the case of working memory at the construct level) and Matrix Reasoning. This model can help adjudicate between the many studies and meta-analyses of working memory training that have provided mixed results but have not examined the relationship between near and far transfer on an individual-differences level.

Impact of Visual Game-Like Features on Cognitive Performance in a Virtual Reality Working Memory Task: Within-Subjects Experiment

BACKGROUND

Although the pursuit of improved cognitive function through working memory training has been the subject of decades of research, the recent growth in commercial adaptations of classic working memory tasks in the form of gamified apps warrants additional scrutiny. In particular, the emergence of virtual reality as a platform for cognitive training presents opportunities for the use of novel visual features.

OBJECTIVE

This study aimed to add to the body of knowledge regarding the use of game-like visual design elements by specifically examining the application of two particular visual features common to virtual reality environments: immersive, colorful backgrounds and the use of 3D depth. In addition, electroencephalography (EEG) data were collected to identify potential neural correlates of any observed changes in performance.

METHODS

A simple visual working memory task was presented to participants in several game-like adaptations, including the use of colorful, immersive backgrounds and 3D depth. The impact of each adaptation was separately assessed using both EEG and performance assessment outcomes and compared with an unmodified version of the task.

RESULTS

Results suggest that although accuracy and reaction time may be slightly affected by the introduction of such game elements, the effects were small and not statistically significant. Changes in EEG power, particularly in the beta and theta rhythms, were significant but failed to correlate with any corresponding changes in performance. Therefore, they may only reflect cognitive changes at the perceptual level.

CONCLUSIONS

Overall, the data suggest that the addition of these specific visual features to simple cognitive tasks does not appear to significantly affect performance or task-dependent cognitive load.

Tactile angle discriminability improvement: Contributions of working memory training and continuous attended sensory input

Perceptual learning is commonly assumed to enhance perception through continuous attended sensory input. However, learning is generalizable to performance in untrained stimuli and tasks. Although previous studies have observed a possible generalization effect across tasks as a result of working memory (WM) training, comparisons of the contributions of WM training and continuous attended sensory input to perceptual learning generalization are still rare. Therefore, we compared which factors contributed most to perceptual generalization and investigated which skills acquired during WM training led to tactile generalization across tasks. Here, a Braille-like dot pattern matching n-back WM task was used as the WM training task, with four workload levels (0, 1, 2, and 3-back levels). A tactile angle discrimination (TAD) task was used as a pre- and posttest to assess improvements in tactile perception. Between tests, four subject groups were randomly assigned to four different workload n-back tasks to consecutively complete three sessions of training. The results showed that tactile n-back WM training could enhance TAD performance, with the 3-back training group having the highest TAD threshold improvement rate. Furthermore, the rate of WM capacity improvement on the 3-back level across training sessions was correlated with the rate of TAD threshold improvement. These findings suggest that continuous attended sensory input and enhanced WM capacity can lead to improvements in TAD ability, and that greater improvements in WM capacity can predict greater improvements in TAD performance.

NEW & NOTEWORTHY Perceptual learning is not always specific to the trained task and stimuli. We demonstrate that both continuous attended sensory input and improved WM capacity can be used to enhance tactile angle discrimination (TAD) ability. Moreover, WM capacity improvement is important in generalizing the training effect to the TAD ability. These findings contribute to understanding the mechanism of perceptual learning generalization across tasks.

Practice schedule and testing per se affect children's transfer abilities in a grapho-motor task

Children's ability to transfer the gains of a motor experience, such as learning to write a letter, to novel conditions, such as cursive writing of the same letter, are affected by the way in which the learning experience is parsed. Parsing may have limitations because a short session may hamper the engagement of procedural memory consolidation processes. Here, we compared the effects of two practice schedules with the total amount of practice identical training provided in a single-session practice versus multi-session practice, wherein each session on its own was insufficient for generating long-term gains. A total of 40 7- and 8-year-old children practiced the production of a novel letter form by connecting dots, namely, the Invented Letter Task (ILT). Multiple ILT-related transfer tasks were assessed at 24 h post-training and again at 4-5 weeks post-training. Although by the end of training the single-session practice group outperformed the multi-session practice group in speed and accuracy, at 24 h post-training both groups showed comparable gains. However, after multi-session practice, children were as fast or faster and more accurate in the transfer tasks. By 4-5 weeks post-training, the multi-session practice group showed larger gains in the trained condition, a speed advantage in the transfer tasks, and a significant improvement on the transfer tasks. The results suggest that parsing training over several brief sessions may lead to long-term gains in children's grapho-motor skills. Moreover, multi-session practice protocols may contribute to the potential for transfer and to more effective learning from experiences such as transfer tasks.

Commercial Brain Training: Efficacy, Transfer Effects, and the Influence of Personality Traits: A Study Conducted on Healthy Young Adults

In the present study, we investigated the effects of a four-week working memory (WM) and attention training program using commercial brain training (Synaptikon GmbH, Berlin). Sixty young healthy adults were assigned to the experimental and active control training programs. The training was conducted in a naturalistic home-based setting, while the pre- and post-examinations were conducted in a controlled laboratory setting. Transfer effects to an untrained WM task and to an untrained episodic memory task were examined. Furthermore, possible influences of personality, i.e., the five-factor model (FFM) traits and need for cognition (NFC), on training outcomes were examined. Additionally, the direct relationship between improvement in single trained tasks and improvement in the transfer tasks was investigated. Our results showed that both training groups significantly increased performance in the WM task, but only the WM training group increased their performance in the episodic memory transfer task. One of the training tasks, a visuospatial WM task, was particularly associated with improvement in the episodic memory task. Neuroticism and conscientiousness showed differential effects on the improvement in training and transfer tasks. It needs to be further examined whether these effects represent training effects or, for example, retest/practice or motivation effects.

The effects of working memory training in children revealed by behavioral responses and ERP

BACKGROUND

Recent studies have examined the effect of computerized cognitive training on working memory (WM), but the behavioral and neural effects were uncertain. Also, few studies have explored WM training effects on children using event-related potentials. The purpose of our study was to investigate the effects of WM training in children, including the effects on behavioral performance and neurophysiological outcomes.

METHODS

Forty-four healthy children (mean age = 7.76 years, SD = 0.57 years, 18 females) were assigned to the training and control groups. Over 20 training sessions, the training group participated in the computation-span and spatial N-back tasks, whereas the control group joined in normal class activities. They all completed the pre- and post-test evaluation of WM tasks (digit span backwards task and N-back task).

RESULTS

The results showed that WM training led to improved performance in the digit span backwards task and 2-back task of post-test evaluation, shortened P3a and P3b latencies in nontarget trials during the spatial 1-back task, shortened P3a latency in target and nontarget trials, as well as increased P3b amplitude and shortened P3b latency in target trials during the spatial 2-back task.

CONCLUSIONS

These results suggested that WM training might enhance children's behavioral performance on WM tasks and brought about neurophysiological changes. This study gives insights into the potential of WM training effects on children's behavioral performance and neurophysiological outcomes.

Investigation of a Model-Based Working Memory Training With and Without Distractor Inhibition and Its Comparative Efficacy: A Randomized Controlled Trial on Healthy Old Adults

Background: Various working memory (WM) trainings have been tested, but differences in experimental designs, the lack of theoretical background, and the need of identifying task-related processes such as filtering efficiency limit conclusions about their comparative efficacy. Objectives: In this study, we compared the efficacy of a model-based WM training with (MB+) and without (MB) distractor inhibition on improving WM capacity to a dual n-back and active control condition. Methods: This randomized clinical trial included 123 healthy elderly adults (78 women, 45 men; aged 64.1 ± 8.3 years). All groups underwent 12 40-min training sessions over 3 weeks and four cognitive testing sessions. The first two sessions served as double baseline to account for practice effects. Primary outcome was WM capacity post-training measured by complex span tasks. Near and far transfer was assessed by simple span, n-back, visuospatial and verbal learning, processing speed, and reasoning tasks. Results: Due to preliminary termination (COVID-19), 93 subjects completed the post-training and 60 subjects the follow-up session. On a whole group level, practice effects occurred from prebaseline to baseline in WM capacity (b = 4.85, t (103) = 4.01, p < 0.001, r = 0.37). Linear mixed-effects models revealed a difference in WM capacity post-training between MB+ and MB (b = -9.62, t (82) = -2.52, p = 0.014, r = 0.27) and a trend difference between MB+ and dual n-back (b = -7.59, t (82) = -1.87, p = 0.065, r = 0.20) and control training (b = -7.08, t (82) = -1.86, p = 0.067, r = 0.20). Univariate analyses showed an increase between pre- and post-training for WM capacity within MB+ (t (22) = -3.34, p < 0.05) only. There was no difference between groups pre- and post-training regarding near and far transfer. Univariate analyses showed improved visuospatial learning within MB+ (t (21) = -3.8, p < 0.05), improved processing speed (t (23) = 2.19, p< 0.05) and n-back performance (t (23) = 2.12, p < 0.05) in MB, and improved n-back performance (t (25) = 3.83, p < 0.001) in the dual n-back training. Interpretation: A model-based WM training including filtering efficacy may be a promising approach to increase WM capacity and needs further investigation in randomized controlled studies.

Training-induced improvement in working memory tasks results from switching to efficient strategies

It is debated whether training with a working memory (WM) task, particularly n-back, can improve general WM and reasoning skills. Most training studies found substantial improvement in the trained task, with little to no transfer to untrained tasks. We hypothesized that training does not increase WM capacity, but instead provides opportunities to develop an efficient task-specific strategy. We derived a strategy for the task that optimizes WM resources and taught it to participants. In two sessions, 14 participants who were taught this strategy performed as well as fourteen participants who trained for 40 sessions without strategy instructions. To understand the mechanisms underlying the no-instruction group's improvement, participants answered questionnaires during their training period. Their replies indicate that successful learners discovered the same strategy and their improvement was associated with this discovery. We conclude that n-back training allows the discovery of strategies that enable better performance with the same WM resources.

Is Training with the N-Back Task More Effective Than with Other Tasks? N-Back vs. Dichotic Listening vs. Simple Listening

Cognitive training most commonly uses computerized tasks that stimulate simultaneous cognitive processing in two modalities, such as a dual n-back task with visual and auditive stimuli, or on two receptive channels, such as a listening task with dichotically presented stimuli. The present study was designed to compare a dual n-back task and a dichotic listening (DL) task with an active control condition (a simple listening task) and a no-training control condition for their impact on cognitive performance, daily life memory, and mindfulness. One hundred thirty healthy adults aged 18–55 years were randomly assigned to one of the four conditions. The training consisted of twenty 15-min sessions spread across 4 weeks. The results indicated some improvement on episodic memory tasks and a trend for enhanced performance in an untrained working memory (WM) span task following cognitive training relative to the no-training control group. However, the only differential training effects were found for the DL training in increasing choice reaction performance and a trend for self-reported mindfulness. Transfer to measures of fluid intelligence and memory in daily life did not emerge. Additionally, we found links between self-efficacy and n-back training performance and between emotion regulation and training motivation. Our results contribute to the field of WM training by demonstrating that our listening tasks are comparable in effect to a dual n-back task in slightly improving memory. The possibility of improving attentional control and mindfulness through dichotic listening training is promising and deserves further consideration.

Working memory training effects across the lifespan: Evidence from human and experimental animal studies

Working memory refers to a cognitive function that provides temporary storage and manipulation of the information necessary for complex cognitive tasks. Due to its central role in general cognition, several studies have investigated the possibility that training on working memory tasks could improve not only working memory function but also increase other cognitive abilities or modulate other behaviors. This possibility is still highly controversial, with prior studies providing contradictory findings. The lack of systematic approaches and methodological shortcomings complicates this debate even more. This review highlights the impact of working memory training at different ages on humans. Finally, it demonstrates several findings about the neural substrate of training in both humans and experimental animals, including non-human primates and rodents.

Enhancing Working Memory Based on Mismatch Negativity Neurofeedback in Subjective Cognitive Decline Patients: A Preliminary Study

Mismatch negativity (MMN) is suitable for studies of preattentive auditory discriminability and the auditory memory trace. Subjective cognitive decline (SCD) is an ideal target for early therapeutic intervention because SCD occurs at preclinical stages many years before the onset of Alzheimer’s disease (AD). According to a novel lifespan-based model of dementia risk, hearing loss is considered the greatest potentially modifiable risk factor of dementia among nine health and lifestyle factors, and hearing impairment is associated with cognitive decline. Therefore, we propose a neurofeedback training based on MMN, which is an objective index of auditory discriminability, to regulate sensory ability and memory as a non-pharmacological intervention (NPI) in SCD patients. Seventeen subjects meeting the standardized clinical evaluations for SCD received neurofeedback training. The auditory frequency discrimination test, the visual digital N-back (1-, 2-, and 3-back), auditory digital N-back (1-, 2-, and 3-back), and auditory tone N-back (1-, 2-, and 3-back) tasks were used pre- and post-training in all SCD patients. The intervention schedule comprised five 60-min training sessions over 2 weeks. The results indicate that the subjects who received neurofeedback training had successfully improved the amplitude of MMN at the parietal electrode (Pz). A slight decrease in the threshold of auditory frequency discrimination was observed after neurofeedback training. Notably, after neurofeedback training, the working memory (WM) performance was significantly enhanced in the auditory tone 3-back test. Moreover, improvements in the accuracy of all WM tests relative to the baseline were observed, although the changes were not significant. To the best of our knowledge, our preliminary study is the first to investigate the effects of MMN neurofeedback training on WM in SCD patients, and our results suggest that MMN neurofeedback may represent an effective treatment for intervention in SCD patients and the elderly with aging memory decline.

Selectively Enhanced Development of Working Memory in Musically Trained Children and Adolescents

In the current longitudinal study, we investigated the development of working memory in musically trained and nontrained children and adolescents, aged 9-20. We measured working memory with the Digit Span (DS) forwards and backwards tests (N = 106) and the Trail-Making A and B (TMT-A and B; N = 104) tests three times, in 2011, 2013, and 2016. We expected that musically trained participants would outperform peers with no musical training. Indeed, we found that the younger musically trained participants, in particular, outperformed their nontrained peers in the TMT-A, TMT-B and DS forwards tests. These tests all primarily require active maintenance of a rule in memory or immediate recall. In contrast, we found no group differences in the backwards test that requires manipulation and updating of information in working memory. These results suggest that musical training is more strongly associated with heightened working memory capacity and maintenance than enhanced working memory updating, especially in late childhood and early adolescence.

Neural and Behavioral Effects of an Adaptive Online Verbal Working Memory Training in Healthy Middle-Aged Adults

Neural correlates of working memory (WM) training remain a matter of debate, especially in older adults. We used functional magnetic resonance imaging (fMRI) together with an n-back task to measure brain plasticity in healthy middle-aged adults following an 8-week adaptive online verbal WM training. Participants performed 32 sessions of this training on their personal computers. In addition, we assessed direct effects of the training by applying a verbal WM task before and after the training. Participants (mean age 55.85 ± 4.24 years) were pseudo-randomly assigned to the experimental group (n = 30) or an active control group (n = 27). Training resulted in an activity decrease in regions known to be involved in verbal WM (i.e., fronto-parieto-cerebellar circuitry and subcortical regions), indicating that the brain became potentially more efficient after the training. These activation decreases were associated with a significant performance improvement in the n-back task inside the scanner reflecting considerable practice effects. In addition, there were training-associated direct effects in the additional, external verbal WM task (i.e., HAWIE-R digit span forward task), and indicating that the training generally improved performance in this cognitive domain. These results led us to conclude that even at advanced age cognitive training can improve WM capacity and increase neural efficiency in specific regions or networks.

Short-term training on working memory updating and metacognition in primary school: The effect on reading comprehension

This study analyzed the potential transfer effects on reading comprehension skills of two different training programs administered to 9- to 10-year-old children attending fourth grade classes. One training program was based on a working memory updating paradigm (i.e., words, digits, sentence and text updating working memory tasks). The other program was based on metacomprehension activities focused on text structures, genres, text sensitivity, and text comprehension strategies. Performance was compared pre and post training on running memory, text updating, and reading comprehension tasks. The results showed that significant gains were obtained in both text updating and reading comprehension tasks, with a far transfer effect for both types of training. Limited nearest transfer effects suggest that gains could be due to acquisition of effective strategies in both programs, with training suitable for improving written text processing; however, performance did not differ between programs.

The efficacy of a training that combines activities on working memory and metacognition: Transfer and maintenance effects in children with ADHD and typical development

Introduction: It has been demonstrated that children with attention deficit and hyperactivity disorder (ADHD) have impairments in working memory (WM), and particularly its visuospatial component, responsible for academic underachievement. Furthermore, children with ADHD have difficulty in metacognition, and consequently use inappropriate strategies to control attention and impulsive behavior. The aim of the present study was to devise a training that combined individual exercises on visuospatial WM and group metacognitive activities capable of helping children with ADHD to ameliorate their performance in executive functioning tasks, and to contain their inattentive and hyperactive/impulsive behavior. Method: A combined training that focused on visuospatial WM and metacognition was administered to 12 children with a diagnosis of ADHD and 15 typically-developing children. Tasks on executive functions and questionnaires for parents and teachers were administered before and at the end of the training, and one month after the post-test. Specific short- and long-term training gains and transfer effects were examined. Effects of the training on parents' and teachers' ratings were also considered. Results: Specific gains and transfer effects were found at the post-test and long-term assessments in both typically-developing children and those with ADHD. Parents' and teachers' ratings also indicated an improvement in the symptomatic behavior of children with ADHD. Conclusion: The results of this study have clinical and educational implications. A training that combines individual computerized visuospatial WM activities with metacognitive group reflection about useful strategies seems to produce promising results, helping children with ADHD to improve their executive functioning and behavioral problems.