Which ‘working’ components of working memory aren’t working in youth with ADHD?
Working memory is a complex cognitive function that consists of three skills: reordering, updating, and dual processing incoming information. Clinical providers and researchers are trying to better understand which working components of working memory aren’t working in youth with ADHD, as youth with ADHD are likely to struggle academically and socially. A research study by Fosco et. al (2020) revealed that children with ADHD struggle most with reordering information, but not dual processing. In this article, we discuss which working components of working memory aren’t working in youth with ADHD.
The study involved 45 children with, and 41 children without ADHD between the ages of 8-13 years of age. Children participated in two sessions of cognitive testing which lasted approximately 3 hours per session. Children were given short breaks between each task and a longer break between every 2-3 tasks to mitigate fatigue. Measures used for the cognitive assessment of the children included phonological working memory , visuospatial working memory, episodic buffer working memory, letter updating, N-back, Keep track, counting span, animal span, and animal context tasks to assess reordering, updating, and dual processing skills.
What researchers found was that out of the 45 children with ADHD, 30 of them experienced impairment in one working memory domain, 12 children were impaired in 2 domains, and 2 children were impaired in all 3 working memory domains. Specifically, children with ADHD are more likely to experience difficulties in working memory reordering tasks than children without ADHD. Between the children with ADHD and children without, there was no evidence that these groups differed in respect to sex, whether they were on medication, IQ, or socioeconomic status. However, researchers did find that girls were more likely than boys to be classified as impaired on working memory reordering tasks than boys, and children who experienced difficulties in updating were younger than children who did not experience these difficulties.
For clinical practice, this means that therapists and education professionals working with children diagnosed with ADHD and those who may be “fine” but are experiencing deficits in working memory, they may want to target the reordering and updating components of working memory during cognitive remediation. While most children with ADHD appear to not have deficits in dual processing, cognitive training tasks where two sensory systems are challenged may help children practice and refine these skills. To practice the different components of working memory, therapists and education professionals may want to try using a digital cognitive therapy tool or using good cognitive therapy worksheets with their young clients.