Journal of Abnormal Child Psychology

, Volume 40, Issue 7, pp 1193–1207

Improving Working Memory in Children with Attention-Deficit/Hyperactivity Disorder: The Separate and Combined Effects of Incentives and Stimulant Medication

  • Michael T. Strand
  • Larry W. HawkJr.
  • Michelle Bubnik
  • Keri Shiels
  • William E. PelhamJr.
  • James G. Waxmonsky
Article

DOI: 10.1007/s10802-012-9627-6

Cite this article as:
Strand, M.T., Hawk, L.W., Bubnik, M. et al. J Abnorm Child Psychol (2012) 40: 1193. doi:10.1007/s10802-012-9627-6

Abstract

Working memory (WM) is considered a core deficit in Attention-Deficit/ Hyperactivity Disorder (ADHD), with numerous studies demonstrating impaired WM among children with ADHD. We tested the degree to which WM in children with ADHD was improved by performance-based incentives, an analog of behavioral intervention. In two studies, WM performance was assessed using a visuo-spatial n-back task. Study 1 compared children (ages 9–12 years) with ADHD–Combined type (n = 24) to a group of typically developing (TD) children (n = 32). Study 1 replicated WM deficits among children with ADHD. Incentives improved WM, particularly among children with ADHD. The provision of incentives reduced the ADHD-control group difference by approximately half but did not normalize WM. Study 2 examined the separate and combined effects of incentives and stimulant medication among 17 children with ADHD-Combined type. Both incentives and a moderate dose of long-acting methylphenidate (MPH; ~0.3 mg/kg t.i.d. equivalent) robustly improved WM relative to the no-incentive, placebo condition. The combination of incentives and medication improved WM significantly more than either incentives or MPH alone. These studies indicate that contingencies markedly improve WM among children with ADHD–Combined type, with effect sizes comparable to a moderate dose of stimulant medication. More broadly, this work calls attention to the role of motivation in studying cognitive deficits in ADHD and in testing multifactorial models of ADHD.

Keywords

Attention-Deficit/Hyperactivity Disorder ADHD Working memory Incentives Reinforcement Methylphenidate 

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Michael T. Strand
    • 1
  • Larry W. HawkJr.
    • 1
    • 4
    • 5
  • Michelle Bubnik
    • 1
  • Keri Shiels
    • 1
  • William E. PelhamJr.
    • 1
    • 2
    • 4
  • James G. Waxmonsky
    • 3
    • 4
  1. 1.Department of PsychologyUniversity at Buffalo, SUNYBuffaloUSA
  2. 2.Department of PediatricsUniversity at Buffalo, SUNYBuffaloUSA
  3. 3.Department of PsychiatryUniversity at Buffalo, SUNYBuffaloUSA
  4. 4.Center for Children and FamiliesUniversity at Buffalo, SUNYBuffaloUSA
  5. 5.University at BuffaloBuffaloUSA

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