Skip to main content

Which ‘Working’ Components of Working Memory aren’t Working in Youth with ADHD?

Abstract

Despite replicated evidence for working memory deficits in youth with ADHD, no study has comprehensively assessed all three primary ‘working’ subcomponents of the working memory system in these children. Children ages 8–13 with (n = 45) and without (n = 41) ADHD (40% female; Mage = 10.5; 65% Caucasian/Non-Hispanic) completed a counterbalanced battery of nine tasks (three per construct) assessing working memory reordering (maintaining and rearranging information in mind), updating (active monitoring of incoming information and replacing outdated with relevant information), and dual-processing (maintaining information in mind while performing a secondary task). Detailed analytic plans were preregistered. Bayesian t-tests indicated that, at the group level, children with ADHD exhibited significant impairments in working memory reordering (BF10 = 4.64 × 105; d = 1.34) and updating (BF10 = 9.49; d = 0.64), but not dual-processing (BF01 = 1.33; d = 0.37). Overall, 67%–71% of youth with ADHD exhibited impairment in at least one central executive working memory domain. Reordering showed the most ADHD-related impairment, with 75% classified as below average or impaired, and none demonstrating strengths. The majority of children with ADHD (52%–57%) demonstrated average or better abilities in the remaining two domains, with a notable minority demonstrating strengths in updating (8%) and dual-processing (20%). Notably, impairments in domain-general central executive working memory, rather than individual subcomponents, predicted ADHD severity, suggesting that common rather than specific working memory mechanisms may be central to understanding ADHD symptoms. These impairment estimates extend prior work by providing initial evidence that children with ADHD not only exhibit heterogeneous profiles across cognitive domains but also exhibit significant heterogeneity within subcomponents of key cognitive processes.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2

Notes

  1. Children in the healthy control group did not exhibit significantly different performance than the clinical control group in any working memory domain (BF10 = 0.32–2.54).

References

  • Baddeley, A. (2003). Working memory: Looking back and looking forward. Nature Reviews Neuroscience, 4, 829–839.

    PubMed  Article  Google Scholar 

  • Baddeley, A. (2012). Working memory: Theories, models, and controversies. Annual Review of Psychology, 63, 1–29.

    Article  PubMed  Google Scholar 

  • Bari, A., & Robbins, T. W. (2013). Inhibition and impulsivity: Behavioral and neural basis of response control. Progress in Neurobiology, 108, 44–79.

    PubMed  Article  Google Scholar 

  • Coghill, D. R., Seth, S., & Matthews, K. (2014). A comprehensive assessment of memory, delay aversion, timing, inhibition, decision making and variability in attention deficit hyperactivity disorder: Advancing beyond the three-pathway models. Psychological Medicine, 44, 1989–2001.

    PubMed  Article  Google Scholar 

  • Conway, A. R., Kane, M. J., Bunting, M. F., Hambrick, D. Z., Wilhelm, O., & Engle, R. W. (2005). Working memory span tasks: A methodological review and user’s guide. Psychonomic Bulletin & Review, 12, 769–786.

    Article  Google Scholar 

  • Denney, C. B., Rapport, M. D., & Chung, K. (2005). Interactions of task and subject variables among continuous performance tests. Journal of Child Psychology and Psychiatry, 46, 420–435.

    PubMed  Article  Google Scholar 

  • Dennis, M., Francis, D. J., Cirino, P. T., Schachar, R., Barnes, M. A., & Fletcher, J. M. (2009). Why IQ is not a covariate in cognitive studies of neurodevelopmental disorders. Journal of the International Neuropsychological Society, 15, 331–343.

    PubMed  PubMed Central  Article  Google Scholar 

  • D'Esposito, M., & Postle, B. R. (2015). The cognitive neuroscience of working memory. Annual Review of Psychology, 66, 115–142.

    PubMed  Article  Google Scholar 

  • DiStefano, C., Zhu, M., & Mindrila, D. (2009). Understanding and using factor scores: Considerations for the applied researcher. Practical Assessment, Research & Evaluation, 14, 1–11.

    Google Scholar 

  • Dvorsky, M. R., & Langberg, J. M. (2016). A review of factors that promote resilience in youth with ADHD and ADHD symptoms. Clinical Child and Family Psychology Review, 19, 368–391.

    PubMed  Article  Google Scholar 

  • DuPaul, G. J., Power, T. J., Anastopoulos, A. D., & Reid, R. (2016). ADHD rating scale- 5 for children and adolescents: Checklists, norms, and clinical interpretation. NY: Guilford Press.

  • Engle, R. W., Tuholski, S. W., Laughlin, J. E., & Conway, A. R. (1999). Working memory, short-term memory, and general fluid intelligence: A latent-variable approach. Journal of Experimental Psychology: General, 128, 309.

    Article  Google Scholar 

  • Fair, D. A., Bathula, D., Nikolas, M. A., & Nigg, J. T. (2012). Distinct neuropsychological subgroups in typically developing youth inform heterogeneity in children with ADHD. Proceedings of the National Academy of Sciences, 109, 6769–6774.

    Article  Google Scholar 

  • Feczko, E., Miranda-Dominguez, O., Marr, M., Graham, A. M., Nigg, J. T., & Fair, D. A. (2019). The heterogeneity problem: Approaches to identify psychiatric subtypes. Trends in Cognitive Sciences. Advance online publication. doi: https://doi.org/10.1016/j.tics.2019.03.009.

  • Friedman, L. M., Rapport, M. D., Raiker, J. S., Orban, S. A., & Eckrich, S. J. (2017). Reading comprehension in boys with ADHD: The mediating roles of working memory and orthographic conversion. Journal of Abnormal Child Psychology, 45, 273–287.

    PubMed  Article  Google Scholar 

  • Halperin, J. M., Trampush, J. W., Miller, C. J., Marks, D. J., & Newcorn, J. H. (2008). Neuropsychological outcome in adolescents/young adults with childhood ADHD: Profiles of persisters, remitters and controls. Journal of Child Psychology and Psychiatry, 49, 958–966.

    PubMed  Article  Google Scholar 

  • Hawk Jr., L. W., Fosco, W. D., Colder, C. R., Waxmonsky, J. G., Pelham Jr., W. E., & Rosch, K. S. (2018). How do stimulant treatments for ADHD work? Evidence for mediation by improved cognition. Journal of Child Psychology and Psychiatry, 59, 1271–1281.

    PubMed  Article  Google Scholar 

  • Hutchinson, E., Bavin, E., Efron, D., & Sciberras, E. (2012). A comparison of working memory profiles in school-aged children with specific language impairment, attention deficit/hyperactivity disorder, comorbid SLI and ADHD and their typically developing peers. Child Neuropsychology, 18, 190–207.

    PubMed  Article  Google Scholar 

  • Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12–19.

    PubMed  Article  Google Scholar 

  • JASP Team (2017). JASP. Version 0.8.5. [Computer Software].

  • Karalunas, S. L., Gustafsson, H. C., Dieckmann, N. F., Tipsord, J., Mitchell, S. H., & Nigg, J. T. (2017). Heterogeneity in development of aspects of working memory predicts longitudinal attention deficit hyperactivity disorder symptom change. Journal of Abnormal Psychology, 126, 774–792.

    PubMed  PubMed Central  Article  Google Scholar 

  • Kasper, L. J., Alderson, R. M., & Hudec, K. L. (2012). Moderators of working memory deficits in children with attention-deficit/hyperactivity disorder (ADHD): A meta-analytic review. Clinical Psychology Review, 32, 605–617.

    PubMed  Article  Google Scholar 

  • Kaufman, J., Birmaher, B., Brent, D., Rao, U., et al. (1997). K-SADS-PL: Initial reliability and validity data. Journal of the American Academy of Child & Adolescent Psychiatry, 36, 980–988.

    Article  Google Scholar 

  • Kaufman, A. S., & Kaufman, N. L. (2014). Technical and interpretive manual: Kaufman test of educational achievement (3rd ed.). Bloomington: Pearson.

    Google Scholar 

  • Kofler, M. J., Irwin, L. N., Soto, E. F., Groves, N. B., Harmon, S. L., & Sarver, D. E. (2019). Executive functioning heterogeneity in pediatric ADHD. Journal of Abnormal Child Psychology, 47, 273–286.

    PubMed  PubMed Central  Article  Google Scholar 

  • Kofler, M. J., Rapport, M. D., Bolden, J., Sarver, D. E., & Raiker, J. S. (2010). ADHD and working memory: The impact of central executive deficits and exceeding storage/rehearsal capacity on observed inattentive behavior. Journal of Abnormal Child Psychology, 38, 149–161.

    PubMed  Article  Google Scholar 

  • Kofler, M. J., Sarver, D. E., Spiegel, J. A., Day, T. N., Harmon, S. L., & Wells, E. L. (2017). Heterogeneity in ADHD: Neurocognitive predictors of peer, family, and academic functioning. Child Neuropsychology, 23, 733–759.

    PubMed  Article  Google Scholar 

  • Kofler, M. J., Spiegel, J. A., Austin, K. E., Irwin, L. N., Soto, E. F., & Sarver, D. E. (2018). Are episodic buffer processes intact in ADHD? Experimental evidence and linkage with hyperactive behavior. Journal of Abnormal Child Psychology, 46, 1171–1185.

    PubMed  PubMed Central  Article  Google Scholar 

  • Kosten, T. A., & Rounsaville, B. J. (1992). Sensitivity of psychiatric diagnosis based on the best estimate procedure. The American Journal of Psychiatry, 149, 1225–1227.

    PubMed  Article  Google Scholar 

  • Larson, K., Russ, S. A., Kahn, R. S., & Halfon, N. (2011). Patterns of comorbidity, functioning, and service use for US children with ADHD, 2007. Pediatrics, 127, 462–470.

    PubMed  PubMed Central  Article  Google Scholar 

  • Martinussen, R., Hayden, J., Hogg-Johnson, S., & Tannock, R. (2005). A meta-analysis of working memory impairments in children with attention-deficit/hyperactivity disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 44, 377–384.

    Article  Google Scholar 

  • McQuade, J. D., Murray-Close, D., Shoulberg, E. K., & Hoza, B. (2013). Working memory and social functioning in children. Journal of Experimental Child Psychology, 115, 422–435.

    PubMed  Article  Google Scholar 

  • Melby-Lervåg, M., & Hulme, C. (2013). Is working memory training effective? A meta-analytic review. Developmental Psychology, 49, 270.

    PubMed  Article  Google Scholar 

  • Miller, M., & Hinshaw, S. P. (2010). Does childhood executive function predict adolescent functional outcomes in girls with ADHD? Journal of Abnormal Child Psychology, 38, 315–326.

    PubMed  Article  Google Scholar 

  • Miyake, A., Friedman, N. P., Emerson, M. J., Witzki, A. H., Howerter, A., & Wager, T. D. (2000). The unity and diversity of executive functions and their contributions to complex “frontal lobe” tasks: A latent variable analysis. Cognitive Psychology, 41, 43–100.

    Article  Google Scholar 

  • Nigg, J. T., Willcutt, E. G., Doyle, A. E., & Sonuga-Barke, E. S. (2005). Causal heterogeneity in attention-deficit/ hyperactivity disorder: Do we need neuropsychologically impaired subtypes? Biological Psychiatry, 57, 1224–1230.

    PubMed  Article  Google Scholar 

  • Nyberg, L., & Eriksson, J. (2016). Working memory: Maintenance, updating, and the realization of intentions. Cold Spring Harbor Perspectives in Biology, 8, a021816.

    PubMed Central  Article  Google Scholar 

  • Pelham Jr., W. E., Fabiano, G. A., & Massetti, G. M. (2005). Evidence-based assessment of ADHD in children and adolescents. Journal of Clinical Child and Adolescent Psychology, 34, 449–476.

    PubMed  Article  Google Scholar 

  • Rapport, M. D., Alderson, R. M., Kofler, M. J., Sarver, D. E., Bolden, J., & Sims, V. (2008). Working memory deficits in boys with attention-deficit/hyperactivity disorder: The contribution of central executive and subsystem processes. Journal of Abnormal Child Psychology, 36, 825–837.

    PubMed  Article  Google Scholar 

  • Rapport, M. D., Bolden, J., Kofler, M. J., Sarver, D. E., Raiker, J. S., & Alderson, R. M. (2009). Hyperactivity in boys with attention-deficit/hyperactivity disorder: A ubiquitous core symptom or manifestation of working memory deficits? Journal of Abnormal Child Psychology, 37, 521–534.

    PubMed  Article  Google Scholar 

  • Rapport, M. D., Orban, S. A., Kofler, M. J., & Friedman, L. M. (2013). Do programs designed to train working memory, other executive functions, and attention benefit children with ADHD? A meta-analytic review of cognitive, academic, and behavioral outcomes. Clinical Psychology Review, 33, 1237–1252.

    PubMed  Article  Google Scholar 

  • Reynolds, C. R., & Kamphaus, R. W. (2004). BASC-2 behavior assessment for children manual. Circle Pines: American Guidance Service.

    Google Scholar 

  • Reynolds, C. R., & Kamphaus, R. W. (2015). Behavior assessment system for children–third edition (BASC-3). Bloomington: Pearson.

    Google Scholar 

  • Rottschy, C., Langner, R., Dogan, I., Reetz, K., Laird, A. R., Schulz, J. B., Fox, P. T., & Eickhoff, S. B. (2012). Modelling neural correlates of working memory: A coordinate-based meta-analysis. Neuroimage, 60, 830–846.

    PubMed  Article  Google Scholar 

  • Rouder, J. N., & Morey, R. D. (2012). Default Bayes factors for model selection in regression. Multivariate Behavioral Research, 47, 877–903.

    PubMed  Article  Google Scholar 

  • Sarver, D. E., Rapport, M. D., Kofler, M. J., Raiker, J. S., & Friedman, L. M. (2015). Hyperactivity in attention-deficit/hyperactivity disorder (ADHD): Impairing deficit or compensatory behavior? Journal of Abnormal Child Psychology, 43, 1219–1232.

    PubMed  Article  Google Scholar 

  • Sattler, J. M., Dumont, R., & Coalson, D. L. (2016). Assessment of children: WISC-V and WPPSI-IV. San Diego: Jerome M. Sattler, Publisher.

    Google Scholar 

  • Schmiedek, F., Lövdén, M., & Lindenberger, U. (2014). A task is a task is a task: Putting complex span, n-back, and other working memory indicators in psychometric context. Frontiers in Psychology, 5, 1475.

    PubMed  PubMed Central  Article  Google Scholar 

  • Shaw, P., Kabani, N. J., Lerch, J. P., Eckstrand, K., Lenroot, R., Gogtay, N., Greenstein, D., Clasen, L., Evans, A., Rapoport, J. L., Giedd, J. N., & Wise, S. P. (2008). Neurodevelopmental trajectories of the human cerebral cortex. Journal of Neuroscience, 28, 3586–3594.

    PubMed  Article  Google Scholar 

  • Simone, A. N., Marks, D. J., Bédard, A. C., & Halperin, J. M. (2018). Low working memory rather than ADHD symptoms predicts poor academic achievement in school-aged children. Journal of Abnormal Child Psychology, 46, 277–290.

    PubMed  PubMed Central  Article  Google Scholar 

  • Snyder, H. R., Miyake, A., & Hankin, B. L. (2015). Advancing understanding of executive function impairments and psychopathology: Bridging the gap between clinical and cognitive approaches. Frontiers in Psychology, 6, 328.

    PubMed  PubMed Central  Article  Google Scholar 

  • Unsworth, N., & Engle, R. W. (2007). On the division of short-term and working memory: An examination of simple and complex span and their relation to higher order abilities. Psychological Bulletin, 133, 1038.

    PubMed  Article  Google Scholar 

  • Wager, T. D., & Smith, E. E. (2003). Neuroimaging studies of working memory. Cognitive, Affective, & Behavioral Neuroscience, 3, 255–274.

    Article  Google Scholar 

  • Wagenmakers, E. J., Marsman, M., Jamil, T., Ly, A., Verhagen, A. J., Love, J., & Morey, R. D. (2016). Bayesian statistical inference for psychological science. Part I: Theoretical advantages and practical ramifications. Psychonomic Bulletin & Review, 25, 169–176.

    Google Scholar 

  • Wåhlstedt, C., Thorell, L. B., & Bohlin, G. (2009). Heterogeneity in ADHD: Neuropsychological pathways, comorbidity and symptom domains. Journal of Abnormal Child Psychology, 37, 551–564.

    PubMed  Article  Google Scholar 

  • Wechsler, D. (2014). WISC-V: Technical and interpretive manual. Incorporated: NCS Pearson.

    Google Scholar 

  • Wells, E. L., Kofler, M. J., Soto, E. F., Schaefer, H. S., & Sarver, D. E. (2018). Assessing working memory in children with ADHD: Minor administration and scoring changes may improve digit span backward’s construct validity. Research in Developmental Disabilities, 72, 166–178.

    PubMed  Article  Google Scholar 

  • Westfall, P. H., Johnson, W. O., & Utts, J. M. (1997). A Bayesian perspective on the Bonferroni adjustment. Biometrika, 84, 419–427.

    Article  Google Scholar 

  • Wilens, T. E., Biederman, J., Brown, S., Tanguay, S., Monuteaux, M. C., Blake, C., & Spencer, T. J. (2002). Psychiatric comorbidity and functioning in clinically referred preschool children and school-age youths with ADHD. Journal of the American Academy of Child & Adolescent Psychiatry, 41, 262–268.

    Article  Google Scholar 

  • Willoughby, M. T., & Blair, C. B. (2016). Measuring executive function in early childhood: A case for formative measurement. Psychological Assessment, 28, 319–330.

    PubMed  Article  Google Scholar 

Download references

Acknowledgements

This work was supported in part by National Institutes of Health grants (R34 MH102499-01, R01 MH115048; PI: Kofler). During the preparation of the manuscript, JSR was supported in part by grants from NIH (R21 MH112002), National Science Foundation (CNS1532061), and The Children’s Trust (#1914-7561). The sponsors had no role in design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Whitney D. Fosco.

Ethics declarations

Conflict of Interest

The authors have no conflicts of interest to report.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional review board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent and assent were obtained from all individual participants included in the study.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

ESM 1

(DOCX 29 kb)

ESM 2

(DOCX 588 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Fosco, W.D., Kofler, M.J., Groves, N.B. et al. Which ‘Working’ Components of Working Memory aren’t Working in Youth with ADHD?. J Abnorm Child Psychol 48, 647–660 (2020). https://doi.org/10.1007/s10802-020-00621-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10802-020-00621-y

Keywords

  • Working memory
  • Central executive
  • Heterogeneity
  • ADHD
  • Preregistration