Online cognitive training not effective in reducing ADHD symptoms, study shows

A major review has found little to no evidence that computerised cognitive training brings benefits for people with attention deficit hyperactivity disorder (ADHD).

Scientists from the University of Southampton undertook the study with researchers from King’s College London on behalf of the European ADHD Guidelines Group (EAGG). The review team conducted a meta-analysis of 36 randomised controlled trials investigating the effects of computerised cognitive training on outcomes in individuals with ADHD.

Computerised cognitive training is a class of online tools designed to improve cognitive processes such as short-term memory, attention and inhibitory control - the ability to control your attention, behaviour, thoughts and emotions.

It has been proposed as a treatment option to help reduce symptoms of hyperactivity/impulsivity and inattention symptoms at the core of ADHD. There has been concern about the lack of evidence to support this usage but a definitive evaluation has been lacking.

The study, published in Molecular Psychiatry, concluded that cognitive training did not produce clinically meaningful reductions in overall ADHD symptoms or on specific hyperactivity/impulsivity symptoms. It may, however, lead to a small improvement in inattention in some settings.

There were some improvements in a limited set cognitive processes – particularly working memory, the ability to hold in mind and manipulate information across the short term, following working memory training, said Professor Samuele Cortese from the University of Southampton.

This may be of benefit to the subset of ADHD individuals with working memory deficits.

Southampton’s Prof Cortese, who is also joint-senior author and chair of the EAGG, added: “Rigorous meta-analytic evidence such as this one is crucial to inform the development of clinical guidelines, with the ultimate goal to provide the best evidence-based treatments to individuals with ADHD.”

The authors explain that the findings do not support the use of computerised cognitive training in its current form as a stand-alone treatment for ADHD symptoms, and that new approaches that target different processes should be explored to develop effective interventions for ADHD.

Dr Samuel Westwood, Lecturer in Psychology Education at King’s College London and lead author of the paper, said: “We conducted the largest, most comprehensive meta-analysis of randomised control trials to date to investigate the effectiveness of computerised cognitive training in reducing ADHD symptoms.

“Our meta-analysis revealed little to no support for the use of this cognitive training as a stand-alone intervention for ADHD symptoms. Although small, short-term effects on inattention symptoms were found, they were likely of limited clinical importance. Overall, I think it’s now time to seek out new interventions targeting different processes.”

Read more about the study at www.nature.com/online-cognitive-training