Combined Intervention of Working Memory and Arithmetic Reasoning in Students with ADHD

ABSTRACT

This study compared the effects of a combined intervention of working memory (WM) and arithmetic reasoning (AR) vs WM intervention alone on the arithmetic reasoning performance of students with ADHD. Third- and fourth-grade elementary school students (n = 46) completed measures for AR, mathematical calculations, and WM. Participants were randomised using a minimisation approach taking age and IQ as variables of interest and assigned to one of the two groups: Combined Intervention (CI, n = 24) and Working Memory Intervention (WMI, n = 22). The results using GEE analysis indicated a significant group × time interaction (Waldχ² = 6.414; gl = 2; p = 0.04) in AR performance in the immediate post-test. CI students showed significantly better performance on AR than WMI students immediately after intervention (p_B = 0.042). There was an effect of time on mathematical calculations in the post-test (Waldχ² = 48.305; gl = 2; p < 0.001). Despite the fact that the results for AR were not maintained in the deferred post-test, a combined intervention of WM and AR seems to be more efficient in improving arithmetic reasoning in ADHD students than a WM intervention alone. Nevertheless, this is not the case with other mathematical issues, such as calculation, where there was no significant difference between groups, but the effects had been maintained in the deferred post-test for both.

KEYWORDS:

• ADHD
• arithmetic
• arithmetic reasoning
• combined intervention
• intervention
• learning
• school performance
• working memory

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. No student was excluded at this step.

2. No student was excluded at this step.

3. Students’ assignment to the different interventions was carried out using QMinim software (http://qminim.sourceforge.net/demo/).

4. The questionnaire was completed only in the immediate post-test period because the instrument aimed to investigate the intensity of improvement resulting from the intervention (if any). The questionnaire was not completed in the late post-test period because it coincided with the beginning of the school year and the teachers did not have enough information about the students. Moreover, it would require a grade adjustment of the scale.

5. The SNAP-IV was not completed by the teachers at the deferred post-test because it coincided with the beginning of the school year and the teachers responsible for the students participating in the study did not have enough information for this evaluation. The same teacher provided the information at the two assessment time points.

6. There were not repeated measures between the intervention programmes application.

7. The session was rescheduled when students missed it. The principal investigator or a research assistant conducted the rescheduled session.

8. In this study, Terezinha Nunes and Oxford University research group designed the games.

9. The Words Game was adapted to Portuguese after a careful analysis of each translated word and picture. Some words and pictures have been modified because they are not common in the Brazilian culture. Efforts were made to keep the same structure in the modified sentences.

10. The phrases were read aloud to the students.

Additional information

Funding

This work was supported by the Attention Deficit/Hyperactivity Program of the Hospital de Clínicas from Porto Alegre and CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior/Brazil).