A new study shows that brain training may not help ADHD.
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The drugs that treat hyperactivity and attention deficit disorder can effective. However, they may also cause unwanted side effects, including anxiety, difficulty sleeping, and loss of appetite. As a result, people have turned to other treatments for ADHD.
One such treatment is brain training, which involves “exercising” the brain to focus and pay attention. Computer- or app-based exercises have widely accepted to reduce ADHD symptoms (such as restlessness, impulsivity, and irritability) by improving working memory. But does the evidence support this?
My colleagues and I reviewed all the available evidence – spanning around two decades – to find out. We analyzed data from 36 studies and over 2,200 people living with ADHD of all ages. These results were publish recently in the journal Molecular Psychiatry.
Largest review to date
This is the most comprehensive review on this topic. This review only contains randomized controlled studies, as they are the best form of evidence to determine if a treatment is effective. Randomized controlled trials randomly assign participants to either a treatment group (real brain training) or a control group (some other intervention).
To further eliminate bias, the studies we examine were “blind.” The participants were unaware of which group they were assign, either the treatment or the control group.
Working memory was the main focus of brain training, delivered primarily at home, in school, or clinics. ADHD symptoms may exacerbated by poor memory.
Our analysis revealed that working memory was improve, but not other cognitive functions such as attention and processing speed. Also, we did not observe any change in academic skills such as reading and mental arithmetic. Children with ADHD have a difficult time doing these tasks.
ADHD can affect a child’s school performance. Andrew Fox/Alamy Stock Photo
It’s easy to be happy about improving working memory, but since these measures were based on tasks, the results might not apply to life outside of the lab.
Most children and adults are more interested in whether brain training has influenced the ratings of symptoms. The attention was improve, but it was too small for me to consider it meaningful. It was too small to justify a program that involved weeks of “therapeutic” video games played after school.
Very few trials examine whether the benefits above lasted after training was complete. However, the available evidence show that any benefits were short-lived and diminish over time.
We found that brain training was not effective in reducing ADHD symptoms, despite the positive results of two decades of research.
We do not prove that brain training is not practical. Furthermore, we do not claim that brain training is useless for those with working memory problems or should not included in a multi-therapy treatment approach.
It is, however, clear that, as a stand-alone treatment, training has limited evidence to show that it can reduce ADHD symptoms. Therefore, it is premature to claim that brain training significantly and reliably affects ADHD symptoms.
Pessimistic outlook
Final note: Some of the studies included in our analysis were of questionable or small size, which may indicate that there is still a lack of solid evidence. We encourage more research of higher quality that focuses on alternative training methods that are likely to be more effective. Although we can’t rule out the possibility of a golden era of research that shows reliable positive evidence for brain training in well-executed studies, I am not holding my breath.
This review confirms many of the findings from our previous review published in 2015. Our update paints a pessimistic view.
In the past year, many high-quality trials have published. These were include in our review. Unfortunately, despite the additions, we have seen that any improvement in 2015 has either decreased substantially or vanished altogether.
In other words, as the quality and quantity of trials increase, the evidence shows that the training effects wax and wane. The current trend of brain training is not favorable.
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