Examining the Impact of Motivation on Working Memory Training in Youth with ADHD
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Background: Working memory (WM), the ability to temporarily store and manipulate information, has been noted as a deficit in children with attention deficit hyperactivity disorder (ADHD) and may be causally related to other cognitive impairments in this clinical population. Cogmed, a computerized WM training program, appears to yield WM improvements although claims of transfer to other domains such as academic achievement are not widely supported by research. Individual differences such as motivation have been suggested as mediating factors, though motivation has not been directly assessed in studies of Cogmed to date. Objective: The overall objective was to examine motivational influences on ADHD youths’ experience with Cogmed using complementary quantitative and qualitative approaches. Aim 1 examined whether individual differences in motivational styles were correlated with a metric of training engagement and scores on transfer outcomes. Aim 2 explored youth’s self-reported motivation and subjective experience from a post-intervention interview. Methods: Data were collected as part of a larger study contrasting a modified Cogmed protocol (n = 20) with physician-monitored standard of care (n = 20) in a community sample of rigorously diagnosed ADHD youth 8 – 14 years of age. Youth in both groups completed comprehensive assessments at baseline, post-intervention (post 1), and again 3 months afterward (post 2). The current study focuses on 10 ADHD youth randomized to the modified Cogmed group who also completed an adapted Self-Regulation Questionnaire (SRQ) and participated in a semi-structured motivational interview at the post 2 follow-up. Results: The subset of ADHD youth who were the focus of this study (n = 10) did not differ on demographic, clinical characteristics, or baseline measures when compared with ADHD youth who were randomized to the modified Cogmed group prior to inclusion of the SRQ and motivational questionnaire (n = 10). In our subset of ADHD youth, all showed perfect adherence to the modified Cogmed protocol. Youth who were more externally motivated started modified Cogmed training at a higher level of performance and also reached higher peak performance during the intervention program. At follow-up, higher levels of external motivation also predicted better spatial working memory and lower self-concept, whereas higher levels of introjected/identified motivation predicted worse academic performance. Qualitative analyses suggested that youth displayed flexible motivation with regard to their participation in modified Cogmed training and perceived subjective improvements in their everyday life function. Conclusions: ADHD youth endorsed multiple types of motivation when motivation was assessed using quantitative and qualitative approaches and reported that modified Cogmed training was useful. Higher external motivation demonstrated a more robust association with modified Cogmed training engagement and better scores on select outcome measures compared with other motivational styles.
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Mahsa Sadeghi (2018). Examining the Impact of Motivation on Working Memory Training in Youth with ADHD. UWSpace. http://hdl.handle.net/10012/13635