Enhancing Executive Function in Adolescents With ADHD: Preliminary Findings From a Multicomponent Intervention.
Elisavet Pavlou Papagianni, Eleni Theodorou
A multicomponent OT program (cognitive training, academic skills coaching, parent education) produced measurable gains in working memory and mental flexibility in 54 adolescents with ADHD, but with no control group, these results are preliminary and cannot confirm the intervention caused the change.
Key findings
1Working memory improved significantly on the Cognifit battery (p = 0.001, r = 0.76) and on the digit span backwards test (p = 0.048, r = 0.38).
2Trail Making Test Parts A and B both showed significant improvements (p < 0.001), with large effect sizes (r = 0.80 and r = 0.86), indicating gains in processing speed and mental flexibility.
3Inhibitory control showed mixed results: CAT omission errors decreased significantly (p = 0.046), but commissions (p = 0.068), reaction time (p = 0.074), and the CAB inhibition measure (p = 0.089) did not reach significance.
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What it does not show
No control group: the one-group pretest–posttest design means improvements could reflect practice effects, maturation, or regression to the mean rather than the intervention itself. 15 of the 69 enrolled participants dropped out or completed fewer than 10 cognitive training sessions and were excluded from analysis; the digit span table reports only 27 post-intervention scores, suggesting substantial attrition on that measure. No long-term follow-up was completed; a planned 3-month reassessment was not achieved due to participants relocating or academic demands. No data on far-transfer effects, academic achievement, or quality of life were collected or analysed. The intervention combined three components (cognitive training, skills coaching, parent psychoeducation), so the contribution of any single element cannot be separated. The sample was recruited from Cyprus, was majority male (66.8%), and 72.7% had never received prior ADHD treatment, limiting generalisability. The authors themselves describe the study as preliminary and exploratory, and recommend a control-group design for future work.
Declared interests
No funding was received for the manuscript. The authors declare no conflicts of interest. The intervention platform (Cognifit) is a commercial product, but no financial relationship with Cognifit is disclosed.
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