OBJECTIVE Executive function deficits are well-established in ADHD. Unfortunately, replicated evidence indicates that executive function training for ADHD has been largely unsuccessful. We hypothesized that this may reflect insufficient targeting, such that extant protocols do not sufficiently and specifically target the neurocognitive systems associated with phenotypic ADHD behaviors/impairments. METHOD Children with ADHD ages 8-12 (M = 10.41, SD = 1.46; 12 girls; 74% Caucasian/Non-Hispanic) were randomized with allocation concealment to either central executive training (CET; n = 25) or newly developed inhibitory control training (ICT; n = 29). Detailed data analytic plans were preregistered. RESULTS Both treatments were feasible/acceptable based on training duration, child-reported ease of use, and parent-reported high satisfaction. CET was superior to ICT for improving its primary intervention targets: phonological and visuospatial working memory (d = 0.70-0.84). CET was also superior to ICT for improving go/no-go (d = 0.84) but not stop-signal inhibition. Mechanisms of change analyses indicated that CET-related working memory improvements produced significant reductions in the primary clinical endpoints (objectively assessed hyperactivity) during working memory and inhibition testing (indirect effects: β ≥ -.11; 95% CIs exclude 0.0). CET was also superior to ICT on 3 of 4 secondary clinical endpoints (blinded teacher-rated ADHD symptoms; d = 0.46-0.70 vs. 0.16-0.42) and 2 of 4 feasibility/acceptability clinical endpoints (parent-reported ADHD symptoms; d = 0.96-1.42 vs. 0.45-0.65). CET-related gains were maintained at 2-4 month follow-up; ICT-related gains were maintained for attention problems but not hyperactivity/impulsivity per parent report. CONCLUSIONS Results support the use of CET for treating executive function deficits and targeting ADHD behavioral symptoms in children with ADHD. Findings for ICT were mixed at best and indicate the need for continued development/study. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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一项针对ADHD的中枢执行培训（CET）与抑制性控制培训（ICT）的随机对照试验。

目的执行功能缺陷在多动症中已得到充分证实。不幸的是，有重复的证据表明，多动症的执行功能培训在很大程度上是不成功的。我们假设这可能反映出不足的靶向性，以至于现有的协议不足以专门针对与表型多动症行为/损害相关的神经认知系统。方法将8-12岁的多动症儿童（M = 10.41，SD = 1.46； 12个女孩； 74％的白种人/非西班牙裔）随机分配，隐匿于中枢执行培训（CET； n = 25）或新开发的抑制性对照中培训（ICT； n = 29）。详细的数据分析计划已预先注册。结果根据训练时间，儿童报告的易用性和父母报告的高度满意，两种治疗方法都是可行/可接受的。CET在改善其主要干预目标（语音和视觉空间工作记忆（d = 0.70-0.84））方面优于ICT。CET在改善“通过/不通过”方面也优于ICT（d = 0.84），但在停止信号抑制方面没有。变化机制分析表明，与CET相关的工作记忆改善导致工作记忆和抑制试验期间主要临床终点（客观评估的机能亢进）显着降低（间接作用：β≥-11； 95％CI排除0.0）。在4个次要临床终点中的3个（盲教师评价的ADHD症状； d = 0.46-0.70对0.16-0.42）和4个可行性/可接受性临床终点中的2个（父母报告的ADHD症状； d = 0.96-1.42与0.45-0.65）。与CET相关的收益保持在2-4个月的随访中；保持与ICT相关的注意力问题得到了改善，但每位家长的报告都没有保持过动/冲动。结论结果支持将CET用于治疗ADHD儿童的执行功能缺陷和针对ADHD行为症状。信息通信技术的发现充其量是混杂的，表明需要继续发展/研究。（PsycInfo数据库记录（c）2020 APA，保留所有权利）。