Academic Outcomes: Behavioral Parent Training vs. Central Executive Training vs. Inhibitory Control Training for ADHD

Objective: Central executive training (CET) is a ‘level 2’ evidence-based treatment for improvingADHD-related executive dysfunction and behavioral symptoms, but the extent to which these gains extend to the disorder’s well-documented academic difficulties has not been investigated. Method: Across two clinical trials, 108 children with ADHD ages 8-13 (M=10.29, SD=1.50; 32 girls; 75% White/Non-Hispanic) were treated with CET (n=52), inhibitory control training (ICT; n=29), or gold- standard behavioral parent training (n=27). Results: Across trials, CET was superior to both BPT and ICT (d=0.62-0.88) for improving masked teacher perceptions of academic success, impulse control, and academic productivity at 1-2 months post-treatment. CET (d=0.76) and ICT (d=0.54) were both superior to BPT for improving objectively-tested academic achievement overall (reading comprehension, math problem-solving, language comprehension) at 2-4 month follow-up. In terms of specific academic domains, CET was superior to BPT (d=0.71) and ICT (d=0.56) for improving math problem-solving skills and superior to BPT for improving reading comprehension (d=0.64). CET was also associated with significant improvements in language comprehension in Study 1 (d=0.46), but this effect failed to replicate in Study 2; neither BPT nor ICT were associated with changes in language comprehension (d=0.01-0.20). The significant benefits of CET on academic success, academic productivity, reading comprehension, and math problem-solving replicated across the two trials. Conclusions: Results across the two trials reported herein provide strong support for the efficacy of CET for ADHD, and are consistent with model-driven hypotheses that academic difficulties in ADHD are due, in part, to these children’s underdeveloped executive functioning abilities.