Authors: (including presenting author): :
Wong TC (1), Ho YT (1), Yau LM (1), So TY (1), Lee WK (1), Chin YM (1)
Affiliation: :
(1) Occupational Therapy Department, Pamela Youde Nethersole Eastern Hospital
Keyword 1: :
Executive Function
Keyword 2: :
Children with ADHD
Keyword 3: :
Computerized cognitive training
Keyword 6: :
Executive Function Group Training
Introduction: :
Attention-deficit/hyperactivity disorder (ADHD) affects 5-9% of children and adolescents in Hong Kong (Hospital Authority, 2024). Early group interventions targeting executive functions can improve cognitive and functional outcomes, with potential long-term benefits (Qiu et al., 2023). Cogmed Working Memory Training (CWMT), an evidence-based computerized program, has demonstrated improvements in attention among children with ADHD (Aksayli et al., 2019). However, few studies in Hong Kong have examined the effectiveness of combining psychoeducational group interventions with CWMT in hospital settings. The present study evaluated a group-based intervention integrating psychoeducation and adaptive CWMT for children with ADHD.
Objectives: :
The primary objective was to enhance overall functioning and independence through a therapeutic group incorporating psychoeducation and CWMT. Secondary objectives included evaluating caregivers' perceptions of skill generalization to home and school settings.
Methodology: :
Forty-seven children (18 females, 29 males; mean age = 9.45 years) diagnosed with ADHD or predominant inattentive presentation were recruited from occupational therapy outpatient clinics. Comorbidities included autism spectrum disorder (n = 10) and specific learning disorder (n = 7). Participants attended 1-hour group sessions across five cohorts from May to September 2025 ranged from 4-6 sessions. Sessions targeted key executive functions, including self-monitoring, sustained attention, inhibition, organization, time management, and problem-solving. Activities incorporated the Zones of Regulation framework, strategies for managing distraction through inhibition, memory tricks, peer evaluation of organizational skills (e.g. school bag organization), and collaborative schedule design. From the first session, participants were introduced to CWMT (15 minutes, three times weekly), featuring adaptive visuospatial and verbal working memory tasks. Homework (e.g., photographs of organized spaces, CWMT progress tracking) was reviewed for peer feedback and reinforcement. Primary outcomes were the Global Executive Composite (GEC) from the BRIEF-2 Parent Form and total difficulties score from the Strengths and Difficulties Questionnaire (SDQ), supplemented by semi-structured parent interviews.
Result & Outcome: :
Paired-samples t-tests revealed significant pre-to-post improvements. Parent-rated executive dysfunction (BRIEF-2 GEC) decreased by 3.35 points (p < .001), and total difficulties (SDQ) decreased by 1.53 points (p = .007). An independent-samples t-test showed that participants who completed any CWMT (n = 26) exhibited significantly greater BRIEF-2 improvement than those who did not (n = 17; p = .040). At 2-month follow-up, parents reported sustained skill application, including adaptive self-regulation strategies. Qualitative feedback highlighted improved task initiation and organizational awareness. Conclusion: The combined psychoeducational group and CWMT intervention demonstrated significant improvements in executive functioning and overall functioning, with evidence suggesting added benefit from CWMT participation.
