An Open Trial of a Metacognitive Executive Function Training for Young Children With ADHD

Objective: Executive functioning is impaired in children with ADHD and putatively related to the pathogenesis of ADHD. The authors developed an innovative treatment teaching parents to administer a metacognitive executive function training intervention with children, promoting positive interactions during activities designed to improve attention and self-regulation. Method: A total of 24 young children with ADHD and their parents participated in an 8-week open trial of the intervention designed to assess feasibility and initial efficacy. Results: The intervention is feasible and accepted by parents as shown by high attendance/adherence, low attrition, and satisfaction ratings. Improvements in executive functions ( visual/auditory attention, working memory, and cognitive flexibility) with corresponding improvements in parent ratings of executive functioning were observed. Reduced inattention symptoms were reported. Conclusion: Executive functioning training is a promising approach to treating young children with ADHD and holds promise for generalizability because parents are trained to be interventionists and coached to apply the strategies to alternative domains.