Central Executive Training for ADHD: Effects on Academic Achievement, Productivity, and Success in the Classroom

Objective: Central executive training (CET) is a “Level 2” evidence-based treatment for improving ADHD-related executive dysfunction and behavioral symptoms, but the extent to which these gains extend to the disorder’s well-documented academic difficulties is unknown. Method: Across two clinical trials, 108 children with attention-deficit/hyperactivity disorder (ADHD) 8–13 years old (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 (BPT; n = 27). Results: CET was superior to 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 posttreatment. At 2–4-month follow-up, CET (d = 0.76) and ICT (d = 0.54) were superior to BPT for improving objectively-tested academic achievement overall (reading comprehension, math problem-solving, language comprehension), and CET was superior to ICT (d = 0.56) for improving math problem-solving. The significant benefits of CET on academic success, academic productivity, reading comprehension, and math problem-solving replicated across both trials and were clinically significant as evidenced by low number needed to treat estimates (Needed to Treat; NNT = 3–7) and significantly higher proportions of individual cases demonstrating reliable improvements in academic success/productivity (33%–36% vs. 0%–18%) and achievement (38%–72% vs. 18%–54%) across outcomes (all p ≤.01).