Comparison of Two Measures of Working Memory Impairments in 220 Adolescents and Adults with ADHD

Ryan J. Kennedy, Donald M. Quinlan, and Thomas E. Brown
Comparison of Two Measures of Working Memory Impairments in 220 Adolescents and Adults with ADHD. Journal of Attention Disorders. Online First, August 1, 2016. DOI: 10.1177/1087054716661232

This study compares two normed measures used in ADHD evaluations to assess impairments in working memory. Although individuals with ADHD may have excellent recall of long-term memories, they often report having chronic difficulty with their short term working memory (WM). They often forget things in the here-and-now: what others have just said to them, where they have put something, what they were about to do, what they have just finished reading, and so on. Measures compared were:

1) A normed story recall test consisting of two brief stories from the Wechsler Memory Scale read aloud to the patient only once. Immediately after each story is read aloud by the examiner, the patient is asked to retell it to the examiner, as close to verbatim as possible. Responses are then scored relative to age norms.

2) The Working Memory Index (WMI), a combination of two subtests from the Wechsler Adult Intelligence Scale–Fourth Edition: the digit span (forward and backward) and mental arithmetic. Both are administered orally.

Results support our hypotheses that adolescents and adults with ADHD tend to score significantly lower on both of these tasks, with significantly more difficulty on story memory, than do most persons of comparable age in the general population.

We suggest that the story memory task has more ecological validity than numerically-based measures of working memory. It provides an objective measure to assess an individual’s ability to pay attention to a sizable, but manageable, chunk of verbal information and to remember what has been heard. This is not so different from many daily life situations where one needs to pay attention to what someone is saying and keep it in mind long enough to understand and recall what has been said. The story memory task can be administered in approximately 10 minutes.

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