Transferability of cognitive training in children with ADHD: Comparison of remediation and compensation approaches

Transferability of cognitive training in children with ADHD: Comparison of remediation and compensation approaches | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Transferability of cognitive training in children with ADHD: Comparison of remediation and compensation approaches Azin Sarraj Khorrami, Jalil Fathabadi, Vahid Nejati This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6505930/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract This study evaluates the effectiveness of two cognitive training interventions—Attentive Rehabilitation of Attention and Memory (ARAM) and the Program for Executive Function Training (PETRA)- in improving behavioral symptoms and cognitive functions in preschoolers with ADHD. 47 preschool children with ADHD were randomly assigned to either the ARAM (N = 15), PETRA (N = 15), or control group (N = 17). Cognitive functions and behavioral symptoms were assessed. Both ARAM and PETRA demonstrated improvements in inhibitory control, shifting attention, memory, planning, and emotion regulation, with sustained reductions in ADHD symptoms. The ARAM group showed greater transfer effects in the domains of function, implement, and ecology, while PETRA excelled in level and duration. Both cognitive interventions effectively enhanced cognitive functions and reduced symptoms, with ARAM favoring broader transferability and PETRA supporting long-term cognitive strategies. Biological sciences/Psychology Biological sciences/Psychology/Human behaviour Cognitive Training Compensation Remediation Transferability Figures Figure 1 Figure 2 Figure 3 Introduction Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by low attention span, high levels of hyperactivity, and an inability to control impulsive behavior 1 . These symptoms often interfere with daily tasks at home or school. At the cognitive level individuals with ADHD experience impairment in perceptual 2 , attentional 3 , executive 4 , temporal 5 , emotional 6 , social 7 , 8 , and motivational 9 , 10 processing. Although ADHD is typically diagnosed during school age, most symptoms emerge during the preschool period. The prevalence of ADHD is estimated to be between 2% and 8% in preschoolers 11 . Early diagnosis and intervention are crucial for improving symptoms and mitigating negative outcomes, such as academic failure in childhood 12 and occupational problems in adulthood 13 . One of the main cognitive theories of ADHD is the executive dysfunction theory, which effectively explains the behavioral and cognitive impairments observed in children with ADHD 14 . Several therapeutic approaches target this theory for the treatment of children with ADHD using cognitive or behavioral methods, including cognitive training 15 , cognitive behavioral therapy 16 , and behavioral parenting training 17 . The goals of an intervention can be classified into three timeframes: 1. Target , representing the short-term goals during intervention sessions; 2. Objective , referring to the mid-term goals expected at the time of discharge; and 3. Aim , which focuses on the long-term outcomes 18 . For example, in the case of children with ADHD, the short-term target could be improving inhibition, the mid-term objective might be reducing symptoms, and the long-term aim could be fostering greater independence. As the intervention progresses from target to aim, the goals become more abstract and less directly tied to the specific therapeutic approach. In detail, the target is closely aligned with the therapeutic method being used. For instance, in cognitive training, the target might be improving specific cognitive functions, whereas in behavioral interventions, it could involve performing a specific behavior correctly. Importantly, the therapeutic target is initially technique-dependent, but this dependency should diminish over time as the individual progresses. Therapeutic techniques can be classified into two main types: practice-based interventions , such as the remediation approach used in cognitive training, and education-based interventions , which include compensation strategies in cognitive training or behavioral approaches like cognitive-behavioral therapy (CBT). Over the course of treatment, the goal is for the individual to internalize the skills and strategies, reducing reliance on specific techniques and fostering greater independence. Cognitive training involves structured programs administered by therapists to remediate or compensate for cognitive deficits and their associated outcomes, aiming to restore or enhance cognitive functioning 18 . This training uses various approaches to address cognitive capacities, including remediation and compensation 19 . In the remediation approach, known as cognitive process training, progressively graded tasks are used to enhance target cognitive functions and extend processing capacity. In the compensation approach, individuals learn strategies to manage existing cognitive assets by reducing external demands or optimally allocating cognitive resources to meet environmental challenges. Although these hypothetical classifications are beneficial for defining the target and pathways of interventions, the objective and aim are integrative. The transfer of training effects from these two approaches should be considered an index of effectiveness in therapeutic interventions. Several cognitive training studies in children with ADHD have demonstrated improvements in both cognitive and behavioral aspects through attention training 20 – 22 , working memory training 15 , 23 , 24 , inhibitory control training 25 , cognitive behavioral therapy 26 , and Metacognitive executive function training 27 . An essential factor in evaluating the effectiveness of different interventions is assessing the transferability of training effects to untrained domains. A comprehensive model for understanding this, known as FIELD (Function, Implement, Level, Ecology, and Durability), provides a structured framework to guide the evaluation of transfer effects 18 . Function-related transfer refers to the classic concept of transfer, where the benefits of training extend from the targeted function to other, untrained functions. Implement transfer involves the application of training effects across various assessment or intervention tools and methods, such as objective or subjective tests, paper-and-pencil tasks, computerized or motor tasks, achievement or attitude tests, and self-report or informant-based measures. Level-related transfer concerns the transfer of training effects across different levels of functioning, such as from neural changes to cognitive improvements or behavioral outcomes. Ecological transfer captures the expansion of training effects beyond the original training setting (e.g., a clinic) to other environments, like schools or homes. Lastly, durability-related transfer focuses on the longevity of training effects, evaluating how long the benefits persist after the intervention ends. In the present study, we hypothesized a common source for the behavioral and cognitive problems in children with ADHD and aimed to compare the transferability of remediation and compensation techniques. To achieve this, children received both compensation and remediation interventions and were assessed using behavioral scales and cognitive tests. Our goal was to determine which intervention exhibited greater transferability to untrained domains, serving as an index of effectiveness. Methods Participants. Forty-seven preschool children diagnosed with ADHD (aged between 4–7 years) were recruited from those referred to child counseling centers in Tehran, Iran. Using G*Power software, with a mean effect size of 0.50 and α = 0.05 for three groups, a sample size of 45 was determined to be sufficient. The children were diagnosed by a registered psychologist or a child psychiatrist. They were then randomly assigned to three groups: 15 children in the remediation group, 15 in the compensation group, and 17 in the control group (with two additional children in the control group to account for potential dropout due to lack of treatment). Children were excluded if they did not exhibit both attention deficit and hyperactivity symptoms simultaneously, had other psychiatric disorders, or if their mothers were unwilling to complete questionnaires or participate in the treatment plan. Two children in each group were receiving psychostimulant medication for their ADHD symptoms. The mean age of the children was 5 years. Informed consent was obtained from all subjects and/or their legal guardian(s). All methods were performed in accordance with relevant guidelines and regulations, including the standards of the Helsinki Declaration of 1975, as revised in 1983. The experimental procedures received ethical approval from the Ethics Committee for Research Involving Human Participants at Shahid Beheshti University (code number: IR.SBU.REC.1403.098). Attentive Rehabilitation of Attention and Memory (ARAM). ARAM includes tasks for inhibition, sustained attention, working memory, and shifting attention was used for remediation training. The program was installed on participants' computers, and both parents and children were given instructions on how to use it. Children were allowed to perform these tasks three sessions per week, with each session lasting 30–45 minutes. The tasks were organized hierarchically from easy to difficult, with the level of difficulty adjusting automatically according to each participant's performance. The tasks were designed to be engaging and featured attractive stimuli to motivate children. Parents were instructed not to interfere with any training session but were allowed to monitor their children's progress. Program for Executive Function Training (PETRA). PETRA combines parent management training with compensatory strategies to educate mothers about the neurological deficits underlying their children's behavioral problems and how to manage them using specific strategies and skills. This program consisted of 10 group training sessions, held twice weekly, with each session lasting 2 hours. The treatment was administered by a well-trained psychologist. Session content included psychoeducation, the main principles of behavior management, and definitions and strategies for executive functions such as inhibition, working memory, sustained attention, cognitive flexibility, planning, time management, initiation, and organization. The tenth session focused on identifying the strengths and weaknesses of both mothers and their children's executive functions, as well as their similarities and differences. ADHD-SC4. ADHD symptoms were measured using the SC4, a 50-item questionnaire that asks parents to rate symptoms of ADHD on a 4-point scale (Never = 0, Sometimes = 1, Often = 2, Very Often = 3), with higher scores representing a greater number of problems. The sum of ADHD scores was used as an outcome measure for further analysis. The SC4 has demonstrated satisfactory psychometric properties 28 , 29 . Executive Function Questionnaire Preschool (BRIEF-P). Executive function deficits were measured using the BRIEF-P, which assesses impairment across domains of everyday function, including Inhibition, Emotional Control, Shift, Working Memory, and Plan/Organize on a 3-point rating scale. Parents responded to 63 items, indicating the occurrence of problematic behavior during the past 6 months on a scale from Never (= 1), Sometimes (= 2), or Often (= 3), with higher scores indicating poorer EF 30 . The standardization of the instrument for Iranian samples was completed in 2014 31 . Day and Night Stroop. Inhibition was assessed using the Day and Night Stroop, designed by Gerstadt et al. (1994) 32 . This task involves a set of 21 pictures depicting either the moon or sun, where children are required to give a conflicting response verbally (e.g., saying "day" when shown a moon card). Missing Scan Test. The Missing Scan Test, designed by Buschke (1963) 33 , was used to measure working memory in preschool children. It involves 34 animal pictures, where children must identify and label them, removing unfamiliar animals. In each trial, children view a set of animals (3–10), which are then concealed, with one animal missing upon return. Children must name the missing animal. The memory span score is the longest range of animals the child can correctly recall. Scores show good correlation with other memory tasks (r = 0.71) 34 . Trail Making Test (TMT). Shifting attention ability was assessed using TMT. Children were presented with a book of dog characters and instructed to draw lines between the dogs in order of size or match dogs to bones of similar sizes, alternating between dogs and bones. The test included distractors (cats) in the final condition. Espy & Cwik (2004) 36 demonstrated good test-retest reliability for this procedure (r = 0.45 to 0.65). A modified version including only the first two steps was used in this research. Procedure. All participants were randomly assigned to one of the remediation, compensation, or control groups. Mothers and children were not given extra information regarding the benefits of either treatment plan to ensure blinding. Following diagnosis, mothers completed the ADHD-SC4 and BRIEF-P. Children were assessed using the Day and Night Stroop, Missing Scan Test, and TMT. These measures were completed before, after, and 2 months post-intervention. Assessments were conducted by an expert in neuropsychological assessments. Descriptive characteristics of each group and all samples as a whole are provided in the table below. Table 1 Participants' characteristics for each group Group/variables compensation (n = 15) remediation (n = 15) control (n = 17) Mothers age, M (SD) 31.47 (5.24) 36.13 (2.64) 34.06 (4.96) Child age, M (SD) 5.40 (1.04) 5.27 (1.10) 4.71 (1.35) Mothers education: below /higher bachelor 13/2 11/4 16/1 Job status: (yes/no) 12/3 10/5 12/5 Child gender:(boy/girl) 13/2 13/2 14/3 Medication (yes/no) 14/1 13/2 15/2 Data Analysis. Analysis was conducted using SPSS. Means and standard deviations were computed for all outcome measures for both the treatment and control groups. A mixed-design ANOVA (3 groups: compensation, remediation, control x 3 conditions: pre, post, follow-up) was used to examine the study’s hypotheses, with groups as the between-subjects factor and sessions as the repeated measure. The Greenhouse-Geisser correction was applied when there was a violation of the sphericity assumption. In our analysis of transferability across the five FIELD domains, test results were organized according to each domain. Using a conceptual meta-analysis approach, we grouped tests into their respective FIELD categories, with the overall effect size for each category calculated as the sum of individual effect sizes. We compared the domains of intervention and training within each FIELD category, where complete overlap indicated no transfer and differences signified transfer. Effect sizes for the tests were computed within their respective FIELD domains, utilizing Cohen's d formula for these calculations. Results ANOVA results on the BRIEF test measure revealed significant main effects of time, group, and their interaction for total scores, as well as for the inhibition, emotion regulation, and memory subscales. In contrast, the planning subscale only exhibited a significant main effect of time, while the shifting attention subscale showed a significant interaction between group and time (Table 4 ). Specifically, shifting attention improved in the compensatory group at posttest compared to the control group, and this improvement was maintained at follow-up for both intervention groups compared to the control group. Post hoc analyses using the LSD test indicated a reduction in symptoms following the intervention across total scores, emotion regulation, and inhibition in all groups except the control group. All subscales, with the exception of shifting attention, demonstrated significant improvements after the intervention and at follow-up compared to pre-intervention scores in all groups except the control group. Notably, improvements in the emotion regulation subscale were sustained at follow-up only in the remediation group. For the memory subscale, reductions in symptoms were observed at both posttest and follow-up in the remediation group, while improvements in the compensatory group became evident only at follow-up. These results were consistent across both intervention groups when compared to the control group. Overall, there was a significant reduction in total scores for symptoms at both posttest and follow-up assessments in the intervention groups, with these differences persisting at follow-up. The ANOVA results indicated a significant interaction of group × time and a main effect of time on the ADHD-SC4 overall scores, although there was no significant main effect of group. A similar pattern was observed for the attention deficit and hyperactivity subscales of ADHD-SC4 (Table 4 ). The LSD post hoc analysis revealed that attention deficit symptoms improved in all groups except the control group. Specifically, attention deficit symptoms significantly improved after the intervention and at follow-up compared to pre-intervention scores in all groups except the control group, with the compensatory group showing more significant reductions than the remediation group. For hyperactivity symptoms, significant improvements were noted at follow-up in both intervention groups. Additionally, the total ADHD symptoms demonstrated significant reductions at follow-up compared to both pre- and post-test scores in the ARAM group, as well as significant improvements at post-test and follow-up assessments compared to pre-test scores in the PETRA group. The missing scan results revealed a significant main effect of time and group, with a marginally significant interaction between group and time (Table 4 ). The LSD post hoc analysis indicated significant improvements in working memory for the intervention groups compared to the control group, with enhancements observed at posttest in both the ARAM and PETRA groups and at follow-up for the PETRA group compared to pre-test scores. Differences between the compensatory and control groups were noted at follow-up. The day and night Stroop task analysis showed significant main effects for both time and group; however, the interaction between group and time was not significant (Table 4 ). LSD post hoc analyses revealed reductions in inhibition errors in all groups except the control group, with significant reductions observed after the intervention and at follow-up compared to pre-intervention scores in all groups except the control group. Improvements were evident in both intervention groups at posttest and follow-up when compared to the control group. For the TMT measures, analysis indicated a significant main effect of time, but neither the main effect of group nor the interaction of group and time were significant (Table 4 ). Post hoc results revealed improvements at follow-up compared to pre-test assessments in the compensatory group. Transferability. The analysis of transferability based on effect sizes demonstrated a significant transfer effect for both interventions across all domains of the FIELD model. Specifically, PETRA exhibited a larger transfer effect in the domains of Function (0.98 vs. 0.48), Implement (0.72 vs. 0.66), Ecology (0.72 vs. 0.62), Level (1.18 vs. 1.06), and Duration (1.02 vs. 0.62) (Table 5 ). These findings indicate that while both interventions effectively promote transferability. Table 2 Means and Standard Deviations for behavioral tasks at Pretest, Posttest and follow up Assessment sessions/ Measures Compensation Group, M (SD) Remediation Group, M (SD) Control Group, M (SD) I II III I II III I II III BRIEF Inhibition 36.13 (4.56) 27.20 (4.97) 27.93 (6.31) 33.40 (3.26) 28 (4.55) 25.53 (5.06) 33.82 (3.48) 34.52 (2.78) 33.58 (3.31) Shifting attention 17.46 (5.20) 14.13 (4.38) 14.46 (4.10) 14.73 (3.21) 15.53 (3.31) 14.13 (3.13) 16.41 (3.60) 17.82 (4.20) 18.05 (4.02) Emotion regulation 21.06 (5.25) 17.40 (4.13) 16.13 (4.27) 17.53 (2.90) 16.27 (3.30) 15.87 (5.30) 19.29 (3.19) 20.05 (3.32) 19.05 (3.61) Memory 33.93 (5.88) 29.40 (6.41) 27.93 (7) 30.20 (4) 27.47 (7.25) 26.47 (5.59) 32 (6.29) 32.82 (6.61) 34.35 (5.78) Planning 20.46 (3.33) 17.33 (4.06) 17.66 (4.13) 18.47 (3.94) 17.53 (4.61) 16.33 (4.22) 19.76 (4.14) 20.11 (3.85) 19.70 (3.33) Total EF 129.06 (19.18) 105.46 (20) 105.86 (27.90) 114.33 (14.42) 104.47 (19.89) 98.13 (19.44) 121.29 (16.67) 125.35 (4.66) 122.94 (19.18) ADHD-SC4 ADD symptoms 22 (3.96) 17.20 (3.46) 16.33 (2.12) 19.93 (4.68) 17.80 (3.98) 21.67 (6.55) 19.41 (5.19) 20.35 (4.13) 21.29 (4.85) Hyperactivity symptoms 26.53 (5.01) 24.40 (6.75) 21.06 (7.49) 22.53 (3.58) 24.33 (6.44) 20.87 (6.16) 24.41 (6.28) 26.76 (5.94) 24.11 (4.70) ADHD symptoms 48.53 (7.60) 41.60 (8.59) 38 (9.59) 42.47 (5.87) 40.93 (9.07) 35.73 (7.99) 43.82 (10.32) 47.11 (9.08) 41.45 (8.33) Note: I: Pretest assessment, II: Posttest assessment, III: Follow up assessment, BRIEF: Behavioral Rating Inventory of Executive Function, M: Mean, SD: Standard deviation Table 3 Means and Standard Deviations for Cognitive tasks at Pretest, Posttest and follow up Assessment sessions/ Measures Compensation Group, M (SD) Remediation Group, M (SD) Control Group, M (SD) I II III I II III I II III Missing Scan Working Memory 4.67 ( 0.81) 6.20 (1.20) 6.07 (1.16) 5.20 (1.14) 6.13 (1.59) 5.66 (1.17) 4.47 (1) 4.59 (1.32) 4.88 (1.26) Day/Night Stroop Inhibition errors 7.53 (3.09) 3.73 (2.46) 3.93 (3.40) 6.13 (3.94) 4.13 (1.55) 3.06 (2.15) 8.82 (3.35) 7.06 (3.81) 7.88 (3.27) TRAIL-P TMT 57.93 (10.04) 38.46 (6.53) 34.40 (7.27) 43.13 (10.04) 38.93 (6.53) 35.60 (7.27) 69.23 (9.43) 49.05 (9.13) 50.70 (6.73) Note: I: Pretest assessment, II: Posttest assessment, III: Follow up assessment, M: Mean, SD: Standard deviation Table 4 The result of ANOVA on the study measures Measures Time Effect Group Effect Time * Group df F p ηp2 df F p ηp2 df F p ηp2 BRIEF Inhibition 2, 88 47.07 < .001 .51 2,44 8.09 < .001 .26 4, 88 14.82 < .001 .40 Shifting attention 2, 88 .81 .44 .01 2,44 2.68 .07 .10 4, 88 5.55 < .001 .20 Emotion regulation 2,88 6.80 .002 .13 2,44 3.44 .04 .13 4, 88 3.16 .01 .12 Memory 2,88 5.78 .004 .11 2,44 3.55 .03 .13 4, 88 5.33 .001 .19 Planning 2,88 5.19 .007 .10 2,44 2.25 .11 .09 4, 88 2.21 .07 .09 Total EF 2,88 13.78 < .001 .23 2,44 4.52 .01 .17 4, 88 6.60 < .001 .23 ADHD-SC4 ADD symptoms 2, 88 5.33 .007 .10 2,44 .98 .38 .04 4, 88 9.27 < .001 .29 Hyperactivity symptoms 2,88 10.40 < .001 .19 2,44 .94 .39 .04 4, 88 2.79 .03 .11 ADHD symptoms 2,88 12.55 < .001 .22 2,44 2.32 .11 .09 4, 88 6.84 < .001 .23 Missing scan test accuracy 2, 88 10.02 < .001 .18 2,44 6.69 .003 .23 4, 88 2.35 .06 .09 Stroop Inhibition errors 2, 88 21.25 < .001 .32 2,44 8.76 .001 .28 4, 88 2.16 .08 .08 TRAIL-P TMT 2, 88 5.38 .006 .10 2,44 2.51 .09 .10 4, 88 .56 .38 .02 Note: ADD: Attention Deficit Disorder., ADHD: Attention Deficit Hyperactivity Disorder., EF: Executive Functions., TMT: Trail Making Test. Table 5 The transfer effects of two interventions across different FILED’s domains Potential Factors Groups (n) Cohen’s D (95% Confidence Interval) F I E L D S Intervention Approach ARAM .44 (.23, .64) .66 (.36, .97) .62 (.30, .94) .62 (.30, .94) .66 (.36, .97) .62 (.49, .76) PETRA .98 (.83, 1.13) .72 (-.09, 1.54) .72 (-.09, 1.54) 1.18 (.86, 1.49) 1.06 (.75, 1.38) 1.02 (.84, 1.20) Note: F: function, I: implements, E: ecology, L: level, D: durability, S: sum of all domains Discussion This study aimed to evaluate the impact of two cognitive training approaches—compensation (PETRA) and remediation (ARAM)—on improving behavioral symptoms and cognitive functions in preschoolers with ADHD. The results demonstrated that both interventions were effective in enhancing cognitive functioning and reducing ADHD symptoms, with minimal differences between the two methods in terms of overall improvements in behavior and cognition. In the following sections, we discuss the impact of the interventions on specific cognitive constructs and their potential in transferability. Inhibitory Control. Inhibitory control, a core deficit in ADHD 37 , 38 , improved significantly in both intervention groups compared to the control group, as measured by the inhibition subscale of the BRIEF and the Stroop task. Inhibitory control is known to be trainable, and previous studies have similarly reported improvements in this area for typically developing 39 , 40 and ADHD preschoolers 25 . Shifting Attention. The results revealed that shifting attention improved in the PETRA group, as indicated by the BRIEF subscale and the Trail Making Test. However, in the ARAM group, improvements were observed only on the BRIEF subscale, not on the Trail Making Test. Shifting attention is not typically considered a primary deficit in ADHD, and some studies suggest that it remains intact in children with ADHD 41 . This may explain the limited improvement in this cognitive construct following cognitive rehabilitation. A lack of improvement in attention-shifting abilities in children with ADHD has been observed following working memory training 23 and attention training 22 . However, a previous study found that improvements in attention-shifting in children with ADHD were observed after inhibitory control training, but not after working memory training. Since shifting attention requires disengaging from one set of information and shifting to another, inhibition plays a crucial role in facilitating this process 42 . Memory. Both intervention groups showed significant improvements in memory, as assessed by the BRIEF subscale and the missing item task. Previous research has documented similar enhancements in working memory in children with ADHD following attention and working memory training 15 , 24 , 43 , inhibitory control training 25 , and attention-focused interventions 21 in children with ADHD. Planning. Planning abilities were significantly enhanced in both intervention groups, as measured by the planning subscale of the BRIEF. These findings are consistent with earlier studies that found improvements in planning ability in children with ADHD following cognitive training, using measures such as the BRIEF 25 and the Tower of Hanoi task 44 . Emotion Regulation. Both interventions led to improvements in emotion regulation in preschoolers with ADHD. This finding aligns with earlier research that has documented similar improvements in emotion regulation in this population following cognitive interventions. Improved emotion regulation in children with ADHD has been descried earlier after executive function training 48 , working memory training 49 , inhibitory control training 48 as cognitive process training and education-based emotion regulation training 50 . ADHD Symptoms. Both intervention methods were effective in reducing core ADHD symptoms, confirming the utility of cognitive training as a well-established intervention for ameliorating ADHD-related impairments. Since the goal of cognitive training is to reduce ADHD symptoms, both interventions were successful in achieving this outcome. Earlier studies have demonstrated the positive effects of both process-based training—such as attention training 20 – 22 , working memory training 23 , and inhibitory control training 51 —and compensatory education-based training 50 in alleviating symptoms in children with ADHD. Comparison of Remediation, Compensation, and Transferability. Both the PETRA and ARAM interventions significantly improved cognitive domains in preschoolers with ADHD, highlighting those cognitive interventions, regardless of the specific technique, can enhance cognitive functions and reduce related behavioral symptoms. The main difference between the two approaches lies in their methods: PETRA focuses on educational materials, environmental modifications, and reinforcement strategies, while ARAM emphasizes process-based training through graded tasks aimed at directly improving cognitive functions. In terms of transferability, which serves as an indicator of the intervention’s effectiveness, both interventions demonstrated strong transfer effects across all domains of the FIELD model. This suggests that the benefits of the training extended to new functions, tools, environments, levels, and over time. Specifically, process-based remediation training (ARAM) showed a greater transfer effect in the domains of function, implement, and environment, meaning improvements were more likely to transfer to new tasks, tools, and settings. On the other hand, education-based compensation training (PETRA) was more effective in the domains of level and durability, indicating better long-term retention and adaptability across different levels of task complexity. Process-based training enhances the capacity for cognitive processing, allowing other cognitive functions to benefit from the intervention. As these functions are involved in assessments using various tools and methods, the training's effects can extend across different implements (e.g., tests or materials) and environments (e.g., school or home). This broader applicability explains the greater transfer effects observed in these domains with process-based training. By increasing overall cognitive capacity, improvements are more likely to generalize to new tasks and settings. On the other hand, the higher transfer of education-based compensation training to behavior can be attributed to the greater similarity between the behavioral goals and the compensation strategies used in training. Since this approach focuses on teaching individuals to adapt to their cognitive challenges by modifying their behaviors in daily life, it aligns closely with real-world applications. Additionally, compensation training emphasizes practical lifestyle modifications, providing individuals with tools to adjust their routines and environments, which supports more sustainable, long-term changes. This focus on real-world relevance and adaptability contributes to the durable transfer effects observed, as the training directly impacts behaviors that are essential for everyday functioning. Conclusion. In summary, the ARAM intervention is particularly effective in creating transferable skills that can be applied to new tasks, settings, and tools, making it a dynamic approach for fostering functional flexibility. Conversely, PETRA’s strength lies in its ability to instill long-term cognitive strategies that children can retain and apply across a range of complexities, offering lasting improvements in ADHD management. This distinction between the two approaches suggests that a hybrid intervention model might be beneficial, combining process-based remediation for immediate, broad transfer effects with compensation strategies for long-lasting and adaptable gains. Limitation and future direction. One limitation of this study is the potential restriction in sample size and diversity, which may affect the generalizability of the findings to a broader population of children with ADHD. Additionally, the follow-up period might not have been long enough to adequately assess the long-term effects of the interventions, highlighting the need for future research with extended durations to evaluate the persistence of training effects. The measurement tools employed to assess cognitive functions and behavioral symptoms may have inherent biases or limitations, which could influence the results. Future research should aim to include larger and more diverse samples to enhance the generalizability of findings and assess intervention effectiveness across various demographic groups. Exploring the underlying mechanisms that contribute to transfer effects is another important avenue for future research, investigating how cognitive improvements translate into behavioral changes and examining potential mediators of this relationship. Declarations Competing Interests There are no conflicts of interest to declare. 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Cognitive rehabilitation in children with attention deficit- hyperactivity disorder: Transferability to untrained cognitive domains and behavior. Asian J. Psychiatr. (2020) doi:10.1016/j.ajp.2020.101949. Solanto, M. V. Cognitive-behavioral therapy for adult ADHD: Targeting executive dysfunction . (Guilford Press, 2011). Kofler, M. J. et al. Can Working Memory Training Work for ADHD? Development of Central Executive Training and Comparison with Behavioral Parent Training. J. Consult. Clin. Psychol. (2018) doi:10.1037/ccp0000308. Nejati, V. Principles of Cognitive Rehabilitation . (Elsevier Science & Technology, 2022). Dark, F. et al. Randomised controlled trial of compensatory cognitive training and a computerised cognitive remediation programme. Trials 21 , 810 (2020). Nejati, V. Balance-based Attentive Rehabilitation of Attention Networks (BARAN) improves executive functions and ameliorates behavioral symptoms in children with ADHD. Complement. Ther. Med. (2021) doi:10.1016/j.ctim.2021.102759. Nejati, V. & Derakhshan, Z. Attention Training Improves Executive Functions and Ameliorates Behavioral Symptoms in Children with Attention-Deficit Hyperactivity Disorder: Implication of Tele-Cognitive-Rehabilitation in the Era of Coronavirus Disease. Games Health J. (2024) doi:10.1089/g4h.2023.0002. Nejati, V. Program for attention rehabilitation and strengthening (PARS) improves executive functions in children with attention deficit- hyperactivity disorder (ADHD). Res. Dev. Disabil. (2021) doi:10.1016/j.ridd.2021.103937. Nejati, V., Derakhshan, Z. & Mohtasham, A. The effect of comprehensive working memory training on executive functions and behavioral symptoms in children with attention deficit-hyperactivity disorder (ADHD). Asian J. Psychiatr. (2023). Klingberg, T. et al. Computerized training of working memory in children with ADHD - A randomized, controlled trial. J. Am. Acad. Child Adolesc. Psychiatry (2005) doi:10.1097/00004583-200502000-00010. Nejati, V., Fallah, F. & Raskin, S. Inhibitory Control Training Improves Attention Deficit-Hyperactivity Disorder Symptoms and Externalizing Behavior. Clin. Child Psychol. Psychiatry 28 , 909–923 (2022). Anastopoulos, A. D. et al. Cognitive-behavioral therapy for college students with ADHD: Temporal stability of improvements in functioning following active treatment. J. Atten. Disord. 24 , 863–874 (2020). Tamm, L. & Nakonezny, P. A. Metacognitive executive function training for young children with ADHD: a proof-of-concept study. ADHD Atten. Deficit Hyperact. Disord. (2015) doi:10.1007/s12402-014-0162-x. Gadow, K. D. & Sprafkin, J. N. ADHD symptom checklist-4 . (Checkmate Plus, 1997). Sprafkin, J., Gadow, K. D. & Nolan, E. E. The utility of a DSM-IV-referenced screening instrument for attention-deficit/hyperactivity disorder. J. Emot. Behav. Disord. (2001) doi:10.1177/106342660100900304. Gioia, G. A., Espy, K. A. & Isquith, P. K. BRIEF-P: behavior rating inventory of executive function--preschool version . (Psychological Assessment Resources (PAR), 2003). Mashhadi, A., Hasani, J. & Teymouri, S. Psychometric properties of preschool behavior rating inventory of executive function: Parent form. J. Clin. Psychol. 9 , 75–84 (2017). Gerstadt, C. L., Hong, Y. J. & Diamond, A. The relationship between cognition and action: performance of children 3 1 2-7 years old on a stroop- like day-night test. Cognition (1994) doi:10.1016/0010-0277(94)90068-X. Buschke, H. Relative retention in immediate memory determined by the missing scan method [54]. Nature at https://doi.org/10.1038/2001129b0 (1963). Roman, A. S., Pisoni, D. B. & Kronenberger, W. G. Assessment of Working Memory Capacity in Preschool Children Using the Missing Scan Task. Infant Child Dev. (2014) doi:10.1002/icd.1849. Conners, C. Conners’ Kiddie Continuous Performance Test Version 5 . (2006). Espy, K. A. & Cwik, M. F. The development of a Trial Making Test in young children: The TRAILS-P. Clin. Neuropsychol. (2004) doi:10.1080/138540409052416. Schachar, R. J., Tannock, R. & Logan, G. Inhibitory control, impulsiveness, and attention deficit hyperactivity disorder. Clin. Psychol. Rev. 13 , 721–739 (1993). Woltering, S., Liu, Z., Rokeach, A. & Tannock, R. Neurophysiological differences in inhibitory control between adults with ADHD and their peers. Neuropsychologia (2013) doi:10.1016/j.neuropsychologia.2013.06.023. Ghodrati, S., Askari Nejad, M. S., Sharifian, M. & Nejati, V. Inhibitory control training in preschool children with typical development: an RCT study. Early Child Dev. Care 191 , 2093–2102 (2021). Nejati, V., Ghotbi, L. & Raskin, S. Inhibitory Control Training Improves Cold but Not Warm Cognition. (2023). Irwin, L. N., Kofler, M. J., Soto, E. F. & Groves, N. B. Do children with attention-deficit/hyperactivity disorder (ADHD) have set shifting deficits? Neuropsychology 33 , 470–481 (2019). Irwin Harper, L. N., Groves, N. B., Marsh, C. L., Cole, A. M. & Kofler, M. J. Does training working memory or inhibitory control produce far-transfer improvements in set shifting for children with ADHD? A randomized controlled trial. Child Neuropsychol. 29 , 825–845 (2023). Klingberg, T., Forssberg, H. & Westerberg, H. Training of working memory in children with ADHD. J. Clin. Exp. Neuropsychol. (2002) doi:10.1076/jcen.24.6.781.8395. Karimi Goodarzi, P., Rafikhah, M., Mohsen Rahnejat, A. & Eskandaripoor, M. The Effect of Cognitive Inhibition Training on the Reduction of Attention-deficit/Hyperactivity Symptoms and the Improvement of Planning Performance. Rom. J. Multidimens. Educ. Românească pentru Educ. Multidimens. 10 , (2018). O’connell, R. G., Bellgrove, M. A., Dockree, P. M. & Robertson, I. H. Cognitive remediation in ADHD: effects of periodic non-contingent alerts on sustained attention to response. Neuropsychol. Rehabil. 16 , 653–665 (2006). O’Connell, R. G. et al. Self-alert training: Volitional modulation of autonomic arousal improves sustained attention. Neuropsychologia 46 , 1379–1390 (2008). Shalev, L., Tsal, Y. & Mevorach, C. Computerized progressive attentional training (CPAT) program: Effective direct intervention for children with ADHD. Child Neuropsychol. (2007) doi:10.1080/09297040600770787. Groves, N. B. et al. Does central executive training and/or inhibitory control training improve emotion regulation for children with attention-deficit/hyperactivity disorder? A randomized controlled trial. Front. Psychiatry 13 , 1034722 (2022). Zhao, D. & Zhang, J. The effects of working memory training on attention deficit, adaptive and non-adaptive cognitive emotion regulation of Chinese children with Attention Deficit/Hyperactivity Disorder (ADHD). BMC Psychol. 12 , 59 (2024). Sánchez, M., Lavigne, R., Romero, J. F. & Elósegui, E. Emotion regulation in participants diagnosed with attention deficit hyperactivity disorder, before and after an emotion regulation intervention. Front. Psychol. 10 , (2019). Nejati, V., Fallah, F. & Raskin, S. Inhibitory control training improves ADHD symptoms and externalizing behavior. Clin. Child Psychol. Psychiatry 13591045221144356. (2022). Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6505930","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":459167897,"identity":"48597cae-7ff7-467a-95f7-cb6ed0bc93c6","order_by":0,"name":"Azin Sarraj Khorrami","email":"","orcid":"","institution":"Shahid Beheshti University","correspondingAuthor":false,"prefix":"","firstName":"Azin","middleName":"Sarraj","lastName":"Khorrami","suffix":""},{"id":459167898,"identity":"60dadcac-f197-4161-8b72-53ae53e32836","order_by":1,"name":"Jalil Fathabadi","email":"","orcid":"","institution":"Shahid Beheshti University","correspondingAuthor":false,"prefix":"","firstName":"Jalil","middleName":"","lastName":"Fathabadi","suffix":""},{"id":459167899,"identity":"a5588dd3-ed8c-4755-a1c1-3f4b9f25a410","order_by":2,"name":"Vahid Nejati","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAv0lEQVRIiWNgGAWjYHCCBAYGAxsGAwhHgkgtBwzSSNPCwHCA4TBMCxHAnL3h4ecPBeftzSUSGD/8YLDIJ6jFsudAssQBg9uJO2ckMEv2MEhYNhDSYnAjIQGkJQHIYJAG+oWwAw3uP0j+ccDgnD1QC/Nv4rTcYEgD2nKAccONBDYibTmTkGZxxiA5cWfPwzbLHgNitBw/k3yj4o+dvTl78uEbPyrqiAlsngQog7GBgcjYYT9AlLJRMApGwSgYwQAAey86fu04yKYAAAAASUVORK5CYII=","orcid":"","institution":"Shahid Beheshti University","correspondingAuthor":true,"prefix":"","firstName":"Vahid","middleName":"","lastName":"Nejati","suffix":""}],"badges":[],"createdAt":"2025-04-22 15:53:10","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6505930/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6505930/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":83513680,"identity":"f07bd9a7-b988-4467-8683-c9fee138aef7","added_by":"auto","created_at":"2025-05-27 17:42:26","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":43471,"visible":true,"origin":"","legend":"\u003cp\u003eThe results of cognitive tasks in the three groups\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6505930/v1/3d516d4e7241bbef9b84d731.jpg"},{"id":83513681,"identity":"5d2a7e12-4503-4cf9-afea-baf2951ba11e","added_by":"auto","created_at":"2025-05-27 17:42:26","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":44110,"visible":true,"origin":"","legend":"\u003cp\u003eFigure 2: The results of ADHD symptoms in the three groups\u003c/p\u003e","description":"","filename":"2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6505930/v1/c9976dbe38ec90ec03ed74fe.jpg"},{"id":83513684,"identity":"33702d1d-ce41-4c5e-85aa-cae2e5d271d1","added_by":"auto","created_at":"2025-05-27 17:42:26","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":58487,"visible":true,"origin":"","legend":"\u003cp\u003eFigure 2: The results of the Behavioral Scale in the three groups\u003c/p\u003e","description":"","filename":"3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6505930/v1/76c3f0ef232151a8edd6db1b.jpg"},{"id":85987199,"identity":"cf16aff2-d71c-4a25-93dd-6e8b354b2b9c","added_by":"auto","created_at":"2025-07-04 03:38:36","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1222485,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6505930/v1/93b869fa-22f5-430a-b585-f000773d1da8.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Transferability of cognitive training in children with ADHD: Comparison of remediation and compensation approaches","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAttention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by low attention span, high levels of hyperactivity, and an inability to control impulsive behavior \u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. These symptoms often interfere with daily tasks at home or school. At the cognitive level individuals with ADHD experience impairment in perceptual \u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e, attentional \u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e, executive \u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e, temporal \u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e, emotional \u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e, social \u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e,\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e, and motivational \u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e,\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e processing. Although ADHD is typically diagnosed during school age, most symptoms emerge during the preschool period. The prevalence of ADHD is estimated to be between 2% and 8% in preschoolers \u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e. Early diagnosis and intervention are crucial for improving symptoms and mitigating negative outcomes, such as academic failure in childhood \u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e and occupational problems in adulthood \u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eOne of the main cognitive theories of ADHD is the executive dysfunction theory, which effectively explains the behavioral and cognitive impairments observed in children with ADHD \u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e. Several therapeutic approaches target this theory for the treatment of children with ADHD using cognitive or behavioral methods, including cognitive training \u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e, cognitive behavioral therapy \u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e, and behavioral parenting training \u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe goals of an intervention can be classified into three timeframes: 1. \u003cem\u003eTarget\u003c/em\u003e, representing the short-term goals during intervention sessions; 2. \u003cem\u003eObjective\u003c/em\u003e, referring to the mid-term goals expected at the time of discharge; and 3. \u003cem\u003eAim\u003c/em\u003e, which focuses on the long-term outcomes \u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e. For example, in the case of children with ADHD, the short-term target could be improving inhibition, the mid-term objective might be reducing symptoms, and the long-term aim could be fostering greater independence. As the intervention progresses from target to aim, the goals become more abstract and less directly tied to the specific therapeutic approach. In detail, the target is closely aligned with the therapeutic method being used. For instance, in cognitive training, the target might be improving specific cognitive functions, whereas in behavioral interventions, it could involve performing a specific behavior correctly.\u003c/p\u003e \u003cp\u003eImportantly, the therapeutic target is initially technique-dependent, but this dependency should diminish over time as the individual progresses. Therapeutic techniques can be classified into two main types: \u003cem\u003epractice-based interventions\u003c/em\u003e, such as the remediation approach used in cognitive training, and \u003cem\u003eeducation-based interventions\u003c/em\u003e, which include compensation strategies in cognitive training or behavioral approaches like cognitive-behavioral therapy (CBT). Over the course of treatment, the goal is for the individual to internalize the skills and strategies, reducing reliance on specific techniques and fostering greater independence.\u003c/p\u003e \u003cp\u003eCognitive training involves structured programs administered by therapists to remediate or compensate for cognitive deficits and their associated outcomes, aiming to restore or enhance cognitive functioning \u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e. This training uses various approaches to address cognitive capacities, including remediation and compensation \u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e. In the remediation approach, known as cognitive process training, progressively graded tasks are used to enhance target cognitive functions and extend processing capacity. In the compensation approach, individuals learn strategies to manage existing cognitive assets by reducing external demands or optimally allocating cognitive resources to meet environmental challenges.\u003c/p\u003e \u003cp\u003eAlthough these hypothetical classifications are beneficial for defining the target and pathways of interventions, the objective and aim are integrative. The transfer of training effects from these two approaches should be considered an index of effectiveness in therapeutic interventions. Several cognitive training studies in children with ADHD have demonstrated improvements in both cognitive and behavioral aspects through attention training \u003csup\u003e\u003cspan additionalcitationids=\"CR21\" citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e, working memory training \u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e,\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e,\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e, inhibitory control training \u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e, cognitive behavioral therapy \u003csup\u003e\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u003c/sup\u003e, and Metacognitive executive function training \u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eAn essential factor in evaluating the effectiveness of different interventions is assessing the transferability of training effects to untrained domains. A comprehensive model for understanding this, known as FIELD (Function, Implement, Level, Ecology, and Durability), provides a structured framework to guide the evaluation of transfer effects \u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e. Function-related transfer refers to the classic concept of transfer, where the benefits of training extend from the targeted function to other, untrained functions. Implement transfer involves the application of training effects across various assessment or intervention tools and methods, such as objective or subjective tests, paper-and-pencil tasks, computerized or motor tasks, achievement or attitude tests, and self-report or informant-based measures. Level-related transfer concerns the transfer of training effects across different levels of functioning, such as from neural changes to cognitive improvements or behavioral outcomes. Ecological transfer captures the expansion of training effects beyond the original training setting (e.g., a clinic) to other environments, like schools or homes. Lastly, durability-related transfer focuses on the longevity of training effects, evaluating how long the benefits persist after the intervention ends.\u003c/p\u003e \u003cp\u003eIn the present study, we hypothesized a common source for the behavioral and cognitive problems in children with ADHD and aimed to compare the transferability of remediation and compensation techniques. To achieve this, children received both compensation and remediation interventions and were assessed using behavioral scales and cognitive tests. Our goal was to determine which intervention exhibited greater transferability to untrained domains, serving as an index of effectiveness.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cb\u003eParticipants.\u003c/b\u003e Forty-seven preschool children diagnosed with ADHD (aged between 4\u0026ndash;7 years) were recruited from those referred to child counseling centers in Tehran, Iran. Using G*Power software, with a mean effect size of 0.50 and α\u0026thinsp;=\u0026thinsp;0.05 for three groups, a sample size of 45 was determined to be sufficient. The children were diagnosed by a registered psychologist or a child psychiatrist. They were then randomly assigned to three groups: 15 children in the remediation group, 15 in the compensation group, and 17 in the control group (with two additional children in the control group to account for potential dropout due to lack of treatment). Children were excluded if they did not exhibit both attention deficit and hyperactivity symptoms simultaneously, had other psychiatric disorders, or if their mothers were unwilling to complete questionnaires or participate in the treatment plan. Two children in each group were receiving psychostimulant medication for their ADHD symptoms. The mean age of the children was 5 years. Informed consent was obtained from all subjects and/or their legal guardian(s). All methods were performed in accordance with relevant guidelines and regulations, including the standards of the Helsinki Declaration of 1975, as revised in 1983. The experimental procedures received ethical approval from the Ethics Committee for Research Involving Human Participants at Shahid Beheshti University (code number: IR.SBU.REC.1403.098).\u003c/p\u003e \u003cp\u003e \u003cb\u003eAttentive Rehabilitation of Attention and Memory (ARAM).\u003c/b\u003e ARAM includes tasks for inhibition, sustained attention, working memory, and shifting attention was used for remediation training. The program was installed on participants' computers, and both parents and children were given instructions on how to use it. Children were allowed to perform these tasks three sessions per week, with each session lasting 30\u0026ndash;45 minutes. The tasks were organized hierarchically from easy to difficult, with the level of difficulty adjusting automatically according to each participant's performance. The tasks were designed to be engaging and featured attractive stimuli to motivate children. Parents were instructed not to interfere with any training session but were allowed to monitor their children's progress.\u003c/p\u003e \u003cp\u003e \u003cb\u003eProgram for Executive Function Training (PETRA).\u003c/b\u003e PETRA combines parent management training with compensatory strategies to educate mothers about the neurological deficits underlying their children's behavioral problems and how to manage them using specific strategies and skills. This program consisted of 10 group training sessions, held twice weekly, with each session lasting 2 hours. The treatment was administered by a well-trained psychologist. Session content included psychoeducation, the main principles of behavior management, and definitions and strategies for executive functions such as inhibition, working memory, sustained attention, cognitive flexibility, planning, time management, initiation, and organization. The tenth session focused on identifying the strengths and weaknesses of both mothers and their children's executive functions, as well as their similarities and differences.\u003c/p\u003e \u003cp\u003e \u003cb\u003eADHD-SC4.\u003c/b\u003e ADHD symptoms were measured using the SC4, a 50-item questionnaire that asks parents to rate symptoms of ADHD on a 4-point scale (Never\u0026thinsp;=\u0026thinsp;0, Sometimes\u0026thinsp;=\u0026thinsp;1, Often\u0026thinsp;=\u0026thinsp;2, Very Often\u0026thinsp;=\u0026thinsp;3), with higher scores representing a greater number of problems. The sum of ADHD scores was used as an outcome measure for further analysis. The SC4 has demonstrated satisfactory psychometric properties \u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e,\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eExecutive Function Questionnaire Preschool (BRIEF-P).\u003c/b\u003e Executive function deficits were measured using the BRIEF-P, which assesses impairment across domains of everyday function, including Inhibition, Emotional Control, Shift, Working Memory, and Plan/Organize on a 3-point rating scale. Parents responded to 63 items, indicating the occurrence of problematic behavior during the past 6 months on a scale from Never (=\u0026thinsp;1), Sometimes (=\u0026thinsp;2), or Often (=\u0026thinsp;3), with higher scores indicating poorer EF \u003csup\u003e\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u003c/sup\u003e. The standardization of the instrument for Iranian samples was completed in 2014 \u003csup\u003e31\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eDay and Night Stroop.\u003c/b\u003e Inhibition was assessed using the Day and Night Stroop, designed by Gerstadt et al. (1994) \u003csup\u003e\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u003c/sup\u003e. This task involves a set of 21 pictures depicting either the moon or sun, where children are required to give a conflicting response verbally (e.g., saying \"day\" when shown a moon card).\u003c/p\u003e \u003cp\u003e \u003cb\u003eMissing Scan Test.\u003c/b\u003e The Missing Scan Test, designed by Buschke (1963) \u003csup\u003e\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e\u003c/sup\u003e, was used to measure working memory in preschool children. It involves 34 animal pictures, where children must identify and label them, removing unfamiliar animals. In each trial, children view a set of animals (3\u0026ndash;10), which are then concealed, with one animal missing upon return. Children must name the missing animal. The memory span score is the longest range of animals the child can correctly recall. Scores show good correlation with other memory tasks (r\u0026thinsp;=\u0026thinsp;0.71) \u003csup\u003e\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTrail Making Test (TMT).\u003c/b\u003e Shifting attention ability was assessed using TMT. Children were presented with a book of dog characters and instructed to draw lines between the dogs in order of size or match dogs to bones of similar sizes, alternating between dogs and bones. The test included distractors (cats) in the final condition. Espy \u0026amp; Cwik (2004) \u003csup\u003e\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e\u003c/sup\u003e demonstrated good test-retest reliability for this procedure (r\u0026thinsp;=\u0026thinsp;0.45 to 0.65). A modified version including only the first two steps was used in this research.\u003c/p\u003e \u003cp\u003e \u003cb\u003eProcedure.\u003c/b\u003e All participants were randomly assigned to one of the remediation, compensation, or control groups. Mothers and children were not given extra information regarding the benefits of either treatment plan to ensure blinding. Following diagnosis, mothers completed the ADHD-SC4 and BRIEF-P. Children were assessed using the Day and Night Stroop, Missing Scan Test, and TMT. These measures were completed before, after, and 2 months post-intervention. Assessments were conducted by an expert in neuropsychological assessments. Descriptive characteristics of each group and all samples as a whole are provided in the table below.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eParticipants' characteristics for each group\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGroup/variables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ecompensation\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;15)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eremediation\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;15)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003econtrol\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;17)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMothers age, M (SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31.47 (5.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36.13 (2.64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e34.06 (4.96)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChild age, M (SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.40 (1.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.27 (1.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.71 (1.35)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMothers education: below /higher bachelor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13/2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11/4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16/1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eJob status: (yes/no)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12/3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10/5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12/5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChild gender:(boy/girl)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13/2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13/2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14/3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedication (yes/no)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14/1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13/2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15/2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eData Analysis.\u003c/b\u003e Analysis was conducted using SPSS. Means and standard deviations were computed for all outcome measures for both the treatment and control groups. A mixed-design ANOVA (3 groups: compensation, remediation, control x 3 conditions: pre, post, follow-up) was used to examine the study\u0026rsquo;s hypotheses, with groups as the between-subjects factor and sessions as the repeated measure. The Greenhouse-Geisser correction was applied when there was a violation of the sphericity assumption. In our analysis of transferability across the five FIELD domains, test results were organized according to each domain. Using a conceptual meta-analysis approach, we grouped tests into their respective FIELD categories, with the overall effect size for each category calculated as the sum of individual effect sizes. We compared the domains of intervention and training within each FIELD category, where complete overlap indicated no transfer and differences signified transfer. Effect sizes for the tests were computed within their respective FIELD domains, utilizing Cohen's d formula for these calculations.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eANOVA results on the BRIEF test measure revealed significant main effects of time, group, and their interaction for total scores, as well as for the inhibition, emotion regulation, and memory subscales. In contrast, the planning subscale only exhibited a significant main effect of time, while the shifting attention subscale showed a significant interaction between group and time (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). Specifically, shifting attention improved in the compensatory group at posttest compared to the control group, and this improvement was maintained at follow-up for both intervention groups compared to the control group. Post hoc analyses using the LSD test indicated a reduction in symptoms following the intervention across total scores, emotion regulation, and inhibition in all groups except the control group. All subscales, with the exception of shifting attention, demonstrated significant improvements after the intervention and at follow-up compared to pre-intervention scores in all groups except the control group. Notably, improvements in the emotion regulation subscale were sustained at follow-up only in the remediation group. For the memory subscale, reductions in symptoms were observed at both posttest and follow-up in the remediation group, while improvements in the compensatory group became evident only at follow-up. These results were consistent across both intervention groups when compared to the control group. Overall, there was a significant reduction in total scores for symptoms at both posttest and follow-up assessments in the intervention groups, with these differences persisting at follow-up.\u003c/p\u003e \u003cp\u003eThe ANOVA results indicated a significant interaction of group \u0026times; time and a main effect of time on the ADHD-SC4 overall scores, although there was no significant main effect of group. A similar pattern was observed for the attention deficit and hyperactivity subscales of ADHD-SC4 (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). The LSD post hoc analysis revealed that attention deficit symptoms improved in all groups except the control group. Specifically, attention deficit symptoms significantly improved after the intervention and at follow-up compared to pre-intervention scores in all groups except the control group, with the compensatory group showing more significant reductions than the remediation group. For hyperactivity symptoms, significant improvements were noted at follow-up in both intervention groups. Additionally, the total ADHD symptoms demonstrated significant reductions at follow-up compared to both pre- and post-test scores in the ARAM group, as well as significant improvements at post-test and follow-up assessments compared to pre-test scores in the PETRA group.\u003c/p\u003e \u003cp\u003eThe missing scan results revealed a significant main effect of time and group, with a marginally significant interaction between group and time (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). The LSD post hoc analysis indicated significant improvements in working memory for the intervention groups compared to the control group, with enhancements observed at posttest in both the ARAM and PETRA groups and at follow-up for the PETRA group compared to pre-test scores. Differences between the compensatory and control groups were noted at follow-up.\u003c/p\u003e \u003cp\u003eThe day and night Stroop task analysis showed significant main effects for both time and group; however, the interaction between group and time was not significant (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). LSD post hoc analyses revealed reductions in inhibition errors in all groups except the control group, with significant reductions observed after the intervention and at follow-up compared to pre-intervention scores in all groups except the control group. Improvements were evident in both intervention groups at posttest and follow-up when compared to the control group. For the TMT measures, analysis indicated a significant main effect of time, but neither the main effect of group nor the interaction of group and time were significant (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). Post hoc results revealed improvements at follow-up compared to pre-test assessments in the compensatory group.\u003c/p\u003e \u003cp\u003eTransferability. The analysis of transferability based on effect sizes demonstrated a significant transfer effect for both interventions across all domains of the FIELD model. Specifically, PETRA exhibited a larger transfer effect in the domains of Function (0.98 vs. 0.48), Implement (0.72 vs. 0.66), Ecology (0.72 vs. 0.62), Level (1.18 vs. 1.06), and Duration (1.02 vs. 0.62) (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). These findings indicate that while both interventions effectively promote transferability.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMeans and Standard Deviations for behavioral tasks at Pretest, Posttest and follow up\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAssessment sessions/ Measures\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eCompensation Group, M (SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eRemediation Group, M (SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003eControl Group, M (SD)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eI\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eII\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eIII\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eI\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eII\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eIII\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003eI\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cem\u003eII\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cem\u003eIII\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBRIEF\u003c/p\u003e \u003cp\u003eInhibition\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36.13 (4.56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27.20 (4.97)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27.93 (6.31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e33.40 (3.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e28 (4.55)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e25.53 (5.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e33.82 (3.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e34.52 (2.78)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e33.58 (3.31)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eShifting attention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17.46 (5.20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14.13 (4.38)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14.46 (4.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e14.73 (3.21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e15.53 (3.31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e14.13 (3.13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e16.41 (3.60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e17.82 (4.20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e18.05 (4.02)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmotion regulation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e21.06 (5.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17.40 (4.13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16.13 (4.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e17.53 (2.90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e16.27 (3.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e15.87 (5.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e19.29 (3.19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e20.05 (3.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e19.05 (3.61)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMemory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e33.93 (5.88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e29.40 (6.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e27.93 (7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e30.20 (4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e27.47 (7.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e26.47 (5.59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e32 (6.29)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e32.82 (6.61)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e34.35 (5.78)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlanning\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e20.46 (3.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17.33 (4.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17.66 (4.13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e18.47 (3.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e17.53 (4.61)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e16.33 (4.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e19.76 (4.14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e20.11 (3.85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e19.70 (3.33)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal EF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e129.06 (19.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e105.46 (20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e105.86 (27.90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e114.33 (14.42)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e104.47 (19.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e98.13 (19.44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e121.29 (16.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e125.35 (4.66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e122.94 (19.18)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eADHD-SC4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eADD symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e22 (3.96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17.20 (3.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16.33 (2.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e19.93 (4.68)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e17.80 (3.98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e21.67 (6.55)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e19.41 (5.19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e20.35 (4.13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e21.29 (4.85)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHyperactivity symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e26.53 (5.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24.40 (6.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21.06 (7.49)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e22.53 (3.58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e24.33 (6.44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e20.87 (6.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e24.41 (6.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e26.76 (5.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e24.11 (4.70)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eADHD symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e48.53 (7.60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e41.60 (8.59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e38 (9.59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e42.47 (5.87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e40.93 (9.07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e35.73 (7.99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e43.82 (10.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e47.11 (9.08)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e41.45 (8.33)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"10\"\u003eNote: I: Pretest assessment, II: Posttest assessment, III: Follow up assessment, BRIEF: Behavioral Rating Inventory of Executive Function, M: Mean, SD: Standard deviation\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMeans and Standard Deviations for Cognitive tasks at Pretest, Posttest and follow up\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAssessment sessions/ Measures\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eCompensation Group, M (SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eRemediation Group, M (SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003eControl Group, M (SD)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eI\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eII\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eIII\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eI\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eII\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eIII\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003eI\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cem\u003eII\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cem\u003eIII\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMissing Scan\u003c/b\u003e\u003c/p\u003e \u003cp\u003eWorking Memory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.67 ( 0.81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.20 (1.20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.07 (1.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.20 (1.14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6.13 (1.59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5.66 (1.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e4.47 (1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e4.59 (1.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e4.88 (1.26)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDay/Night Stroop\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInhibition errors\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7.53 (3.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.73 (2.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.93 (3.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6.13 (3.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4.13 (1.55)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e3.06 (2.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e8.82 (3.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e7.06 (3.81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e7.88 (3.27)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTRAIL-P\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTMT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e57.93 (10.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e38.46 (6.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e34.40 (7.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e43.13 (10.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e38.93 (6.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e35.60 (7.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e69.23 (9.43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e49.05 (9.13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e50.70 (6.73)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"10\"\u003eNote: I: Pretest assessment, II: Posttest assessment, III: Follow up assessment, M: Mean, SD: Standard deviation\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe result of ANOVA on the study measures\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"15\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c15\" colnum=\"15\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMeasures\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e \u003cp\u003eTime Effect\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c10\" namest=\"c7\"\u003e \u003cp\u003eGroup Effect\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c15\" namest=\"c12\"\u003e \u003cp\u003eTime * Group\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003edf\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eηp2\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003edf\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eηp2\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e \u003cp\u003edf\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c13\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c14\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c15\"\u003e \u003cp\u003eηp2\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBRIEF\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInhibition\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2, 88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e47.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2,44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e8.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e4, 88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e14.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e.40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eShifting attention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2, 88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2,44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e2.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e4, 88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e5.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e.20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmotion regulation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2,88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e.002\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2,44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e3.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e.04\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e4, 88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e3.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e\u003cb\u003e.01\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e.12\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMemory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2,88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e.004\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2,44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e3.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e.03\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e4, 88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e5.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e\u003cb\u003e.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e.19\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlanning\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2,88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e.007\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2,44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e2.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e4, 88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e2.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e.09\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal EF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2,88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2,44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e4.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e.01\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e4, 88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e6.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e.23\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eADHD-SC4\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eADD symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2, 88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e.007\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2,44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e4, 88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e9.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e.29\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHyperactivity symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2,88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2,44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e4, 88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e2.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e\u003cb\u003e.03\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e.11\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eADHD symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2,88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2,44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e2.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e4, 88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e6.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e.23\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMissing scan test\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eaccuracy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2, 88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2,44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e6.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e.003\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e4, 88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e2.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e.09\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eStroop\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInhibition errors\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2, 88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2,44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e8.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e4, 88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e2.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e.08\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTRAIL-P\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTMT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2, 88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e.006\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2,44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e2.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e4, 88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e.02\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"15\"\u003eNote: ADD: Attention Deficit Disorder., ADHD: Attention Deficit Hyperactivity Disorder., EF: Executive Functions., TMT: Trail Making Test.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe transfer effects of two interventions across different FILED\u0026rsquo;s domains\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePotential Factors\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGroups (n)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c7\" namest=\"c3\"\u003e \u003cp\u003eCohen\u0026rsquo;s D (95% Confidence Interval)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eL\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eS\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntervention Approach\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eARAM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.44 (.23, .64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.66 (.36, .97)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.62 (.30, .94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.62 (.30, .94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.66 (.36, .97)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.62 (.49, .76)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePETRA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.98 (.83, 1.13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.72 (-.09, 1.54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.72 (-.09, 1.54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.18 (.86, 1.49)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.06 (.75, 1.38)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.02 (.84, 1.20)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e Note: F: function, I: implements, E: ecology, L: level, D: durability, S: sum of all domains\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study aimed to evaluate the impact of two cognitive training approaches\u0026mdash;compensation (PETRA) and remediation (ARAM)\u0026mdash;on improving behavioral symptoms and cognitive functions in preschoolers with ADHD. The results demonstrated that both interventions were effective in enhancing cognitive functioning and reducing ADHD symptoms, with minimal differences between the two methods in terms of overall improvements in behavior and cognition. In the following sections, we discuss the impact of the interventions on specific cognitive constructs and their potential in transferability.\u003c/p\u003e \u003cp\u003eInhibitory Control. Inhibitory control, a core deficit in ADHD \u003csup\u003e\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e,\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e\u003c/sup\u003e, improved significantly in both intervention groups compared to the control group, as measured by the inhibition subscale of the BRIEF and the Stroop task. Inhibitory control is known to be trainable, and previous studies have similarly reported improvements in this area for typically developing \u003csup\u003e\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e,\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e\u003c/sup\u003e and ADHD preschoolers \u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eShifting Attention. The results revealed that shifting attention improved in the PETRA group, as indicated by the BRIEF subscale and the Trail Making Test. However, in the ARAM group, improvements were observed only on the BRIEF subscale, not on the Trail Making Test. Shifting attention is not typically considered a primary deficit in ADHD, and some studies suggest that it remains intact in children with ADHD \u003csup\u003e\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e\u003c/sup\u003e. This may explain the limited improvement in this cognitive construct following cognitive rehabilitation. A lack of improvement in attention-shifting abilities in children with ADHD has been observed following working memory training \u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e and attention training \u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e. However, a previous study found that improvements in attention-shifting in children with ADHD were observed after inhibitory control training, but not after working memory training. Since shifting attention requires disengaging from one set of information and shifting to another, inhibition plays a crucial role in facilitating this process \u003csup\u003e\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eMemory. Both intervention groups showed significant improvements in memory, as assessed by the BRIEF subscale and the missing item task. Previous research has documented similar enhancements in working memory in children with ADHD following attention and working memory training \u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e,\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e,\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e\u003c/sup\u003e, inhibitory control training \u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e, and attention-focused interventions \u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e in children with ADHD.\u003c/p\u003e \u003cp\u003ePlanning. Planning abilities were significantly enhanced in both intervention groups, as measured by the planning subscale of the BRIEF. These findings are consistent with earlier studies that found improvements in planning ability in children with ADHD following cognitive training, using measures such as the BRIEF \u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e and the Tower of Hanoi task \u003csup\u003e\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eEmotion Regulation. Both interventions led to improvements in emotion regulation in preschoolers with ADHD. This finding aligns with earlier research that has documented similar improvements in emotion regulation in this population following cognitive interventions. Improved emotion regulation in children with ADHD has been descried earlier after executive function training \u003csup\u003e\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e\u003c/sup\u003e, working memory training \u003csup\u003e\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e\u003c/sup\u003e, inhibitory control training \u003csup\u003e\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e\u003c/sup\u003e as cognitive process training and education-based emotion regulation training \u003csup\u003e\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eADHD Symptoms. Both intervention methods were effective in reducing core ADHD symptoms, confirming the utility of cognitive training as a well-established intervention for ameliorating ADHD-related impairments. Since the goal of cognitive training is to reduce ADHD symptoms, both interventions were successful in achieving this outcome. Earlier studies have demonstrated the positive effects of both process-based training\u0026mdash;such as attention training \u003csup\u003e\u003cspan additionalcitationids=\"CR21\" citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e, working memory training \u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e, and inhibitory control training \u003csup\u003e\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e\u003c/sup\u003e\u0026mdash;and compensatory education-based training \u003csup\u003e\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e\u003c/sup\u003e in alleviating symptoms in children with ADHD.\u003c/p\u003e \u003cp\u003eComparison of Remediation, Compensation, and Transferability. Both the PETRA and ARAM interventions significantly improved cognitive domains in preschoolers with ADHD, highlighting those cognitive interventions, regardless of the specific technique, can enhance cognitive functions and reduce related behavioral symptoms. The main difference between the two approaches lies in their methods: PETRA focuses on educational materials, environmental modifications, and reinforcement strategies, while ARAM emphasizes process-based training through graded tasks aimed at directly improving cognitive functions.\u003c/p\u003e \u003cp\u003eIn terms of transferability, which serves as an indicator of the intervention\u0026rsquo;s effectiveness, both interventions demonstrated strong transfer effects across all domains of the FIELD model. This suggests that the benefits of the training extended to new functions, tools, environments, levels, and over time. Specifically, process-based remediation training (ARAM) showed a greater transfer effect in the domains of function, implement, and environment, meaning improvements were more likely to transfer to new tasks, tools, and settings. On the other hand, education-based compensation training (PETRA) was more effective in the domains of level and durability, indicating better long-term retention and adaptability across different levels of task complexity.\u003c/p\u003e \u003cp\u003eProcess-based training enhances the capacity for cognitive processing, allowing other cognitive functions to benefit from the intervention. As these functions are involved in assessments using various tools and methods, the training's effects can extend across different implements (e.g., tests or materials) and environments (e.g., school or home). This broader applicability explains the greater transfer effects observed in these domains with process-based training. By increasing overall cognitive capacity, improvements are more likely to generalize to new tasks and settings.\u003c/p\u003e \u003cp\u003eOn the other hand, the higher transfer of education-based compensation training to behavior can be attributed to the greater similarity between the behavioral goals and the compensation strategies used in training. Since this approach focuses on teaching individuals to adapt to their cognitive challenges by modifying their behaviors in daily life, it aligns closely with real-world applications. Additionally, compensation training emphasizes practical lifestyle modifications, providing individuals with tools to adjust their routines and environments, which supports more sustainable, long-term changes. This focus on real-world relevance and adaptability contributes to the durable transfer effects observed, as the training directly impacts behaviors that are essential for everyday functioning.\u003c/p\u003e \u003cp\u003eConclusion. In summary, the ARAM intervention is particularly effective in creating transferable skills that can be applied to new tasks, settings, and tools, making it a dynamic approach for fostering functional flexibility. Conversely, PETRA\u0026rsquo;s strength lies in its ability to instill long-term cognitive strategies that children can retain and apply across a range of complexities, offering lasting improvements in ADHD management. This distinction between the two approaches suggests that a hybrid intervention model might be beneficial, combining process-based remediation for immediate, broad transfer effects with compensation strategies for long-lasting and adaptable gains.\u003c/p\u003e \u003cp\u003eLimitation and future direction. One limitation of this study is the potential restriction in sample size and diversity, which may affect the generalizability of the findings to a broader population of children with ADHD. Additionally, the follow-up period might not have been long enough to adequately assess the long-term effects of the interventions, highlighting the need for future research with extended durations to evaluate the persistence of training effects. The measurement tools employed to assess cognitive functions and behavioral symptoms may have inherent biases or limitations, which could influence the results. Future research should aim to include larger and more diverse samples to enhance the generalizability of findings and assess intervention effectiveness across various demographic groups. Exploring the underlying mechanisms that contribute to transfer effects is another important avenue for future research, investigating how cognitive improvements translate into behavioral changes and examining potential mediators of this relationship.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003ch2\u003eCompeting Interests\u003c/h2\u003e \u003cp\u003eThere are no conflicts of interest to declare.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eAS: data gathering and writing, JF: methodology, VN: supervision, conceptualization and writing\u003c/p\u003e\u003ch2\u003eAvailability of Data and Materials\u003c/h2\u003e \u003cp\u003eThe datasets gathered during the current study available from the corresponding author on reasonable request\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAmerican Psychiatric Association. American Psychiatric Association. 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(2022).\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Cognitive Training, Compensation, Remediation, Transferability","lastPublishedDoi":"10.21203/rs.3.rs-6505930/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6505930/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThis study evaluates the effectiveness of two cognitive training interventions\u0026mdash;Attentive Rehabilitation of Attention and Memory (ARAM) and the Program for Executive Function Training (PETRA)- in improving behavioral symptoms and cognitive functions in preschoolers with ADHD. 47 preschool children with ADHD were randomly assigned to either the ARAM (N\u0026thinsp;=\u0026thinsp;15), PETRA (N\u0026thinsp;=\u0026thinsp;15), or control group (N\u0026thinsp;=\u0026thinsp;17). Cognitive functions and behavioral symptoms were assessed. Both ARAM and PETRA demonstrated improvements in inhibitory control, shifting attention, memory, planning, and emotion regulation, with sustained reductions in ADHD symptoms. The ARAM group showed greater transfer effects in the domains of function, implement, and ecology, while PETRA excelled in level and duration. Both cognitive interventions effectively enhanced cognitive functions and reduced symptoms, with ARAM favoring broader transferability and PETRA supporting long-term cognitive strategies.\u003c/p\u003e","manuscriptTitle":"Transferability of cognitive training in children with ADHD: Comparison of remediation and compensation approaches","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-27 17:42:21","doi":"10.21203/rs.3.rs-6505930/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e0b47723-6468-4293-9846-98e177edc8fa","owner":[],"postedDate":"May 27th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":48775591,"name":"Biological sciences/Psychology"},{"id":48775592,"name":"Biological sciences/Psychology/Human behaviour"}],"tags":[],"updatedAt":"2025-07-04T03:38:12+00:00","versionOfRecord":[],"versionCreatedAt":"2025-05-27 17:42:21","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6505930","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6505930","identity":"rs-6505930","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}