The effects of sound-cognitive training intervention to the sensory gating abilities and working memory skill in children with attention deficit hyperactivity disorders symptoms

Abstract

Attention Deficit Hyperactivity Disorder (ADHD) is characterized by the inability of the brain to focus and to filter irrelevant stimuli, affecting working memory and sensory gating functions. To date, medication is prescribed to control ADHD symptoms, however, the prolonged use of these medications has shown some adverse effects for individuals with ADHD. Alternatively, two non-pharmacological approaches have been proposed to help reduce ADHD symptoms, which are sound therapy interventions and systematic working memory trainings. Despite the potential use of white noise in sound therapy to reduce ADHD symptoms, it has poor melody harmonization, thus preventing children with ADHD features from participating in long training sessions. To address this issue, the present study investigated the possible use of a combination of working memory trainings and sound therapy using various sounds, including white noise, waterfall, and Quranic recitation. The present study aimed to examine the effect of sound-working memory training intervention on sensory gating, working memory, and severity of ADHD symptoms in children with ADHD features in Kuantan, Pahang. The study was conducted in three phases. In Phase 1, the Swanson, Nolan and Pelham Teachers and Parents Rating Scale of ADHD symptoms (SNAP-IV) were cross-culturally translated into Malay (M-SNAP-IV). Additionally, the Sensory Gating Scale (SGS) was also developed. The M-SNAP-IV and the new SGS were psychometrically evaluated among 702 parents and were proven to be culturally suited and valid for use in Phases 2 (participants’ selection process) and 3 (intervention). In Phase 3, 39 children aged 8 – 11 years old with ADHD symptoms participated, and these children were divided randomly into five groups [white noise + working memory training (n=8); waterfall + working memory training (n=8); Al-Fatihah + working memory training (n=8); working memory training alone (no sound stimulus) (n=8)], and one control group (n=7). The training groups received repetitive computerised working memory training for 4 – 5 weeks (10 – 13 sessions), while the control group did not receive any intervention. The Corsi test (untrained working memory test), M-SNAP-IV, and SGS were used as pre- and post-intervention testing. In general, some of the findings showed a significant increase in sensory gating abilities and working memory, and significant decrease of ADHD symptoms in the training groups. Furthermore, it was found that the combination of white noise and working memory training was the best method in improving working memory performance and sensory gating ability, and in reducing ADHD symptoms. The present study also found a significant high-negative correlation between SGS and M-SNAP-IV scores, indicating that the increase of SGS score (the severity of sensory gating deficits reduces) led to the decrease of the M-SNAP-IV score (the reduction of severity of ADHD symptoms). However, some of the findings were negative for SGS and M-SNAP-IV, for example, a significant improvement of M-SNAP-IV’s post-intervention scores was shown in the control group, which was believed to be due to random effect. To conclude, the positive findings from the current study suggested that the sound-working memory training approach has great potential as one of the future alternative psychological and behavioural approaches for ADHD intervention.