Executive Function Training and ADHD: What Do the Programs Actually Improve?
Updated: 3 days ago
If you have a child with ADHD, you may have seen an app or computer game that promises to strengthen attention, memory, or self-control. It is easy to see the appeal: a child practices for a few weeks, the game gets easier, and perhaps homework and mornings get easier too. But those are two different kinds of improvement. The research is more useful when we ask what each program trains and what changed outside the game.
First, what is executive functioning?
Executive functioning is a name for the mental skills we use to manage our actions and work toward a goal. They include holding information in mind, getting started, planning, shifting when something changes, and pausing before acting. A child uses these skills when they remember a two-step direction, gather their school materials, or return to homework after an interruption. Children with ADHD can struggle with different parts of this process. One child may keep track of belongings but have trouble starting; another may begin quickly and lose track of the steps.
“Executive function training” is not one program. Some products repeatedly exercise memory or attention on a screen. Others have children practice organizing a backpack or planning assignments. These approaches should not be judged as if they were the same thing.
Cogmed: working-memory exercises
Cogmed asks children to practice increasingly difficult tasks that involve holding and manipulating information. Some studies find improvement on memory tasks, including tasks similar to those practiced. The harder question is whether that changes ADHD symptoms, grades, or daily routines. In a placebo-controlled trial of 51 children ages 5–7 with ADHD, Cogmed did not outperform the comparison game on the main ADHD symptom outcome or daily executive-function ratings. A separate trial in school-age children found no advantage over an alternative attention program on classroom behavior or academic performance. These results do not mean no child enjoys or benefits from practice; they do not establish Cogmed as a way to treat ADHD symptoms or school difficulties. [1, 2]
Braingame Brian: practicing several skills in one game
Braingame Brian combines working-memory, inhibition, and flexible-thinking tasks. In a blinded trial of 89 children with ADHD, the active version improved some tested memory and inhibition skills compared with the placebo version. It did not produce a clear advantage on parent- or teacher-rated ADHD behavior or everyday executive functioning. Practicing more than one skill, by itself, did not solve the problem of transfer into daily life. [3]
EndeavorRx: a game studied for attention
EndeavorRx, studied as AKL-T01, is different from a generic “brain training” app. In a randomized trial of 348 children ages 8–12 who were not taking ADHD medication, it performed better than a digital control on the trial’s computerized attention test after four weeks. The study did not find a corresponding advantage on its parent and clinician symptom-rating measures. That is a meaningful but narrow result: improvement on an objective test of attention should not be described as proof that homework, behavior, or all ADHD symptoms improve. [4, 5]
Central executive training: an encouraging smaller research line
A research program called central executive training asks children to practice the active use of working memory. In a smaller randomized study, teachers rated organization more favorably after this training than after a comparison inhibition-training game. Parents reported improvement in both groups, without a clear advantage for central executive training. Many of the gains within the central executive training group were still reported a few months later. These findings suggest that some improvements may persist after training ends. The results come from a particular research program and should not be applied to every commercial app. [6]
What do studies of computer training show overall?
When researchers pooled 36 randomized trials of computerized cognitive training for ADHD, they found better performance on working-memory tests and a small short-term improvement in inattention ratings from assessors considered probably blinded. They did not find a clear improvement in overall ADHD symptoms, hyperactivity or impulsivity, or pooled academic outcomes. A newer 2026 synthesis of 17 trials reported small improvements on some executive-function measures and inattention, but not overall clinical symptoms or hyperactivity and impulsivity; several included studies had concerns about outcome measurement. Taken together, the results are mixed and depend on what was measured. “Brain training works” and “brain training never works” both skip that distinction. [7, 8]
Training the task a child actually needs to do
Another kind of executive-function training directly teaches a child how to organize materials and plan an assignment. It is different from repeatedly exercising memory in a game. In a randomized trial of 158 elementary-school children with ADHD, organizational-skills training improved organization and related functioning, with benefits maintained at follow-up. This type of work teaches and practices the behavior parents and teachers want to see, so there is less of a leap from a screen exercise to everyday life. It still takes practice and may need adjustment as the child’s demands change. [9]
The distinction matters: a child may become faster at a game, improve on an attention test, or actually manage assignments more consistently. Those are different outcomes. Before trying a training program, decide which change you hope to see and look for studies that measured it.
What I would tell a parent
Before paying for a program, ask which skill it practices, what outcome was actually measured in children with ADHD, and whether improvement was seen at home or school rather than only on the training task or a computer test. A program can be engaging and still have limited evidence for the change your family is hoping for. The useful question is not whether an app made a score go up; it is whether the child is doing better at the thing that matters to them.
Research cited
van Dongen-Boomsma M et al. Working memory training in young children with ADHD: a randomized placebo-controlled trial. J Child Psychol Psychiatry. 2014. doi:10.1111/jcpp.12218.
van der Donk M et al. Cognitive training for children with ADHD: a randomized controlled trial of Cogmed working memory training and “Paying Attention in Class.” Front Psychol. 2015. doi:10.3389/fpsyg.2015.01081.
Dovis S et al. Improving executive functioning in children with ADHD: training multiple executive functions within the context of a computer game. PLoS One. 2015. doi:10.1371/journal.pone.0121651.
Kollins SH et al. A novel digital intervention for actively reducing severity of paediatric ADHD (STARS-ADHD): a randomised controlled trial. Lancet Digit Health. 2020. doi:10.1016/S2589-7500(20)30017-0.
US Food and Drug Administration. De Novo summary DEN200026 (AKL-T01). https://www.accessdata.fda.gov/cdrh_docs/reviews/DEN200026.pdf
Chan ESM et al. Central executive training for ADHD: impact on organizational skills at home and school. Neuropsychology. 2023. PMID:37439737.
Westwood SJ et al. Computerized cognitive training in ADHD: a meta-analysis of randomized controlled trials with blinded and objective outcomes. Mol Psychiatry. 2023. doi:10.1038/s41380-023-02000-7.
Effectiveness of Computerized Cognitive Remediation Therapy on Executive Functions and Clinical Symptoms in Children and Adolescents With ADHD: A Meta-Analysis of Randomized Controlled Trials. Alpha Psychiatry. 2026. PMID:42110889.
Abikoff H et al. Remediating organizational functioning in children with ADHD: immediate and long-term effects from a randomized controlled trial. J Consult Clin Psychol. 2013. doi:10.1037/a0029648.
