Working memory and learning in school: A screening and intervention study

Susan E. Gathercole, Julian Elliott (U. Durham), Tracy Alloway (U. Stirling), Hannah Kirkwood (U. Durham), Joni Holmes (U. Northumbria)

We use working memory to hold information in mind for brief periods of time, and to mentally process it. It enables us to carry out mentally demanding activities such as mental arithmetic and following instructions. Problems with working memory could therefore cause difficulties for children's learning and progress at school. However, working memory problems have not so far been widely recognised in schools as a cause of learning difficulties.

In this project funded by the Economic and Social Research Council, the first large-scale study of children with working memory problems in mainstream schooling was conducted. The aims were to provide routine methods for teachers to identify such children through their behaviour and classroom performance, and to investigate ways of helping them learn effectively. The study, in which over 300 primary-school children took part, established a standard test for working memory problems and demonstrated an effective system for boosting working memory and learning.

Key points

• Working memory problems are linked to poor academic progress and inattentiveness

A total of 308 children age 4 to 5 or 8 to 9 with poor working memory (identified by scoring on two working memory tests) were identified, but no major sensory or emotional problems. Assessments of these children revealed that they had difficulty in remembering visual patterns and movements, as well as verbal material such as words and sentences.

The children generally made poor academic progress. They were often unable to carry out classroom activities that required holding material in memory. Two-thirds were performing below the level expected for their age in reading and mathematics. In the older age group, there was a high level of educational under-achievement. The children were also judged by teachers to be inattentive and easily distracted.

Alloway, T. P., Gathercole, S. E., Kirkwood, H., & Elliott, J. (2009). The cognitive and behavioural characteristics of children with low working memory. Child Development, 80, 606-621.

Gathercole, S. E., Alloway, T. P., Kirkwood, H. J., Elliott, J. G., Holmes, J., & Hilton, K. A. (2008). Attentional and executive function behaviours of children with poor working memory. Learning and Individual Differences, 18, 214-223.

• A classroom-based intervention to help children with working memory problems

To help with these difficulties, a classroom-based approach was developed with the aim of reducing working memory overload through teacher and child strategies, and the adaptation of curriculum materials.They trained and monitored teachers using the strategy, and compared the results to two more standard methods (focusing on areas of poor learning, normal classroom support). Although children in the working memory strategy group made no more progress that those in the other two groups, the pupils whose teachers implemented the strategies most effectively made most progress.

Gathercole, S. E. & Alloway, T. P. (2008). Working memory and learning: A practical guide. Sage Publishing.

Alloway, T. P. & Gathercole, S. E (2007). Understanding Working memory: A classroom guide.

Elliott, JG, Gathercole SE, Alloway, TP, Holmes, J & Kirkwood, H. (in press). An evaluation of a classroom-based intervention to help overcome working memory difficulties and improve long-term academic achievement. Journal of Cognitive Education and Psychology.

• Working memory ability can be enhanced through training

A commercially developed training programme designed to enhance working memory was also evaluated in collaboration with the developers, Cogmed – with agreed freedom to publish the results irrespective of outcome. Three studies evaluating this computer-based programme were carried out, with encouraging results. Children with working memory problems receiving the training showed considerable improvements in memory. Most achieved working memory scores appropriate for their age by the end of training, and these gains were sustained for at least six months after training stopped. Mathematics scores had also improved by this later date. .

Holmes, J., Gathercole, S.E., Place, M., Dunning, D.L., Hilton, K.A., & Elliott, J.G. (2010). Working memory deficits can be overcome: Impacts of training and medication on working memory in children with ADHD, Applied Cognitive Psychology, 24, 827-836.

Holmes, J., Gathercole, S.E., & Dunning, D.L. (2009). Adaptive training leads to sustained enhancement of poor working memory in children, Developmental Science, 12, F9-F15.

• Development of a behaviour checklist to identify working memory problems

To help teachers and other professionals identify children with working memory problems, the researchers also developed a checklist of behaviours based on the data collected during the project. This tool, the Working Memory Rating Scale has now been published and is already established as a valuable aid in identifying such children.

Alloway, T. P., Gathercole, S. E., Kirkwood, H. J., Elliott, J. G. (2009). The Working Memory Rating Scale. Pearson Publishing.

Alloway, T. P., Gathercole, S. E., Kirkwood, H. J., Elliott, J. G. (2009). The Working Memory Rating Scale: A classroom-based behavioral assessment of working memory. Learning and Individual Differences, 19, 242-245.

Training working memory in children with ADHD and attentional problems

Working memory is strongly associated with children's abilities to learn in key areas of the school curriculum. Children with poor working memory skills often struggle in individual learning activities in the classroom and, over time, they begin to fall behind. Poor working memory is also associated with a wide range of developmental disorders, including attention deficit hyperactivity disorder (ADHD) and reading difficulties.

It has been claimed that a recently-developed intensive cognitive training programme boosts working memory skills. The method was developed by the neuroscientist Torkel Klingberg of the Karolinska Institute and is produced by Cogmed, who are part of Pearson. We have evaluated the impact of this training in a number of populations of children; key findings are summarized below.

• Impact of medication and working memory training in children with ADHD

The aim of this project was to evaluate the impact of two interventions, stimulant medication and a training program, on the working memory skills of children with ADHD.

Twenty-five children aged 8 to 11 years, with a clinical diagnosis of combined-type ADHD receiving stimulant medication for their symptoms, completed working memory and IQ assessments both on and off their medication, and before and after training.

While stimulant medication boosted only non-verbal aspects of working memory, training improved all aspects of working memory across both the verbal and non-verbal domains. These gains persisted six months after training ceased. There was no significant effect of training or medication on children's IQ scores.

These findings suggest that while medication is useful for managing the behavioural symptoms of ADHD, its impact on the working memory system that supports learning is somewhat restricted in scope. The generalised benefits of training to working memory, particularly verbal aspects of working memory, however holds the promise of enhancing learning in children with memory difficulties.

Holmes, J., Gathercole, S.E., Place, M., Dunning, D.L., Hilton, K.A., & Elliott, J.G. (2010). Working memory deficits can be overcome: Impacts of training and medication on working memory in children with ADHD, Applied Cognitive Psychology, 24, 827-836.

• Enhancing working memory in children with low working memory

This project investigated whether a working memory training program could improve reading and mathematics in children with poor working memory skills for their age.

A total of 42 children aged 8 to 11 with poor working memory (identified by poor scores on two working memory tests) were identified. They formed two groups: i) an adaptive group who completed a version of the training program in which the difficulty of the training activities was matched to the child's ability every day ii) a non-adaptive control group, who completed the same training activities that were set at a low/easy level throughout the training period.

All children completed assessments of working memory, IQ, single word reading and mathematical reasoning before and after training. They also completed a classroom-analogue of a working memory task, which measured their ability to follow multi-step spoken instructions.

Adaptive training that taxed working memory to its limits boosted all aspects of working memory from the deficit to the age-appropriate range for the majority of children. These effects were sustained six months after training stopped, at which point mathematical skills had improved significantly. These findings suggest that working memory impairments and associated learning difficulties may be overcome through working memory training.

Holmes, J., Gathercole, S.E., & Dunning, D.L. (2009). Adaptive training leads to sustained enhancement of poor working memory in children, Developmental Science, 12, F9-F15.

• The impact of training on everyday use of working memory in the classroom: A randomized controlled trial

Susan Gathercole, Darren Dunning (U. York), Joni Holmes (U. Northumbria)

Funded by the Leverhulme Trust, the aim of this project is to provide a rigorous evaluation of the impact of working memory training on the memory, cognitive and academic skills of children with poor working memory in a fully randomized controlled trial. Adaptive training is compared with a non-adaptive version of the software in which the same memory tasks are tested at levels below span, and a control no intervention condition, in children aged 7 to 9 years. Data collection will be completed by July 2011.

• Improving support in schools for children with working memory problems

Susan Gathercole, Joni Holmes (U. Northumbria)

In a project funded by the Economic and Social Research Council that commenced in September 2010, we are engaging a range of activities that increase accessibility and relevance to classroom practice of our research on working memory and learning. Key elements include:

· 2 field trials of the classroom-based intervention and working memory training programme for children with poor working memory, in a middle school and a secondary technology college;

· a conference and workshops for specialist groups within education and health aimed at identifying and supporting children with working memory problems;

· the development of outreach materials that will facilitate global access to the research evidence on working memory and learning, and to the practical methods that help children overcome the learning difficulties associated with working memory problems;

· the preparation of briefings of best practice in the effective management of working memory problems in education to policy-makers.

Executive functions in children with reading difficulties

Shinmin Wang (PhD student, U. York), Susan Gathercole

Many children fail to learn to read readily at the same time and with the same ease as their peers. The aim of this project is to investigate the cognitive origins of such difficulties in learning to read.

The main focus of the project is on the possible role in reading difficulties that is played by deficits in executive functions, a term that refers to the higher-level control of cognitive processes. Examples of executive functions are attention, planning, inhibitory control and working memory, and they are each associated with activity in the frontal areas of the brain.

In this project, a range of executive function tasks including working memory and divided attention measures are being administered to children aged between 8 and 10 years who are either struggling to read or to understand written text. Preliminary findings indicate that problems in both working memory and inhibitory control are characteristic of children with reading difficulties.

Working memory and following instructions

Tianxiao Yang (PH.D student, U. York), Susan Gathercole, Alan Baddeley (U. York), Richard Allen (U. Leeds)

The ability to follow instructions is crucial for our effective functioning in everyday life, particularly during periods of study and learning. There is now considerable evidence that working memory plays an important role in supporting this ability. Children with poor working memory skills perform very poorly in following instructions of the form of "Touch the green pencil and put it in the blue folder" (Gathercole, Durling, Evans, Jeffcock, & Stone, 2008). The same difficulties are evident in classroom observations of children with working memory problems (Gathercole & Alloway, 2008).

The purpose of this project, led by PhD student Tianxiao Yang, is to provide a detailed experimental analysis of the contributions of subcomponents of working memory to the task of performing actions on instruction. Preliminary experiments required participants to either carry out sequences of actions by moving objects on a computer screen with the mouse, or to repeat the instructions. The spoken instructions were of the form "Click the flag; drag the star onto the triangle".

A number of different concurrent tasks were compared in order to identify the contribution of distinct components of working memory to task performance. Backward counting, an activity known to disrupt the central executive, led to large deficits in both repeating and performing the action sequences. The contribution of phonological loop varied both with recall type and task environment.

A further experiment compared the performance of action sequences with repetition of the instructions in a paradigm involving the display and manipulation of real world objects rather than computerised displays. In this situation, there was a substantial advantage to action recall over verbal recall. Moreover, this action advantage was only acquired in a rich environment and disappeared in a computerized environment.

Further experiments are planned to explore the nature of the action recall advantage, with the purposes of advancing both our theoretical understanding of the cognitive process underpinning the ability to following instructions, and also more practically to help individuals who struggle to do this in practical learning situations in everyday life.

Gathercole, S. E. & Alloway, T. P. (2008). Working memory and learning: A practical guide for teachers. Sage Publishing.

Gathercole, S. E., Durling, M. Evans, S. Jeffcock, & S. Stone (2008). Working memory abilities and children's performance in laboratory analogues of classroom activities. Applied Cognitive Psychology, 22, 1019-1037.

Older students with learning difficulties

Kartini Abd Ghani (Ph.D student), Susan Gathercole, Tom Hartley (U. York)

Many individuals now reach tertiary education despite having persisting specific learning difficulties. Despite their personal successes in doing so, such individuals face considerable challenges in meeting the many demands of study at advanced levels.

The aim of this project, which forms the basis of the PhD studies of Kartini Abd Ghani, is to provide a systematic investigation of the cognitive skills and study skills of young adult students who have been diagnosed with specific learning difficulties. Of particular interest is how the profiles of working memory skills of these individuals correspond with the study skills strategies that they have been able to apply both successfully and unsuccessfully.

A number of different concurrent tasks were compared in order to identify the contribution of distinct components of working memory to task performance. Backward counting, an activity known to disrupt the central executive, led to large deficits in both repeating and performing the action sequences. The contribution of phonological loop varied both with recall type and task environment.

A first study has investigated working memory skills and self-reported learning strategies of university students with and without dyslexia. The group with dyslexia performed poorly on measures of verbal working memory, and also reported having less confidence in selecting main ideas, developing test-taking strategies, and managing anxiety. Strengths in verbal working memory were associated linked with greater reported use of anxiety management, test taking and selecting main ideas strategies.

The next step in this research is to extend this approach to investigate memory and study skills in older secondary school children with a range of different learning difficulties.

Working memory and hypertension

Susan Gathercole, Ahmet Fuat (U. Durham), Jerry Murphy (Co. Durham and Darlington Acute Hospitals, University of Durham, Elizabeth Littlewood (U. York), Barbara Conway (Darlington PCT)

The objectives of the study were to: i) investigate what aspects of working memory if any are impaired in untreated hypertension, and ii) establish if any impairments are resolved or persist after successful antihypertensive treatment. Working memory abilities were assessed in 10 patients with a recent diagnosis of hypertension who had not yet commenced treatment, and 7 patients after successful treatment. A matched comparison group of normotensive individuals from the same GP surgery was also tested.

Significant deficits in verbal working memory were found in the hypertensive group relative to the normotensive group both before and after antihypertensive treatment. Pre-treatment systolic blood pressure was highly correlated with working memory performance. These cognitive deficits may reflect permanent damage to the frontal regions of the brain that serve working memory, caused either by lengthy periods of untreated hypertension or blood pressure levels that although elevated, fail to meet current diagnostic criteria.

It is proposed that the presence of impaired working memory may therefore identify the need to review thresholds for BP treatment, and the potential value of combining low working memory scores with elevated blood pressure values as markers for cardiovascular risk.