Effectiveness of Computerized Cognitive Remediation Therapy on Executive Functions and Clinical Symptoms in Children...

This meta-analysis of randomized clinical trials (RCTs) aimed to determine whether computer-assisted cognitive remediation therapy (CCRT) is a feasible adjunctive treatment to improve executive function and clinical symptoms in adolescents and children with attention deficit hyperactivity disorder (ADHD).

We systematically searched 9 English and Chinese databases from database inception until May 2025. Randomized controlled trials investigating CCRT in children and adolescents with ADHD were collected. The risk of bias was assessed using the Cochrane Collaboration's tool for assessing risk of bias (RoB 2.0) and the Jadad Scale. Standardized mean differences in post-intervention data were calculated using RevMan 5.4 software. This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered on the International Prospective Register of Systematic Reviews (PROSPERO) platform.

This review included 17 RCTs comprising 1087 cases. In the CCRT intervention groups, there was a significant decrease in overall executive function (standardized mean difference (SMD) = -0.23; 95% CI = [-0.45, -0.01]; p = 0.04), working memory (SMD = -0.25; 95% CI = [-0.46, -0.03]; p = 0.03), inhibition (SMD = -0.25; 95% CI = [-0.44, -0.05]; p = 0.01), planning (SMD = -0.26; 95% CI = [-0.50, -0.01]; p = 0.04), and inattention (SMD = -0.22; 95% CI = [-0.39, -0.05]; p = 0.01) compared to the control groups; however, results did not show significant effects on cognitive flexibility, overall clinical symptoms, or hyperactivity/impulsivity compared to the control group.

CCRT played an important role in improving specific executive functions and attention symptoms in children and adolescents with ADHD. However, high-quality research is needed to validate these preliminary findings.

CRD42024619958, https://www.crd.york.ac.uk/PROSPERO/view/CRD42024619958.