Assessing working memory in children with ADHD: Minor administration and scoring changes may improve digit span backward's construct validity.
Keep giving digit span backward trials past the old stop point and count every digit recalled to get a working-memory score that truly reflects kids with ADHD.
01Research in Context
What this study did
Stephens et al. (2018) looked at digit span backward, a quick working-memory test.
They tried two small changes: keep giving trials after the old stop rule and count every digit recalled instead of only full strings.
Kids with ADHD took the test before and after the tweaks.
What they found
The new scoring lined up better with other working-memory and school scores.
In short, the tiny edits made the test feel more real and useful.
How this fits with other research
Emerson et al. (2023) did the same kind of fix for Down syndrome. They swapped the classic lab task for a game-like tool and also saw cleaner scores.
Wagner et al. (2011) and Schulz et al. (2011) used factor math to show the Movement ABC-2 really has three motor scales. L et al. use simpler math—just count more and quit later—but the goal is the same: make scores mean what we think they mean.
Sasson et al. (2022) worked with adults and a checklist, yet they also wanted to split ADHD from look-alike problems. All four papers share one theme: tweak the tool, not the child.
Why it matters
Next time you test working memory in a child with ADHD, ignore the old "stop at two misses" rule. Keep going a bit longer and score each digit right. The number you write down will better predict how the child does in math and reading, and you will not need extra kits or time.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →During your next digit span test, continue trials after two failures and tally total digits correct instead of only perfect strings.
02At a glance
03Original abstract
BACKGROUND: Pediatric ADHD is associated with impairments in working memory, but these deficits often go undetected when using clinic-based tests such as digit span backward. AIMS: The current study pilot-tested minor administration/scoring modifications to improve digit span backward's construct and predictive validities in a well-characterized sample of children with ADHD. METHODS AND PROCEDURES: WISC-IV digit span was modified to administer all trials (i.e., ignore discontinue rule) and count digits rather than trials correct. Traditional and modified scores were compared to a battery of criterion working memory (construct validity) and academic achievement tests (predictive validity) for 34 children with ADHD ages 8-13 (M=10.41; 11 girls). OUTCOMES AND RESULTS: Traditional digit span backward scores failed to predict working memory or KTEA-2 achievement (allns). Alternate administration/scoring of digit span backward significantly improved its associations with working memory reordering (r=.58), working memory dual-processing (r=.53), working memory updating (r=.28), and KTEA-2 achievement (r=.49). CONCLUSIONS AND IMPLICATIONS: Consistent with prior work, these findings urge caution when interpreting digit span performance. Minor test modifications may address test validity concerns, and should be considered in future test revisions. Digit span backward becomes a valid measure of working memory at exactly the point that testing is traditionally discontinued.
Research in developmental disabilities, 2018 · doi:10.1037/a0017739