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The assessment and training of working memory for prevention and early
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In: Working Memory: Capacity, Developments and… ISBN: 978-1-61761-980-9
Editor: Eden S. Levin © 2010 Nova Science Publishers, Inc.

Chapter 5

THE ASSESSMENT AND TRAINING OF WORKING

MEMORY FOR PREVENTION AND EARLY
INTERVENTION IN CASE OF READING, WRITING
AND ARITHMETICAL DIFFICULTIES IN CHILDREN

Antonella D’Amico
Dipartimento di Psicologia, Università degli Studi di Palermo, Palermo, Italy

ABSTRACT
The first part of the chapter reviews the recent literature regarding the involvement
of working memory functions in scholastic learning and its role as an underlying factor of
reading, writing and arithmetical difficulties. In the second part of the chapter we find an
experience of assessment and training of working memory for the prevention of reading,
writing and mathematical learning difficulties. On the basis of this study, an Italian
working memory test battery and a training programme have been developed, including a
series of activities involving both verbal and visual-spatial working memory with
different degrees of central executive demand.

INTRODUCTION
Working memory (Baddeley, 1986) is considered as a measure of the capacity to
manipulate and transform material while remembering information.
Recent literature reports different models which seek to explain how working memory
functions. Some approaches consider WM as the activated portion of long-term memory and
emphasize the role of attention resources and control processes (Cowan, 2005; Engle, 2002).
The other well known working memory model proposed by Baddeley and Hitch (1974),
which will be focused on in this chapter, considers working memory as a system composed of
three main components: the central executive, the phonological loop and the visual-spatial
sketchpad. The central executive (CE) is responsible for performing a series of high order
2 Antonella D’Amico

functions, such as the inhibition of irrelevant information, switching between retrieval plans
or between different strategies and the temporary activation of long-term memory information
(Baddeley, 1996; Lehto, Juujärvi, Kooistra, & Pulkkinen, 2003; Miyake, Friedman, Emerson,
Witzki, Howerter, & Wager, 2000); the phonological loop (PL) and the visual-spatial
sketchpad (VSSP) are assumed to be slave systems coordinated by the central executive and
are devoted respectively to storing phonological (Vallar & Baddeley, 1984) and visual-spatial
information (i.e. Della Sala, Gray, Baddeley, Allamano, & Wilson, 1999; Logie, 1991; Logie
& Pearson, 1997; Quinn, 1988; Quinn & McConnell, 1996). Thus, while the central executive
component is considered to work with both verbal-phonological and visual-spatial
information, the slave mechanisms are highly specialized and domain dependent. More
recently (Baddeley, 2000) a fourth component has been added to the model: the episodic
buffer. This a limited-capacity temporary storage system that is capable of integrating
information from a variety of sources and is assumed to feed information into and retrieve
information from episodic LTM.
In order to fully understand the nature of the three component structures of the Working
Memory model, it is necessary to discuss the issue of its measurement. Indeed, many tasks
have been developed in order to assess working memory in children and adults.
Only the tasks involving the CE component are defined as working memory tasks, and
they generally require the simultaneous storage and manipulation of verbal-phonological or
visual-spatial information. One of the best known and used working memory tasks is the
Listening span task (Daneman & Carpenter, 1980), which is considered to involve both the
CE and the PL; in particular, the processing component of verbal information is supported by
the central executive, whereas storage is provided by the phonological loop (Baddeley &
Logie, 1999).The task involves processing a series of sentences and expressing a true/false
judgment on their content. At the end of the list of sentences, participants have to recall the
last word of each sentence.
The PL is generally measured through tasks classically used to measure verbal and
phonological short-term memory span. Individuals are required to recall increasing lists of
verbal information in the given order (digit names, words or non-words), and the span
measure of the subject corresponds to the maximum length of the list correctly recalled.
Many studies have widely demonstrated that the type of verbal material that is used in the
span tasks may lead to significant differences in individuals’ span. Indeed, people show
generally higher spans in tasks involving short words than in tasks involving long words
(length effect, Baddeley, Thomson & Buchanan, 1975); people show higher spans in tasks
involving phonologically dissimilar words than in tasks involving phonologically similar
words (phonological similarity effect); people show higher spans in tasks involving known
words than in tasks involving foreign words or non-words (lexicality effect, Hulme, Maughan
& Brown, 1991). Finally, people show lower verbal spans when they are required to performs
a concurrent task, such as to say “bla, bla” while a verbal list is presented (articulatory
suppression condition, Baddeley, Lewis & Vallar, 1984), or simply if they are exposed to an
unattended discourse while they are learning lists of verbal items (unattended speech
condition, Salame & Baddeley, 1982). All these experimental effects have demonstrated the
nature of PL. Indeed, both phonological and unattended speech effects demonstrated the
existence of a store specialized for phonological material and sensible to phonological
interference, where phonological traces are stored for a very short period of time before
decay; the length and suppression effects have demonstrated the existence and the importance
 The Assessment and Training of Working Memory for Prevention and Early… 3

of the rehearsal mechanism, which allows the traces in the phonological store to be refreshed
and reactivated, contrasting their decay. Lexicality effect, finally, is the evidence for a long-
term memory contribution to short-term memory span. All the above described effects
highlight that phonological abilities, articulatory rate and long term knowledge may
significantly influence individuals’ performance. In order to control these influences,
Gathercole and colleagues developed the non-words repetition test (Gathercole & Baddeley,
1996; Gathercole & Pickering, 2000), defined as a “pure” measure of phonological short term
memory since it does not require the use of verbal rehearsal (the children have simply to
repeat one non-word at a time) and, using low wordlike nonwords, makes little use of long
term knowledge.
Similar to the PL, the VSSP is also generally measured through tasks classically used to
measure visual spatial short-term memory span. The most famous task is certainly the Corsi
block recall, used to measure memory for visual sequences. In this task, the experimenter taps
from two up to nine blocks following a series of fixed sequences, and the subject is required
to reproduce the tapping sequences in the same serial order. Other VSSP tasks require the
recognition and/or the reproduction of visual patterns (Della Sala et al., 1999; McLean &
Hitch, 1999; Wilson, Scott, & Power, 1987).
A complete assessment of the three component structures of the working memory was
developed by Pickering and Gathercole (2001) and by Alloway (2007). Both test batteries are
suitable for use with children age 5 and older and include measures of CE function, measures
of PL function and measures of VSSP function.

1. INDIVIDUAL DIFFERENCES IN WORKING MEMORY AND

THEIR RELATIONSHIPS WITH READING, WRITING
AND ARITHMETIC LEARNING

Several studies have evidenced the role of working memory in explaining individual
differences in reading, writing (see Gathercole & Baddeley, 1993, or Pickering, 2006, for a
review) and arithmetic learning (i.e. Geary, 1993, 2003; Jordan, Hanich, & Kaplan, 2003;
Swanson & Sachse-Lee, 2001) as well as its causal role in learning disabilities, and they will
be briefly examined below.

1.1. Working Memory and Reading

Reading development, and specific reading disorders, such as dyslexia, have been studied
in depth in the last 20 years, and many authors have focused on the individuation of the factor
leading to normal development and learning disorders. Many authors place phonological
abilities at the core or reading abilities and phonological deficit as principal causal factors of
dyslexia (Snowling, 1995), whereas other focused on rapid perception of auditory and visual
information (Tallal, 1980). Many other studies, described below, have focused on the role of
working memory in reading development and reading disorders using different methodologies
such as longitudinal studies, matching-groups studies and experimental studies.
4 Antonella D’Amico

Longitudinal studies evidenced that working memory abilities assessed in preschool

children predict their reading level during primary school. Mann and Liberman (1984)
evidenced that children showing a reduced letter span of phonological similar and dissimilar
letters showed reading difficulties during primary school. Only these tasks involving PL,
however, predict reading learning performance, while tasks involving VSSP, such as the
Corsi span task, were not associated with later levels of reading. Gathercole and Baddeley
(1993a), moreover, demonstrated that preschool performance in non-word repetition tests
predicts later performance in reading tasks involving phonological processes. Both results
have been replicated by D’Amico (2000a), and evidenced that digit and word span, as well as
non-word repetition measured in preschool children, predict their reading levels during
primary school.
Other demonstrations of the strong association between working memory and reading
come from studies where working memory abilities of children with learning difficulties are
matched to those of normal achievers. Indeed, many studies have demonstrated that children
with specific reading disabilities have lower performance in tasks involving the PL (digit
span, word span or non-word repetition), while they seem to have normal performance in
VSSP tasks (Siegel, 1994). However, it should be noted that children with specific reading
disabilities do display sensitivity to the phonological similarity effect, word length effect and
unattended speech effects (Ackerman & Dykman, 1993; D’Amico, 2000b; Hall, Wilson,
Humphreys, Tinzmann & Bowyer, 1983; Hansen & Bowey, 1994; Holligan & Johnston,
1988; Johnston, Rugg & Scott, 1987; Sechi, D'Amico, Longoni & Levi, 1997). These results,
taken together, seem to demonstrate that children with reading difficulties use phonological
codes in short term memory and make use of rehearsal strategies as well as children with
normal abilities, although their performance is poorer than that of good readers.
Other interesting results regarding the involvement of working memory in reading
processes come form studies involving normal readers performing different reading tasks.
Arthur, Hitch, Halliday (1994), proposed reading tasks to 8-year old children respectively
requiring the use of visual or phonological reading strategies under articulatory suppression
condition. Only the reading task requiring the use of phonological route was significantly
damaged by the suppression condition, while performance in the reading task requiring the
use of visual route was unaltered by the experimental condition. This result, which has been
replicated by Kimura and Bryant (1983) in children and, in adults by Besner, Davies and
Daniels (1981) and Baddeley and Lewis (1981), demonstrates the importance of PL processes
for phonological reading.
Other studies focussing on reading comprehension demonstrated that it basically relies on
CE processes. Glanzer, Dorfman and Kaplan (1981), evidenced that concurrent tasks
involving CE processes (backward enumeration) had a destructive effect on reading
comprehension performances. Similarly, Daneman and Carpenter (1980) and Baddeley, Logie
Nimmo-Smith and Brereton (1985) evidenced that reading comprehension of a group of
university students was highly associated with the performance in the Listening Span Task. In
a subsequent study, Daneman and Carpenter (1983) have also evidenced that subjects with
high Listening Span performance were more skilled in ambiguous text comprehension.
Interesting results come also from a study by Yuill, Oakhill, and Parkin (1989) involving
children with selective difficulties in reading comprehension and normal phonological
reading, who found significant differences in a working memory task requiring reading aloud
multi-digit numbers and recalling the last number of each group. A series of other studies
 The Assessment and Training of Working Memory for Prevention and Early… 5

produced converging evidence of an association between reading comprehension and working

memory tasks that require the processing and storage of words (De Beni, Palladino,
Pazzaglia, & Cornoldi, 1998), sentences (Seigneuric, Ehrlich, Oakhill, & Yuill, 2000), and
numbers (Yuill et al., 1989), but not with tasks that require the manipulation of shapes and
patterns (Nation, Adams, Bowyer-Crane, & Snowling, 1999; Seigneuric et al., 2000).
Cain, Oakhill, and Bryant (2004) however, have argued that the relation between working
memory and comprehension could have been overestimated since all the considered tasks are
verbally mediated. Thus, in order to explore the extent to which the predictive power of the
working memory tasks is mediated by verbal ability, they studied the relation between
working memory and text comprehension taking into account the contribution of verbal
ability as well. Results, however, demonstrated that working memory and component skills of
comprehension (inference making, comprehension monitoring, story structure knowledge)
predicted unique variance in reading comprehension after word reading ability and
vocabulary and verbal ability were controlled. Thus, working memory should be regarded as
one, even if unique, of several factors that can influence comprehension ability and
comprehension development.

1.2. Working Memory, Writing and Spelling

There are not many studies about the role of working memory in writing and spelling
abilities. However, obtained results demonstrated that central executive processes are
involved in writing composition, while phonological Loop processes are involved in spelling
and orthography.
Swanson and Berninger (1996a) evidenced that performance in listening span tasks
(Daneman & Carpenter, 1980) are associated to text generation. A second study by the same
authors (Swanson & Berninger, 1996b) investigated the role of working memory tasks
involving CE, PL and VSSP in writing. Results evidenced that VSSP tasks were not related to
writing abilities, while performances in CE tasks were related to text generation and the
ability in PL tasks was related to the use of orthography and punctuation. The relationships
between performances in tasks involving PL and orthography were confirmed in a study by
Kroese, Hynd, Knight, Hiemenz and Hall (2000).

1.3. Working Memory and Mathematical Learning

As regards the relationships between working memory abilities and mathematical

achievement, different studies have reported a linear relationship between performances in
digit span (Gathercole, Pickering, Knight, & Stegmann, 2004; Hoosain & Salili, 1987) or in
central executive tasks (Bull & Scerif, 2001; Gathercole et al., 2004) and mathematical
abilities as evaluated using standardized achievement batteries. Other studies have
demonstrated that conditions that overload the working memory capacity, e.g. solving mental
calculations rather than written calculations, result in poorer performances both in adults
(Hitch, 1978) and children (Adams & Hitch, 1997). Finally, a series of experimental studies
have shown that concurrent tasks involving the central executive component (Furst & Hitch,
6 Antonella D’Amico

2000; Lemaire, Abdi, & Fayol, 1996; Logie, Gilhooly, & Wynn, 1994; Seitz & Schumann-
Hengsteler, 2000), the phonological loop (Furst & Hitch, 2000; Haughey, in Hitch, Cundick,
Haughey, Pugh, & Wrigth, 1987; Lau & Hoosain, 1999; Lee & Kang, 2002; Lemaire, Abdi &
Fayol, 1996; Logie et al., 1994; Seitz & Schumann-Hengsteler, 2000) or the visual-spatial
sketchpad (Heathcote, 1994; Lee & Kang, 2002) have a deleterious effect on the execution of
calculation processes.
The role played by the different components of working memory in arithmetical
performance has been further explored in a series of studies involving children with
Arithmetical Learning Difficulties (ALD) and controls (e.g. Bull & Johnston, 1997; Bull,
Johnston, & Roy, 1999; McLean & Hitch, 1999; Passolunghi & Siegel, 2001). The literature
examined is quite consistent in highlighting an impairment of the central executive process in
children with ALD. Indeed, these subjects perform worse than controls in more general
executive tasks such as the Wisconsin Sorting Card Tasks (Bull et al., 1999), in central
executive tasks that require a switch between numerical/ linguistic retrieval strategies
(McLean & Hitch, 1999) and in working memory tasks with a high executive demand (Siegel
& Ryan, 1989) which involve both numerical or linguistic material (Gathercole, Pickering,
Ambridge, & Wearing, 2004; Passolunghi & Siegel, 2001; Swanson & Sachse-Lee, 2001).
The results concerning the role of PL and VSSP in children with ALD seem more
controversial. While converging evidence has demonstrated that these subjects perform
normally in non-word repetition (McLean & Hitch, 1999) and word span (Bull & Johnston,
1997; Passolunghi & Siegel, 2001), their results in the short-term recall of digits are often
inconsistent. In a number of studies, low arithmetical achievers performed normally in digit
span tasks (Bull & Johnston, 1997; Geary, Hamson & Hoard, 2000; Geary, Hoard, &
Hamson, 1999), whereas in other studies they performed at a significantly lower level than
controls (Passolunghi & Siegel, 2001; Swanson & Sachse-Lee, 2001; see also McLean &
Hitch, 1999, who found group differences very close to the statistical significance).
With regard to the functioning of the visual-spatial sketchpad, McLean and Hitch (1999),
reported that children with ALD and normal reading abilities showed impairment in the Corsi
Block task, even though they performed normally in the short-term recall of random visual-
spatial patterns (Matrix task, adapted from Wilson, Scott, & Power, 1987), a result more
recently replicated by Swanson and Sachse-Lee (2001), using a very similar task.
For these reasons, a study by D’Amico & Guarnera (2005) was aimed at drawing a
complete and extensive picture of all the working memory functions of children with
arithmetical difficulties but with normal reading abilities, focusing particularly on the
differences between tasks that use linguistic and numerical material. A group of Italian
children with low arithmetical achievement and normal reading skills (mean age: 9 years) and
a group of age-matched controls with normal arithmetical and reading achievement were
involved in the study. The two groups were presented with a series of working memory tasks,
involving CE, PL and VSSP components.
Results of the study supported the view that the CE and the VSSP play an important role
in arithmetical abilities, while the involvement of the PL seems to have been overestimated in
the literature that based its observation only on the digit span performance of children with
ALD. Indeed children with ALD underperformed in all CE tasks involving linguistic
information (Listening Span task), and numerical information (Digit Span Backward) or both
linguistic and numerical information (Making Verbal Trails) as compared to the control
group. These results, consistent with the evidence from recent literature (Gathercole et al.,
 The Assessment and Training of Working Memory for Prevention and Early… 7

2004; Passolunghi & Siegel, 2001; Swanson & Sachse-Lee, 2001) and with the results of a
further study by D’Amico and Passolunghi (2009), confirmed the hypothesis of a domain
independent central executive disorder in children with ALD. The CE impairment could be
one of the causal factors of the difficulty of children with ALD in tasks such as the mental
and written calculations that require pupils to simultaneously retain information (the amount
carried, the loan, etc.) and to transform the new incoming items (i.e. the new addends) as well
as to inhibit a pre-activated retrieval strategy (Barrouillet, Fayol, & Lathulière, 1997; Bull &
Scerif, 2001; Passolunghi & Siegel, 2001; Swanson & Sachse-Lee, 2001).
Concerning the PL, D’Amico and Guarnera (2005) evidenced that children with ALD
underachieved only in the digit span forward while, consistent with Bull and Johnston (1997)
and Passolunghi and Siegel (2001), they showed normal word span abilities as well as normal
non-word repetition abilities (McLean and Hitch’s study, 1999). This selective impairment in
the short-term recall of numerical material would have highlighted a difficulty in the access
and retrieval of information from the numerical lexicon. However, D’Amico and Passolunghi
(2009), investigating the rate of access to long term information in children with arithmetic
difficulties compared to controls, revealed that children with ALD were slower than the
controls in naming both digits and letters, and do not show a selective impairment in the long-
term representation of numbers.
Finally, children with ALD underachieved both in the visual-spatial passive short-term
memory task (Matrix Task) and in the visual-spatial sequential memory task (Corsi Block
Task). Even if the literature regarding this issue is not really consistent (Bull et al., 1999;
McLean & Hitch, 1999; Swanson & Sachse-Lee, 2001; Passolunghi & Cornoldi, 2008), many
of the difficulties of children with ALD could be explained with reference to their visual-
spatial difficulties: consider that one of the subtypes of learning disabilities in mathematics
described by Geary (1993, 2004) is actually considered to be caused by difficulties in
spatially representing numerical and other forms of mathematical information and
relationships. Actually, visual spatial abilities are involved in a lot of arithmetical tasks such
as alignment process in performing arithmetical operations Rourke (1993; see also Rourke
and Conway, 1997), mental calculations requiring the manipulation of a number in a “mental
blackboard” (compared to the visual sketchpad) where individuals store information while
performing an operation Heathcote (1994), comparison between quantities that are based on
an analogical magnitude code and require subjects to generate and use the mental
representation of the number line (Campbell, 1994; Dehaene, 1997) or pay attention to the
order of each digit in multi-digit numbers.
Controversial results of literature are explainable if we consider several methodological
difficulties of studies involving children with arithmetical difficulties and controls. Indeed,
these studies generally involve groups of children with arithmetic difficulties, who show non-
homogeneous levels and typologies of arithmetical difficulties: some of them show
calculation difficulties whereas others show particular troubles with number comprehension
(McCloskey, Caramazza & Basili, 1985). It is also possible that different components of
working memory underlie different subgroups of arithmetic disabilities as was found for
reading disabilities (Swanson, Howard, Saetz, 2006).
8 Antonella D’Amico

2. ASSESSMENT AND TREATMENT OF WORKING MEMORY

FOR PREVENTING READING AND MATHEMATICAL
DIFFICULTIES: A STUDY REPORT
Working memory abilities improve significantly during the first years of life. Different
studies involving children demonstrated that their memory span increases significantly from
the age of 3 to the age of 8-9 (Orsini, Grossi, Capitani, Laiacona, Papagno & Vallar, 1987;
Gathercole et al., 2004).
This improvement is basically explained referring to cerebral maturation but also to the
development of other cognitive functions (i.e. language) or to the use of coding, maintaining
and retrieving strategies (Schneider & Pressley, 1989; Coyle & Bjorklund, 1997; Coyle,
Read, Gaultney & Bjorklund, 1999). For instance, the increase of PL is considered to be
linked to the increased rate of rehearsal, which enables the child to maintain growing amounts
of verbal material in the phonological store (Gathercole & Baddeley, 1993b).
Increasing performance is also due to changes in coding and recall strategies. Indeed, it
has been demonstrated that children younger than 7 years old typically rely on the
visuospatial sketchpad to support recall of pictures of familiar objects. Older children,
however, tend to use the phonological loop to mediate immediate memory performance
where possible, and so recode the visual inputs into a phonological form via rehearsal (e.g.,
Hitch & Halliday, 1983).
Despite the fact that the capacity of each component of working memory shows a steady
increase from the preschool years through adolescence, the basic modular structure of the
WM is present from 6 years of age (Gathercole et al., 2004). This is very important because it
implies the possibility to assess working memory in young children and, when low
performances are evidenced, to set up early intervention programmes.
Studies aimed at improving working memory in children are not numerous. Ho, Cheung
and Chan (2003), in a study involving children and adolescents, reported the significant effect
on verbal memory of a training based on listening to musical pieces. Hays e Pereira (1972)
and Whisler (1974) demonstrated that visual spatial training produced significant
improvements in reading abilities of primary school children. Klingberg, Forssberg and
Westerberg (2002) demonstrated that visual spatial training produces significant effects on
the ability to perform the same visual spatial memory tasks, as well as a generalization effect
in other visual-spatial tasks.
Based on this and other subsequent studies by Klingberg and colleagues (Klingberg, et
al., 2002; Thorell, Lindqvist, Bergman, Bohlin & Klingberg, 2008), CogMed developed a
computerised training programme designed to enhance working memory through intensive
practice in working memory activities. Work sessions of about 35 minutes a day for six weeks
were shown to have a positive impact on working memory performance and inattentive
behaviours in children with ADHD (Klingberg et al., 2005) and in enhancing childrens’
working memory (Holmes, Gathercole & Dunning, 2009).
In particular, the study by Thorell, Lindqvist, Bergman, Bohlin e Klingberg (2008)
demonstrated that the Cogmed program has a positive impact in improving working memory
abilities in preschool children with normal abilities thus preventing difficulties in early
academic achievement that may have otherwise occurred.
 The Assessment and Training of Working Memory for Prevention and Early… 9

D’Amico (2006) also reported significant effects of a working memory training program
on memory abilities and mathematical learning in children of the first class of primary school.
This study will be reported on in more detail, describing the results concerning reading and
writing abilities of children as well.

2.1. Method

A test-treatment-retest experimental design was adopted in order to study the efficacy of

working memory treatment and its role in reading and mathematical achievement.
During the test phase, two classes of children attending the first year of primary school
were administered with a series of working memory tasks. Moreover, teachers were asked to
rate scholastic abilities of children participating in the study. During the treatment phase, one
of the two classes (where lower scholastic achievements were rated) followed the training
program described below, while the control class carried out the normal scholastic activities.
During the retest phase children were again administered with the same working memory
tests and teachers rated their scholastic achievement. Moreover, reading, writing and
arithmetical levels of children in both classes were assessed through standardised tests.
Test-treatment-retest phases are described in more details below.

2.2. Participants

32 children, attending the first two classes of an Italian primary school, took part in the
research (whole group: mean age= 75.3 months SD = 3.7, 18 males, 14 females; group
assigned to the experimental condition: mean age= 74.8 months, 10 males, 5 females; group
assigned to the control condition: mean age= 75.7 months, 8 males, 9 females).
Children in the two classes shared the same three teachers of Italian, Mathematics and
Anthropology. This was retained to minimise the effect of different teaching styles and
educational methods between the two groups.

2.3. Material and Procedures

2.3.1. Test phase

Scholastic achievement
Given that children were just at the beginning of the first year of primary school, it was
not possible to assess their scholastic achievement using standardised tests, which are usually
administered beginning in the middle of the first year of primary school. Thus, teachers were
requested to rate the reading, writing and arithmetic baselines of children involved in the
study assigning them a score form 0 to 4, basing their judgement in part on final profiles of
the children at the end of pre-school. In particular they rated children’s abilities in reading
comprehension, reading aloud, writing under dictation, single digit calculations and logical-
spatial knowledge (up-down, right-left knowledge).
10 Antonella D’Amico

The teachers’ ratings were then examined and the class that was assigned to the
experimental condition obtained lower scores than the other class in all the considered
variables. Some of the differences between classes in teachers’ ratings were statistically
significant, and in particular for quantity judgements (F(1,30) = 5.39, p<.05) and logical-
spatial knowledge, F(1,30) = 5.85 p<.05).

Working memory abilities

All children were administered a series of working memory tasks, listed and described
below.

Listening span task. In the Italian version by D’Amico (2002a) of the Daneman and
Carpenter (1980) listening span task, the experimenter reads a set of sentences aloud, asking
the child to express a true/false judgment on the content of each sentence and to recall, at the
end of the set, the last word of each sentence. Examples of true and false sentences are
respectively “The child has a red umbrella” or “The ship floats in the sky”. “Sky” and
“umbrella” are, in these examples, the words to be recalled at the end of the set presentation.
The test is composed of 12 sets of increasing length from 2 to 5 sentences (three sets for each
length); following the Daneman and Carpenter (1980) procedure, the listening span score
corresponds to the longest set of sentences of which the last words have been correctly
recalled. For assigning the score, the true/false judgment is irrelevant. Listening span task is
considered to involve both CE and PL.

Digit span backward. Recalling digits in the inverse order of presentation is generally
considered to involve both the phonological loop and the central executive (Morra, 1994;
Pickering & Gathercole, 2001), as the sequence spoken by the experimenter must be stored
and reversed to produce the correct answer. The administration procedure of the digit span
backward (drawn from the Wechsler Scale for Children—Revised, 1974) is as follows: the
experimenter reads a series of digits aloud (starting from sets of 2 digits up to sets of 8 digits),
asking children to recall the digit set in the reverse order (i.e.: 3, 4, 8 becomes 8, 4, 3). The
score corresponds to the maximum length of the digit set recalled in the reverse order of
presentation.

Non-word repetition task. The non-word repetition task used in this study was developed
by D’Amico (2002b) and required children to repeat, one at a time, a series of non-words
pronounced by the experimenter. The task consists of 18 non-words from 5 to 9 phonemes in
length. The Non-word Repetition score corresponds to the total number of phonemes
correctly repeated. This task is considered to measure phonological short term memory.

Bisyllabic word span task. In order to measure PL processes, a word span task was used.
It was developed by D’Amico (2000b) and consisted of a series of frequently occurring
Italian bisyllabic words like “sole” (sun) and “gatto” (cat). The task administration and the
scoring method were similar to those used for the digit span tasks: the experimenter read a
series of words aloud (starting from sets of 2 items up to sets of 8 items), asking children to
recall the words in the same order as the presentation. The Bisyllabic Word Span score
corresponds to the maximum length of the word set recalled in the same serial order.
 The Assessment and Training of Working Memory for Prevention and Early… 11

Digit span forward task. A second task used to measure the PL was the Digit Span
Forward Task, drawn from the WISC-R Scale (Wechsler, 1974). The administration
procedure is as follows: the experimenter reads a series of digits aloud (starting from sets of 2
items up to sets of 8 items), asking children to recall the item set in the same order as the
presentation. The Digit Span Forward score corresponds to the maximum length of the item
set recalled in the correct order of presentation.

Short-term memory for patterns and positions. In order to assess VSSP processes, a new
task was developed (D’Amico, 2006). Each child is presented with ten 5x5 matrixes where
the experimenter places an increasing number of cards (from 2 to 5) reproducing circles
printed with different patterns. After 10 seconds, each matrix is removed and the child is
presented with a blank matrix where he has to replace the same cards in the same positions.
Two scores are assigned; the pattern score reflects the numbers of correct patterns
recalled, the position score reflects the number of correct positions recalled.

Visual-spatial working memory. A second VSSP task was also developed for the aims of
the study (D’Amico, 2006). Children are presented with sets of pairs of figures presenting the
same geometrical pattern or different geometrical patterns. The sets may be from 2 to 5 pairs
in length. Firstly, children are requested to judge if the figures in each couple are the same or
different. At the end of the set of pairs, they have to recall the second figure of each couple by
pointing it out from a series of distracters. The score corresponds to the longest set of couples
of which the last figures have been correctly recalled. For assigning the score, the
same/different judgment is irrelevant. Since this task requires the simultaneous elaboration of
visual spatial information and its maintenance in short term memory, it is considered to
involve both VSSP and CE processes.

2.3.2. Treatment phase

The treatment phase had a duration of 1 hour, twice a week, for 6 weeks. The training
was performed during school hours, in a playful context and in group sessions. The specific
activities are described below.

Random number/letter generation. The trainer asked children to say aloud, in random
order, the number in the range between 1 and 20 or the letter of the alphabet. Each child had
to say one item, in turn, without repeating the item that has already been said by his
classmates and without following a fixed sequence (i.e. number sequence of alphabetical
sequence).
This activity, inspired to the well known random generation tasks (Baddeley, 1998) was
intended to involve CE functions of information updating and long-term information
retrieving, as well as PL functions, required to maintain the item already pronounced by
classmates.

Serial and free recall of verbal material. The trainer read aloud a list of 20 words. Then,
he asked each child, in turn, to recall each word without repeating words already pronounced
by his classmates. The activities were performed with different word lists, which were
composed of: 20 high frequency 2-syllable words (3 lists of concrete words and 1 list of
abstract words), 20 high frequency 3-4 syllable words (3 lists of concrete words and 1 list of
12 Antonella D’Amico

abstract words), 20 low frequency 2-syllable words (3 lists of concrete words and 1 list of
abstract words).
The same activities were performed both in free order recall conditions or in serial recall
condition. Similar to the previous one, this activity was intended to involve the CE and the PL
functions.

Serial and free recall of names in categories with concurrent task. The trainer read aloud
a list of 20 words requiring children to tap a hand on the desk every time they heard an
animal’s name. At the end of the list, they were required to recall all the non-animal names
and then all the animals’ names that they were presented with. This activity was intended to
stimulate the executive control, since it required children to perform a categorization task, and
then an inhibition and updating task, which are necessary to recall all the non target items (the
non-animal names) and the target items (the animals’ names). PL loop was also implicated in
this activity, to the extent to which the manipulation of verbal material was required.

Figure matching. The activity is inspired by the well known game “Memory”. The trainer
placed 36 covered cards with 18 pairs of identical objects printed on the back on a desk. Each
child turned up 2 cards in order to find the pairs with identical objects; every time that a child
found a pair, it remained turned face up on the desk, otherwise, both cards were turned down
again and another child played the game. This activity was intended to improve the VSSP,
and in particular memory for figures and positions.

Memory for positions. Children were presented with a series of 3x3 matrixes with some
coloured squares. After 10 seconds, the target matrix was removed and children were
presented with a blank matrix where they had to colour the squares identical to the target
matrix. This activity was intended to improve the VSSP and in particular memory for
positions.

Memory for “live” positions. A large cardboard matrix 5x5 (150x150 centimetres) was
placed on the floor, and the experimenter placed some bonbons on three, four or five squares
in the matrix. After 10 seconds the bonbons were removed and the children were required, in
turn, to place themselves in the same squares where the bonbons had previously been placed.
When children recalled all the correct positions, they got the bonbons as a reward. In another
version of the game, a group of children displayed the target positions in the matrix and then
their classmates had to reproduce the same positions. These activities were intended to
improve the VSSP in a more lively context.

Memory for “smiles” and positions. Children were presented with a series of 3x3
matrixes, where some emoticons had been drawn. After 10 seconds, the target matrix was
removed and children were presented with a blank matrix where they had to draw the same
emoticons in the same positions as they had been presented. This activity was intended to
improve VSSP, and in particular memory for figures and positions.

Memory for visual-spatial routes. The trainer showed a 3x3 matrix, indicating a square as
the starting point. Then the matrix was removed and children were given some visual spatial
instructions such as “go to the square on the right”, “go one square up”, “go two squares
 The Assessment and Training of Working Memory for Prevention and Early… 13

down” and so on. At the end, the children were asked to indicate the final position with an X,
on a black matrix. This activity was inspired by the “active matrix task” by Cornoldi, Friso,
Giordano, Molin, Poli, Rigoni, & Tressoldi (1997) and required children to generate and to
move inside a sort of mental space. It was intended to improve visual-spatial memory, with an
involvement of high level executive processes.

2.3.3. Retest phase

At the end of treatment, the class assigned to the experimental condition and the control
class were submitted to a second phase of assessment of working memory, with the same
tasks used in the test phase. Then, teachers were again required to rate (assigning a score from
0 to 4) reading, writing and arithmetic achievement of children at the end of the school year.
Since effect of treatment on scholastic achievement was evaluated based only on
teachers’ ratings, scores obtained by children in the standardised tests of reading, writing and
arithmetic were used in order to verify the concurrent validity of teachers’ ratings. In
particular, reading has been assessed using the standardised MT battery (Cornoldi & Colpo,
1981). This test allows assessment of children’s accuracy and speed in reading aloud,
requiring them to read aloud a passage, while the experimenter scores the reading errors and
the time taken to read it. Moreover, the test allows assessment of reading comprehension,
requiring pupils to read a passage to themselves and to answer 10 questions about its content.
The reading comprehension score corresponds to the total number of correct answers.
Writing under dictation was assessed using a passage drawn from Tressoldi and
Cornoldi’s test battery (1991). All children are collectively required to write under dictation
and the total number of spelling errors are recorded.
The AC-MT standardised test was used for the assessment of number comprehension and
calculation (Cornoldi, Lucangeli & Bellina, 2002). This test allows the calculation of four
scores of Written Calculation, Number Knowledge, Accuracy and Speed using both collective
and individual testing. Written Calculation tasks and Number Knowledge tasks are paper and
pencil tasks in which the participant must solve four written multi-digit calculations (two
additions and two subtractions) and to perform a series of number magnitude judgments, with
an increasing and decreasing number arrangement and tasks of numerical syntax
comprehension. Accuracy and Speed correspond respectively to the total accuracy and the
total time taken to perform some individual tasks such as 6 mental simple calculations, 2
written simple calculations, 1-20 counting, 1-10 numbers dictation and retrieval of
arithmetical facts.

2.4. Results

The descriptive statistics of participants and the summary of main effects and interactions
are reported in Table 1.
A series of factorial analyses of variance (ANOVA) with repeated measures were
performed to evaluate the differences between the experimental group and controls in all the
considered tasks. Results do not reveal any significant effect of Group in the considered
variables, while the effect of Time factor was significant for digit span forward task (F(1,30)
14 Antonella D’Amico

= 8.9 p < .01), Listening span task (F(1,30) = 6 p < .05) and STM for positions (F(1,30) =
10.7 p < .005).
A significant interaction Group x Time in visual spatial working memory task (F(1,30) =
12.95 p < .001), and an interaction close to statistical significance in STM for positions (F(1)
= 3.34 p = .07) evidenced that children in the experimental group, after treatment, improved
their working memory abilities in these tasks significantly more than children in the control
group.

Table 1. Descriptive statistics of children in Experimental group and in the Control

group and summary of main effects and interactions

Experimental Group Control Group ANOVAs

(N 15; 10 M, 5 F) (N 17; 8 M, 9 F)
Test Retest Test Retest Group Time Group x
M (DS) M (DS) M (DS) M (DS) F (1, 30) F (1, 30) Time
F (1, 30)
Working memory
Non-word 118.3 118.1 117.5 117.3 .25 .21 .001
repetition task (3.5) (4.5) (5.7) (5.8)
Bisyllabic word 3.7 (1.1) 4 (.7) 3.8 (.6) 3.8 (.7) .003 2.23 1.23
span task
Digit span 4.4 (.6) 4.8 (.9) 4.2 (.8) 4.8 .13 8.89 .49
forward task (1.2)
Digit span 2.4 (.9) 2.5 (.7) 2.5 (.8) 2.5 (.6) .08 .14 .001
backward
Listening span 1.3 (.9) 1.5 (1.3) 1.1 (.9) 2 (.9) .47 6.07* 2.41
task
Visual-spatial .8 (.6) 1.7 (1.1) 1.6 (.8) 1 (.6) .17 .76 12.95***
working memory
STM for patterns 9.6 (2.7) 9.5 (2) 9.6 9.6 .001 .06 .06
(2.2) (2.1)
STM for 8.4 (2.6) 11.5 9.2 10.1 .15 10.97** 3.45 a
positions (3.3) (3.1) (1.5)
Scholastic achievement (teachers’ ratings)
Reading and
writing
Reading 1.8 2.6 2.17 2.94 .99 78.47*** .40
Comprehension (1.08) (1.18) (1.01) (.89)
Reading aloud 1.66 2.6 1.88 2.76 .27 73.6*** .58
(1.17) (1.12) (1.05) (.90)
Writing under 1.73 2.46 1.94 2.53 .13 46.13*** .56
dictation (1.16) (1.12) (1.02) (1.12)
Arithmetic
Quantity 2.07 2.67 2.82 3 (.71) 3.77 a 14.31 *** 4.26*
knowledge (1.10) (.81) (.73)
Calculations 2.00 2.6 (.9) 2.12 2.53 .006 25.2*** .87
(1.00) (.99) (.62)
Spatial 2.07 2.6 2.82 2.7 1.9 7.5* 18.43***
relationships (1.03) (1.05) (.72) (.77)
*p < .05, **p < .01, ***p < .001, ap = .07
 The Assessment and Training of Working Memory for Prevention and Early… 15

Similarly, a series of ANOVAs were performed using teachers’ ratings as dependent

variables. Results (reported in Table 1) did not reveal any Group effect. Significant Time
effects for all the considered variables, on the contrary, demonstrated that all the children
improved their scholastic achievement from the beginning of the school year to the end.
Significant Group x Time interactions in Quantity Knowledge and Spatial Relationship
teachers’ ratings demonstrated that children in the experimental group improved their
scholastic achievement in these arithmetical areas significantly more than children in the
control group.
The validity of the retest teachers’ ratings was confirmed through a series of correlation
analyses that revealed many significant associations between teachers’ rating and
standardised test scores, and in particular between teachers’ ratings in Reading aloud and MT
Correctness and Speed (r=-.60 p<.001 and r=-.66 p<.001), between teachers’ ratings in
Reading comprehension and MT Reading comprehension (r=.32 p= .07, close to
significance), and between teachers’ ratings in Writing under dictation and Tressoldi and
Cornoldi’s Writing under dictation (r=.70 p<.001). Teachers’ ratings in Quantity knowledge
were associated to AC-MT Number knowledge (r=.40 p<.05) and AC-MT Accuracy (r=.-36
p<.05). Teachers’ ratings in Calculation were associated to AC-MT Number knowledge
(r=.37 p<.05) and Speed (r=-.39 p<.05). Teachers’ ratings in Spatial relationships were
associated to AC-MT Number knowledge (r=.54 p<.005), Accuracy (r=-.36 p<.05) and
Speed (r=-.38 p<.05).

2.5. Discussion

This study represents a good example of application of methodologies coming from

experimental research in an educational context. Indeed, all the treatment activities were
performed during school hours, in the school context and with the class-group. This gave an
entertaining and playful aspect to the entire treatment, motivating interest and participation of
the children.
As reported in the results section, the working memory treatment had a significant effect
on improving visual spatial working memory abilities of children belonging to the
experimental group. In fact, the activities intended to improve the VSSP were particularly
suitable to be performed in group sessions. Children enjoyed playing, and engaged more in
these activities than in the verbal ones. Last but not least, in the Memory for “live” positions,
children also received a reward for their performances.
A second result of the study was that children in the experimental group showed a
significantly higher improvement than children in the control group in quantity knowledge
and spatial relationships teachers’ ratings. As reported in the test section, children in the
experimental group had shown lower performance than the children in the control group in
these aspects of arithmetic achievement; if we consider that both groups shared the same
teachers and the same scholastic programme, it is quite plausible to infer that the
strengthening of these abilities in the experimental group was also due to the working
memory treatment. This interpretation is also supported by the interconnected evidence that
children in the experimental group improved their performance in visual spatial memory tasks
but not in verbal memory tasks and, at the same time, they obtained improved scholastic
16 Antonella D’Amico

ratings in some aspects of arithmetic but not in reading. As reported in the first part of this
chapter, psychological literature has revealed that VSSP is an important underlying factor of
arithmetic processes, while it does not seem implicated in reading processes. All things
considered, it is possible to claim that an improvement of VSSP processes in children of
experimental groups might have lead to a subsequent improvement of their arithmetical
abilities, and to overcoming the difficulties that had been recorded by teachers at the
beginning of the school year.

CONCLUSION
In conclusion, all the studies described in this chapter denote the growing interest of
researchers regarding working memory and its role in explaining individual learning
differences. The interest in working memory, moreover, is not specific to psychologists
interested in cognitive processes research, as it is shared also by clinical psychologists
working with children with learning or cognitive disabilities, and by educators and teachers.
Assessment of working memory, indeed, may give important insights to school and
clinical psychologists in order to cope with the sometimes puzzling problem of diagnosis of
learning disabilities. Indeed, many children, during the first years of primary school, show
difficulties in reading, writing or arithmetic, and it is even more frequent when socio-cultural
disadvantages or educational dysfunctional conditions are present.
Under these circumstances, it is very hard to say whether the learning failure symptoms
shown by children reflect a learning disability or rather they simply reflect learning
difficulties, which may be overcome by more intense teaching sessions and practice. One of
the approaches that could be used in order to distinguish between children with false positive
and true positive learning disability, thus, could be an in-depth assessment of their working
memory processes. If children show good functions in all working memory processes, their
diagnosis might plausibly be formulated as learning difficulty, and the relative prognosis
might be more optimistic. Otherwise, if the working memory functions of children appear to
be compromised, it is more probable that the observed learning failure symptoms reflect a
learning disability.
Assessment of working memory, moreover, may help school psychologists and teachers
to formulate prediction of risk for specific learning difficulties, and to indicate some children
for additional attention starting in pre-school.
It should be noted, however, that working memory individual profiles may also be
improved by specific intervention programmes, as the research’s findings previously
described have evidenced.
These results stress the potentialities of working memory treatment programmes for the
early intervention in children at risk for learning disabilities and for cognitive rehabilitation of
declared cases of learning disabilities or ADHA. Indeed, working memory improvements, in
turn, often lead to better reading, writing and arithmetic performances, as well as to a
reduction of ADHD’s symptoms.
Given the importance of the assessment and training of working memory, one of our
recent efforts has been to develop an Italian working memory test followed by a treatment
 The Assessment and Training of Working Memory for Prevention and Early… 17

program (D’Amico & Lipari, 2010), aimed at measuring and improving working memory
functions in 5 to 15 year olds.
The test, actually under standardisation on a sample of about 500 primary school
children, has a two-level structure. The first level, following Baddeley and Hitch’s working
memory model (1974; Baddeley, 1986) is composed of three measures of phonological loop
(non-word repetition, word span and digit span), three measures of visual-spatial sketchpad
(visual pattern span, visual-spatial pattern span, visual-spatial sequences span), and three
tasks involving central executive functions (listening span, counting span, visual-spatial
span).
The second level is composed of 5 tasks aimed at examining different cognitive processes
which are considered to be involved in working memory functions (Baddeley, 2000;
Barrouillet, Bernardin & Camos 2004; Cowan, 1995; Miyake et al., 2000). In particular, three
tasks (number-letter shifting, random number generation and Navon task) measure
respectively the executive functions of shifting, updating and inhibition. The remaining two
tasks measure rate of access to long term memory and speed of processing (letter, number and
picture naming, and visual target search).
The treatment programme includes many of the activities already used in the study
previously described, along with other new activities aimed at improving the use of memo-
techniques, as well as at improving attentional processes involved in working memory and
speed of processing.

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