1
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Naamanka E, Salakka I, Parkkila M, Hotti J, Poutiainen E. Effectiveness of teleneuropsychological rehabilitation: Systematic review of randomized controlled trials. J Int Neuropsychol Soc 2024; 30:295-312. [PMID: 37746802 DOI: 10.1017/s1355617723000565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
OBJECTIVE The effectiveness of neuropsychological rehabilitation is supported by the evidence found in previous reviews, but there is a lack of research regarding the effectiveness of remotely conducted neuropsychological rehabilitation. This review aimed to identify and evaluate the results of studies investigating the effectiveness of teleneuropsychological rehabilitation. METHODS Relevant articles were extracted from electronic databases and filtered to include studies published in 2016 or later to focus on recent practices. Data were synthesized narratively. RESULTS A total of 14 randomized controlled studies were included in the synthesis (9 for children/adolescents, 5 for adults). The most common type of intervention was computerized cognitive training with regular remote contact with the therapist (seven studies). Regarding children and adolescents, the evidence for the effectiveness was found only for these types of interventions with improvements in cognitive outcomes. The results regarding the family-centered interventions were mixed with improvements only found in psychosocial outcomes. No support was found for the effectiveness of interventions combining cognitive and motor training. Regarding adults, all included studies offered support for the effectiveness, at least to some extent. There were improvements particularly in trained cognitive functions. Long-term effects of the interventions with generalization to global functioning remained somewhat unclear. CONCLUSION Remote interventions focused on computerized cognitive training are promising methods within teleneuropsychological rehabilitation. However, their impact on long-term meaningful, everyday functioning remained unclear. More research is needed to reliably assess the effectiveness of teleneuropsychological interventions, especially with more comprehensive approaches.
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Affiliation(s)
| | - Ilja Salakka
- Rehabilitation Foundation, Helsinki, Finland
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | | | - Joona Hotti
- Rehabilitation Foundation, Helsinki, Finland
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2
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van de Wouw CL, Visser M, Gorter JW, Huygelier H, Nijboer TCW. Systematic review of the effectiveness of innovative, gamified interventions for cognitive training in paediatric acquired brain injury. Neuropsychol Rehabil 2024; 34:268-299. [PMID: 36908114 DOI: 10.1080/09602011.2023.2174561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 01/24/2023] [Indexed: 03/14/2023]
Abstract
Effectiveness of innovative, gamified interventions (i.e., Augmented Reality, Computer-Based Cognitive Retraining [CBCR], and Virtual Reality [VR] in conjunction with a Serious Game) for cognitive training in paediatric ABI was evaluated. Studies were identified on PsycINFO, PubMed and Scopus; last searched 4 January 2022. Eligibility criteria were participants diagnosed with ABI and aged ≤ 18 years, experimental intervention to train cognition, cognition assessed pre- and post-intervention at: (1) The level of function, or (2) The level of activity, and written in English. ROB 2 and ROBINS-I were utilised to assess risk of bias. Extracted study characteristics were methods, participants, interventions, outcomes, and results. Seven studies were included, comprising six CBCR studies and one VR study, with 182 participants. Following CBCR: (1) Improvements were observed in several cognitive functions, but there was inconsistent evidence; (2) Improvements were reported in attention and executive functions (EF) at home and at school. Following VR: (1) Improvements were observed in attention and EF; (2) Not evaluated. Due to the small number of included studies with (relatively) small and heterogeneous samples, only a cautious interpretation of the evidence was provided. There is a need for carefully designed studies with more attention to inter-individual differences and generalisation to daily life.
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Affiliation(s)
- C L van de Wouw
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, Netherlands
- Wilhelmina Children's Hospital, Utrecht, Netherlands
| | - M Visser
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, Netherlands
| | - J W Gorter
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, Netherlands
- Pediatric Rehabilitation, Physical Therapy Science & Sports, Wilhelmina Children's Hospital and Princess Maxima Centre, Utrecht, Netherlands
- Paediatrics, CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| | - H Huygelier
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, Netherlands
- Brain and Cognition, Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - T C W Nijboer
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, Netherlands
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, Netherlands
- Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands
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3
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Chavez Arana C, van IJzendoorn MH, Serrano-Juarez CA, de Pauw SSW, Prinzie P. [Formula: see text] Interventions to improve executive functions in children and adolescents with acquired brain injury: a systematic review and multilevel meta-analysis. Child Neuropsychol 2024; 30:164-187. [PMID: 36718104 DOI: 10.1080/09297049.2023.2172150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 01/17/2023] [Indexed: 02/01/2023]
Abstract
To investigate the effectiveness of interventions aiming to improve hot and cold executive functions (EFs) in children and adolescents with acquired brain injury (ABI) and to examine whether characteristics of the intervention, participants, etiology of ABI (Traumatic-brain-injury [TBI] or non-TBI), time of assessment, or study quality moderate intervention effects. Whereas cold EFs refer to purely cognitive EFs, hot EFs refer to the affective aspects of these cognitive skills. A total of 970 participants from 23 randomized-controlled-trial studies (112 effect sizes [ES]) were included. A three-level random effects approach (studies, ES, individual participants) was used. Moderation analyses were conducted through meta-regressions. The three-level random effects model showed a better fit than the two-level model. Almost all individual studies showed non-significant ES across outcomes but in combination interventions were effective (Cohen's d = 0.38, CI 0.16 ~ 0.61). Lower methodological quality, inclusion of participants with non-TBI, and parental participation predicted larger ES. Participants' age, time of assessment, number of sessions, and focus on hot or cold EFs were not related to ES. We found no evidence of publication bias. Interventions are effective with small to medium ES according to conventional criteria. Intervention effects do not seem to fade away with time. Parent participation in the intervention is important to improve EFs. The efficacy of interventions seems larger when non-TBI is part of the etiology of ABI. Variation between studies is relevant for tracing the effective intervention characteristics. Most studies are conducted in adolescence, and studies in early childhood are needed.
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Affiliation(s)
- Clara Chavez Arana
- Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioral Sciences, Erasmus University of Rotterdam, Rotterdam, The Netherlands
| | - Marinus H van IJzendoorn
- Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioral Sciences, Erasmus University of Rotterdam, Rotterdam, The Netherlands
- Research Department of Clinical, Education and Health Psychology, Faculty of Brain Sciences, UCL, University of London, London, UK
| | - Carlos A Serrano-Juarez
- Laboratorio de Neurometría, FES Iztacala, Universidad Nacional Autónoma de México, State of Mexico, Mexico
| | - Sarah S W de Pauw
- Department of Special Needs Education, Ghent University, Ghent, Belgium
| | - Peter Prinzie
- Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioral Sciences, Erasmus University of Rotterdam, Rotterdam, The Netherlands
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4
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Brandt AE, Rø TB, Finnanger TG, Hypher RE, Lien E, Lund B, Catroppa C, Andersson S, Risnes K, Stubberud J. Intelligence and executive function are associated with age at insult, time post-insult, and disability following chronic pediatric acquired brain injury. Front Neurol 2024; 14:1192623. [PMID: 38249741 PMCID: PMC10796693 DOI: 10.3389/fneur.2023.1192623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 12/05/2023] [Indexed: 01/23/2024] Open
Abstract
Background Pediatric acquired brain injury (pABI) profoundly affects cognitive functions, encompassing IQ and executive functions (EFs). Particularly, young age at insult may lead to persistent and debilitating deficits, affecting daily-life functioning negatively. This study delves into the intricate interplay of age at insult, time post-insult, and their associations with IQ and EFs during chronic (>1 year) pABI. Additionally, we investigate cognitive performance across different levels of global function, recognizing the multifaceted nature of developmental factors influencing outcomes. Methods Drawing upon insult data and baseline information analyzing secondary outcomes from a multicenter RCT, including comprehensive medical and neuropsychological assessments of participants aged 10 to 17 years with pABI and parent-reported executive dysfunctions. The study examined associations between age at insult (early, EI; ≤7y vs. late, LI; > 7y) and time post-insult with IQ and EFs (updating, shifting, inhibition, and executive attention). Additionally, utilizing the Pediatric Glasgow Outcome Scale-Extended, we explored cognitive performance across levels of global functioning. Results Seventy-six participants, median 8 years at insult and 5 years post-insult, predominantly exhibiting moderate disability (n = 38), were included. Notably, participants with LI demonstrated superior IQ, executive attention, and shifting compared to EI, [adjusted mean differences with 95% Confidence Intervals (CIs); 7.9 (1.4, 14.4), 2.48 (0.71, 4.24) and 1.73 (0.03, 3.43), respectively]. Conversely, extended post-insult duration was associated with diminished performances, evident in mean differences with 95% CIs for IQ, updating, shifting, and executive attention compared to 1-2 years post-insult [-11.1 (-20.4, -1.7), -8.4 (-16.7, -0.1), -2.6 (-4.4, -0.7), -2.9 (-4.5, -1.2), -3.8 (-6.4, -1.3), -2.6 (-5.0, -0.3), and -3.2 (-5.7, -0.8)]. Global function exhibited a robust relationship with IQ and EFs. Conclusion Early insults and prolonged post-insult durations impose lasting tribulations in chronic pABI. While confirmation through larger studies is needed, these findings carry clinical implications, underscoring the importance of vigilance regarding early insults. Moreover, they dispel the notion that children fully recover from pABI; instead, they advocate equitable rehabilitation offerings for pABI, tailored to address cognitive functions, recognizing their pivotal role in achieving independence and participation in society. Incorporating disability screening in long-term follow-up assessments may prove beneficial.
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Affiliation(s)
- Anne Elisabeth Brandt
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Children’s Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Torstein B. Rø
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Children’s Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Torun G. Finnanger
- Children’s Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Ruth E. Hypher
- Department of Clinical Neurosciences for Children, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Espen Lien
- Children’s Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Bendik Lund
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Children’s Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Cathy Catroppa
- Brain and Mind, Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, VIC, Australia
- Department of Psychology, Royal Children’s Hospital, Melbourne, VIC, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | | | - Kari Risnes
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Children’s Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Jan Stubberud
- Department of Clinical Neurosciences for Children, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Research, Lovisenberg Diaconal Hospital, Oslo, Norway
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5
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Crook L, Riccardi JS, Ruddock HS, Ciccia A. Speech-Language Pathology Treatment of Cognitive-Communication Deficits in School-Aged Children With Traumatic Brain Injury: A Scoping Review. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:1826-1841. [PMID: 37116307 DOI: 10.1044/2023_jslhr-22-00417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
PURPOSE The purpose of this scoping review was to synthesize the current evidence-based treatment practices used with school-aged children with any severity of traumatic brain injury (TBI) that could benefit the practice of speech-language pathologists (SLPs). METHOD A scoping review of the literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Included studies were assigned thematic labels based on a modified version of the Rehabilitation Treatment Specification System. RESULTS A total of 27 articles that covered 16 different treatment approaches met inclusion criteria for this study. Most studies included adolescent or teenage participants with moderate-severe TBIs. Treatment targets included executive functioning (n = 15), social competence (n = 6), postconcussive symptoms (n = 5), behavior (n = 3), family functioning (n = 1), and health-related quality of life (n = 1). The majority of current interventions for school-aged children with TBI include a multidisciplinary approach and components of family involvement education. CONCLUSIONS Further research is needed on interventions that are specifically implemented by SLPs as well as protocols that include more heterogeneous samples (e.g., varied sociodemographic factors and injury severity) to allow for the development and testing of ecologically valid intervention practice. SLPs can use the results of this scoping review to individualize treatment based on the child's areas of need while considering individual characteristics and to provide person-centered intervention for children with school-aged TBI.
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Affiliation(s)
- Libby Crook
- Communication Sciences Program, Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH
| | - Jessica S Riccardi
- Communication Sciences Program, Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH
| | - Hannah S Ruddock
- Communication Sciences Program, Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH
| | - Angela Ciccia
- Communication Sciences Program, Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH
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6
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Macchitella L, Tosi G, Romano DL, Iaia M, Vizzi F, Mammarella IC, Angelelli P. Visuo-Spatial Working Memory and Mathematical Skills in Children: A Network Analysis Study. Behav Sci (Basel) 2023; 13:bs13040294. [PMID: 37102808 PMCID: PMC10136205 DOI: 10.3390/bs13040294] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/13/2023] [Accepted: 03/28/2023] [Indexed: 04/28/2023] Open
Abstract
Visuo-spatial working memory is one of the main domain-general cognitive mechanisms underlying mathematical abilities and their development in children. However, if visuo-spatial working memory involves different processes and components, then the term 'mathematics' refers to a broad concept that includes multiple domains and skills. The aim of this present study was to investigate the relationship between different visuo-spatial working memory components and several mathematical abilities in a sample of third- to fifth-grade Italian children. To assess the relationships between different visuo-spatial working memory components and different mathematical abilities, we relied on Network Analysis (NA). Results indicate that some but not all visuo-spatial working memory components are associated with some mathematical abilities.
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Affiliation(s)
- Luigi Macchitella
- Scientific Institute I.R.C.C.S. "E. Medea", Unit for Severe Disabilities in Developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), 72100 Brindisi, Italy
| | - Giorgia Tosi
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
| | - Daniele Luigi Romano
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
- Lab of Applied Psychology and Intervention, Department of Human and Social Studies, University of Salento, 73100 Lecce, Italy
| | - Marika Iaia
- Lab of Applied Psychology and Intervention, Department of Human and Social Studies, University of Salento, 73100 Lecce, Italy
| | - Francesca Vizzi
- Lab of Applied Psychology and Intervention, Department of Human and Social Studies, University of Salento, 73100 Lecce, Italy
| | - Irene C Mammarella
- Department of Developmental and Social Psychology, University of Padova, 35100 Padova, Italy
| | - Paola Angelelli
- Lab of Applied Psychology and Intervention, Department of Human and Social Studies, University of Salento, 73100 Lecce, Italy
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7
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Ishida J, Murai T, Ueda K, Furukawa TA, Tanemura R. Utility of a novel tablet computer software for memory impairment in participants with brain injuries: A randomized control trial. Neuropsychol Rehabil 2023; 33:85-102. [PMID: 34635005 DOI: 10.1080/09602011.2021.1987276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study examined the effectiveness of a novel information and communication technology (ICT) tool developed for external memory compensation to improve memory function in participants with brain injuries. In this 3-month randomized control study, participants with memory impairment secondary to brain injury were randomly assigned on a 1:1 basis to either intervention (the ICT tool [ARATA]) or 3-month waitlist control groups. This study's primary outcome measure was memory-related difficulties in everyday life, assessed using the Everyday Memory Checklist (EMC). Secondary outcomes included tests for memory function and psychosocial status, all of which were administered by blinded assessors. Seventy-eight participants (53 males, 25 females; mean age, 43.5 ± 12.7 [SD] years) were enrolled and 39 participants were allocated to each group (intervention and control). There was no significant difference in EMC scores between the two groups throughout the study (mean 0.26; 95% CI: -2.55-3.07; p=0.853); however, the intervention group scored significantly higher on the Rivermead Behavioural Memory and General Self-Efficacy tests compared to the control group. While the ICT tool did not improve the primary study outcome, evidence suggests that the ICT tool can improve memory functions related to activities of daily living.
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Affiliation(s)
- Junko Ishida
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Hyogo, Japan
| | - Toshiya Murai
- Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Keita Ueda
- Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Department of medical Welfare, Kyoto Koka Women's University, Faculty of Health Sciences, Kyoto, Japan
| | - Toshiaki A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Rumi Tanemura
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Hyogo, Japan
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8
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Mrakotsky C, Williams TS, Shapiro KA, Westmacott R. Rehabilitation in Pediatric Stroke: Cognition and Behavior. Semin Pediatr Neurol 2022; 44:100998. [PMID: 36456041 DOI: 10.1016/j.spen.2022.100998] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/11/2022] [Accepted: 09/12/2022] [Indexed: 10/14/2022]
Abstract
Pediatric stroke is associated with a range of maladaptive cognitive and behavioral outcomes that often require targeted intervention. Despite increasing research on neuropsychological outcomes over the past decade, evidence for effective therapies and interventions for the most commonly reported cognitive and behavioral challenges is still limited. The most widely prescribed interventions address more overt deficits in sensorimotor and speech/language functions, yet interventions for higher-order cognitive, linguistic and behavioral deficits are notably less defined. Moreover, concepts of rehabilitation in adult stroke cannot be easily translated directly to pediatric populations because the effect of stroke and recovery in the developing brain takes a very different course than in the mature brain. In pediatric stroke, neuropsychological deficits often emerge gradually over time necessitating a long-term approach to intervention. Furthermore, family and school context often play a much larger role. The goal of this review is to describe cognitive and behavioral interventions for perinatal and childhood stroke, as motor rehabilitation is covered elsewhere in this issue. We also discuss cognitive aspects of current rehabilitative therapies and technology. Acknowledging the current limited state of stroke-specific rehabilitation research in children, findings from pediatric acquired brain injury intervention and use of transdiagnostic approaches lend important insights. Because there is limited support for single domain (cognitive) trainings and translation of research rehabilitation programs to clinical practice can be challenging, the value of holistic multidisciplinary approaches to improve everyday function in children and adolescents following stroke is emphasized.
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Affiliation(s)
- Christine Mrakotsky
- Departments of Neurology & Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, MA.
| | - Tricia S Williams
- Department of Psychology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Kevin A Shapiro
- Cortica Healthcare, Department of Neurology, Children's Hospital Los Angeles, Los Angeles, CA
| | - Robyn Westmacott
- Department of Psychology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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9
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Studer-Luethi B, Toermaenen M, Margelisch K, Hogrefe AB, Perrig WJ. Effects of Working Memory Training on Children’s Memory and Academic Performance: the Role of Training Task Features and Trainee’s Characteristics. JOURNAL OF COGNITIVE ENHANCEMENT 2022. [DOI: 10.1007/s41465-022-00242-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Abstract
Learning and academic performance are explained mainly by basic limited-capacity processes, most notably by working memory (WM). Consequently, training WM has been considered a promising approach to fostering these abilities. However, school-based investigations are rare. This study examined the effects of training task features and trainees’ characteristics on transfer to cognitive and academic measures. Eighty-six typically developing 8–12-year-old children completed 6 weeks of either WM training with n-back and complex span tasks or a control training with perceptual-matching tasks in a regular school setting. The study also assessed some personal variables of the children, such as neuroticism, conscientiousness, joy of learning, and power of endurance. The WM training group showed increased WM and math performance compared to the control group. Also, there was a trend toward some improvements in vocabulary after WM training, and overall improvements after both trainings were observed in fluid intelligence and reading. Analyses of individual differences in the WM training group indicated increased training performance in relation to emotional stability, conscientiousness, power of endurance, as well as teacher-reported joy of learning and social integration of participants. Thus, the results indicate the potential of WM training to improve WM capacity and mathematical skills and reveal the impact of regulative, motivational, and social factors on cognitive training performance.
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10
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Pedrotty M, Wong TS, Wilde EA, Bigler ED, Laatsch LK. Application of neuropsychology and imaging to brain injury and use of the integrative cognitive rehabilitation psychotherapy model. NeuroRehabilitation 2021; 49:307-327. [PMID: 34420990 DOI: 10.3233/nre-218028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND An early approach to cognitive rehabilitation therapy (CRT) was developed based on A. R. Luria's theory of brain function. Expanding upon this approach, the Integrative Cognitive Rehabilitation Psychotherapy model (ICRP) was advanced. OBJECTIVE To describe the ICRP approach to treatment of clients post brain injury and provide a comprehensive list of evaluation tools to determine the client's abilities and needs. Finally, to provide a link between CRT and functional imaging studies designed to improve rehabilitation efforts. METHODS History of cognitive rehabilitation and neuropsychological testing is reviewed and description of cognitive, academic, psychiatric, and substance abuse tools are provided. Cognitive and emotional treatment techniques are fully described. Additionally, a method of determining the client's stage of recovery and pertinent functional imaging studies is detailed. RESULTS Authors have been able to provide a set of tools and techniques to use in comprehensive treatment of clients with brain injury. CONCLUSIONS Inclusive treatment which is outlined in the ICRP model is optimal for the client's recovery and return to a full and satisfying life post brain injury. The model provides a framework for neuropsychologists to integrate issues that tend to co-occur in clients living with brain injury into a unified treatment plan.
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Affiliation(s)
- Mark Pedrotty
- Tingley Hospital Outpatient -UNM, Albuquerque, NM, USA
| | - Tiffanie S Wong
- Polytrauma Rehabilitation Center, Comprehensive Rehabilitation Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.,Stem Cognitive and Psychological Rehabilitation, Inc., Palo Alto, CA, USA
| | - Elisabeth A Wilde
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah, Salt Lake City, UT, USA.,George E. Wahlen Veterans' Affairs Medical Center, Salt Lake City, UT, USA
| | - Erin D Bigler
- Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah, Salt Lake City, UT, USA.,Psychology Department and Neuroscience Center, Brigham Young University, Provo, UT, USA
| | - Linda K Laatsch
- Department of Neurology, University of Illinois, Chicago, IL, USA
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11
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Bharadwaj SV, Yeatts P, Headley J. Efficacy of cogmed working memory training program in improving working memory in school-age children with and without neurological insults or disorders: A meta-analysis. APPLIED NEUROPSYCHOLOGY-CHILD 2021; 11:891-903. [PMID: 34085876 DOI: 10.1080/21622965.2021.1920943] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This meta-analysis assessed the efficacy of the Cogmed Working Memory Training program in improving near-transfer measures (verbal and visuospatial working memory) and far-transfer measures (attention, executive function, and academic achievement) in school-age children with and without neurological insults or disorders. Relevant studies were searched in databases and clinical trial registries using the keyword Cogmed. Ten published studies and unpublished data from one study met the inclusion criteria. Hedges g was calculated for each outcome measure obtained at pre-intervention, post-intervention, and 3-6 month time points. Analysis compared outcome measures in the control versus experimental groups and examined the role of moderators on treatment effects (control group intervention, intervention environment). Data revealed significant medium-size effects of the Cogmed program in improving verbal and visuospatial working memory post-intervention and for verbal working memory only at the 3-6 month time point. However, the training did not generalize to the far-transfer measures. Analyses indicated that only the type of intervention provided for the control group moderated treatment effects on verbal and visual working memory. Meta-analytic findings suggest that the Cogmed program leads to short-term improvements and in some cases, long-term improvements in working memory in school-age children; however, these effects may not generalize to far-transfer measures.
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Affiliation(s)
- Sneha V Bharadwaj
- Department of Communication Sciences and Oral Health, Texas Woman's University, Denton, Texas, USA
| | - Paul Yeatts
- Center for Research Design & Analysis, Office of Research and Sponsored Programs, Texas Woman's University, Denton, Texas, USA
| | - Johnna Headley
- Department of Communication Sciences and Oral Health, Texas Woman's University, Denton, Texas, USA
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12
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Poole BJ, Phillips NL, Stewart E, Harris IM, Lah S. Working Memory in Pediatric Epilepsy: A Systematic Review and Meta-Analysis. Neuropsychol Rev 2021; 31:569-609. [PMID: 33818735 DOI: 10.1007/s11065-021-09491-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 02/21/2021] [Indexed: 10/21/2022]
Abstract
Working memory is a multicomponent system that is supported by overlapping specialized networks in the brain. Baddeley's working memory model includes four components: the phonological loop, visuo-spatial sketchpad, the central executive, and episodic buffer. The aim of this review was to establish the gravity and pattern of working memory deficits in pediatric epilepsy. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guided electronic searches. Sixty-five studies were included in the review. Meta-analyses revealed significant impairments across each working memory component: phonological loop (g = 0.739), visuo-spatial sketchpad (g = 0.521), and central executive (g = 0.560) in children with epilepsy compared to controls. The episodic buffer was not examined. The pattern of impairments, however, differed according to the site and side of seizure focus. This suggests that working memory components are differentially vulnerable to the location of seizure focus in the developing brain.
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Affiliation(s)
- Belinda J Poole
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia.,ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, NSW, 2109, Australia
| | - Natalie L Phillips
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia.,ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, NSW, 2109, Australia
| | - Elizabeth Stewart
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia.,ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, NSW, 2109, Australia
| | - Irina M Harris
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia
| | - Suncica Lah
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia. .,ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, NSW, 2109, Australia.
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13
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Pei Y, O'Brien KH. Reading Abilities Post Traumatic Brain Injury in Adolescents and Adults: A Systematic Review and Meta-Analysis. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:789-816. [PMID: 33755512 DOI: 10.1044/2020_ajslp-20-00213] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose People with traumatic brain injury (TBI) often struggle with complex reading, limiting participation in work and educational settings. This systematic review and meta-analysis examined studies of reading conducted with adolescents and adults with TBI to describe reading problems post TBI and investigate underlying factors for the effects of TBI on reading abilities. Method The search was conducted in EBSCO (including MEDLINE, PsycINFO, etc.), BIOSIS, ProQuest, and Web of Science. Empirical studies that used samples with a mean age greater than 10 years, reported injury characteristics, and investigated complex reading abilities (defined as greater than single-word reading) were eligible for this review. Study quality was evaluated using QualSyst. Study and sample characteristics, measures, and outcomes of interest were extracted and synthesized in the review. Studies that compared reading abilities between people with and without TBI were included in the meta-analysis. Results Twenty-four studies met inclusion criteria, six of which addressed reading in pediatric samples. Findings from heterogeneous samples supported the existence of reading deficits post TBI, including mild TBI. In studies of children, comprehension was examined most frequently, whereas reading speed was the focus of most adult studies. Oculomotor functions and processing speed were related to reading speed; cognitive functions, such as attention and memory, were associated with reading comprehension. Intervention studies were limited, but most reported positive effects. The meta-analysis confirmed the impact of TBI on reading with a large effect size (g = 1.23). Demographic, injury, and study variables did not moderate overall reading outcomes, but male sex was a significant moderator of impairment in reading speed. Discussion Global reading ability, including both comprehension and speed, is negatively impacted by TBI. Future research should continue to explore reading after TBI, including its underlying mechanisms, effects on complex reading activities such as inferencing, development of screening and assessment tools that address a range of functional reading needs, and efficacy of reading-related interventions.
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Affiliation(s)
- Yalian Pei
- Department of Communication Sciences and Special Education, University of Georgia, Athens
| | - Katy H O'Brien
- Department of Communication Sciences and Special Education, University of Georgia, Athens
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14
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Yeo V, Phillips NL, Bogdanov S, Brookes N, Epps A, Teng A, Naismith SL, Lah S. The persistence of sleep disturbance and its correlates in children with moderate to severe traumatic brain injury: A longitudinal study. Sleep Med 2021; 81:387-393. [PMID: 33819841 DOI: 10.1016/j.sleep.2021.03.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 03/04/2021] [Accepted: 03/06/2021] [Indexed: 01/24/2023]
Abstract
OBJECTIVES The primary aim was to examine whether sleep disturbances persist in children in the chronic stage of recovery from moderate or severe traumatic brain injury (TBI). The secondary aim was to examine whether memory difficulties and/or other previously identified factors relate to sleep disturbances in children with moderate to severe TBI. METHODS This longitudinal study included 21 children with moderate to severe TBI, 8-18 years old, recruited from an urban tertiary paediatric specialised brain injury rehabilitation unit. Participants were seen 5 years and again 7 years post-injury, on average. Sleep disturbances were assessed with Sleep Disturbance Scale for Children (SDSC). Correlates that were considered included indicators of TBI severity, and questionnaires assessing everyday memory, fatigue, internalizing and externalizing behaviors and pain intensity. RESULTS The SDSC scores of children with moderate to severe TBI indicated greater disturbances in initiating and maintaining sleep, arousal, sleep-wake transition, and excessive somnolence relative to the norms, at follow-up. The mean SDSC scores and the number of participants with subclinical to clinical sleep disturbances on the SDSC remained unchanged from baseline to follow-up. At follow-up, the SDSC initiating and maintaining sleep, and excessive somnolence scales were associated with poorer everyday memory and greater fatigue. CONCLUSIONS Children with moderate to severe TBI experience ongoing sleep disturbances for years post-injury. Greater sleep disturbances are associated with worse functional outcomes. Further research into sleep disturbances and development of treatments is important, as it could improve the outcomes of children with TBI.
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Affiliation(s)
- Vera Yeo
- School of Psychology, The University of Sydney, New South Wales, Australia
| | - Natalie L Phillips
- School of Psychology, The University of Sydney, New South Wales, Australia
| | - Stefan Bogdanov
- School of Psychology, The University of Sydney, New South Wales, Australia
| | - Naomi Brookes
- Rehab2Kids, Rehabilitation Unit, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Adrienne Epps
- Rehab2Kids, Rehabilitation Unit, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Arthur Teng
- Department of Sleep Medicine, Sydney Children's Hospital, Randwick, New South Wales, Australia; School of Paediatrics and Women's Health, University of New South Wales, Kensington, New South Wales, Australia
| | - Sharon L Naismith
- School of Psychology, The University of Sydney, New South Wales, Australia; Brain and Mind Centre, and Charles Perkins Centre, The University of Sydney, New South Wales, Australia
| | - Suncica Lah
- School of Psychology, The University of Sydney, New South Wales, Australia.
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15
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Weicker J, Hudl N, Hildebrandt H, Obrig H, Schwarzer M, Villringer A, Thöne-Otto A. The effect of high vs. low intensity neuropsychological treatment on working memory in patients with acquired brain injury. Brain Inj 2020; 34:1051-1060. [PMID: 32511937 DOI: 10.1080/02699052.2020.1773536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AIM To evaluate the combined effect of compensation therapy and functional training on working memory (WM) in patients with acquired injury and chronic cognitive deficits by investigating the dose-response relationship and specificity of transfer effects. RESEARCH DESIGN Double-blind randomized controlled trial. METHODS All patients underwent 4 weeks of compensation therapy in a day-care setting. In addition, they received either 20 sessions of computer-based WM training (n = 11) or attention training (n = 9). Transfer effects on cognition and their functional relevance in daily life were assessed before treatment, after 2 weeks (10 additional training sessions), and after 4 weeks (20 additional training sessions) of therapy. RESULTS The combined treatment led to significant improvements in WM performance, verbal memory, and self-reported changes in daily life. The amount of training was identified to modulate efficacy: Significant improvements showed only in the later training phase. We observed no differences between the two training schemes (WM vs. attentional training). CONCLUSIONS Even in the chronic phase after brain lesion WM performance can be enhanced by the combination of compensation therapy and computerized cognitive training when applied intensely; both a more general attention and a specific WM training regimen are effective.
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Affiliation(s)
- Juliane Weicker
- Clinic of Cognitive Neurology, University of Leipzig , Leipzig, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences , Leipzig, Germany
| | - Nicole Hudl
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences , Leipzig, Germany.,Professorship of Sports Psychology, Chemnitz University of Technology , Chemnitz, Germany
| | - Helmut Hildebrandt
- Department of Psychology, Carl Von Ossietzky University of Oldenburg , Oldenburg, Germany
| | - Hellmuth Obrig
- Clinic of Cognitive Neurology, University of Leipzig , Leipzig, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences , Leipzig, Germany
| | - Magdalena Schwarzer
- Department of Psychology, Carl Von Ossietzky University of Oldenburg , Oldenburg, Germany
| | - Arno Villringer
- Clinic of Cognitive Neurology, University of Leipzig , Leipzig, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences , Leipzig, Germany
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16
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Moore AL, Carpenter DM, James RL, Miller TM, Moore JJ, Disbrow EA, Ledbetter CR. Neuroimaging and Neuropsychological Outcomes Following Clinician-Delivered Cognitive Training for Six Patients With Mild Brain Injury: A Multiple Case Study. Front Hum Neurosci 2020; 14:229. [PMID: 32670040 PMCID: PMC7326946 DOI: 10.3389/fnhum.2020.00229] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 05/25/2020] [Indexed: 12/12/2022] Open
Abstract
Nearly half of all mild brain injury sufferers experience long-term cognitive impairment, so an important goal in rehabilitation is to address their multiple cognitive deficits to help them return to prior levels of functioning. Cognitive training, or the use of repeated mental exercises to enhance cognition, is one remediation method for brain injury. The primary purpose of this hypothesis-generating pilot study was to explore the statistical and clinical significance of cognitive changes and transfer of training to real-life functioning following 60 h of Brain Booster, a clinician-delivered cognitive training program, for six patients with mild traumatic brain injury (TBI) or non-traumatic acquired brain injury (ABI). The secondary purpose was to explore changes in functional connectivity and neural correlates of cognitive test gains following the training. We used a multiple case study design to document significant changes in cognitive test scores, overall IQ score, and symptom ratings; and we used magnetic resonance imaging (MRI) to explore trends in functional network connectivity and neural correlates of cognitive change. All cognitive test scores showed improvement with statistically significant changes on five of the seven measures (long-term memory, processing speed, reasoning, auditory processing, and overall IQ score). The mean change in IQ score was 20 points, from a mean of 108 to a mean of 128. Five themes emerged from the qualitative data analysis including improvements in cognition, mood, social identity, performance, and Instrumental Activities of Daily Living (IADLs). With MRI, we documented significant region-to-region changes in connectivity following cognitive training including those involving the cerebellum and cerebellar networks. We also found significant correlations between changes in IQ score and change in white matter integrity of bilateral corticospinal tracts (CST) and the left uncinate fasciculus. This study adds to the growing body of literature examining the effects of cognitive training for mild TBI and ABI, and to the collection of research on the benefits of cognitive training in general. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT02918994.
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Affiliation(s)
- Amy Lawson Moore
- Department of Psychology, Gibson Institute of Cognitive Research, Colorado Springs, CO, United States
| | - Dick M. Carpenter
- College of Education, University of Colorado Colorado Springs, Colorado Springs, CO, United States
| | | | - Terissa Michele Miller
- Department of Psychology, Gibson Institute of Cognitive Research, Colorado Springs, CO, United States
| | - Jeffrey J. Moore
- School of Nursing, Colorado State University-Pueblo, Pueblo, CO, United States
| | - Elizabeth A. Disbrow
- Department of Neurology, Louisiana State University Health Sciences Center, Shreveport, LA, United States
- Louisiana State University Health Sciences Center, Center for Brain Health, Shreveport, LA, United States
| | - Christina R. Ledbetter
- Louisiana State University Health Sciences Center, Center for Brain Health, Shreveport, LA, United States
- Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, LA, United States
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17
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Luis-Ruiz S, Caldú X, Sánchez-Castañeda C, Pueyo R, Garolera M, Jurado MÁ. Is cognitive training an effective tool for improving cognitive function and real-life behaviour in healthy children and adolescents? A systematic review. Neurosci Biobehav Rev 2020; 116:268-282. [PMID: 32565174 DOI: 10.1016/j.neubiorev.2020.06.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 01/09/2023]
Abstract
Computerised cognitive training (CCT) has been applied to improve cognitive function in pathological conditions and in healthy populations. Studies suggest that CCT produces near-transfer effects to cognitive functions, with less evidence for far-transfer. Newer applications of CTT in adults seem to produce certain far-transfer effects by influencing eating behaviour and weight loss. However, this is more unexplored in children and adolescents. We conducted a systematic review of 16 studies with randomised controlled design to assess the impact of CCT on cognitive functioning and real-life outcomes, including eating behaviour, in children and adolescents with typical development (PROSPERO registration number: CRD42019123889). Results show near-transfer effects to working memory, with inconsistent results regarding far-transfer effects to other cognitive functions and real-life measures. Long-term effects show the same trend. Far-transfer effects occurred after cue-related inhibitory control and attentional training, although effects seem not to last. CCT may be a potential weight-loss treatment option but more research is needed to determine the specific characteristics to enhance treatment outcomes.
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Affiliation(s)
- Sandra Luis-Ruiz
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Institut de Neurociències (UBNeuro), Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (IRSJD), Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Xavier Caldú
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Grup de Neuropsicologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Institut de Neurociències (UBNeuro), Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (IRSJD), Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Cristina Sánchez-Castañeda
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Grup de Neuropsicologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Institut de Neurociències (UBNeuro), Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (IRSJD), Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Roser Pueyo
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Grup de Neuropsicologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Institut de Neurociències (UBNeuro), Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (IRSJD), Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Maite Garolera
- Grup de Neuropsicologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Unitat de Neuropsicologia, Consorci Sanitari de Terrassa, Carretera de Torrebonica, S/N, 08227, Terrasa, Barcelona, Spain; Brain, Cognition and Behaviour Clinical Research Group, Consorci Sanitari de Terrassa, Carretera de Torrebonica, S/N, 08227, Terrasa, Barcelona, Spain
| | - María Ángeles Jurado
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Grup de Neuropsicologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Institut de Neurociències (UBNeuro), Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (IRSJD), Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain.
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Home-based cognitive training in pediatric patients with acquired brain injury: preliminary results on efficacy of a randomized clinical trial. Sci Rep 2020; 10:1391. [PMID: 31996709 PMCID: PMC6989528 DOI: 10.1038/s41598-020-57952-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 01/09/2020] [Indexed: 12/19/2022] Open
Abstract
Cognitive rehabilitation may compensate for cognitive deficits of children with acquired brain injury (ABI), capitalizing on the use-dependent plasticity of a developing brain. Remote computerized cognitive training (CCT) may be delivered to patients in ecological settings, ensuring rehabilitation continuity. This work evaluated cognitive and psychological adjustment outcomes of an 8-week multi-domain, home-based CCT (Lumosity Cognitive Training) in a sample of patients with ABI aged 11–16 years. Two groups of patients were engaged in five CCT sessions per week for eight weeks (40 sessions). According to a stepped-wedge research design, one group (Training-first Group) started the CCT immediately, whereas the other group (Waiting-first Group) started the CCT after a comparable time of waiting list. Changes after the training and after the waiting period were compared in the two groups. Both groups improved in visual-spatial working memory more after the training than after the waiting-list period. The Training-first group improved also in arithmetic calculation speed. Findings indicate that a multi-domain CCT can produce benefits in visual-spatial working memory, probably because, in accordance with previous research, computer games heavily tax visuo-spatial abilities. This suggests that the prolonged stimulation of the same cognitive ability may generate the greatest benefits in children with ABI.
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19
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Sung IY, Jeon JY, Yun KJ, Yuk JS, Byun EM, Yoo HW, Ko TS, Kim HW, Jang DH. Development of tablet personal computer-based cognitive training programs for children with developmental disabilities whose cognitive age is less than 4 years. Medicine (Baltimore) 2020; 99:e18674. [PMID: 31914058 PMCID: PMC6959963 DOI: 10.1097/md.0000000000018674] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This study was to develop tablet personal computer-based cognitive training programs for children with developmental disabilities whose cognitive age is less than 4 years. Twelve cognitive training programs (named Injini) were designed comprising cognitive domains that included attention, visual and auditory perception, memory, executive function, language, and reasoning. In addition, programs related to learning experiences, such as self-regulation, role play, learning of number, and letter/shape concepts, comparison, classification, and pattern matching, were included. Six of 12 programs comprised approximately 10 levels for each program, with different difficulty levels. Other programs consisted of universal tasks that did not have a difficulty level. To ensure that the difficulty level was appropriate, we pre-tested the pilot version of Injini among 80 children with typical development aged 18 to 41 months. After modifying the pilot version, we developed the final version and tested it among 80 children with cognitive impairment whose cognitive age was 18 to 41 months. All children were assessed using the Bayley Scales of Infant and Toddler Development to determine their development and cognitive age. The difficulty level analyses in children with typical development revealed several inappropriate results wherein the success rate did not decrease with increase in level in some programs. After adjusting the difficulty level, the analyses in children with cognitive impairment demonstrated that the success rate gradually decreased with increasing level in all programs. Cognitive training programs for children with developmental disabilities were successfully developed.
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Affiliation(s)
| | | | | | | | | | - Han-Wook Yoo
- Department of Pediatrics
- Medical Genetics Clinic and Laboratory
| | | | - Hyo-Won Kim
- Department of Psychiatry, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine
| | - Dae-Hyun Jang
- Department of Rehabilitation Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
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20
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McKay E, Richmond S, Kirk H, Anderson V, Catroppa C, Cornish K. Training attention in children with acquired brain injury: a study protocol of a randomised controlled trial of the TALI attention training programme. BMJ Open 2019; 9:e032619. [PMID: 31806614 PMCID: PMC6924822 DOI: 10.1136/bmjopen-2019-032619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Childhood inattention has been linked with poor academic outcomes, and increased lifetime social, occupational and psychiatric morbidity. Children with an acquired brain injury (ABI) are particularly susceptible to attention deficits and may benefit from interventions aimed at enhancing attention. The primary objective of this study is to evaluate the short-term efficacy of the TALI Train programme, compared with a placebo, on the outcome of attention in children with ABI. METHODS AND ANALYSIS The study is a parallel, double-blind, randomised controlled trial. Participants will consist of 80 children with a diagnosis of ABI aged 4-9 years 11 months. Participants will be randomly allocated to either (1) TALI Train (intervention group), an adaptive game-based attention training programme, or (2) a non-adaptive placebo programme (control group). Both programmes are delivered on a touchscreen tablet, and children complete five 20 min sessions per week for a 5-week period at home. Assessment of selective, sustained and executive attention (primary outcomes), and behavioural attention, working memory, social skills and mathematics ability (secondary outcomes) will occur at baseline, post-training, and at 3-month and 6-month follow-up to assess immediate and long-term efficacy of TALI Train compared with placebo. Assessments will be completed at the Royal Children's Hospital in Melbourne, Australia. All assessments and analyses will be undertaken by researchers blinded to group membership. Latent growth curve modelling will be employed to examine primary and secondary outcomes. ETHICS AND DISSEMINATION Ethics approval has been obtained from the Royal Children's Hospital Human Research Ethics Committee (HREC) (38132) and the Monash University HREC (17446). Results will be disseminated through peer-reviewed journals, conference presentations, media outlets, the internet and various community/stakeholder activities. TRIAL REGISTRATION NUMBER ACTRN12619000511134.
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Affiliation(s)
- Erin McKay
- Turner Institute for Brain and Mental Health, School of Psychological Science, Monash University, Clayton, Victoria, Australia
| | - Sally Richmond
- Turner Institute for Brain and Mental Health, School of Psychological Science, Monash University, Clayton, Victoria, Australia
| | - Hannah Kirk
- Turner Institute for Brain and Mental Health, School of Psychological Science, Monash University, Clayton, Victoria, Australia
| | - Vicki Anderson
- Clinical Sciences, Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
- Psychology Service, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Cathy Catroppa
- Clinical Sciences, Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Kim Cornish
- Turner Institute for Brain and Mental Health, School of Psychological Science, Monash University, Clayton, Victoria, Australia
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Laatsch L, Dodd J, Brown T, Ciccia A, Connor F, Davis K, Doherty M, Linden M, Locascio G, Lundine J, Murphy S, Nagele D, Niemeier J, Politis A, Rode C, Slomine B, Smetana R, Yaeger L. Evidence-based systematic review of cognitive rehabilitation, emotional, and family treatment studies for children with acquired brain injury literature: From 2006 to 2017. Neuropsychol Rehabil 2019; 30:130-161. [PMID: 31671014 DOI: 10.1080/09602011.2019.1678490] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This paper updates guidelines for effective treatments of children with specific types of acquired brain injury (ABI) published in 2007 with more recent evidence. A systematic search was conducted for articles published from 2006 to 2017. Full manuscripts describing treatments of children (post-birth to 18) with acquired brain injury were included if study was published in peer-reviewed journals and written in English. Two independent reviewers and a third, if conflicts existed, evaluated the methodological quality of studies with an Individual Study Review Form and a Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Strength of study characteristics was used in development of practice guidelines. Fifty-six peer-reviewed articles, including 27 Class I studies, were included in the final analysis. Established guidelines for writing practice recommendations were used and 22 practice recommendations were written with details of potential treatment limitations. There was strong evidence for family/caregiver-focused interventions, as well as direct interventions to improve attention, memory, executive functioning, and emotional/behavioural functioning. A majority of the practice standards and guidelines provided evidence for the use of technology in delivery of interventions, representing an important trend in the field.
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Affiliation(s)
- Linda Laatsch
- Department of Neurology, University of Illinois, Chicago, IL, USA
| | | | - Tanya Brown
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Angela Ciccia
- Department of Psychological Science and Communication Science Program, Case Western Reserve University, Cleveland, OH, USA
| | - Felicia Connor
- Rusk Rehabilitation, Langone Health, Outpatient Psychology and Neuropsychology, New York, NY, USA
| | - Kim Davis
- Department of Pediatrics, Psychology Section, Baylor College of Medicine, Houston, TX, USA
| | - Meghan Doherty
- Occupational Therapy and Occupational Science, Saint Louis University, Saint Louis, MO, USA
| | - Mark Linden
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Gianna Locascio
- Department of Neurology, New York University, New York, NY, USA
| | - Jennifer Lundine
- Department of Speech and Hearing Science, Ohio State University, Columbus, OH, USA
| | - Samantha Murphy
- Department of Psychology, University of Missouri-St. Louis, St. Louis, MO, USA
| | - Drew Nagele
- Department of Psychology, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Janet Niemeier
- Department of Physical Medicine & Rehabilitation, Carolinas Medical Center, Charlotte, NC, USA
| | - Adam Politis
- National Institutes of Health, Bethesda, MD, USA
| | - Catrin Rode
- Center on Brain Injury Research and Training, University of Oregon, Eugene, OR, USA
| | - Beth Slomine
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Working Memory Training Following Neonatal Critical Illness: A Randomized Controlled Trial. Crit Care Med 2019; 46:1158-1166. [PMID: 29624536 DOI: 10.1097/ccm.0000000000003151] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To test the immediate and long-term effectiveness of Cogmed Working Memory Training following extracorporeal membrane oxygenation and/or congenital diaphragmatic hernia. DESIGN A nationwide randomized controlled trial assessing neuropsychologic outcome immediately and 1 year post Cogmed Working Memory Training, conducted between October 2014 and June 2017. Researchers involved in the follow-up assessments were blinded to group allocation. SETTING Erasmus MC-Sophia Children's Hospital, Rotterdam, and Radboud University Medical Center, Nijmegen, the Netherlands. PATIENTS Eligible participants were neonatal extracorporeal membrane oxygenation and/or congenital diaphragmatic hernia survivors (8-12 yr) with an intelligence quotient greater than or equal to 80 and a z score less than or equal to -1.5 on at least one (working) memory test at first assessment. INTERVENTIONS Cogmed Working Memory Training, comprising 25 45-minute training sessions for 5 consecutive weeks at home. MEASUREMENTS AND MAIN RESULTS Participants were randomized to Cogmed Working Memory Training (n = 19) or no intervention (n = 24) (two dropped out after T0). Verbal working memory (estimated coefficient = 0.87; p = 0.002) and visuospatial working memory (estimated coefficient=0.96, p = 0.003) significantly improved at T1 post Cogmed Working Memory Training but was similar between groups at T2 (verbal, p = 0.902; visuospatial, p = 0.416). Improvements were found at T2 on long-term visuospatial memory following Cogmed Working Memory Training (estimated coefficient = 0.95; p = 0.003). Greater improvements in this domain at T2 following Cogmed Working Memory Training were associated with better self-rated school functioning (r = 0.541; p = 0.031) and parent-rated attention (r = 0.672; p = 0.006). CONCLUSIONS Working memory improvements after Cogmed Working Memory Training disappeared 1 year post training in neonatal extracorporeal membrane oxygenation and/or congenital diaphragmatic hernia survivors. Gains in visuospatial memory persisted 1 year post intervention. Cogmed Working Memory Training may be beneficial for survivors with visuospatial memory deficits.
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Remote Technology-Based Training Programs for Children with Acquired Brain Injury: A Systematic Review and a Meta-Analytic Exploration. Behav Neurol 2019; 2019:1346987. [PMID: 31467613 PMCID: PMC6701292 DOI: 10.1155/2019/1346987] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 05/17/2019] [Accepted: 06/11/2019] [Indexed: 12/16/2022] Open
Abstract
Introduction Multidisciplinary rehabilitation interventions are considered to be a need for children with acquired brain injury (ABI), in order to remediate the important sequelae and promote adjustment. Technology-based treatments represent a promising field inside the rehabilitation area, as they allow delivering interventions in ecological settings and creating amusing exercises that may favor engagement. In this work, we present an overview of remote technology-based training programs (TP) addressing cognitive and behavioral issues delivered to children with ABI and complement it with the results of a meta-analytic exploration. Evidence Acquisition We performed the review process between January and February 2019. 32 studies were included in the review, of which 14 were further selected to be included in the meta-analysis on TP efficacy. Evidence Synthesis Based on the review process, the majority of TP addressing cognitive issues and all TP focusing on behavioral issues were found to be effective. Two meta-analytic models examining the means of either cognitive TP outcomes or behavioral TP outcomes as input outcome yielded a nonsignificant effect size for cognitive TP and a low-moderate effect size for behavioral TP. Additional models on outcomes reflecting the greatest beneficial effects of TP yielded significant moderate effect sizes for both types of TP. Nevertheless, consistent methodological heterogeneity was observed, pointing to cautious interpretation of findings. A subgroup analysis on visuospatial skill outcomes showed a smaller yet significant effect size of cognitive TP, with low heterogeneity, providing a more reliable estimation of overall cognitive TP effects. Conclusions Promising results on remote cognitive and behavioral TP efficacy emerged both at the review process and at the meta-analytic investigation. Nevertheless, the high heterogeneity that emerged across studies prevents us from drawing definite conclusions. Further research is needed to identify whether specific training characteristics and population subgroups are more likely to be associated with greater training efficacy.
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De Luca R, Portaro S, Le Cause M, De Domenico C, Maggio MG, Cristina Ferrera M, Giuffrè G, Bramanti A, Calabrò RS. Cognitive rehabilitation using immersive virtual reality at young age: A case report on traumatic brain injury. APPLIED NEUROPSYCHOLOGY-CHILD 2019; 9:282-287. [DOI: 10.1080/21622965.2019.1576525] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Sood N, Godfrey C, Anderson V, Catroppa C. Rehabilitation of Executive function in Paediatric Traumatic brain injury (REPeaT): protocol for a randomized controlled trial for treating working memory and decision-making. BMC Pediatr 2018; 18:362. [PMID: 30458737 PMCID: PMC6247519 DOI: 10.1186/s12887-018-1338-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Accepted: 11/12/2018] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Working memory allows us to hold information in an active state for short periods of time, and is essential in facilitating goal directed cognitive functioning. Difficulties in working memory and decision-making are common post childhood Traumatic Brain Injury (TBI). Despite this, there is a paucity of research pertaining to implementation and effectiveness of interventions to reduce these common difficulties which impact significantly on one's ability to function independently. One such intervention, Cogmed Working Memory Training Program, has shown success in improving working memory in other childhood clinical populations, but has received little evaluation in the TBI area. This study aims to evaluate whether Cogmed improves working memory and decision-making post childhood TBI and whether these benefits generalize to functional areas. METHODS The study is a randomized controlled trial (RCT) of the Cogmed (RM version) intervention for children post-TBI. Children aged 7-15 years are initially screened for working memory impairments. Eligible participants are then randomized into either the treatment group (Cogmed) or the active-control group (Lexia Reading). Each group trains online for 50 min each day, 5 days per week, for 5 consecutive weeks. The online training is supported by online clinician meetings each week. Outcome neuropsychological and functional assessments are carried out immediately at the completion of the intervention and at 6 months follow-up. DISCUSSION This study follows gold standard methodology in intervention research; uses a novel measure of decision-making; measures the effects of intervention on functional outcomes immediately and longer-term post intervention; uses online clinician support in order to allow more families easy access to the program; and promotes the use of technology to improve health services. If efficacious in improving working memory, decision-making, and functional outcomes, our team will then take a key role in implementing Cogmed into clinical care. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12617000085370 . Trial Registration Date: 16/01/2017. Protocol Version/Date: HREC 35181G/18.08.2017. Study Status: Ongoing.
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Affiliation(s)
- Nikita Sood
- Level 4 West, Brain and Mind, Clinical Sciences, Murdoch Children’s Research Institute, 50 Flemington Road, Parkville, VIC 3052 Australia
- The Royal Children’s Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Celia Godfrey
- Level 4 West, Brain and Mind, Clinical Sciences, Murdoch Children’s Research Institute, 50 Flemington Road, Parkville, VIC 3052 Australia
| | - Vicki Anderson
- Level 4 West, Brain and Mind, Clinical Sciences, Murdoch Children’s Research Institute, 50 Flemington Road, Parkville, VIC 3052 Australia
- The Royal Children’s Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Department of Psychology, The Royal Children’s Hospital, Melbourne, Australia
- Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Cathy Catroppa
- Level 4 West, Brain and Mind, Clinical Sciences, Murdoch Children’s Research Institute, 50 Flemington Road, Parkville, VIC 3052 Australia
- The Royal Children’s Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Department of Psychology, The Royal Children’s Hospital, Melbourne, Australia
- Psychological Sciences, University of Melbourne, Melbourne, Australia
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Morgan PL, Farkas G, Hillemeier MM, Pun WH, Maczuga S. Kindergarten Children's Executive Functions Predict Their Second-Grade Academic Achievement and Behavior. Child Dev 2018; 90:1802-1816. [PMID: 29884983 DOI: 10.1111/cdev.13095] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Whether and to what extent kindergarten children's executive functions (EF) constitute promising targets of early intervention is currently unclear. This study examined whether kindergarten children's EF predicted their second-grade academic achievement and behavior. This was done using (a) a longitudinal and nationally representative sample (N = 8,920, Mage = 97.6 months), (b) multiple measures of EF, academic achievement, and behavior, and (c) extensive statistical control including for domain-specific and domain-general lagged dependent variables. All three measures of EF-working memory, cognitive flexibility, and inhibitory control-positively and significantly predicted reading, mathematics, and science achievement. In addition, inhibitory control negatively predicted both externalizing and internalizing problem behaviors. Children's EF constitute promising targets of experimentally evaluated interventions for increasing academic and behavioral functioning.
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Rossignoli-Palomeque T, Perez-Hernandez E, González-Marqués J. Brain Training in Children and Adolescents: Is It Scientifically Valid? Front Psychol 2018; 9:565. [PMID: 29780336 PMCID: PMC5946581 DOI: 10.3389/fpsyg.2018.00565] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 04/04/2018] [Indexed: 01/14/2023] Open
Abstract
Background: Brain training products are becoming increasingly popular for children and adolescents. Despite the marketing aimed at their use in the general population, these products may provide more benefits for specific neurologically impaired populations. A review of Brain Training (BT) products analyzing their efficacy while considering the methodological limitations of supporting research is required for practical applications. Method: searches were made of the PubMed database (until March 2017) for studies including: (1) empirical data on the use of brain training for children or adolescents and any effects on near transfer (NT) and/or far transfer (FT) and/or neuroplasticity, (2) use of brain training for cognitive training purposes, (3) commercially available training applications, (4) computer-based programs for children developed since the 1990s, and (5) relevant printed and peer-reviewed material. Results: Database searches yielded a total of 16,402 references, of which 70 met the inclusion criteria for the review. We classified programs in terms of neuroplasticity, near and far transfer, and long-term effects and their applied methodology. Regarding efficacy, only 10 studies (14.2%) have been found that support neuroplasticity, and the majority of brain training platforms claimed to be based on such concepts without providing any supporting scientific data. Thirty-six studies (51.4%) have shown far transfer (7 of them are non-independent) and only 11 (15.7%) maintained far transfer at follow-up. Considering the methodology, 40 studies (68.2%) were not randomized and controlled; for those randomized, only 9 studies (12.9%) were double-blind, and only 13 studies (18.6%) included active controls in their trials. Conclusion: Overall, few independent studies have found far transfer and long-term effects. The majority of independent results found only near transfer. There is a lack of double-blind randomized trials which include an active control group as well as a passive control to properly control for contaminant variables. Based on our results, Brain Training Programs as commercially available products are not as effective as first expected or as they promise in their advertisements.
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Affiliation(s)
- Teresa Rossignoli-Palomeque
- Department of Basic Psychology II, Complutense University of Madrid, Madrid, Spain.,Department of Psychology and Education, Centro Universitario Cardenal Cisneros, Alcalá de Henares, Madrid, Spain
| | - Elena Perez-Hernandez
- Department of Development and Educational Psychology, Autonomous University of Madrid, Madrid, Spain
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Resch C, Rosema S, Hurks P, de Kloet A, van Heugten C. Searching for effective components of cognitive rehabilitation for children and adolescents with acquired brain injury: A systematic review. Brain Inj 2018; 32:679-692. [PMID: 29621405 DOI: 10.1080/02699052.2018.1458335] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
AIM Cognitive rehabilitation is of interest after paediatric acquired brain injury (ABI). The present systematic review examined studies investigating cognitive rehabilitation interventions for children with ABI, while focusing on identifying effective components. Components were categorized as (1) metacognition and/or strategy use, (2) (computerized) drill-based exercises, and (3) external aids. METHODS The databases PubMed (including MEDLINE), PsycInfo, and CINAHL were searched until 22nd June 2017. Additionally, studies were identified through cross-referencing and by consulting experts in the field. RESULTS A total of 20 articles describing 19 studies were included. Metacognition/strategy use trainings (five studies) mainly improved psychosocial functioning. Drill-based interventions (six studies) improved performance on tasks similar to training tasks. Interventions combining these two components (six studies) benefited cognitive and psychosocial functioning. External aids (two studies) improved everyday memory. No studies combined external aids with drill-based interventions or all three components. CONCLUSION Available evidence suggests that multi-component rehabilitation, e.g. combining metacognition/strategy use and drill-based training is most promising, as it can lead to improvements in both cognitive and psychosocial functioning of children with ABI. Intervention setting and duration may play a role. Conclusions remain tentative due to small sample sizes of included studies heterogeneity regarding outcome measures, intervention and therapist variables, and patient characteristics.
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Affiliation(s)
- Christine Resch
- a Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience , Maastricht University , Maastricht , The Netherlands.,b Limburg Brain Injury Center , Maastricht , The Netherlands
| | - Stefanie Rosema
- c Sophia Rehabilitation , The Hague , The Netherlands.,d Department of Complex Behavioral Disorders and Forensic Psychiatry , De Bascule, Academic Center for Child- and Adolescent Psychiatry , Amsterdam , The Netherlands.,e Department of Child- and Adolescent Psychiatry , VU University Medical Center , Amsterdam , The Netherlands
| | - Petra Hurks
- a Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience , Maastricht University , Maastricht , The Netherlands
| | - Arend de Kloet
- c Sophia Rehabilitation , The Hague , The Netherlands.,f The Hague University of Applied Sciences , the Hague , The Netherlands
| | - Caroline van Heugten
- a Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience , Maastricht University , Maastricht , The Netherlands.,b Limburg Brain Injury Center , Maastricht , The Netherlands.,g School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences , Maastricht University Medical Center , Maastricht , The Netherlands
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Memory Rehabilitation in Patients with Epilepsy: a Systematic Review. Neuropsychol Rev 2018; 28:88-110. [PMID: 29450813 DOI: 10.1007/s11065-018-9367-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 01/21/2018] [Indexed: 10/18/2022]
Abstract
Memory failure is a common clinical concern of patients with epilepsy and is associated with significant functional impairments. Thus, memory rehabilitation is of critical clinical importance. In this article, we aimed to systematically evaluate the efficacy of memory rehabilitation in patients with epilepsy. The Preferred Items for Systematic Reviews and Meta-Analyses (PRISMA) was used to guide searches, extraction and reporting of data in this review. PsycINFO, Medline and PsychBITE searches yielded 95 studies. Twelve papers met inclusion criteria, reporting outcomes of cognitive or behavioural interventions that specifically targeted the rehabilitation of memory in patients with epilepsy. Methodological rigour was rated using the Single-Case Experimental Design (SCED) scale for single-case studies and a modified version of the Downs and Black checklist for group studies. Twelve prospective studies, nine group (six pre-post design, one waitlist crossover, two randomised controlled trials) and three single-case studies were identified. Eleven of the studies included adults, eight of which involved adults with temporal lobe epilepsy (TLE). One paediatric study was identified. The quality of group studies ranged from 36% (poor) to 72% (good), using the modified Downs and Black checklist. Single-case studies were assessed using the SCED scale and assessed to range in quality from four to seven out to 11. Overall, memory rehabilitation was associated with improved memory function in all studies. Verbal memory outcomes were most commonly examined and associated with improvements. This review found that the level of evidence available to support rehabilitation of memory in patients with epilepsy was generally weak and inconsistent. Nevertheless, studies conducted to date, albeit of limited methodological quality, offer preliminary evidence that memory rehabilitation is associated with improvements in verbal memory in patients with temporal lobe epilepsy. Little is known about the efficacy of memory rehabilitation in patients with non-TLE, children, and other aspects of memory difficulties. Guidelines for future research are proposed.
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Wade SL, Narad ME, Shultz EL, Kurowski BG, Miley AE, Aguilar JM, Adlam ALR. Technology-assisted rehabilitation interventions following pediatric brain injury. J Neurosurg Sci 2017; 62:187-202. [PMID: 29154509 DOI: 10.23736/s0390-5616.17.04277-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Following traumatic brain injury (TBI), children experience a variety of physical, motor, speech, and cognitive deficits that can have a long-term detrimental impact. The emergence and popularity of new technologies has led to research into the development of various apps, gaming systems, websites, and robotics that might be applied to rehabilitation. The objective of this narrative review was to describe the current literature regarding technologically-assisted interventions for the rehabilitation of motor, neurocognitive, behavioral, and family impairments following pediatric TBI. EVIDENCE ACQUISITION We conducted a series of searches for peer-reviewed manuscripts published between 2000 and 2017 that included a technology-assisted component in the domains of motor, language/communication, cognition, behavior, social competence/functioning, family, and academic/school-based functioning. EVIDENCE SYNTHESIS Findings suggested several benefits of utilizing technology in TBI rehabilitation including facilitating engagement/adherence, increasing access to therapies, and improving generalizability across settings. There is fairly robust evidence regarding the efficacy of online family problem-solving therapy in improving behavior problems, executive functioning, and family functioning. There was less compelling, but still promising, evidence regarding the efficacy other technology for motor deficits, apps for social skills, and computerized programs for cognitive skills. Overall, many studies were limited in the rigor of their methodology due to small heterogeneous samples and lack of control groups. CONCLUSIONS Technology-assisted interventions have the potential to enhance pediatric rehabilitation after TBI. Future research is needed to further support their efficacy with larger controlled trials and to identify characteristics of children who are most likely to benefit.
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Affiliation(s)
- Shari L Wade
- Division of Physical Medicine and Rehabilitation, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA -
| | - Megan E Narad
- Division of Physical Medicine and Rehabilitation, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Emily L Shultz
- Division of Physical Medicine and Rehabilitation, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Psychology, University of Cincinnati, Cincinnati, OH, USA
| | - Brad G Kurowski
- Division of Physical Medicine and Rehabilitation, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Aimee E Miley
- Division of Physical Medicine and Rehabilitation, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jessica M Aguilar
- Division of Physical Medicine and Rehabilitation, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Dvorak E, van Heugten C. A summary on the effectiveness of the Amsterdam memory and attention training for children (Amat-c) in children with brain injury. Brain Inj 2017; 32:18-28. [PMID: 29115862 DOI: 10.1080/02699052.2017.1367961] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To summarise the current research on the effectiveness of the Amsterdam Memory and Attention Training for Children (Amat-c). METHODS A literature search was conducted to find articles published about the Amat-c, using PubMed, psychINFO, and PsychBITE databases. Relevant search terms included Amat-c, attention and memory, and childhood ABI. RESULTS Our literature search identified 7 articles that described 5 separate studies including 61 children in total (mostly TBI). Only one study had a control group. All results indicated positive effects on memory and attention, although in three of the studies, these results were not statistically tested. Positive results were generally maintained six months follow up. CONCLUSIONS This review showed that the Amat-c is effective for treating attention and memory disturbances in children with ABI. However, evidence is limited and training material is outdated. We suggest that the Amat-c should be digitised and implemented in a school setting and further evaluated.
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Affiliation(s)
- Elizabeth Dvorak
- a Department of Neuropsychology & Psychopharmacology , Maastricht University , Maastricht , the Netherlands
| | - Caroline van Heugten
- a Department of Neuropsychology & Psychopharmacology , Maastricht University , Maastricht , the Netherlands.,b School for mental health and neuroscience , Maastricht University Medical Center , Maastricht , the Netherlands
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Brooks SJ, Funk SG, Young SY, Schiöth HB. The Role of Working Memory for Cognitive Control in Anorexia Nervosa versus Substance Use Disorder. Front Psychol 2017; 8:1651. [PMID: 29018381 PMCID: PMC5615794 DOI: 10.3389/fpsyg.2017.01651] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 09/07/2017] [Indexed: 01/20/2023] Open
Abstract
Prefrontal cortex executive functions, such as working memory (WM) interact with limbic processes to foster impulse control. Such an interaction is referred to in a growing body of publications by terms such as cognitive control, cognitive inhibition, affect regulation, self-regulation, top-down control, and cognitive–emotion interaction. The rising trend of research into cognitive control of impulsivity, using various related terms reflects the importance of research into impulse control, as failure to employ cognitions optimally may eventually result in mental disorder. Against this background, we take a novel approach using an impulse control spectrum model – where anorexia nervosa (AN) and substance use disorder (SUD) are at opposite extremes – to examine the role of WM for cognitive control. With this aim, we first summarize WM processes in the healthy brain in order to frame a systematic review of the neuropsychological, neural and genetic findings of AN and SUD. In our systematic review of WM/cognitive control, we found n = 15 studies of AN with a total of n = 582 AN and n = 365 HC participants; and n = 93 studies of SUD with n = 9106 SUD and n = 3028 HC participants. In particular, we consider how WM load/capacity may support the neural process of excessive epistemic foraging (cognitive sampling of the environment to test predictions about the world) in AN that reduces distraction from salient stimuli. We also consider the link between WM and cognitive control in people with SUD who are prone to ‘jumping to conclusions’ and reduced epistemic foraging. Finally, in light of our review, we consider WM training as a novel research tool and an adjunct to enhance treatment that improves cognitive control of impulsivity.
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Affiliation(s)
- Samantha J Brooks
- Functional Pharmacology, Department of Neuroscience, Uppsala UniversityUppsala, Sweden.,Department of Psychiatry and Mental Health, University of Cape TownCape Town, South Africa
| | - Sabina G Funk
- Department of Psychiatry and Mental Health, University of Cape TownCape Town, South Africa
| | - Susanne Y Young
- Department of Psychiatry, Stellenbosch UniversityBellville, South Africa
| | - Helgi B Schiöth
- Functional Pharmacology, Department of Neuroscience, Uppsala UniversityUppsala, Sweden
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Gorman S, Barnes MA, Swank PR, Ewing-Cobbs L. Recovery of Working Memory Following Pediatric Traumatic Brain Injury: A Longitudinal Analysis. Dev Neuropsychol 2017; 42:127-145. [PMID: 28497984 DOI: 10.1080/87565641.2017.1315581] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
In a prospective longitudinal study, the trajectory of verbal and visual-spatial working memory (WM) development was examined 2-, 6-, 12-, and 24-months following complicated-mild to severe pediatric traumatic brain injury (TBI; n = 55) relative to an orthopedic injury comparison group (n = 47). Individual growth curve modeling revealed an interaction of age, severity, and time for verbal, but not visual-spatial WM. The youngest children with severe TBI had the lowest scores and slowest verbal WM growth. WM outcome is best understood in light of age at injury and TBI severity. Findings support the early vulnerability hypothesis and highlight the need for long-term follow-up.
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Affiliation(s)
- Stephanie Gorman
- a Department of Psychology , University of Houston , Houston , Texas
| | - Marcia A Barnes
- b Department of Special Education , University of Texas at Austin , Austin , Texas
| | - Paul R Swank
- c Children's Learning Institute, Department of Pediatrics , University of Texas Health Science Center at Houston , Houston , Texas
| | - Linda Ewing-Cobbs
- c Children's Learning Institute, Department of Pediatrics , University of Texas Health Science Center at Houston , Houston , Texas
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Bergman Nutley S, Söderqvist S. How Is Working Memory Training Likely to Influence Academic Performance? Current Evidence and Methodological Considerations. Front Psychol 2017; 8:69. [PMID: 28223948 PMCID: PMC5295142 DOI: 10.3389/fpsyg.2017.00069] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 01/11/2017] [Indexed: 11/13/2022] Open
Abstract
Working memory (WM) is one of our core cognitive functions, allowing us to keep information in mind for shorter periods of time and then work with this information. It is the gateway that information has to pass in order to be processed consciously. A well-functioning WM is therefore crucial for a number of everyday activities including learning and academic performance (Gathercole et al., 2003; Bull et al., 2008), which is the focus of this review. Specifically, we will review the research investigating whether improving WM capacity using Cogmed WM training can lead to improvements on academic performance. Emphasis is given to reviewing the theoretical principles upon which such investigations rely, in particular the complex relation between WM and mathematical and reading abilities during development and how these are likely to be influenced by training. We suggest two possible routes in which training can influence academic performance, one through an effect on learning capacity which would thus be evident with time and education, and one through an immediate effect on performance on reading and mathematical tasks. Based on the theoretical complexity described we highlight some methodological issues that are important to take into consideration when designing and interpreting research on WM training and academic performance, but that are nonetheless often overlooked in the current research literature. Finally, we will provide some suggestions for future research for advancing the understanding of WM training and its potential role in supporting academic attainment.
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Affiliation(s)
| | - Stina Söderqvist
- Pearson Clinical Assessment, Clinical Research Stockholm, Sweden
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