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Saleh Al Rasheed L, Hanafy AAM. Effects of brain-based instruction on executive function and habits of mind among young children at-risk for learning disabilities. APPLIED NEUROPSYCHOLOGY. CHILD 2024; 13:292-299. [PMID: 36634202 DOI: 10.1080/21622965.2022.2161904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
PURPOSE The aim of this study was to investigate the effects of brain-based instruction on executive function and habits of mind among young children at-risk for learning disabilities. METHOD This study employed a quantitative approach using a quasi-experimental, pretest, post-test, and follow-up design. Analysis of covariance (ANCOVA), repeated-measures, pre-, post-, and follow-up testing design was used. Total number of participants were 40 children: treatment group (n = 20, 8 males, 12 females) and control group (n = 20, 9 males, 11 females). Accordingly, 40 students were chosen from four kindergartens in Qassim, Saudi Arabia. The sampling methodology employed used convenience sampling. RESULTS The results found that using brain-based instruction to improve functions and habits of mind indicate the effectiveness of this method for children at-risk with learning disabilities. CONCLUSIONS Using multisensory instructional techniques to actively engage students presents a channel for magnifying student learning experiences. Brain-based learning is a constructivism teaching method where in the brain constructing learning process finds and structures knowledge by means of association with previous experiences and knowledge.
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Affiliation(s)
- Loul Saleh Al Rasheed
- College of Education, Department of Psychology, Qassim University, Buraidah, Saudi Arabia
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Zhang H, Fan S, Yang J, Yi J, Guan L, He H, Zhang X, Luo Y, Guan Q. Attention control training and transfer effects on cognitive tasks. Neuropsychologia 2024; 200:108910. [PMID: 38777117 DOI: 10.1016/j.neuropsychologia.2024.108910] [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: 11/05/2023] [Revised: 05/08/2024] [Accepted: 05/18/2024] [Indexed: 05/25/2024]
Abstract
Attention control is the common element underlying different executive functions. The backward Masking Majority Function Task (MFT-M) requires intensive attention control, and represents a diverse situation where attentional resources need to be allocated dynamically and flexibly to reduce uncertainty. Aiming to train attention control using MFT-M and examine the training transfer effects in various executive functions, we recruited healthy young adults (n = 84) and then equally randomized them into two groups trained with either MFT-M or a sham program for seven consecutive days. Cognitive evaluations were conducted before and after the training, and the electroencephalograph (EEG) signals were recorded for the revised Attention Network Test (ANT-R), N-back, and Task-switching (TS) tasks. Compared to the control group, the training group performed better on the congruent condition of Flanker and the double-congruency condition of Flanker and Location in the ANT-R task, and on the learning trials in the verbal memory test. The training group also showed a larger P2 amplitude decrease and P3 amplitude increase in the 2-back task and a larger P3 amplitude increase in the TS task's repeat condition than the control group, indicating improved neural efficiency in two tasks' attentional processes. Introversion moderated the transfer effects of training, as indicated by the significant group*introversion interactions on the post-training 1-back efficiency and TS switching cost. Our results suggested that attention control training with the MFT-M showed a broad transfer scope, and the transfer effect was influenced by the form of training task. Introversion facilitated the transfer to working memory and hindered the transfer to flexibility.
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Affiliation(s)
- Haobo Zhang
- School of Psychology, Shenzhen University, Shenzhen, 518060, China.
| | - Shaoxia Fan
- School of Psychology, Shenzhen University, Shenzhen, 518060, China
| | - Jing Yang
- School of Psychology, Shenzhen University, Shenzhen, 518060, China
| | - Jing Yi
- School of Psychology, Shenzhen University, Shenzhen, 518060, China
| | - Lizhen Guan
- School of Psychology, Shenzhen University, Shenzhen, 518060, China
| | - Hao He
- School of Psychology, Shenzhen University, Shenzhen, 518060, China
| | - Xingxing Zhang
- School of Psychology, Shenzhen University, Shenzhen, 518060, China
| | - Yuejia Luo
- Department of Applied Psychology, University of Health and Rehabilitation Sciences, Qingdao, 266113, China
| | - Qing Guan
- School of Psychology, Shenzhen University, Shenzhen, 518060, China; Shenzhen-Hong Kong Institute of Brain Science, Shenzhen, 518060, China
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Del Lucchese B, Parravicini S, Filogna S, Mangani G, Beani E, Di Lieto MC, Bardoni A, Bertamino M, Papini M, Tacchino C, Fedeli F, Cioni G, Sgandurra G. The wide world of technological telerehabilitation for pediatric neurologic and neurodevelopmental disorders - a systematic review. Front Public Health 2024; 12:1295273. [PMID: 38694988 PMCID: PMC11061864 DOI: 10.3389/fpubh.2024.1295273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 03/08/2024] [Indexed: 05/04/2024] Open
Abstract
Introduction The use of Information and Communication Technology (ICT) for assessing and treating cognitive and motor disorders is promoting home-based telerehabilitation. This approach involves ongoing monitoring within a motivating context to help patients generalize their skills. It can also reduce healthcare costs and geographic barriers by minimizing hospitalization. This systematic review focuses on investigating key aspects of telerehabilitation protocols for children with neurodevelopmental or neurological disorders, including technology used, outcomes, caregiver involvement, and dosage, to guide clinical practice and future research. Method This systematic review adhered to PRISMA guidelines and was registered in PROSPERO. The PICO framework was followed to define the search strategy for technology-based telerehabilitation interventions targeting the pediatric population (aged 0-18) with neurological or neurodevelopmental disorders. The search encompassed Medline/PubMed, EMBASE, and Web of Science databases. Independent reviewers were responsible for selecting relevant papers and extracting data, while data harmonization and analysis were conducted centrally. Results A heterogeneous and evolving situation emerged from our data. Our findings reported that most of the technologies adopted for telerehabilitation are commercial devices; however, research prototypes and clinical software were also employed with a high potential for personalization and treatment efficacy. The efficacy of these protocols on health or health-related domains was also explored by categorizing the outcome measures according to the International Classification of Functioning, Disability, and Health (ICF). Most studies targeted motor and neuropsychological functions, while only a minority of papers explored language or multi-domain protocols. Finally, although caregivers were rarely the direct target of intervention, their role was diffusely highlighted as a critical element of the home-based rehabilitation setting. Discussion This systematic review offers insights into the integration of technological devices into telerehabilitation programs for pediatric neurologic and neurodevelopmental disorders. It highlights factors contributing to the effectiveness of these interventions and suggests the need for further development, particularly in creating dynamic and multi-domain rehabilitation protocols. Additionally, it emphasizes the importance of promoting home-based and family-centered care, which could involve caregivers more actively in the treatment, potentially leading to improved clinical outcomes for children with neurological or neurodevelopmental conditions. Systematic review registration PROSPERO (CRD42020210663).
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Affiliation(s)
- Benedetta Del Lucchese
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris Foundation, Pisa, Italy
| | - Stefano Parravicini
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Pediatric Neuroscience Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Silvia Filogna
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris Foundation, Pisa, Italy
| | - Gloria Mangani
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris Foundation, Pisa, Italy
| | - Elena Beani
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris Foundation, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Maria Chiara Di Lieto
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris Foundation, Pisa, Italy
| | | | - Marta Bertamino
- Physical Medicine and Rehabilitation Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Marta Papini
- Scientific Institute, IRCCS E. Medea, Lecco, Italy
| | - Chiara Tacchino
- Physical Medicine and Rehabilitation Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | | | - Giovanni Cioni
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris Foundation, Pisa, Italy
| | - Giuseppina Sgandurra
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris Foundation, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Bombonato C, Del Lucchese B, Ruffini C, Di Lieto MC, Brovedani P, Sgandurra G, Cioni G, Pecini C. Far Transfer Effects of Trainings on Executive Functions in Neurodevelopmental Disorders: A Systematic Review and Metanalysis. Neuropsychol Rev 2024; 34:98-133. [PMID: 36633797 PMCID: PMC10920464 DOI: 10.1007/s11065-022-09574-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 12/01/2022] [Indexed: 01/13/2023]
Abstract
Executive Functions are a set of interrelated, top-down processes essential for adaptive goal-directed behaviour, frequently impaired across different neurodevelopmental disorders with variable degrees of severity. Many executive-function-training studies in children with neurodevelopmental disorders have focused on near effects, investigating post-treatment improvements on directly trained processes, while enhancements of skills not directly trained, defined as far effects, are less considered, albeit these could be extremely relevant for reducing the negative impact of a disorder's core symptomatology. This systematic review and metanalysis aims to investigate the far effect outcomes after EF training in children with different types of neurodevelopmental disorders. 17 studies met the inclusion criteria for the systematic review, while 15 studies were selected in the metanalysis. An overall statistically significant effect size was found in the majority of far effect outcome measures considered in the studies. In particular, trainings on executive functions determine significant far effects on daily life functioning (0.46, 95% CI: [0.05-0.87]) and clinical symptoms (0.33, 95% CI: [0.15-0.51]). Despite a high variability of the results, intensity, frequency and the laboratory/life contexts dimension seem to be the most influential variables in determining far effects. This systematic review and metanalysis highlights the need to measure far effects of executive function training in neurodevelopmental disorders, selecting treatments not only on directly targeted processes, but also according to far impacts on the functional weakness of the disorder.
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Affiliation(s)
- Clara Bombonato
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Calambrone, Pisa, Italy
- Tuscan Programme of Neuroscience, University of Florence, Pisa and Siena, Italy
| | - Benedetta Del Lucchese
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Calambrone, Pisa, Italy
- Tuscan Programme of Neuroscience, University of Florence, Pisa and Siena, Italy
| | - Costanza Ruffini
- Department of Education, Intercultures, Literatures and Psychology (FORLIPSI), University of Florence, Languages, Florence, Italy
| | - Maria Chiara Di Lieto
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Calambrone, Pisa, Italy
| | - Paola Brovedani
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Calambrone, Pisa, Italy
| | - Giuseppina Sgandurra
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Calambrone, Pisa, Italy.
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
| | - Giovanni Cioni
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Calambrone, Pisa, Italy
| | - Chiara Pecini
- Department of Education, Intercultures, Literatures and Psychology (FORLIPSI), University of Florence, Languages, Florence, Italy
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Wols A, Pingel M, Lichtwarck-Aschoff A, Granic I. Effectiveness of applied and casual games for young people's mental health: A systematic review of randomised controlled studies. Clin Psychol Rev 2024; 108:102396. [PMID: 38320420 DOI: 10.1016/j.cpr.2024.102396] [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: 05/12/2023] [Revised: 01/24/2024] [Accepted: 01/29/2024] [Indexed: 02/08/2024]
Abstract
Many youth experience mental health problems and digital games hold potential as mental health interventions. This systematic review provides an overview of randomised controlled studies assessing the effectiveness of digital applied and casual games for improving mental health in youth aged 6-24 years. A systematic search of PsycINFO, Web of Science and Pubmed yielded 145 eligible studies. Studies on (sub)clinical participant samples (n = 75) most often focused on attention-deficit/hyperactivity disorder (ADHD), autism and anxiety. Applied games were found most effective for improving social skills, verbal memory and anxiety, whereas casual games were found most effective for improving depression, anxiety and ADHD. Studies involving healthy youth (n = 70) were grouped into papers examining anxiety in medical settings, momentary effects on positive and negative affect, and papers employing a longitudinal design measuring mental health trait outcomes. Promising results were found for the use of games as distraction tools in medical settings, and for applied and casual games for improving momentary affect. Overall, our findings demonstrate the potential of digital games for improving mental health. Implications and recommendations for future research are discussed, such as developing evaluation guidelines, clearly defining applied games, harmonising outcome measures, including positive outcomes, and examining nonspecific factors that may influence symptom improvement as well.
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Affiliation(s)
- Aniek Wols
- Radboud University, Behavioural Science Institute, Nijmegen, the Netherlands.
| | - Michelle Pingel
- Radboud University, Behavioural Science Institute, Nijmegen, the Netherlands
| | - Anna Lichtwarck-Aschoff
- Rijksuniversiteit Groningen, Department of Pedagogical & Educational Sciences, Groningen, the Netherlands
| | - Isabela Granic
- McMaster University, Health, Aging & Society, Hamilton, Ontario, Canada
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Yousef Alsheef M. The effectiveness of a program based on mental imagery on improvement working memory in children with ASD in inclusion classroom. APPLIED NEUROPSYCHOLOGY. CHILD 2023:1-9. [PMID: 38104348 DOI: 10.1080/21622965.2023.2292272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
This study examines the effectiveness of a program based on mental imagery on improvement working memory in children with Autism spectrum disorder (ASD) in inclusion classroom. 30 children (both sexes; 20 boys and 10 girls) with ASD aged 7-8 years old in primary one from school for inclusion were recruited. T-tests analyses were performed to determine whether there were differences between pretest and posttest measures for both the intervention and control groups. Quantitative data obtained at the beginning and end of the experimental process were analyzed in the SPSS 23.00 package program. Then, the necessary tests were conducted to determine the difference in the working memory performance level children in the experimental and control groups. T-test analysis for the differences in post- test mean scores between control and treatment groups in working memory(WM) shows that the intervention group outperformed the control group in numerical, verbal, and visual memory.
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Bos E, Preller KH, Kaur G, Malhotra P, Kharawala S, Motti D. Challenges With the Use of Digital Sham: Systematic Review and Recommendations. J Med Internet Res 2023; 25:e44764. [PMID: 37874638 PMCID: PMC10630857 DOI: 10.2196/44764] [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: 12/16/2022] [Revised: 06/26/2023] [Accepted: 07/20/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Digital therapeutics (DTx) are software-based products that prevent, manage, or treat a medical condition and are delivered through a smartphone app, web application, or wearable device. Clinical trials assessing DTx pose challenges, foremost among which is designing appropriate digital shams (or digital placebos), which should ideally mimic DTx (in terms of design, components, and duration of treatment) while omitting the active principle or component. OBJECTIVE The objective of our review was to understand how digital shams are being used in clinical research on DTx in neuroscience, which is the most common therapy area for DTx. METHODS We conducted a systematic literature review of DTx in neuroscience (including neurodevelopmental, neurodegenerative, and psychiatric disorders) with a focus on controlled clinical trials involving digital shams. Studies were identified from trial registries (ClinicalTrials.gov, the European Union Clinical Trials Register, and Trial Trove) and through structured searches in MEDLINE and Embase (both via the Embase website) and were limited to articles in English published from 2010 onward. These were supplemented by keyword-based searches in PubMed, Google, and Google Scholar and bibliographic searches. Studies assessing DTx in neuroscience (including neurodevelopmental, neurodegenerative, and psychiatric disorders) were included. Details related to the publication, DTx, comparator, patient population, and outcomes were extracted and analyzed. RESULTS Our search criteria identified 461 neuroscience studies involving 213 unique DTx. Most DTx were extended reality based (86/213, 40.4%) or mobile device based (56/213, 26.3%); 313 were comparative, of which 68 (21.7%) used shams. The most common therapeutic areas assessed in these studies were stroke (42/213, 19.7%), depression (32/213, 15%), and anxiety (24/213, 11.3%). The most common treatments were cognitive behavioral therapy or behavioral therapy (67/213, 32.4%), physical rehabilitation (60/213, 28.2%), and cognitive training (41/213, 19.2%). We identified the following important issues related to the use of digital shams in neuroscience: shams were not validated before use in studies, they varied widely in design (from being nearly identical to the DTx to using different software programs altogether), and the level of patient engagement or satisfaction with the sham and the impact of the sham on study outcomes were infrequently reported. CONCLUSIONS Digital shams are critical for the clinical development of DTx in neuroscience. Given the importance of sham controls in evaluating DTx efficacy, we provide recommendations on the key information that should be reported in a well-designed DTx trial and propose an algorithm to allow the correct interpretation of DTx study results. Sham-controlled studies should be routinely used in DTx trials-in early-phase studies-to help identify DTx active components and-in late-phase studies-to confirm the efficacy of DTx. The use of shams early in development will ensure that the appropriate sham control is used in later confirmatory trials.
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Affiliation(s)
- Ernst Bos
- F Hoffmann-La Roche Ltd, Basel, Switzerland
| | | | - Gavneet Kaur
- Bridge Medical Consulting Limited, London, United Kingdom
| | - Pooja Malhotra
- Bridge Medical Consulting Limited, London, United Kingdom
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Vacca RA, Augello A, Gallo L, Caggianese G, Malizia V, La Grutta S, Murero M, Valenti D, Tullo A, Balech B, Marzano F, Ghezzo A, Tancredi G, Turchetta A, Riccio MP, Bravaccio C, Scala I. Serious Games in the new era of digital-health interventions: A narrative review of their therapeutic applications to manage neurobehavior in neurodevelopmental disorders. Neurosci Biobehav Rev 2023; 149:105156. [PMID: 37019246 DOI: 10.1016/j.neubiorev.2023.105156] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/10/2023] [Accepted: 04/02/2023] [Indexed: 04/05/2023]
Abstract
Children and adolescents with neurodevelopmental disorders generally show adaptive, cognitive and motor skills impairments associated with behavioral problems, i.e., alterations in attention, anxiety and stress regulation, emotional and social relationships, which strongly limit their quality of life. This narrative review aims at providing a critical overview of the current knowledge in the field of serious games (SGs), known as digital instructional interactive videogames, applied to neurodevelopmental disorders. Indeed, a growing number of studies is drawing attention to SGs as innovative and promising interventions in managing neurobehavioral and cognitive disturbs in children with neurodevelopmental disorders. Accordingly, we provide a literature overview of the current evidence regarding the actions and the effects of SGs. In addition, we describe neurobehavioral alterations occurring in some specific neurodevelopmental disorders for which a possible therapeutic use of SGs has been suggested. Finally, we discuss findings obtained in clinical trials using SGs as digital therapeutics in neurodevelopment disorders and suggest new directions and hypotheses for future studies to bridge the gaps between clinical research and clinical practice.
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Gao W, Biswal B, Yang J, Li S, Wang Y, Chen S, Yuan J. Temporal dynamic patterns of the ventromedial prefrontal cortex underlie the association between rumination and depression. Cereb Cortex 2023; 33:969-982. [PMID: 35462398 DOI: 10.1093/cercor/bhac115] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 11/14/2022] Open
Abstract
As a major contributor to the development of depression, rumination has proven linked with aberrant default-mode network (DMN) activity. However, it remains unclear how the spontaneous spatial and temporal activity of DMN underlie the association between rumination and depression. To illustrate this issue, behavioral measures and resting-state functional magnetic resonance images were connected in 2 independent samples (NSample1 = 100, NSample2 = 95). Fractional amplitude of low-frequency fluctuations (fALFF) and regional homogeneity (ReHo) were used to assess spatial characteristic patterns, while voxel-wise functional concordance (across time windows) (VC) and Hurst exponent (HE) were used to assess temporal dynamic patterns of brain activity. Results from both samples consistently show that temporal dynamics but not spatial patterns of DMN are associated with rumination. Specifically, rumination is positively correlated with HE and VC (but not fALFF and ReHo) values, reflecting more consistent and regular temporal dynamic patterns in DMN. Moreover, subregion analyses indicate that temporal dynamics of the ventromedial prefrontal cortex (VMPFC) reliably predict rumination scores. Furthermore, mediation analyses show that HE and VC of VMPFC mediate the association between rumination and depression. These findings shed light on neural mechanisms of individual differences in rumination and corresponding risk for depression.
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Affiliation(s)
- Wei Gao
- Institute of Brain and Psychological Science, Sichuan Normal University, Chengdu, Sichuan, China.,Faculty of Psychology, Southwest University, Chongqing, China
| | - Bharat Biswal
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, United States
| | - Jiemin Yang
- Institute of Brain and Psychological Science, Sichuan Normal University, Chengdu, Sichuan, China
| | - Songlin Li
- School of Educational Science, Sichuan Normal University, Chengdu, Sichuan, China
| | - YanQing Wang
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Shengdong Chen
- School of Psychology, Qufu Normal University, Qufu, Shandong, China
| | - JiaJin Yuan
- Institute of Brain and Psychological Science, Sichuan Normal University, Chengdu, Sichuan, China
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Wu J, Peng J, Li Z, Deng H, Huang Z, He Y, Tu J, Cao L, Huang J. Multi-domain computerized cognitive training for children with intellectual developmental disorder: A randomized controlled trial. Front Psychol 2023; 13:1059889. [PMID: 36698581 PMCID: PMC9868813 DOI: 10.3389/fpsyg.2022.1059889] [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: 10/02/2022] [Accepted: 12/08/2022] [Indexed: 01/12/2023] Open
Abstract
Purpose To verify the effects of multi-domain computerized cognitive training on intellectual function and adaptive functioning in children with intellectual developmental disorder (IDD). Methods Children with IDD were randomized to a multi-domain computerized cognitive training (CCT) group (n = 30) and control group (n = 30). Both groups received a 5-week training program. Intellectual function was assessed by Chinese-Wechsler Young Children scale (C-WYCSI) and adaptive functioning was assessed by the Chinese Vineland Adaptive Behavior Rating Scale (VABS-C), which were used at baseline, post-training, and 3-month follow-up. Results There were significant differences for intellectual function and adaptive functioning between the two groups. The CCT group showed significant improvements in total full-scale intelligence quotient (FSIQ) score the Wechsler Intelligence Scale (F[60] = 31.97, p < 0.01) and its subdomain VIQ score (F[60] = 33.83, p < 0.01). For adaptive functioning, CCT had a better adaptive developmental quotient (ADQ) score (F[60] = 28.05, p < 0.01), and subdomain communication (F[60] = 10.86, p < 0.01) and socialization scores (F[60] = 4.35, p < 0.015). Moreover, there was a positive correlation between FSIQ changes and ADQ changes in the CCT group (rs = 0.74, p < 0.01). A greater increase in VIQ score was associated with a greater increase in adaptive functioning (bootstrapping CI: [0.16, 3.30]) in the CCT group. Conclusion Multi-domain CCT improves the intellectual function and adaptive functioning of children with IDD.
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Features and effects of computer-based games on cognitive impairments in children with autism spectrum disorder: an evidence-based systematic literature review. BMC Psychiatry 2023; 23:2. [PMID: 36597046 PMCID: PMC9809031 DOI: 10.1186/s12888-022-04501-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 12/27/2022] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Children with Autism Spectrum Disorder (ASD) have different cognitive and intelligence profiles than typical developing individuals. Some of these children need cognitive rehabilitation. This study's main purpose is to provide a systematic review about applying computerized cognitive games for autistic children and to determine the effectiveness of such interventions. MATERIAL AND METHODS A thorough search of the ISI Web of Science, Medline (through PubMed), Scopus, IEEE Xplore, and APA PsycInfo databases was performed for articles published from inception to May 17, 2022. RESULTS Of 1746 papers, 28 studies were found to be eligible in this systematic review. Fifteen studies (53.57%) compared a Control Group (CG) with Experimental Groups (EGs), while 13 papers (46.42%) evaluated only the impact of the applied intervention in an experimental group. Major domains of cognitive functions are divided into five main categories: 1. Executive functions, 2. Social cognition/emotions, 3. Attention/concentration, 4. Learning and memory, and 5. Language. In 42.85% (12 studies) of the screened papers, social cognition and emotions were assessed after cognitive rehabilitation. The highest rate of effects reported by studies were related to social cognition enhancement. Of the total number of included studies, 17 studies reported a positive effect at all scales, of which nine were quasi-experimental, and seven were fully experimental. CONCLUSION Using suitable computerized game-based solutions could enhance cognition indexes in autistic children. Hence, further investigation is needed to determine the real effectiveness of these novel technologies.
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Looney L, Wong EH, Rosales KP, Rosales F, Tirado G. Teacher perceptions of working memory and executive function improvements following school-day cognitive training. SCHOOL PSYCHOLOGY INTERNATIONAL 2022. [DOI: 10.1177/01430343221122454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Considerable research has documented the impact of teacher perceptions on students’ academic-related outcomes (e.g., classroom performance). This body of literature clearly shows that teacher perceptions (resulting from direct interactions with students) can have both positive and negative effects with respect to student behaviors and experiences in the classroom. What remains unclear is whether teachers perceive changes that result from interventions administered outside of their classrooms. The purpose of this study was to examine changes in teacher perceptions of working memory and executive function concerns (two important predictors of academic success) among students who participated in a computerized cognitive training program designed to enhance working memory skills. The current results indicate that teachers perceived fewer concerns following students’ participation in the training; this outcome was supplemented with significant improvements in the students’ working memory capabilities following the training program. These findings have important implications given the literature highlighting the relation between teacher perceptions and student outcomes as a function of a school-based computerized cognitive training intervention.
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Affiliation(s)
- Lisa Looney
- California State University, San Bernardino, USA
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Fan Z, Sun H, Wang L, Zhu M, Peng T. Team idiosyncratic deals and team breakthrough innovation: Based on the perspective of input-process-output model. Front Psychol 2022; 13:974569. [PMID: 36148128 PMCID: PMC9487393 DOI: 10.3389/fpsyg.2022.974569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 08/12/2022] [Indexed: 11/13/2022] Open
Abstract
PurposeAs a new human resource management practice, idiosyncratic deals are personalized employment arrangements negotiated between employees and employers and intended to benefit them both. It plays an important role in attracting, retaining and motivating employees to promote breakthrough innovation. Based on the input-process-output (I-P-O) model, this paper examines the relationship between team idiosyncratic deals and team breakthrough innovation, the mediating role of team exploratory-exploitative knowledge sharing, and the moderating roles of team transactive memory systems and team cognitive flexibility.Participants and methodsIn order to reduce the effects of common method biases and causal lag effect, this study is divided into three stages for data collection, with a time interval of 1 month. Eighty teams (406 employees) from six enterprises in Shanghai and Hangzhou were selected as samples, and the hypothesis test was carried out by hierarchical regression analysis, bootstrap, and Johnson-Neyman method.ResultsThe results show that higher team idiosyncratic deals are associated with higher team breakthrough innovation through higher team exploratory-exploitative knowledge sharing, and that team transactive memory systems and team cognitive flexibility positively moderate the mediating effect of team exploratory-exploitative knowledge sharing in the relationship between team idiosyncratic deals and team breakthrough innovation in the first stage and the second stage, respectively. Under the joint effect of high team transactive memory systems and high team cognitive flexibility, the mediating effect of team exploratory-exploitative knowledge sharing is stronger.ConclusionThe research results break through the previous research framework of social exchange theory, and I-P-O model to explore the influence mechanism of team idiosyncratic deals, in order to promote the sustainable growth of team breakthrough innovation through this non-standard work arrangement. It is hoped that this research can inspire modern enterprises to create team idiosyncratic deals for valuable teams engaged in breakthrough innovation, which are more conducive to give full play to their heterogeneous talents, and finally help enterprises break through the industry bottleneck and win the market competition.
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Affiliation(s)
- Zili Fan
- School of Economics and Management, Hubei University of Technology, Wuhan, China
| | - Hao Sun
- School of Economics and Management, Hubei University of Technology, Wuhan, China
| | - Lijun Wang
- School of Economics and Management, Hubei University of Technology, Wuhan, China
| | - Mengting Zhu
- School of Management, Shanghai University, Shanghai, China
- *Correspondence: Mengting Zhu,
| | - Ting Peng
- School of Economics and Management, Hubei University of Technology, Wuhan, China
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14
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Schmitt LM, Sweeney JA, Erickson CA, Shaffer R. Brief Report: Feasibility of the Probabilistic Reversal Learning Task as an Outcome Measure in an Intervention Trial for Individuals with Autism Spectrum Disorder. J Autism Dev Disord 2022; 52:4191-4199. [PMID: 34557984 PMCID: PMC8459822 DOI: 10.1007/s10803-021-05288-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2021] [Indexed: 11/25/2022]
Abstract
Cognitive flexibility deficits are a hallmark feature of autism spectrum disorder (ASD), but few evidence-based behavioral interventions have successfully addressed this treatment target. Outcome measurement selection may help account for previous findings. The probabilistic reversal learning task (PRL) is a measure of cognitive flexibility previously validated for use in ASD, but its use as an outcome measure has not yet been assessed. The current study examined the feasibility, reproducibility, and sensitivity of PRL in a within-subjects trial of Regulating Together, a group-based intervention targeting emotion regulation. We demonstrated the PRL is highly feasible, showed test-retest reproducibility, and is sensitive to detect change following the intervention. Our findings demonstrate the PRL task may be a useful outcome measure of cognitive flexibility in future intervention trials in ASD.
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Affiliation(s)
- Lauren M Schmitt
- Cincinnati Children's Hospital Medical Center, Cincinnati, USA.
- College of Medicine, University of Cincinnati, Cincinnati, USA.
| | - John A Sweeney
- College of Medicine, University of Cincinnati, Cincinnati, USA
| | - Craig A Erickson
- Cincinnati Children's Hospital Medical Center, Cincinnati, USA
- College of Medicine, University of Cincinnati, Cincinnati, USA
| | - Rebecca Shaffer
- Cincinnati Children's Hospital Medical Center, Cincinnati, USA
- College of Medicine, University of Cincinnati, Cincinnati, USA
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15
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Calub CA, Benyakorn S, Sun S, Iosif AM, Boyle LH, Solomon M, Hessl D, Schweitzer JB. Working Memory Training in Youth With Autism, Fragile X, and Intellectual Disability: A Pilot Study. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2022; 127:369-389. [PMID: 36018768 PMCID: PMC9915337 DOI: 10.1352/1944-7558-127.5.369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 08/03/2021] [Indexed: 06/15/2023]
Abstract
This pilot study sought to identify potential markers of improvement from pre-post treatment in response to computerized working memory (WM) training for youth (ages 8-18) with autism spectrum disorder (ASD) and comorbid intellectual disability (ID) in a single arm, pre-post design. Participants included 26 children with ASD and 18 with comorbid ASD and fragile X syndrome (ASD+FXS). Analyses were adjusted for age and IQ. The ASD group demonstrated greater improvement on WM training relative to the ASD+FXS group. Participants improved on WM and far transfer outcomes, however, there were no significant group differences in improvement except for repetitive behavior. Higher hyperactivity/impulsivity ratings predicted lower performance on visuospatial WM. Findings suggest cognitive training may be beneficial for youth with ASD and ID, warranting further exploration.
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16
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Escolano-Pérez E, Acero-Ferrero M. Evaluating in the Real-World Educational Intervention to Improve Interference Control in Children with Autism Spectrum Disorder. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1294. [PMID: 36138603 PMCID: PMC9497143 DOI: 10.3390/children9091294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/09/2022] [Accepted: 08/23/2022] [Indexed: 11/17/2022]
Abstract
Children with autism spectrum disorder (ASD) present deficiencies in interference control processes. The main aim of this pilot study was to analyze the efficacy of an educational intervention designed to optimize the interference control of eight ASD children, attending to their ASD severity level. A mixed-methods approach grounded in systematic observation and nomothetic/follow-up/multidimensional observational designs was used. An observation instrument was developed to code data, which were grouped according to the ASD severity level (Group 1, requires support; Group 2, requires substantial support) and were analyzed using a lag sequential analysis. The results show that, although both groups progressed during the intervention and could have continued to improve, each group evolved differently. Group 1 performed relatively well from the onset and increased and developed their interference control strategies throughout the intervention, while Group 2, despite also acquiring new interference control strategies, took more time to show improvements. One month after the intervention ended, both groups were unable to consolidate the strategies learned. A mixed-methods approach allowed for real interference control deficits in ASD children to be captured in a natural context. To conclude, it would be necessary to lengthen this intervention and adapt it to the needs of each group.
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Affiliation(s)
- Elena Escolano-Pérez
- Faculty of Education, Department of Psychology, University of Zaragoza, 50009 Zaragoza, Spain
| | - Marian Acero-Ferrero
- Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain
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17
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Far transfer effects of executive working memory training on cognitive flexibility. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03363-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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18
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Edmunds SR, MacNaughton GA, Rueda MR, Combita LM, Faja S. Beyond group differences: Exploring the preliminary signals of target engagement of an executive function training for autistic children. Autism Res 2022; 15:1261-1273. [PMID: 35481725 PMCID: PMC9322009 DOI: 10.1002/aur.2735] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 02/24/2022] [Accepted: 04/11/2022] [Indexed: 11/20/2022]
Abstract
Understanding both for whom and how interventions work is a crucial next step in providing personalized care to children with autism spectrum disorder (ASD). Autistic children present with heterogeneity both within core ASD criteria and with respect to co‐occurring mental health challenges, which may affect their ability to benefit from intervention. In a secondary data analysis of a randomized control trial evaluating an executive function (EF) training with 70 7‐ to 11‐year‐old autistic children, we explored: (1) whether co‐occurring attention‐deficit/hyperactivity disorder (ADHD) features or anxiety features at baseline moderated the extent to which children benefited from the EF training. In other words, we asked, “For whom is training effective?” We also explored: (2) the extent to which changes in a brain‐based measure of target engagement predicted the clinical outcomes of the EF training. This is a step towards asking, “How is training effective?” We found that EF training improved behavioral inhibition only for children with clinically significant co‐occurring ADHD features. Anxiety features, while prevalent, did not moderate EF training efficacy. Finally, for the EF training group only, there was a significant correlation between pre‐to‐post change in an EEG‐based measure of target engagement, N2 incongruent amplitude during a flanker task, and change in repetitive behaviors, a behavioral outcome that was reported in the parent RCT to have improved with training compared to waitlist control. This study provides preliminary evidence that EF training may differentially affect subgroups of autistic children and that changes at the neural level may precede changes in behavior.
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Affiliation(s)
- Sarah R Edmunds
- Department of Psychology, St. Barnwell College, Columbia, South Carolina, USA.,Laboratories of Cognitive Neuroscience, Boston Children's Hospital, Brookline, Massachusetts, USA
| | - Gabrielle A MacNaughton
- Department of Psychology, University of California, Los Angeles, Los Angeles, California, USA
| | - M Rosario Rueda
- Mind, Brain and Behavior Research Center (CIMCYC), Universidad de Granada, Campus Universitario de Cartuja, Granada, Spain
| | - Lina M Combita
- Mind, Brain and Behavior Research Center (CIMCYC), Universidad de Granada, Campus Universitario de Cartuja, Granada, Spain
| | - Susan Faja
- Department of Psychology, St. Barnwell College, Columbia, South Carolina, USA.,Laboratories of Cognitive Neuroscience, Boston Children's Hospital, Brookline, Massachusetts, USA
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19
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Faja S, Clarkson T, Gilbert R, Vaidyanathan A, Greco G, Rueda MR, Combita LM, Driscoll K. A preliminary randomized, controlled trial of executive function training for children with autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:346-360. [PMID: 34474598 PMCID: PMC8813874 DOI: 10.1177/13623613211014990] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
LAY ABSTRACT Executive function, which is a set of thinking skills that includes stopping unwanted responses, being flexible, and remembering information needed to solve problems, is a challenge for many children on the autism spectrum. This study tested whether executive function could be improved with a computerized executive function training program under the guidance of a coach who reinforced the use of executive function skills. Seventy children with autism spectrum disorder from age 7 to 11 years of age participated in the study. They were randomly assigned to receive training or to a waiting group. The tests most likely to determine whether the training may be effective were chosen from a larger battery before the study started and included one task measuring brain responses, two measures of executive function in the lab, and a parent questionnaire. Changes in social functioning and repetitive behaviors were also explored. All children assigned to training completed the program and families generally reported the experience was positive. Brain responses of the training group changed following training, but not within the waiting group during a similar time period. Children who received training did not exhibit behavioral changes during the two the lab-based tasks. Parent report on questionnaires indicated that neither group showed a significant change in their broad use of executive function in other settings. Yet, children who received training were reported to have fewer restricted and repetitive behaviors following training. These initial findings suggest that short executive function training activities are feasible and may improve some functioning of school-aged children on the autism spectrum.
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Affiliation(s)
- Susan Faja
- Boston Children's Hospital, USA.,Harvard Medical School, USA
| | | | - Rachel Gilbert
- Boston Children's Hospital, USA.,University of Florida, USA
| | | | - Gabriella Greco
- Boston Children's Hospital, USA.,University of Washington, USA
| | | | | | - Kate Driscoll
- Boston Children's Hospital, USA.,Harvard Medical School, USA
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20
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Wittwer J. Autismus: Ein Überblick über Lernvoraussetzungen und Fördermaßnahmen. ZEITSCHRIFT FUR PADAGOGISCHE PSYCHOLOGIE 2022. [DOI: 10.1024/1010-0652/a000326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Zusammenfassung. Autistische Schülerinnen und Schüler besitzen häufig geringere schulische Kompetenzen als nicht-autistische Schülerinnen und Schüler. Zugleich bestehen große Unterschiede in den schulischen Kompetenzen zwischen autistischen Schülerinnen und Schülern. Nicht selten weisen sie schulische Kompetenzen auf, die niedriger sind, als es aufgrund ihrer kognitiven Fähigkeiten zu erwarten wäre. Um zu verstehen, welche Faktoren das Lernen autistischer Schülerinnen und Schüler beeinflussen, wird in diesem Artikel ein Überblick über die Lernvoraussetzungen autistischer Schülerinnen und Schüler gegeben. Der Überblick zeigt, dass es autistischen Schülerinnen und Schülern schwerfallen kann, Vorwissen abzurufen und in Lernsituationen aktiv anzuwenden, Lernprozesse aufgrund von Einschränkungen in den exekutiven Funktionen angemessen zu steuern, verbale und visuelle Informationen im Arbeitsgedächtnis zu verarbeiten, kognitive und metakognitive Lernstrategien spontan anzuwenden, sich mit Lerninhalten auseinanderzusetzen, die nicht ihren eigenen Interessen entsprechen, und lernabträgliche Emotionen mittels geeigneter Strategien zu regulieren. Um autistische Schülerinnen und Schüler im Lernen zu unterstützen, werden Fördermaßnahmen zu den einzelnen Lernvoraussetzungen vorgestellt. Implikationen für Forschung und Praxis werden diskutiert.
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Affiliation(s)
- Jörg Wittwer
- Albert-Ludwigs-Universität Freiburg, Deutschland
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21
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Hajri M, Abbes Z, Yahia HB, Jelili S, Halayem S, Mrabet A, Bouden A. Cognitive deficits in children with autism spectrum disorders: Toward an integrative approach combining social and non-social cognition. Front Psychiatry 2022; 13:917121. [PMID: 36003981 PMCID: PMC9393361 DOI: 10.3389/fpsyt.2022.917121] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 07/13/2022] [Indexed: 11/13/2022] Open
Abstract
Autism spectrum disorder (ASD) is associated with neurocognitive impairment, including executive dysfunctioning and social cognition (SC) deficits. Cognitive remediation (CR) is a behavioral training-based intervention aiming to improve cognitive processes. Its first use in psychiatry interested patients with schizophrenia, in whom promising results have been shown. Integrated CR programs targeting both social and non-social cognition have demonstrated to be effective in improving both cognitive domains and functional outcomes. CR studies in children and adolescents with ASD are still new, those regarding CR approaches combining social and executive functioning remediation are scares. One study examining the efficacy of cognitive enhancement therapy (CET) for improving cognitive abilities in ADS adults, showed significant differential increases in neurocognitive function and large social-cognitive improvements. Therefore, taking into account the overlap between ASD and schizophrenia, and considering the close link between executive functions (EF) and SC, we suggest that integrative approach in ASD could result in better outcomes. The present perspective aimed to highlight cognitive remediation (CR) programs contributions in ASD (especially in children and adolescents), and to discuss the value of combining social and non-social programs.
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Affiliation(s)
- Melek Hajri
- Razi Hospital Child and Adolescent Psychiatry Department, Faculty of Medicine of Tunis, Tunis El Manar University, Manouba, Tunisia
| | - Zeineb Abbes
- Razi Hospital Child and Adolescent Psychiatry Department, Faculty of Medicine of Tunis, Tunis El Manar University, Manouba, Tunisia
| | - Houda Ben Yahia
- Razi Hospital Child and Adolescent Psychiatry Department, Manouba, Tunisia
| | - Selima Jelili
- Razi Hospital Child and Adolescent Psychiatry Department, Faculty of Medicine of Tunis, Tunis El Manar University, Manouba, Tunisia
| | - Soumeyya Halayem
- Razi Hospital Child and Adolescent Psychiatry Department, Faculty of Medicine of Tunis, Tunis El Manar University, Manouba, Tunisia
| | - Ali Mrabet
- Health Minsitery, General Directorate of Military Health, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Asma Bouden
- Razi Hospital Child and Adolescent Psychiatry Department, Faculty of Medicine of Tunis, Tunis El Manar University, Manouba, Tunisia
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22
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Cavalli G, Galeoto G, Sogos C, Berardi A, Tofani M. The efficacy of executive function interventions in children with autism spectrum disorder: a systematic review and meta-analysis. Expert Rev Neurother 2021; 22:77-84. [PMID: 34821185 DOI: 10.1080/14737175.2022.2011215] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Children with Autism Spectrum Disorder (ASD) experience difficulties in Executive Functions (EFs) performance. However, the efficacy of EF intervention needs to be further investigated. OBJECTIVE To evaluate the efficacy of different EF interventions in children and adolescents with ASD. METHODS A systematic review and meta-analysis were carried out according to PRISMA guidelines. Relevant databases including PubMed, PsycINFO, Scopus, and Web of Science were searched up to November 2019. Papers included in the study have the following characteristics: randomized controlled trial or quasi-experimental design and published in English or Spanish. RESULTS After the elimination of duplicates, 949 were screened. Among these, six were included in the systematic review. The main approaches for EF in ASD were computer-based interventions, cognitive-behavioral therapy, and assisted-animal therapy. Statistically significant results (p = 0.003) were found in using exergames. CONCLUSION Different approaches can be used for improving EF intervention, with positive effects on working memory, behavior, and flexibility.
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Affiliation(s)
- Gioia Cavalli
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Giovanni Galeoto
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.,Neuromed IRCCS, Pozzilli (Isernia), Italy
| | - Carla Sogos
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Anna Berardi
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Marco Tofani
- Department of Neurorehabilitation and Robotics, Bambino Gesù Childrens Hospital, Rome, Italy
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23
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Pasqualotto A, Mazzoni N, Bentenuto A, Mulè A, Benso F, Venuti P. Effects of Cognitive Training Programs on Executive Function in Children and Adolescents with Autism Spectrum Disorder: A Systematic Review. Brain Sci 2021; 11:1280. [PMID: 34679345 PMCID: PMC8534174 DOI: 10.3390/brainsci11101280] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 09/21/2021] [Accepted: 09/23/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Autism Spectrum Disorder is often associated with deficits in executive functions (EFs), which is contributing significantly to individuals with ASD's difficulties in conducting an independent life, particularly considering social skills. Technologies offer promising opportunities to structure EF intervention programs for children on the autistic spectrum. METHODS This study aimed to review the effectiveness of randomized controlled trials or quasi-experimental studies of EF interventions delivered to children and young people (up to 23 years old) with a diagnosis of ASD. A special focus was dedicated to document the effectiveness of computerized and non-computerized cognitive training on (1) EFs and on (2) ASD symptomatology and social skills. Of 2601 studies retrieved, 19 fulfilled the inclusion criteria. RESULTS Most of the interventions identified were effective in enhancing EFs and reducing symptoms in children and young people with ASD. Limited evidence is available on their generalization to untrained skills (i.e., social abilities) as well as long-term effects. CONCLUSIONS There is growing evidence for overall effectiveness of EF training, particularly when computerized. However, caution should be taken when interpreting these findings owing to methodological limitations, the minimal number of papers retrieved, and a small samples of included studies.
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Affiliation(s)
- Angela Pasqualotto
- Laboratory of Observational, Diagnosis and Education (ODFLab), Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy; (N.M.); (A.B.); (A.M.); (F.B.); (P.V.)
- Faculty of Psychology and Educational Sciences, University of Geneva, 1205 Geneva, Switzerland
| | - Noemi Mazzoni
- Laboratory of Observational, Diagnosis and Education (ODFLab), Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy; (N.M.); (A.B.); (A.M.); (F.B.); (P.V.)
- Laboratory for Autism and Neurodevelopmental Disorders, Center for Neuroscience and Cognitive Systems, Istituto Italiano di Tecnologia, 38068 Rovereto, Italy
| | - Arianna Bentenuto
- Laboratory of Observational, Diagnosis and Education (ODFLab), Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy; (N.M.); (A.B.); (A.M.); (F.B.); (P.V.)
| | - Anna Mulè
- Laboratory of Observational, Diagnosis and Education (ODFLab), Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy; (N.M.); (A.B.); (A.M.); (F.B.); (P.V.)
| | - Francesco Benso
- Laboratory of Observational, Diagnosis and Education (ODFLab), Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy; (N.M.); (A.B.); (A.M.); (F.B.); (P.V.)
| | - Paola Venuti
- Laboratory of Observational, Diagnosis and Education (ODFLab), Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy; (N.M.); (A.B.); (A.M.); (F.B.); (P.V.)
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24
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Plemeniti Tololeski B, Suhodolčan Grabner A, Kumperscak HG. Adolescents With Autism Spectrum Disorder and Anorexia Nervosa Comorbidity: Common Features and Treatment Possibilities With Cognitive Remediation Therapy and Oxytocin. Front Psychiatry 2021; 12:686030. [PMID: 34413796 PMCID: PMC8369034 DOI: 10.3389/fpsyt.2021.686030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 07/01/2021] [Indexed: 12/16/2022] Open
Abstract
Autistic traits or autism spectrum disorder (ASD) can be found in 4% to 52% of anorexic patients, which makes the treatment of these patients very challenging. In this review, possible ways to treat ASD and anorexia nervosa (AN) comorbidity in children and adolescents are summarized. Over recent years, the focus has shifted from searching for the evidence of connections between these two disorders, which have started with Gillberg's study in 1983, to searching for more effective and holistic treatment of this comorbidity. The latter is known to contribute to more severe courses and worse prognosis, which is probably related to the obstacles in both diagnosing and treating. Since AN usually starts in early adolescence and high-functioning ASD children seem to begin struggling with increased pressure in adolescence, while various comorbidities can occur, it is important to improve the treatment of this comorbidity in young patients and to tailor it specifically in terms of diagnosing. In this paper, a literature review is conducted on common features and promising treatment possibilities. We describe cognitive remediation therapy and the promising pharmacotherapeutic candidate oxytocin with a special focus on adolescents.
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Affiliation(s)
- Barbara Plemeniti Tololeski
- Centre for Mental Health, Unit for Adolescent Psychiatry, University Psychiatric Hospital Ljubljana, Ljubljana, Slovenia
| | | | - Hojka Gregoric Kumperscak
- Department for Child and Adolescent Psychiatry, University Medical Centre, Maribor, Slovenia
- Faculty for Medicine, University of Maribor, Maribor, Slovenia
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25
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Macoun SJ, Schneider I, Bedir B, Sheehan J, Sung A. Pilot Study of an Attention and Executive Function Cognitive Intervention in Children with Autism Spectrum Disorders. J Autism Dev Disord 2021; 51:2600-2610. [PMID: 33029666 DOI: 10.1007/s10803-020-04723-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This pilot study investigated the efficacy of a game-based cognitive training program (Caribbean Quest; CQ) for improving attention and executive function (EF) in school-aged children with Autism Spectrum Disorder (ASD). CQ is a 'serious game' that uses a hybrid process-specific/compensatory approach to remediate attention and EF abilities through repetitive, hierarchically graded exercises delivered in an adaptive format. Game-play is accompanied by instruction in metacognitive strategies delivered by an adult trainer. Twenty children diagnosed with ASD (ages 6-12 years) completed 12 h of intervention in schools over 8-10 weeks that was facilitated by a trained Research Assistant. Pre-post testing indicated near transfer gains for visual working memory and selective attention and far transfer effects for math fluency. Exit interviews with parents and school staff indicated anecdotal gains in attention, EF, emotion-regulation, flexibility, communication, and social skills. Overall, this study provides preliminary support for the feasibility and potential efficacy of the CQ when delivered in schools to children with ASD.
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Affiliation(s)
- Sarah J Macoun
- Psychology Department, University of Victoria, PO Box 1700 STN CSC, Victoria, BC, V8W 2Y2, Canada.
| | - Isabel Schneider
- Psychology Department, University of Victoria, PO Box 1700 STN CSC, Victoria, BC, V8W 2Y2, Canada
| | - Buse Bedir
- Psychology Department, University of Victoria, PO Box 1700 STN CSC, Victoria, BC, V8W 2Y2, Canada
| | - John Sheehan
- Psychology Department, University of Victoria, PO Box 1700 STN CSC, Victoria, BC, V8W 2Y2, Canada
| | - Andrew Sung
- Educational Psychology Department, University of Victoria, Victoria, BC, Canada
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26
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Spaniol MM, Mevorach C, Shalev L, Teixeira MCTV, Lowenthal R, de Paula CS. Attention training in children with autism spectrum disorder improves academic performance: A double-blind pilot application of the computerized progressive attentional training program. Autism Res 2021; 14:1769-1776. [PMID: 34227246 DOI: 10.1002/aur.2566] [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] [Received: 04/30/2020] [Revised: 04/10/2021] [Accepted: 04/21/2021] [Indexed: 01/22/2023]
Abstract
Atypical attention has been reported in individuals with autism spectrum disorder (ASD) with studies pointing to an increase in attention deficit and hyperactivity disorder-like symptomatology. Individuals with ASD may also present academic difficulties and it is possible that they face a double-barrier for academic attainment from both core ASD symptomatology and from attention atypicalities, which are directly linked to academic performance. This raises the possibility that academic difficulties in ASD may benefit from cognitive training targeting attention. To test this possibility, we used the computerized progressive attentional training (CPAT) intervention in a double-blind, active control with follow-up intervention study in Brazil. The CPAT is a computerized attention training program that was recently piloted with schoolchildren with ASD in the UK. Twenty-six participants (8-14 years) with ASD in the São Paulo's ASD Reference Unit were assigned to either the CPAT (n = 14) or active control group (n = 12), which were matched at baseline. Two 45-min intervention sessions per week were conducted over a 2-month period. School performance, attention, fluid intelligence, and behavior were assessed before, immediately after and 3 months following the intervention. Significant group by time interactions show improvements in math, reading, writing and attention that were maintained at follow-up for the CPAT (but not the active control) group, while parents of children from both groups tended to report behavioral improvements. We conclude that attention training has the potential to reduce obstacles for academic attainment in ASD. Combined with the previous pilot study, the current results point to the generality of the approach, which leads to similar outcomes in different cultural and social contexts. LAY ABSTRACT: Attention difficulties tend to occur in ASD and are linked to academic performance. In this study, we demonstrate that school performance in math, reading and writing in children with ASD can improve following an intervention that trains basic attention skills (the CPAT intervention). The improvements we report are stable and were maintained 3-months following the intervention. This study, which was conducted in a public-health setting in Brazil, extends previous research in schools in the UK pointing to the cross-cultural and cross-settings efficacy of the intervention.
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Affiliation(s)
- Mayra Muller Spaniol
- Developmental Disorders Program, Mackenzie Presbyterian University, São Paulo, Brazil
| | - Carmel Mevorach
- School of Psychology and the Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Lilach Shalev
- School of Education and the Sagol School of Neuroscience, Tel-Aviv University, Israel
| | | | - Rosane Lowenthal
- Mental Health Department, Santa Casa School of Medical Sciences, São Paulo, Brazil
| | - Cristiane Silvestre de Paula
- Developmental Disorders Program, Mackenzie Presbyterian University, São Paulo, Brazil.,Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
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Wagle S, Ghosh A, Karthic P, Ghosh A, Pervaiz T, Kapoor R, Patil K, Gupta N. Development and testing of a game-based digital intervention for working memory training in autism spectrum disorder. Sci Rep 2021; 11:13800. [PMID: 34226615 PMCID: PMC8257736 DOI: 10.1038/s41598-021-93258-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 06/23/2021] [Indexed: 02/06/2023] Open
Abstract
Autism spectrum disorder (ASD) is prevalent globally, yet it lacks cost-effective treatment approaches. Deficits in executive functions occur frequently in autism spectrum disorder and present a target for intervention. Here we report the design and development of five smartphone-based games for training working memory in children with ASD. These open-source games, available free of cost to the community, were designed to match the behavioral preferences and sensorimotor abilities of children with ASD. We then conducted a preliminary trial to test the effectiveness of a month-long intervention using these games. Although we did not see a significant change in the working memory of all children with a month-long training, children who performed better on the games also showed more improvement in their working memory, suggesting that a longer intervention with the games might be useful in improving working memory. Using a Hindi translation of the autism treatment evaluation checklist, we also tested the collateral gains of the training in reducing autistic symptoms. We found no significant change in the autistic symptoms after the intervention. Further, there was no correlation between the change in the working memory and the change in the autistic symptoms.
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Affiliation(s)
- Surbhit Wagle
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology Kanpur, Kanpur, Uttar Pradesh, 208016, India
| | - Arka Ghosh
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology Kanpur, Kanpur, Uttar Pradesh, 208016, India
| | - P Karthic
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology Kanpur, Kanpur, Uttar Pradesh, 208016, India
| | - Akriti Ghosh
- Amrita School for Special Children and Rehabilitation Center, Kanpur, Uttar Pradesh, 208005, India
| | - Tarana Pervaiz
- Amrita School for Special Children and Rehabilitation Center, Kanpur, Uttar Pradesh, 208005, India
| | - Rashmi Kapoor
- Amrita School for Special Children and Rehabilitation Center, Kanpur, Uttar Pradesh, 208005, India
- Regency Hospital Limited, Kanpur, Uttar Pradesh, 208005, India
| | - Koumudi Patil
- Design Program and Department of Humanities and Social Sciences, Indian Institute of Technology Kanpur, Kanpur, Uttar Pradesh, 208016, India
| | - Nitin Gupta
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology Kanpur, Kanpur, Uttar Pradesh, 208016, India.
- Cognitive Science Program, Indian Institute of Technology Kanpur, Kanpur, Uttar Pradesh, 208016, India.
- Mehta Family Center for Engineering in Medicine, Indian Institute of Technology Kanpur, Kanpur, Uttar Pradesh, 208016, India.
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The Effect of Comorbid Attention-Deficit/Hyperactivity Disorder Symptoms on Face Memory in Children with Autism Spectrum Disorder: Insights from Transdiagnostic Profiles. Brain Sci 2021; 11:brainsci11070859. [PMID: 34203375 PMCID: PMC8301798 DOI: 10.3390/brainsci11070859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/20/2021] [Accepted: 06/23/2021] [Indexed: 11/17/2022] Open
Abstract
Face memory impairments are common but heterogeneous in autism spectrum disorder (ASD), which may be influenced by co-occurrence with attention-deficit/hyperactivity disorder (ADHD). Here, we aimed to investigate the phenotype change of face memory in children with ASD comorbid ADHD symptoms, and discuss the potential role of executive function (EF). Ninety-eight children were analyzed in the present study, including ASD- (ASD-only, n = 24), ADHD (n = 23), ASD+ (with ADHD symptoms, n = 23) and neurotypical controls (NTC, n = 28). All participants completed two tests: face encoding and retrieving task and Wisconsin Card Sorting Test (WCST) for measuring face memory and EF, respectively. Results revealed that: compared with the NTC group, children with ASD- exhibited lower accuracy in both face encoding and retrieving, and participants with ASD+ showed lower accuracy only in the retrieving, whereas no differences were found among participants with ADHD. Moreover, in the ASD+ group, face encoding performance was correlated with response perseverative errors (RPE) and failure to maintain sets (FMS) of WCST; significantly, there were no group differences between ASD+ and NTC in these two indices. The transdiagnostic profiles indicated that comorbid ADHD symptoms could modulate the face encoding deficiency of ASD, which may be partially compensated by EF. Shared and distinct intervention strategies to improve social cognition are recommended for children undergoing treatment for each condition.
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Abstract
Cognitive and behavioural flexibility permit the appropriate adjustment of thoughts and behaviours in response to changing environmental demands. Brain mechanisms enabling flexibility have been examined using non-invasive neuroimaging and behavioural approaches in humans alongside pharmacological and lesion studies in animals. This work has identified large-scale functional brain networks encompassing lateral and orbital frontoparietal, midcingulo-insular and frontostriatal regions that support flexibility across the lifespan. Flexibility can be compromised in early-life neurodevelopmental disorders, clinical conditions that emerge during adolescence and late-life dementias. We critically evaluate evidence for the enhancement of flexibility through cognitive training, physical activity and bilingual experience.
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Affiliation(s)
- Lucina Q Uddin
- Department of Psychology, University of Miami, Coral Gables, FL, USA.
- Neuroscience Program, University of Miami Miller School of Medicine, Miami, FL, USA.
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30
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Executive function training in very preterm children: a randomized controlled trial. Eur Child Adolesc Psychiatry 2021; 30:785-797. [PMID: 32458091 PMCID: PMC7250540 DOI: 10.1007/s00787-020-01561-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 05/15/2020] [Indexed: 11/20/2022]
Abstract
Objective of the current study was to assess whether game-formatted executive function (EF) training, is effective in improving attention, EF and academic performance in very preterm and/or extremely low birthweight children aged 8-12 years. A multi-center, double-blind, placebo- and waitlist controlled randomized trial (NTR5365) in two academic hospitals in The Netherlands was performed. Eighty-five very preterm children with parent-rated attention problems on the Child Behavior Checklist were randomized to one of three treatment conditions: EF training, placebo training or waitlist condition. EF or placebo training was completed at home (6 weeks, 25 sessions of 30-45 min each). At baseline, 2 weeks after training or being on the waitlist, and five months after first follow-up visit, children underwent assessments of primary outcomes (parent and teacher ratings of attention) and secondary outcomes (parent and teacher ratings of daily-life EF, computerized EF tasks and academic performance). Linear mixed model analyses were performed for all outcome measures. There were no significant differences in improvement over time on parent- and teacher ratings of attention, parent- and teacher ratings of daily-life EF, computerized EF tasks, and academic performance (arithmetic and reading) between the EF training, placebo training and waitlist condition. In conclusion, game-formatted EF training does not improve attention, EF or academic performance in very preterm children with parent-rated attention problems.
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Gómez-Pérez MM, Mata S, Serrano F, Calero MD. Wisconsin Card Sorting Test-Learning Potential: Usefulness for Assessing Children with Autism Spectrum Disorder. J Autism Dev Disord 2020; 50:4230-4242. [PMID: 32246383 DOI: 10.1007/s10803-020-04488-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
This study analyzes the Wisconsin Card Sorting Test-Learning Potential (WCST-LP) in children with Autism Spectrum Disorder (ASD) versus children with typical development (TD). Its main aim was to assess: the test's construct validity; the effect of IQ on its pretest and LP scores; and whether the WCST-LP held any relationship to cognitive/EF and social abilities. Participants were 105 children (43 with ASD/62 with TD). Results showed evidence of construct validity in an ASD population (improvements from pretest to posttest), that full IQ influenced pretest performance but did not affect LP, and that a relationship between LP and verbal and social abilities existed only in children with ASD. Conclusions indicate the appropriateness of the WCST-LP in ASD prognosis assessment.
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Affiliation(s)
- M Mar Gómez-Pérez
- Departamento de Psicología Evolutiva y de la Educación, Facultad de Psicología, Universidad de Granada, Granada, Spain
| | - Sara Mata
- Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC), Granada, Spain.
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universidad de Granada, Campus Cartuja S/N, 18071, Granada, Spain.
| | - Francisca Serrano
- Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC), Granada, Spain
- Departamento de Psicología Evolutiva y de la Educación, Facultad de Psicología, Universidad de Granada, Granada, Spain
| | - M Dolores Calero
- Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC), Granada, Spain
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32
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Cao Y, Huang T, Huang J, Xie X, Wang Y. Effects and Moderators of Computer-Based Training on Children's Executive Functions: A Systematic Review and Meta-Analysis. Front Psychol 2020; 11:580329. [PMID: 33324291 PMCID: PMC7726355 DOI: 10.3389/fpsyg.2020.580329] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 10/06/2020] [Indexed: 01/04/2023] Open
Abstract
Computer-based training has attracted increasing attention from researchers in recent years. Several studies have found that computer-based training resulted in improved executive functions (EFs) in adults. However, it remains controversial whether children can benefit from computer-based training and what moderator could influence the training effects. The focus of the present meta-analysis was to examine the effects of computer-based training on EFs in children: working memory, cognitive flexibility, and inhibitory control. A thorough search of published work yielded a sample of 36 studies with 216 effect sizes. The results indicated that computer-based training showed moderate training effects on improving EFs in children (g = 0.35, k = 36, p < 0.001), while training effects of working memory were significantly higher. Furthermore, we found near-transfer effects were marginally significantly higher than far-transfer effects. The standard training method was significantly more effective than training with game elements. In computer-based training, typically developing children had significantly better training effects than atypically developing children. Some additional factors, such as the number of training sessions and age, also modulated the training effects. In conclusion, the present study investigated the effects and moderators of computer-based training for children's EFs. The results provided evidence that computer-based training (especially standard training) may serve as an efficient way to improve EFs in children (especially typically developing individuals). We also discussed some directions for future computer-based training studies.
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Affiliation(s)
- Yifei Cao
- School of Psychology, Northeast Normal University, Changchun, China
| | - Ting Huang
- School of Psychology, Northeast Normal University, Changchun, China
| | - Jipeng Huang
- School of Psychology, Northeast Normal University, Changchun, China
| | - Xiaochun Xie
- School of Psychology, Northeast Normal University, Changchun, China
| | - Yuan Wang
- School of Psychology, Northeast Normal University, Changchun, China
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33
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Sandgreen H, Frederiksen LH, Bilenberg N. Digital Interventions for Autism Spectrum Disorder: A Meta-analysis. J Autism Dev Disord 2020; 51:3138-3152. [PMID: 33170393 DOI: 10.1007/s10803-020-04778-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2020] [Indexed: 12/22/2022]
Abstract
This study aimed to review digital interventions in the treatment of autism spectrum disorder (ASD). A systematic review and meta-analysis was conducted. Nineteen studies were included. The interventions aimed to improve social skills (n = 11), developmental skills (n = 2) and 6 other different targets. Technology used were computer programs (n = 14), tablet apps (n = 3), a robot (n = 1) and an interactive DVD (n = 1). The meta-analysis resulted in an overall effect size (Cohen's d) of 0.32 [0.12-0.51], indicating a small effect. Heterogeneity between studies was high (I2 = 100%), limiting the generalization of results. Therefore, we recommend larger RCT studies, and guidelines for the development of trials evaluating digital interventions for ASD, for making comparison of future studies possible.Registration can be found online at Prospero: https://www.crd.york.ac.uk/prospero/ , registration no. CRD42020146542.
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Affiliation(s)
- Helena Sandgreen
- Department of Child and Adolescent Mental Health Odense, Research Unit (University Function), Mental Health Services in the Region of Southern Denmark, J. B. Winsløws Vej 16, entrance 230, 5000, Odense C, Denmark.
- Psychiatric Research Academy, Mental Health Services in the Region of Southern Denmark, Odense, Denmark.
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - Line Hofmann Frederiksen
- Department of Child and Adolescent Mental Health Odense, Research Unit (University Function), Mental Health Services in the Region of Southern Denmark, J. B. Winsløws Vej 16, entrance 230, 5000, Odense C, Denmark
- Psychiatric Research Academy, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Internal Medicine, Aabenraa Hospital, Aabenraa, Denmark
| | - Niels Bilenberg
- Department of Child and Adolescent Mental Health Odense, Research Unit (University Function), Mental Health Services in the Region of Southern Denmark, J. B. Winsløws Vej 16, entrance 230, 5000, Odense C, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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34
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Chen MT, Chang YP, Marraccini ME, Cho MC, Guo NW. Comprehensive attention training system (CATS): A computerized executive-functioning training for school-aged children with autism spectrum disorder. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2020; 68:528-537. [PMID: 35937171 PMCID: PMC9351557 DOI: 10.1080/20473869.2020.1827673] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 09/19/2020] [Accepted: 09/20/2020] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Theory suggests that impaired executive functioning (EF) might explain several symptoms of autism spectrum disorder (ASD) in children. However, only a few studies have examined the efficacy of EF training for the children using randomized control trial designs, and only two of them found significant benefits of the training. METHOD We designed Comprehensive Attention Training System (CATS), and tested this new EF intervention for children with ASD in a small-sampled randomized controlled trial. Twenty-five children with ASD aged six to twelve were randomly assigned to either the CATS or the control training and were assessed pre- and post-training. RESULTS Relative to the control group, the CATS group improved on EF as measured by the trail-making test, avoiding perseverative errors, and forming conceptual responses in the Wisconsin Card Sorting Task. There were also indications that CATS contributed to long-term communication skills as measured by the Vineland adaptive behavior scales. CONCLUSIONS We report preliminary evidence that the CATS intervention may improve the EF of school-aged children with ASD compared to a control intervention. We discuss the results in terms of their generalizability to other developmental disorders.
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Affiliation(s)
- Meng-Ting Chen
- Department of Child and Family Studies, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Yen-Ping Chang
- Department of Educational Psychology and Counseling, National Tsing Hua University, Hsinchu City, Taiwan
| | - Marisa E. Marraccini
- School of Education, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Miao-Chun Cho
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital Kaohsiung Branch, Kaohsiung City, Taiwan
| | - Nai-Wen Guo
- Institute of Behavioral Medicine, National Cheng Kung University, Tainan City, Taiwan
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35
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Solomon M, Gordon A, Iosif AM, Geddert R, Krug MK, Mundy P, Hessl D. Using the NIH Toolbox to Assess Cognition in Adolescents and Young Adults with Autism Spectrum Disorders. Autism Res 2020; 14:500-511. [PMID: 33006263 DOI: 10.1002/aur.2399] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 08/05/2020] [Accepted: 09/02/2020] [Indexed: 11/08/2022]
Abstract
Despite the clinically significant impact of executive dysfunction on the outcomes of adolescents and young adults with autism spectrum disorders (ASD), we lack a clear understanding of its prevalence, profile, and development. To address this gap, we administered the NIH Toolbox Cognition Battery to a cross-sectional Intelligence Quotient (IQ) case-matched cohort with ASD (n = 66) and typical development (TD; n = 66) ages 12-22. We used a general linear model framework to examine group differences in task performance and their associations with age. Latent profile analysis (LPA) was used to identify subgroups of individuals with similar cognitive profiles. Compared to IQ case-matched controls, ASD demonstrated poorer performance on inhibitory control (P < 0.001), cognitive flexibility (P < 0.001), episodic memory (P < 0.02), and processing speed (P < 0.001) (components of Fluid Cognition), but not on vocabulary or word reading (components of Crystallized Cognition). There was a significant positive association between age and Crystallized and Fluid Cognition in both groups. For Fluid (but not Crystallized) Cognition, ASD performed more poorly than TD at all ages. A four-group LPA model based on subtest scores best fit the data. Eighty percent of ASD belonged to two groups that exhibited relatively stronger Crystallized versus Fluid Cognition. Attention deficits were not associated with Toolbox subtest scores, but were lowest in the group with the lowest proportion of autistic participants. Adaptive functioning was poorer in the groups with the greatest proportion of autistic participants. Autistic persons are especially impaired on Fluid Cognition, and this more flexible form of thinking remains poorer in the ASD group through adolescence. LAY SUMMARY: A set of brief tests of cognitive functioning called the NIH Toolbox Cognition Battery was administered to adolescents and young adults with autism spectrum disorders (ASD; n = 66) and typical development (TD; n = 66) ages 12-22 years. Compared to TD, ASD showed poorer performance in inhibiting responses, acting flexibly, memorizing events, and processing information quickly (Fluid Cognition). Groups did not differ on vocabulary or word reading (Crystallized Cognition). Crystallized and Fluid Cognition increased with age in both groups, but the ASD group showed lower Fluid, but not Crystallized, Cognition than TD at all ages. A categorization analysis including all participants showed that most participants with ASD fell into one of two categories: a group characterized by poor performance across all tasks, or a group characterized by relatively stronger Crystallized compared to Fluid Cognition. Adaptive functioning was poorer for participants in these groups, which consisted of mostly individuals with ASD, while ADHD symptoms were lowest in the group with the greatest proportion of TD participants.
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Affiliation(s)
- Marjorie Solomon
- Department of Psychiatry and Behavioral Sciences, University of California-Davis, Sacramento, California, USA.,Imaging Research Center, University of California-Davis, Sacramento, California, USA.,MIND Institute, University of California-Davis, Sacramento, California, USA
| | - Andrew Gordon
- Department of Psychiatry and Behavioral Sciences, University of California-Davis, Sacramento, California, USA.,MIND Institute, University of California-Davis, Sacramento, California, USA
| | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California-Davis, Davis, California, USA
| | - Raphael Geddert
- Department of Psychiatry and Behavioral Sciences, University of California-Davis, Sacramento, California, USA.,MIND Institute, University of California-Davis, Sacramento, California, USA
| | - Marie K Krug
- Department of Psychiatry and Behavioral Sciences, University of California-Davis, Sacramento, California, USA.,MIND Institute, University of California-Davis, Sacramento, California, USA
| | - Peter Mundy
- Department of Psychiatry and Behavioral Sciences, University of California-Davis, Sacramento, California, USA.,MIND Institute, University of California-Davis, Sacramento, California, USA.,School of Education, University of California-Davis, Davis, California, USA
| | - David Hessl
- Department of Psychiatry and Behavioral Sciences, University of California-Davis, Sacramento, California, USA.,MIND Institute, University of California-Davis, Sacramento, California, USA
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36
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Vermeir JF, White MJ, Johnson D, Crombez G, Van Ryckeghem DML. The Effects of Gamification on Computerized Cognitive Training: Systematic Review and Meta-Analysis. JMIR Serious Games 2020; 8:e18644. [PMID: 32773374 PMCID: PMC7445616 DOI: 10.2196/18644] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 01/05/2023] Open
Abstract
Background There has been a growing interest in the application of gamification (ie, the use of game elements) to computerized cognitive training. The introduction of targeted gamification features to such tasks may increase motivation and engagement as well as improve intervention effects. However, it is possible that game elements can also have adverse effects on cognitive training (eg, be a distraction), which can outweigh their potential motivational benefits. So far, little is known about the effectiveness of such applications. Objective This study aims to conduct a systematic review and meta-analysis to investigate the effect of gamification on process outcomes (eg, motivation) and on changes in the training domain (eg, cognition), as well as to explore the role of potential moderators. Methods We searched PsycINFO, Cumulative Index to Nursing and Allied Health Literature, ProQuest Psychology, Web of Science, Scopus, PubMed, Science Direct, Excerpta Medica dataBASE, Institute of Electrical and Electronics Engineers Xplore, Association for Computing Machinery, and a range of gray-area literature databases. The searches included papers published between 2008 and 2018. Meta-analyses were performed using a random-effects model. Results The systematic review identified 49 studies, of which 9 randomized controlled trials were included in the meta-analysis. The results of the review indicated that research in this context is still developing and lacks well-controlled empirical studies. Gamification in cognitive training is applied to a large range of age groups and audiences and is mostly delivered at a research site through computers. Rewards and feedback continue to dominate the gamification landscape, whereas social-oriented features (eg, competition) are underused. The meta-analyses showed that gamified training tasks were more motivating/engaging (Hedges g=0.72) and more demanding/difficult (Hedges g=–0.52) than non- or less-gamified tasks, whereas no effects on the training domain were found. Furthermore, no variables moderated the impact of gamified training tasks. However, meta-analytic findings were limited due to a small number of studies. Conclusions Overall, this review provides an overview of the existing research in the domain and provides evidence for the effectiveness of gamification in improving motivation/engagement in the context of cognitive training. We discuss the shortcomings in the current literature and provide recommendations for future research.
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Affiliation(s)
- Julie F Vermeir
- School of Psychology and Counselling, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Melanie J White
- School of Psychology and Counselling, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Daniel Johnson
- Science and Engineering Faculty, Queensland University of Technology, Brisbane, Australia
| | - Geert Crombez
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Dimitri M L Van Ryckeghem
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.,Department of Clinical Psychological Science, Maastricht University, Maastricht, Netherlands.,Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
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37
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Dandil Y, Smith K, Kinnaird E, Toloza C, Tchanturia K. Cognitive Remediation Interventions in Autism Spectrum Condition: A Systematic Review. Front Psychiatry 2020; 11:722. [PMID: 32793009 PMCID: PMC7393993 DOI: 10.3389/fpsyt.2020.00722] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 07/09/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Autism spectrum condition (ASC) is a lifelong neurodevelopmental condition characterized by difficulties in social cognition and heterogeneity of executive function which are suggested to be underpinned by neurobiological, prenatal and genetic factors. Cognitive remediation (CR) interventions are frequently used to address cognitive characteristics and improve cognitive and general functioning. However, the evidence is limited for ASC. This systematic review is the first to provide a narrative synthesis of all studies of CR interventions and ASC. The review aimed to delineate the development of research in this area in both adolescents and adults, with implications for clinical practice and future research. METHOD The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. The literature was reviewed using the PubMed, PsycINFO, Web of Science, Scopus and Embase from inception to 1st April 2020. Out of 1,503 publications, a total of 13 papers were identified as being relevant for the review. RESULTS The 13 studies meeting the inclusion criteria were: four randomized control trials (RCTs); two non-randomized control trials, four case series, two feasibility studies and one case study. A narrative synthesis of the data suggested that CR interventions are potentially effective in improving social cognition and cognitive functioning in ASC. RCTs supported the efficacy of CR interventions in improving social cognition and executive functioning. Non-randomized control trials provided evidence for the effectiveness of social cognition remediation interventions in ASC. Case series and a case study have also supported the feasibility of CR interventions, including reflections on their adaptation for ASC populations and the positive feedback from participants. CONCLUSIONS CR interventions are potentially effective in improving social cognition and cognitive functioning in ASC. However, the generalizability of the included empirical studies was hampered by several methodological limitations. To further strengthen understandings of the effectiveness of CR interventions for ASC, future RCTs are needed with larger sample sizes in exploring the long-term effectiveness of CR interventions, using age-appropriate valid and reliable outcome measures. They should also consider the heterogeneity in neuropsychological functioning in ASC and the mediating and moderating mechanisms of the CR intervention for ASC.
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Affiliation(s)
- Yasemin Dandil
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King’s College London, London, United Kingdom
| | - Katherine Smith
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King’s College London, London, United Kingdom
| | - Emma Kinnaird
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King’s College London, London, United Kingdom
| | - Cindy Toloza
- Department of Psychology, National Eating Disorder Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Kate Tchanturia
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King’s College London, London, United Kingdom
- Department of Psychology, National Eating Disorder Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Department of Psychology, Illia State University, Tbilisi, Georgia
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Doyen C, Renou S, Burnouf I, Baron T, Amado I, Launay C, Kaye K. La remédiation cognitive pour l’inclusion des enfants et des adolescents avec troubles du neurodéveloppement et/ou émotionnels. ACTA ACUST UNITED AC 2020. [DOI: 10.1016/j.neurenf.2020.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Bednarz HM, Trapani JA, Kana RK. Metacognition and behavioral regulation predict distinct aspects of social functioning in autism spectrum disorder. Child Neuropsychol 2020; 26:953-981. [PMID: 32253979 DOI: 10.1080/09297049.2020.1745166] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Executive function (EF) deficits are common in autism spectrum disorder (ASD), and previous studies suggest that EF may influence or predict social functioning. Thus, EF is a potential treatment target in this population. However, the nature of how specific metacognition and behavioral regulation components of EF may differentially impact social function remains unclear. The goal of the current study was to examine the relationships between sub-components of EF (e.g., working memory, shifting, inhibition, etc.) and social functioning as measured by parent ratings on the Behavior Rating Inventory of Executive Functioning (BRIEF) and the Social Responsiveness Scale (SRS), while controlling for the influence of age, sex, and IQ. A second goal was to examine whether BRIEF scores were predictive of clinician-rated measures of ASD symptoms. Behavioral data were acquired from the Autism Brain Imaging Data Exchange-II database and included 106 children with ASD (ages 5-13). Based on analysis of parent ratings, self-monitoring skills predicted social awareness; shifting ability predicted social cognition; working memory and monitoring skills predicted social communication; initiation predicted social motivation; and shifting ability predicted restrictive and repetitive behaviors among children with ASD. Parent ratings on the BRIEF did not predict clinician-rated measures of ASD symptoms; this requires further study. Overall, the current findings indicate that metacognition and behavioral regulation both contribute to social functioning in ASD, although they each have distinct patterns of influence on different aspects of social functioning. These findings have promising implications for tailoring social interventions for ASD that target specific EF skills.
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Affiliation(s)
- Haley M Bednarz
- Department of Psychology, University of Alabama at Birmingham , Birmingham, AL, USA
| | - Julie A Trapani
- Department of Psychology, University of Alabama at Birmingham , Birmingham, AL, USA
| | - Rajesh K Kana
- Department of Psychology, University of Alabama at Birmingham , Birmingham, AL, USA
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Oldrati V, Corti C, Poggi G, Borgatti R, Urgesi C, Bardoni A. Effectiveness of Computerized Cognitive Training Programs (CCTP) with Game-like Features in Children with or without Neuropsychological Disorders: a Meta-Analytic Investigation. Neuropsychol Rev 2020; 30:126-141. [PMID: 32112369 DOI: 10.1007/s11065-020-09429-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 02/13/2020] [Indexed: 12/18/2022]
Abstract
Computerized cognitive training programs (CCTP) are based on the assumption that cognitive abilities may be boosted by repetitively performing challenging tasks. The integration of game-like features in these programs, associated with the goal of amusing or rewarding participants, may contribute to generate cognitive benefits. Indeed, reinforcement contingencies have been reported to produce positive effects on performance and motivation, especially in children. This meta-analysis was aimed at providing a quantitative summary of the effectiveness of CCTP with game-like features in school-aged children with typical and atypical development. A total of 24 studies, with the cognitive and behavioral outcome data of 1547 participants, were selected for inclusion in the meta-analysis. Subgroup analyses were performed to identify the sources of the observed methodological heterogeneity. A robust variance estimation model, after removal of study outliers, yielded a small-to-moderate significant effect size. Final results pointed out smaller but more precise estimate effect sizes according to methodological aspects related to cognitive domain of outcomes, standardization of measures and type of control applied. Alongside supporting the use of CCTP for rehabilitating cognitive functions, the present results shed light on how different methodological choices are able to shape research findings in the field of children's cognitive rehabilitation.
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Affiliation(s)
- Viola Oldrati
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, Lecco, Italy.
| | - Claudia Corti
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, Lecco, Italy
| | - Geraldina Poggi
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, Lecco, Italy
| | - Renato Borgatti
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, Lecco, Italy
| | - Cosimo Urgesi
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, Lecco, Italy
- Laboratory of Cognitive Neuroscience, Department of Languages and Literatures, Communication, Education and Society, University of Udine, Udine, Italy
- Scientific Institute, IRCCS E. Medea, San Vito al Tagliamento, Pordenone, Italy
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Zervogianni V, Fletcher-Watson S, Herrera G, Goodwin M, Pérez-Fuster P, Brosnan M, Grynszpan O. A framework of evidence-based practice for digital support, co-developed with and for the autism community. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 24:1411-1422. [PMID: 32026715 PMCID: PMC7376625 DOI: 10.1177/1362361319898331] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
A wide array of digital supports (such as apps) have been developed for the autism community, many of which have little or no evidence to support their effectiveness. A Delphi study methodology was used to develop a consensus on what constitutes good evidence for digital supports among the broader autism community, including autistic people and their families, as well as autism-related professionals and researchers. A four-phase Delphi study consultation with 27 panel members resulted in agreement on three categories for which evidence is required: reliability, engagement and effectiveness of the technology. Consensus was also reached on four key sources of evidence for these three categories: hands-on experience, academic sources, expert views and online reviews. These were differentially weighted as sources of evidence within these three categories.
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Lim JM. Emotion regulation and intervention in adults with autism spectrum disorder: a synthesis of the literature. ADVANCES IN AUTISM 2019. [DOI: 10.1108/aia-12-2018-0050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Emotion regulation is an ongoing multiprocess phenomenon and is a challenging developmental task to acquire in individuals with autism spectrum disorder (ASD) who have different neurobiological profiles and emotion regulation problems. The purpose of this paper is to review recent literature to understand the neurobiological and psychological perspective of emotion regulation in ASD, while converging themes of psychosocial interventions and existing best practices on emotion regulation within this heterogeneous population are reviewed and discussed in consideration of intellectual disability (ID).
Design/methodology/approach
Review of recent literature and common empirically supported interventions addressing emotional regulation implemented in individuals with and without ASD, and with and without ID were included in the electronic database search through PubMed, EBSChost, Science Direct, Wiley Online Library, GALE and SAGE. Search terms used included autism, ID, cognitive control, executive function, sensory processing/intervention, emotion regulation, cognitive behavior therapy, mindfulness, social stories, positive behavior support and behavior therapy.
Findings
Neural systems governing emotion regulation can be divided into “top-down” and “bottom-up” processing. Prefrontal cortex, cognitive and attentional control are critical for effective emotion regulation. Individuals with ASD, and with ID show impairments in these areas have problems with emotion regulation. Targeted psychosocial intervention need to consider bottom-up and top-down processes of emotion regulation, and that standardized interventions require adaptations.
Originality/value
There are limited studies looking into understanding the neurobiological and psychological perspective of emotion regulation in ASD and linking them to interventions. This review highlights psychosocial interventions that are important for further research, investigation and development as treatment in this population is limited.
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Effets des programmes d’interventions cognitivo-comportementaux et d’entraînements cognitifs sur les fonctions exécutives (FE) chez les personnes atteintes du trouble du spectre autistique (TSA) : revue systématique. ANNALES MEDICO-PSYCHOLOGIQUES 2019. [DOI: 10.1016/j.amp.2018.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Saniee S, Pouretemad HR, Zardkhaneh SA. Developing set-shifting improvement tasks (SSIT) for children with high-functioning autism. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:1207-1220. [PMID: 31267604 DOI: 10.1111/jir.12633] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 12/08/2018] [Accepted: 04/24/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Children with autism spectrum disorder (ASD) experience set-shifting deficit as a part of executive function, which can lead to cognitive and behavioural flexibility deficits and/or restricted behaviours. Despite the increasing body of research on this cognitive deficit, set-shifting training has not been exclusively studied in ASD. AIMS In this study, a training condition [set-shifting improvement tasks (SSIT)] was developed to improve set-shifting ability; afterwards, the possible effects of these tasks were investigated. METHODS AND PROCEDURES With the aim of improving set-shifting ability in children with autism, a training program (SSIT), involving a computer game (Tatka, a puzzle game produced by our research team) with some home-based tasks (for generalisation purposes), was developed. Then, in a quasi-experimental design, the effects of SSIT tasks were studied on children (n = 13, 5-7 years old) with high-functioning autism. Outcome measures (pre-training, post-training and a 6-week follow-up) were assessed using Modified Wisconsin Card Sorting Test, Bender-Gestalt Test and Behavioural Flexibility Rating Scale. RESULTS AND OUTCOMES A significant change was observed in both cognitive (Bender Gestalt, ηp2=0.84 ; WCST; =p20.87 ) and behavioural flexibilities ( ηp2=0.79 ) and also in repetitive behaviours ( ηp2=0.45 ). Furthermore, the result remained stable to some extent for about 1 month after the training condition. CONCLUSIONS AND IMPLICATIONS Developing the SSIT is just an initial step in the major target of creating cognitive rehabilitation tools to be used by clinicians and parents for children diagnosed with ASD and should be understood as a supplement, rather than an alternative, to the main treatments such as applied behaviour analysis. Future research with larger samples are needed to confirm whether this intervention is effective for children with ASD.
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Affiliation(s)
- S Saniee
- Department of Cognitive Psychology, Shahid Beheshti University, Tehran, Iran
| | - H R Pouretemad
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - S A Zardkhaneh
- Department of Psychology, Shahid Beheshti University, Tehran, Iran
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Renou S, Doyen C. Programme de Remédiation cognitive NEAR (Neuropsychological Educational Approach to Cognitive Remediation) chez des adolescents présentant un Trouble Déficit de l’Attention/Hyperactivité et/ou un Trouble du spectre Autistique. ANNALES MEDICO-PSYCHOLOGIQUES 2019. [DOI: 10.1016/j.amp.2018.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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van Houdt CA, Aarnoudse-Moens CSH, van Wassenaer-Leemhuis AG, Laarman ARC, Koopman-Esseboom C, van Kaam AH, Oosterlaan J. Effects of Executive Function Training on Attentional, Behavioral and Emotional Functioning and Self-Perceived Competence in Very Preterm Children: A Randomized Controlled Trial. Front Psychol 2019; 10:2100. [PMID: 31572276 PMCID: PMC6753219 DOI: 10.3389/fpsyg.2019.02100] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 08/29/2019] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE Very preterm children have poorer attentional, behavioral and emotional functioning than term-born children. Problems on these domains have been linked to poorer executive function (EF). This study examined effects of a game-formatted, comprehensive EF training on attentional, behavioral and emotional functioning and self-perceived competence in very preterm children. STUDY DESIGN Eighty-five children participated in a multi-center, double-blind, placebo and waitlist-controlled randomized trial. Children were recruited from neonatal follow-up units of two academic medical centers in The Netherlands. Eligible for inclusion were 8-12 year old children born very preterm (<30 weeks of gestation) and/or with extremely low birthweight (<1000 g) with parent reported attention problems. Children were randomly assigned to one of three treatment arms: EF training, placebo training or waitlist. The EF and placebo training involved a 6 weeks, 25 (30-45 min) sessions training program. Attentional functioning (Attention Network Test), behavioral and emotional functioning (parent and teacher Strengths and Difficulties questionnaire) and self-perceived competence (Self-Perception Profile for Children) were assessed at baseline, at the end of the training program and 5 months after the training was finished. Data analyses involved linear mixed model analyses. RESULTS Children in the EF training arm significantly improved on all training tasks over the course of the EF training program. Despite these improvements on the EF training tasks, there were no significant differences over time on any of the outcome measures between the three treatment arms, indicating that this computerized EF training program had no beneficial effects. CONCLUSION Although there were significant improvements in the EF training tasks, there was no generalization of these improvements to any of the outcome measures. Thus, our findings do not support the use of computerized EF training programs. Future research should investigate effectivity of more ecologically valid, real-world like EF training programs.
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Affiliation(s)
- Carolien A. van Houdt
- Department of Neonatology, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Emma Neuroscience Group, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Cornelieke S. H. Aarnoudse-Moens
- Department of Neonatology, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Emma Neuroscience Group, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Section of Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Psychosocial Department, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | | | - A. R. Céleste Laarman
- Department of Neonatology, Emma Children’s Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | - Anton H. van Kaam
- Department of Neonatology, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Department of Neonatology, Emma Children’s Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Jaap Oosterlaan
- Section of Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Department of Pediatrics, Amsterdam Reproduction and Development, Emma Neuroscience Group, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
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Computer- and Robot-Assisted Therapies to Aid Social and Intellectual Functioning of Children with Autism Spectrum Disorder. ACTA ACUST UNITED AC 2019; 55:medicina55080440. [PMID: 31387274 PMCID: PMC6724404 DOI: 10.3390/medicina55080440] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/01/2019] [Accepted: 08/02/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND OBJECTIVES Children with autism spectrum disorder (ASD) experience challenges with social interactions, a core feature of the disorder. Social skills therapy has been shown to be helpful. Over the past several years, computer-assisted and robot-assisted therapies have been infiltrating the social skills teaching environment. Rapid progress in the field of technology, especially in the robotics area, offers tremendous possibilities for innovation and treatment or even education for individuals with ASD. This paper's purpose is to drive awareness of these innovative interventions in order to support the social lives of children with ASD. The aims of the paper are identifying (1) the types of Information Technology platforms that are being evaluated in computer and robot-assisted therapies for children with ASD; (2) the various disciplines or professions studying and utilizing these computer and robot-assisted social skill therapies; (3) the outcomes being evaluated in each trial; and (4) if results demonstrate benefits to children with autism. MATERIALS AND METHODS PubMed, CINAHL, Science Direct, and Web of Science databases were searched for clinical trials published over the past five years. Search terms incorporated the subject intersection of autism, and computer or robot-assisted therapy. Results were mined for pediatric populations only and study designs establishing controlled comparisons. RESULTS Eighteen unique international studies were identified that utilize robot interventions (11 studies) and serious computer game interventions (seven studies). Most demonstrated promising results in improving outcomes for children with ASD. Study implications reveal a rapidly evolving assistive technology for ASD social skills therapy. CONCLUSIONS These interventions show considerable promise, but more effectiveness and cost effectiveness research of high quality should be carried out with larger numbers of children. Also, further studies are necessary to evaluate these technologies' effectiveness amongst adults with ASD and within unique subsets of the higher functioning autism population.
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Flynn RM, Colón-Acosta N, Zhou J, Bower J. A Game-Based Repeated Assessment for Cognitive Monitoring: Initial Usability and Adherence Study in a Summer Camp Setting. J Autism Dev Disord 2019; 49:2003-2014. [PMID: 30656527 DOI: 10.1007/s10803-019-03881-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The current feasibility study examined the adherence, reliability, and assessment potential of an evidence-based game-like mobile Monitoring Tool (Akili Interactive Labs), to monitor 100 participants' cognition for eight sessions at a summer camp for children with special needs. A validated measure of attention was administered at baseline. In the last session, participants completed an exit questionnaire. The Monitoring Tool was found to be enjoyable, and showed a high rate of adherence. No Monitor-related adverse events were reported. Monitor metrics showed good reliability across repeated measurements, indicating it is stable over long-term cognitive monitoring. There was evidence that the Monitoring Tool was able to detect differences in cognition between the children diagnosed with attention deficit hyperactivity disorder and autism spectrum disorders.
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Affiliation(s)
- Rachel M Flynn
- Silver School of Social Work, McSilver Institute for Poverty Policy and Research, New York University, 41 East 11th Street, 7th Floor, New York, NY, 10003, USA. .,Feinberg School of Medicine, Northwestern University, 633 N St. Clair St, 19th Floor, Chicago, IL, 60611, USA.
| | | | - Jimmy Zhou
- Akili Interactive, 125 Broad Street, 4th Floor, Boston, MA, 02110, USA
| | - Jeffrey Bower
- Akili Interactive, 125 Broad Street, 4th Floor, Boston, MA, 02110, USA
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Chouinard B, Gallagher L, Kelly C. He said, she said: Autism spectrum diagnosis and gender differentially affect relationships between executive functions and social communication. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 23:1793-1804. [DOI: 10.1177/1362361318815639] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Autism spectrum disorder is characterized by difficulties with social communication, with a preponderance in males. Evidence supports a relationship between metacognitive executive functions (e.g. planning, working memory) and social communication in autism spectrum disorder, yet relationships with specific metacognitive executive functions and how gender alters the expression of these relationships require further study. We used multiple regression to examine relationships between informant-based measures of metacognitive executive function and social communication in intellectually able (IQ ⩾ 85) female ( n = 111; mean age = 10.2 ± 2.8; 31 autism spectrum disorder) and male youth ( n = 310; mean age = 10.5 ± 1.9; 146 autism spectrum disorder) with and without autism spectrum disorder from the Autism Brain Imaging Data Exchange-II database. Executive function–social communication relationships were different in females and males with autism spectrum disorder. Relationships between the entire metacognitive index and social communication were stronger in males with autism spectrum disorder than without; this pattern was also observed for metacognitive sub-indices ‘monitor’ and ‘working memory’. These patterns were not observed in females. Relationships between executive function and social communication appear different for female and male youth with an autism spectrum disorder diagnosis. To better understand the nature of metacognitive contributions to social communication in autism spectrum disorder, future work should investigate the co-development of monitoring, working memory and social communication, while taking gender into account.
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Affiliation(s)
- Brea Chouinard
- Department of Psychiatry at the School of Medicine, Ireland
- Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland
| | - Louise Gallagher
- Department of Psychiatry at the School of Medicine, Ireland
- Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland
| | - Clare Kelly
- Department of Psychiatry at the School of Medicine, Ireland
- Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland
- School of Psychology, Trinity College Dublin, Ireland
- Department of Child and Adolescent Psychiatry at NYU Langone Medical Center, New York, USA
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Tse CYA, Lee HP, Chan KSK, Edgar VB, Wilkinson-Smith A, Lai WHE. Examining the impact of physical activity on sleep quality and executive functions in children with autism spectrum disorder: A randomized controlled trial. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 23:1699-1710. [PMID: 30663324 DOI: 10.1177/1362361318823910] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sleep disturbance and executive dysfunction have been widely reported in children with autism spectrum disorder. While the positive impacts of physical activity on sleep quality and cognition are documented in children with typical development, similar studies in children with autism spectrum disorder are scarce. The objective of this study was to examine the impact of physical activity on sleep quality and cognition in children with autism spectrum disorder. A total of 40 children diagnosed with autism spectrum disorder (mean age = 9.95 years) were randomly assigned into two groups: physical activity intervention and control. Four sleep parameters (sleep efficiency, sleep onset latency, sleep duration, and wake after sleep onset) and two executive functions (inhibition control and working memory) were assessed. Results revealed a significant improvement in sleep efficiency, sleep onset latency, and sleep duration in the intervention group but not in the control group during weekdays. Moreover, a significant improvement in inhibitory control was shown in the intervention group but not in the control group. No significant improvement in working memory capacity was documented in either group (ps > 0.05). Our findings highlight the value of physical activity in improving sleep quality and cognition among children with autism spectrum disorder, but specific physical activity may be required to benefit individual executive functions.
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