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Computerized Working Memory Training for Children with Moderate to Severe Traumatic Brain Injury: A Double-Blind, Randomized, Placebo-Controlled Trial.

Abstract

Pediatric traumatic brain injury (TBI) places children at risk for deficits in working memory (WM; comprising a central executive [CE], and two storage systems: phonological loop [PL] and visuospatial sketchpad [VSSP]), which is strongly related to attention and academic skills in childhood. This study aimed to examine whether different components of WM can be improved following adaptive WM training (Cogmed) and whether improvements in WM generalize to other cognitive (attention) and academic skills (reading and mathematics) in children with TBI. Twenty-seven children with moderate to severe TBI were randomized to adaptive (Cogmed; n = 13) or non-adaptive training (active placebo; n = 14) and evaluated at baseline, post-training, and 3-months follow-up. Three children in the adaptive group and one child in the non-adaptive group withdrew from the study before completion of training. Complete case (CC) and intention-to-treat (ITT) analyses were conducted. Children in the adaptive group demonstrated significantly greater gains on select WM tasks (VSSP, but not PL or CE) from pre- to post-training (pre-post) and pre-training to follow-up (pre-follow-up; CC and ITT analyses). No gains were found on tests of attention. Adaptive training resulted in significantly greater gains on select academic skills (reading, but not mathematics): reading comprehension pre-post-training (ITT analyses) and reading accuracy pre-follow-up (CC and ITT analyses). This first, to our knowledge, study to examine the efficacy of adaptive WM training for children with TBI provides preliminary evidence of near and far transfer of training to WM and academic skills, respectively.

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  • Publisher Full Text
  • Authors+Show Affiliations

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    1 School of Psychology, The University of Sydney , Sydney, Australia . 2 ARC Centre of Excellence in Cognition and its Disorders , Sydney, Australia .

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    3 Department of Psychology, Sydney Children's Hospital Randwick , Sydney, Australia .

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    4 Kids Rehab, The Children's Hospital at Westmead , Sydney, Australia .

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    3 Department of Psychology, Sydney Children's Hospital Randwick , Sydney, Australia . 5 Brain Injury Rehabilitation Program, Sydney Children's Hospital Randwick , Sydney, Australia .

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    5 Brain Injury Rehabilitation Program, Sydney Children's Hospital Randwick , Sydney, Australia .

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    4 Kids Rehab, The Children's Hospital at Westmead , Sydney, Australia .

    1 School of Psychology, The University of Sydney , Sydney, Australia . 2 ARC Centre of Excellence in Cognition and its Disorders , Sydney, Australia .

    Source

    Journal of neurotrauma 33:23 2016 12 01 pg 2097-2104

    MeSH

    Adolescent
    Brain Concussion
    Brain Injuries, Traumatic
    Child
    Cognitive Behavioral Therapy
    Double-Blind Method
    Female
    Humans
    Male
    Memory Disorders
    Memory, Short-Term
    Therapy, Computer-Assisted

    Pub Type(s)

    Journal Article
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    27050628

    Citation

    Phillips, Natalie Lynette, et al. "Computerized Working Memory Training for Children With Moderate to Severe Traumatic Brain Injury: a Double-Blind, Randomized, Placebo-Controlled Trial." Journal of Neurotrauma, vol. 33, no. 23, 2016, pp. 2097-2104.
    Phillips NL, Mandalis A, Benson S, et al. Computerized Working Memory Training for Children with Moderate to Severe Traumatic Brain Injury: A Double-Blind, Randomized, Placebo-Controlled Trial. J Neurotrauma. 2016;33(23):2097-2104.
    Phillips, N. L., Mandalis, A., Benson, S., Parry, L., Epps, A., Morrow, A., & Lah, S. (2016). Computerized Working Memory Training for Children with Moderate to Severe Traumatic Brain Injury: A Double-Blind, Randomized, Placebo-Controlled Trial. Journal of Neurotrauma, 33(23), pp. 2097-2104.
    Phillips NL, et al. Computerized Working Memory Training for Children With Moderate to Severe Traumatic Brain Injury: a Double-Blind, Randomized, Placebo-Controlled Trial. J Neurotrauma. 2016 12 1;33(23):2097-2104. PubMed PMID: 27050628.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Computerized Working Memory Training for Children with Moderate to Severe Traumatic Brain Injury: A Double-Blind, Randomized, Placebo-Controlled Trial. AU - Phillips,Natalie Lynette, AU - Mandalis,Anna, AU - Benson,Suzanne, AU - Parry,Louise, AU - Epps,Adrienne, AU - Morrow,Angie, AU - Lah,Suncica, Y1 - 2016/05/09/ PY - 2016/4/7/pubmed PY - 2018/1/11/medline PY - 2016/4/7/entrez KW - cognitive training KW - pediatric KW - randomized controlled trial KW - traumatic brain injury KW - working memory SP - 2097 EP - 2104 JF - Journal of neurotrauma JO - J. Neurotrauma VL - 33 IS - 23 N2 - Pediatric traumatic brain injury (TBI) places children at risk for deficits in working memory (WM; comprising a central executive [CE], and two storage systems: phonological loop [PL] and visuospatial sketchpad [VSSP]), which is strongly related to attention and academic skills in childhood. This study aimed to examine whether different components of WM can be improved following adaptive WM training (Cogmed) and whether improvements in WM generalize to other cognitive (attention) and academic skills (reading and mathematics) in children with TBI. Twenty-seven children with moderate to severe TBI were randomized to adaptive (Cogmed; n = 13) or non-adaptive training (active placebo; n = 14) and evaluated at baseline, post-training, and 3-months follow-up. Three children in the adaptive group and one child in the non-adaptive group withdrew from the study before completion of training. Complete case (CC) and intention-to-treat (ITT) analyses were conducted. Children in the adaptive group demonstrated significantly greater gains on select WM tasks (VSSP, but not PL or CE) from pre- to post-training (pre-post) and pre-training to follow-up (pre-follow-up; CC and ITT analyses). No gains were found on tests of attention. Adaptive training resulted in significantly greater gains on select academic skills (reading, but not mathematics): reading comprehension pre-post-training (ITT analyses) and reading accuracy pre-follow-up (CC and ITT analyses). This first, to our knowledge, study to examine the efficacy of adaptive WM training for children with TBI provides preliminary evidence of near and far transfer of training to WM and academic skills, respectively. SN - 1557-9042 UR - https://www.unboundmedicine.com/medline/citation/27050628/Computerized_working_memory_training_for_children_with_moderate_to_severe_traumatic_brain_injury:_a_double_blind_randomized_placebo_controlled_trial_ L2 - https://www.liebertpub.com/doi/full/10.1089/neu.2015.4358?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -