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Systematic review and meta-analysis of cognitive interventions for children with central nervous system disorders and
Kristen E Robinson1, Eloise Kaizar2, Cathy Catroppa1
1Department of Pediatrics, The Ohio State University, Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Department of Statistics, The Ohio State University, Clinical Sciences, Murdoch Childrens Research Institute, and Department of Psychology, Royal Children's Hospital Department of Pediatrics, The Ohio State University, Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Department of Statistics, The Ohio State University, Clinical Sciences, Murdoch Childrens Research Institute, and Department of Psychology, Royal Children's Hospital.
Insights
Cognitive interventions show potential benefits for children with neurological and developmental disorders, particularly in attention and memory. However, the evidence quality is very low, requiring further robust research.
Area of Science:
- Pediatric Neurology
- Developmental Psychology
- Rehabilitation Medicine
Background:
- Cognitive interventions are increasingly explored for children with neurological and neurodevelopmental disorders.
- Assessing the efficacy of these interventions is crucial for guiding clinical practice and future research.
Purpose of the Study:
- To systematically evaluate the effectiveness of cognitive interventions in children diagnosed with neurological disorders, acquired brain injuries, and neurodevelopmental disorders.
- To synthesize findings from randomized controlled trials (RCTs) across various cognitive and functional outcome domains.
Main Methods:
- A comprehensive literature search identified 13 RCTs meeting inclusion criteria for cognitive interventions.
- Risk of bias was assessed for each study, and standardized effect sizes were calculated across seven outcome domains.
- The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used to rate the overall quality of evidence.
Main Results:
- Significant positive treatment effects were observed in most outcome domains, excluding inhibitory control.
- Large effect sizes were noted for attention, working memory, and general memory tasks.
- Smaller effects were found for academic achievement and behavior rating scales, with substantial heterogeneity across all domains.
Conclusions:
- Cognitive interventions demonstrate some evidence of positive benefits for the target pediatric population.
- However, the overall very low quality of evidence necessitates caution, indicating substantial uncertainty regarding the reliability of these findings.
Objective:
To assess the efficacy of cognitive interventions for children with neurological disorders, acquired brain injuries, and neurodevelopmental disorders.
Method:
We searched for randomized controlled trials of cognitive interventions; 13 studies met inclusion criteria. Risk of bias was rated for each study. Standardized effect size estimates were examined in 7 outcome domains. The overall quality of evidence was rated using the Grading of Recommendations Assessment, Development and Evaluation system.
Results:
Significant positive treatment effects were found in all outcome domains aside from inhibitory control. Effects were large for attention, working memory, and memory tasks, and small for academic achievement and behavior rating scales. Results exhibited substantial heterogeneity in all domains. Overall quality of evidence was rated very low in all domains, suggesting substantial uncertainty about effect size estimates.
Discussion:
The results provide some evidence of a positive benefit from cognitive interventions, but cannot be regarded as robust given the overall very low quality of the evidence.
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