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Published on: February 13, 2020
Feasibility of Home-Based Computerized Working Memory Training With Children and Adolescents With Sickle Cell Disease
Steven J Hardy1, Kristina K Hardy2,1, Jeffrey C Schatz3
1Departments of Pediatrics and Psychiatry & Behavioral Sciences, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
Insights
This study explored a home-based computer program to improve working memory in children with sickle cell disease (SCD). While some improvements were seen, program completion was low, indicating a need for better adherence strategies.
Area of Science:
- Neuroscience
- Pediatrics
- Cognitive Psychology
Background:
- Children with sickle cell disease (SCD) face higher risks of neurocognitive deficits.
- Limited research exists on interventions to improve cognitive function and academic success in these children.
Purpose of the Study:
- To assess the feasibility and preliminary effectiveness of a home-based computerized working memory (WM) training program called Cogmed.
- To evaluate Cogmed's impact on cognitive deficits in children with SCD.
Main Methods:
- Children aged 7-16 with SCD and WM deficits used an iPad with Cogmed at home.
- Participants were instructed to complete 25 training sessions over 5 weeks.
- Usage data and changes in WM assessment scores were analyzed.
Main Results:
- 60% of screened children had WM deficits; 50% completed the intervention.
- Completion rates were higher for females and those with less SCD-related pain.
- Children completing the program showed improvements in verbal WM, visuospatial short-term memory, and visuospatial WM.
Conclusions:
- The Cogmed intervention shows potential for improving WM in youth with SCD.
- Lower-than-expected adherence highlights the need for strategies to overcome completion barriers.
- Home-based WM interventions may help address cognitive deficits in SCD, but program completion needs improvement.
Background:
Children with sickle cell disease (SCD) are at increased risk for neurocognitive deficits, yet the literature describing interventions to ameliorate these problems and promote academic achievement is limited. We evaluated the feasibility and preliminary efficacy of a home-based computerized working memory (WM) training intervention (Cogmed) in children with SCD.
Procedure:
Youth with SCD between the age of 7 and 16 years completed an initial neuropsychological assessment; those with WM deficits were loaned an iPad on which they accessed Cogmed at home. Participants were instructed to work on Cogmed 5 days each week for 5 weeks (25 training sessions). We examined Cogmed usage characteristics and change on WM assessment scores following the intervention.
Results:
Of the 21 participants (M age = 11.38, SD = 2.78; Mdn age = 10.00, interquartile range [IQR] = 5.00; 52% female) screened, 60% exhibited WM deficits (n = 12) and received the intervention and 50% (n = 6) completed Cogmed. The mean number of sessions completed was 15.83 (SD = 7.73; Mdn = 17.00, IQR = 16.00); females were more likely to complete Cogmed, χ(2) (1) = 6.00, P = 0.01. Participants who reported lower SCD-related pain impact completed more sessions (r = 0.71, P = 0.01). Children who completed Cogmed exhibited improvements in verbal WM, visuospatial short-term memory, and visuospatial WM.
Conclusions:
Initial findings suggest Cogmed is associated with WM improvement in youth with SCD; however, adherence was lower than expected. Home-based WM interventions may ameliorate SCD-related WM deficits but strategies are needed to address barriers to program completion.
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