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Published on: February 13, 2020
Executive Function Computerized Training in Very Preterm-Born Children: A Pilot Study
Cornelieke S H Aarnoudse-Moens1,2, E Sabrina Twilhaar2, Jaap Oosterlaan1,2
11 Department of Pediatrics, Emma Children's Hospital, Academic Medical Centre , Amsterdam, The Netherlands .
Insights
This study found that BrainGame Brian is a feasible intervention for very preterm children experiencing attention problems. The computerized training showed positive results in improving visual working memory and speed variability.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatrics
Background:
- Very preterm birth (≤32 weeks gestation) is linked to significant attention problems in school-aged children.
- Executive functions (EFs), including working memory and impulse control, are strongly associated with attention deficits in this population.
- No previous research has explored interventions for attention problems in school-aged very preterm children.
Purpose of the Study:
- To assess the feasibility of the computerized training program, BrainGame Brian, for very preterm children with attention problems.
- To evaluate user experiences, participation, and dropout rates.
- To examine preliminary training outcomes on core EFs and attention.
Main Methods:
- A pilot feasibility intervention study involving 15 very preterm children (age 10) with reported attention problems.
- A 6-week intervention using BrainGame Brian, targeting working memory, impulse control, and cognitive flexibility.
- Feasibility measured by participation/dropout rates and user feedback; outcomes assessed via pre/post-training comparisons of EFs and parent-rated attention.
Main Results:
- High participation (12/15) and completion (11/15) rates indicate feasibility.
- Parents reported positive training characteristics but high effort.
- Clinically significant improvements were observed in visual working memory and speed variability post-training.
Conclusions:
- BrainGame Brian is a feasible intervention for very preterm children with attention problems.
- The training shows promise for improving specific executive functions relevant to attention.
- Further research is warranted to confirm efficacy in larger trials.
Objective:
Attention problems are one of the most pronounced and documented consequences of very preterm birth (gestational age ≤32 weeks). However, up to now, there is no research published on suitable interventions at school age aimed to overcome these problems. Research in this population did show that executive functions (EFs) are strongly associated with inattention. BrainGame Brian is a newly developed computerized training, in which, in 25 training sessions, the core EFs, including working memory, impulse control, and cognitive flexibility, are trained. This pilot study aimed to examine the feasibility of studying BrainGame Brian in very preterm-born children with attention problems.
Design:
Pilot feasibility intervention study with one baseline and one follow-up assessment.
Materials And Methods:
Feasibility was measured by the participation rate, dropout rate, and user experiences with regard to effort, training characteristics, and recommendation to others. From a larger cohort study, 15 very preterm-born children at age 10 years with parent-reported attention problems on the Child Behavior Checklist/6-18 years were invited to participate in this pilot study. BrainGame Brian was performed for a period of 6 weeks. Training outcome measures included visual working memory, impulse control, cognitive flexibility, speed variability, and parent-rated attention, for which pre- and post-training differences were examined at the group level by the Wilcoxon signed-rank test as well as for each individual child separately by the reliable change index.
Results:
Twelve of 15 children and their parents agreed to participate and 11 children successfully completed BrainGame Brian in the 6-week period. Parents were positive about training characteristics and lack of interference with schooling, but scored the effort as high. We found clinically significant changes in visual working memory and speed variability in post-training assessments.
Conclusion:
BrainGame Brian is a feasible intervention for very preterm-born children with attention problems.
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