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Published on: February 13, 2020
Daily Training efficiency during computerized cognitive rehabilitation training (CCRT): an analysis from a randomized
Valentina Larrivey1, Jennifer Neva2, Katherine Finn3
1University of Michigan, Ann Arbor, MI, USA.
Insights
Titrated computerized cognitive rehabilitation training (CCRT) significantly improved learning in Ugandan children compared to non-titrated methods. This adaptive approach offers a promising intervention for cognitive deficits, even in resource-limited settings.
Area of Science:
- Neuroscience
- Pediatrics
- Cognitive Psychology
Background:
- Severe malaria poses a significant risk of cognitive deficits in Ugandan children, affecting working memory, behavior, and executive functions.
- Computerized Cognitive Rehabilitation Training (CCRT) is a potential intervention to mitigate these cognitive sequelae.
Purpose of the Study:
- To compare the training efficiency of titrated (adaptive) versus non-titrated (non-adaptive) CCRT in school-aged children.
- To investigate the impact of malaria severity on CCRT effectiveness.
- To analyze how factors like BMI and socioeconomic status influence CCRT outcomes.
Main Methods:
- Secondary analysis of a randomized control trial involving 201 school-aged children (healthy or with prior severe/cerebral malaria).
- Children received 24 one-hour sessions of Captain's Log® CCRT over 8 weeks.
- Participants were randomized into titrated or non-titrated learning arms.
Main Results:
- Children generally benefited from CCRT, with titrated CCRT demonstrating a clear advantage over non-titrated training.
- Malaria severity, BMI, and other factors did not significantly moderate CCRT performance.
- Improvements were observed across all CCRT performance scores, irrespective of children's rural, low-resource background or computer familiarity.
Conclusions:
- Titrated CCRT leads to more rapid learning improvements compared to non-titrated approaches.
- The effectiveness of CCRT is not negatively impacted by a history of severe malaria or by socioeconomic factors.
- CCRT, particularly the titrated version, is a viable and effective cognitive rehabilitation strategy for children in diverse settings.
Abstract:
Children in Uganda are at risk for significant cognitive sequelae from severe malaria. Computerized cognitive rehabilitation training (CCRT) represents a potential method to improve working memory, behavior, and executive functioning, cognitive domains most at risk following severe malaria. The primary aim of this study was to complete a secondary analysis of data from a concluded CCRT randomized control trial in order to compare the training efficiency of a commonly used CCRT program under conditions of titrated (adaptive) or non-titrated (non-adaptive) training and with children with increasing malaria severity to determine how various factors may affect potential CCRT improvement. A total of 201 school-aged children (66.2% boys) who were either healthy (n = 102) or previously diagnosed with severe or cerebral malaria (n = 99) were randomized into two active treatment arms (titrated and non-titrated learning). Each child received 24 one-hour sessions of training over 8 weeks using Captain's Log® CCRT by BrainTrain, which includes a comprehensive set of CCRT tasks. Children generally benefited from CCRT over the 24 training sessions, but titrated CCRT showed a clear advantage over non-titrated. Severity of illness or factors such as BMI, did not moderate CCRT performance indicators. These findings support our hypothesis that titrated CCRT would result in steeper improvement in learning, but do not support our hypothesis that history of recent significant illness would affect learning proficiency. Findings were evident across all CCRT performance scores, even given that children were from generally rural, low-resource settings and were generally unfamiliar with computers.ABBREVIATIONS:Computerized Cognitive Rehabilitation Training (CCRT); Mental Processing Index (MPI); Home Observation for the Measurement of the Environment (HOME); Socioeconomic Status (SES); least square means (LSM).
