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Working Memory Training for Older Participants: A Control Group Training Regimen and Initial Intellectual Functioning Assessment
Published on: September 20, 2020
Working memory training in children with borderline intellectual functioning and neuropsychiatric disorders: a
S Roording-Ragetlie1, M Spaltman1, E de Groot1
1Department of Mild Intellectual Disabilities, Karakter Child and Adolescent Psychiatry, Nijmegen, The Netherlands.
Insights
Adaptive working memory training (WMT) did not show superior effects compared to placebo in children with borderline intellectual functioning and neuropsychiatric disorders. Both groups showed improvements, suggesting benefits from structured learning environments.
Area of Science:
- Neuroscience
- Developmental Psychology
- Child Psychiatry
Background:
- Children with borderline intellectual functioning (BIF) and co-occurring ADHD/ASD often exhibit poor working memory, lower IQ, and maladaptive behaviors impacting development.
- Limited evidence-based treatment options exist for this population.
- This study addresses the need for effective interventions targeting cognitive and behavioral deficits.
Purpose of the Study:
- To investigate if adaptive computerized working memory training (WMT) improves non-trained visuospatial working memory tasks more than a non-adaptive placebo WMT in children with BIF and neuropsychiatric disorders.
- To assess near-transfer, far-transfer, and behavioral outcomes as secondary measures.
Main Methods:
- A triple-blind, placebo-controlled randomized clinical trial involving 72 children (aged 10-13) with BIF and comorbid ADHD/ASD.
- Participants completed 25 sessions of either adaptive Cogmed WMT or a non-adaptive placebo version over 5 weeks.
- Outcomes were measured immediately post-intervention and at 6-month follow-up.
Main Results:
- No significant difference in improvement on the primary outcome (non-trained visuospatial WM task) between adaptive WMT and placebo WMT groups.
- Secondary and tertiary outcomes also showed no significant superior improvement in the adaptive WMT group.
- Both groups demonstrated changes over time, indicating potential benefits from the training structure itself.
Conclusions:
- Adaptive WMT did not demonstrate superior training effects compared to a non-adaptive placebo in children with BIF and neuropsychiatric disorders.
- Observed changes in the placebo group suggest that structured learning environments may facilitate neurocognitive and coping strategy improvements.
- Further research is required to identify specific effective training elements and long-term effects for this population.
Background:
Poor working memory, lower IQ and maladaptive behaviour form a triple disability known to have negative effects on the academic and social development of children with borderline intellectual functioning (BIF; IQ: 70 < IQ < 85) and neuropsychiatric disorders [attention-deficit hyperactivity disorder (ADHD) and/or autism spectrum disorder (ASD)]. Treatment possibilities for these children are scarce and hardly evidence based. This study primarily investigated whether adaptive computerised working memory training (WMT) may lead to significantly more improvement on a non-trained visuospatial WM task compared with a non-adaptive control WMT (placebo) in children with BIF and neuropsychiatric disorders. As secondary outcome measures, we used the scores on several non-trained neuropsychological near-transfer and far-transfer tasks as well as behavioural measures.
Method:
We conducted a triple-blind placebo-controlled randomised clinical trial in 72 children (aged 10;0-13;11 years, 53 boys, 19 girls) with BIF and comorbid neuropsychiatric disorders (ADHD = 37, ASD = 21, both = 14) that were referred to child and adolescent psychiatry care, between May 2012 and March 2019. Children completed the Dutch version of Cogmed WMT, either the adaptive training version or the non-adaptive placebo version, 25 sessions (30-45 min a day), for 5 weeks. The primary outcome measure was the score on a non-trained visuospatial working memory task. The primary outcome was measured before and directly after 5 weeks of WMT and again 6 months after training.
Results:
A total of 375 children were screened for eligibility and 72 were randomised. No significantly higher levels of improvement over time were found on our primary outcome measure in the experimental WMT group compared with the placebo control WMT, nor in the secondary (near-transfer and far-transfer tasks) or tertiary (behavioural measures) outcome measures. However, this study did show changes over time for these measurements for both the experimental and placebo conditions.
Conclusions:
This study was unable to document superior training effects over time of an adaptive WMT in children with BIF and neuropsychiatric disorders, compared with a placebo (non-adaptive) WMT. The objectively documented changes over time in the non-adaptive WMT arm suggest that these children with persistent impairments in WM may benefit from a structured learning environment that is associated with improvement of neurocognitive functioning and coping strategies. Further research is needed to examine which elements of cognitive training may be useful for which specific patients and to study long-term effects of training.
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