A randomized controlled trial of a home-based computerized executive function intervention for children with cerebral
María García-Galant1,2,3, Montse Blasco1,2,3, Olga Laporta-Hoyos1,2,3
1Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.
Insights
A home-based computerized program improved core executive functions in children with cerebral palsy (CP). These improvements in inhibitory control, working memory, and cognitive flexibility were sustained long-term.
Area of Science:
- Neuroscience
- Developmental Psychology
- Rehabilitation Medicine
Background:
- Children with cerebral palsy (CP) frequently experience executive function (EF) deficits, impacting their quality of life.
- While motor impairments are a primary focus in CP interventions, research on cognitive interventions, particularly for EFs, remains limited.
- Existing knowledge suggests that cognitive interventions may benefit core EFs in children with CP, with potential for sustained effects.
Purpose of the Study:
- To evaluate the efficacy of a home-based computerized intervention in enhancing executive functions (EFs) among children with CP.
- To compare the outcomes of the computerized EF intervention against a waitlist control group receiving usual care.
Main Methods:
- A randomized controlled trial involving 60 children (ages 8-12) with CP, matched for age, sex, motor ability, and IQ.
- Participants were assigned to either a 12-week home-based computerized EF intervention (30 hours total) or a waitlist control group.
- Core and higher-order EFs were assessed pre-intervention, immediately post-intervention, and at a 9-month follow-up.
Main Results:
- The intervention group demonstrated significant improvements in core EFs, including inhibitory control, working memory, and cognitive flexibility, compared to the control group.
- These improvements in core EFs were maintained at the 9-month follow-up assessment.
- No significant differences were observed between groups in higher-order EFs or in the manifestation of EFs in daily life.
Conclusions:
- A home-based computerized intervention effectively enhances core executive functions in children with cerebral palsy.
- Further research is necessary to develop strategies that facilitate the generalization of these cognitive improvements into everyday functional activities.
Abstract:
Children with cerebral palsy (CP) often show executive function (EF) impairments that are key to quality of life. The aim of this study was to assess whether a home-based computerized intervention program improves executive functions (EFs) compared to usual care. Sixty participants (30 females) with CP (8-12 years old) were paired by age, sex, motor ability, and intelligence quotient score and then randomized to intervention and waitlist control groups. The intervention group received a 12-week home-based computerized EF intervention (5 days/week, 30 min/day, total dose 30 h). Core and higher-order EFs were assessed before, immediately after, and 9 months after completing the intervention. The intervention group performed better than the waitlist control group in the three core EFs (immediately and 9 months after the intervention): inhibitory control (F = 7.58, p = 0.13 and F = 7.85, p = 0.12), working memory (F = 8.34, p = 0.14 and F = 7.55, p = 0.13), and cognitive flexibility (F = 4.87, p = 0.09 and F = 4.19, p = 0.08). No differences were found between the groups in higher-order EFs or EF manifestations in daily life.
Conclusions:
A home-based computerized EF intervention improved core EFs in children with CP, but further research is needed to identify strategies that allow the transfer of these improvements to everyday life.
Trial Registration:
NCT04025749 retrospectively registered on 19 July 2019.
What Is Known:
• One in two children with cerebral palsy has an intellectual impairment. Visual perception and executive functions are the most reported specific cognitive deficits. • The majority of interventions for cerebral palsy focus on motor impairments, but only a few randomized controlled trials have explored the effect of interventions on executive functions.
What Is New:
• A home-based computerized cognitive intervention can improve the core executive functions of children with cerebral palsy. • Short- and long-term effects on core executive functions have been found.
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