Eye-tracking working memory intervention in young people with severe dyskinetic cerebral palsy: a pilot study

Working memory (WM) is fundamental to learning, reasoning and everyday functioning and is frequently impaired in cerebral palsy (CP). In severe dyskinetic CP, profound motor and speech impairments limit access to reliable cognitive assessment and intervention. Eye-tracking technology may provide an accessible interface for computerised cognitive training. This study examined the feasibility and preliminary efficacy of adaptive eye-tracking WM training in four young people with severe dyskinetic CP (14-20 years; all female). Participants completed a 5-week intensive Cogmed training (five sessions/week) using the Light (n = 3) or Standard (n = 1) version. Tobii PCEye Mini eye-tracker was used for training; assessments were conducted at baseline, post-intervention and 3-month follow-up using Tobii Dynavox TD Pilot integrated with the Pearson Q-interactive platform. Near-transfer outcomes comprised Cogmed Improvement Index (trained WM) and Wechsler Intelligence Scale for Children-Fifth Edition (WISC-V) Picture Span score (untrained WM). Far-transfer outcomes included WISC-V fluid reasoning, visuospatial reasoning and planning; language comprehension using the Computer-Based instrument for Low motor Language Testing (C-BiLLT) and everyday executive functioning (Behaviour Rating Inventory of Executive Function-Second Edition) reported by parents and teachers. All participants completed 23-25 sessions within five weeks, corresponding to 100% adherence; mean session duration ranged from 22 to 34 min. Trained (+10.5 to +27) and untrained WM (+12 to +21) scores increased post-intervention, with gains largely maintained at follow-up. Far-transfer effects were inconsistent across participants. Adaptive eye-tracking WM training appears feasible in severe dyskinetic CP and may yield cognitive benefits. Larger controlled studies are needed to establish efficacy and generalisation of training effects.