Long-Term Academic Functioning Following Cogmed Working Memory Training for Children Born Extremely Preterm: A Randomized Controlled Trial

Anderson, Peter J.; Lee, Katherine J.; Roberts, Gehan; Spencer‐Smith, Megan; Thompson, Deanne K.; Seal, Marc L.; Nosarti, Chiara; Grehan, Andrea; Josev, Elisha K.; Gathercole, Susan E.; Doyle, Lex W.; Pascoe, Leona

doi:10.1016/j.jpeds.2018.07.003

Cited by 41 publications

(62 citation statements)

References 39 publications

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“…Early interventions are warranted to improve outcomes for children born preterm/low birthweight. There is evidence that effects of a computerized executive function training programme do not generalize to other functions than the trained executive function . However, this literature is based on solely training working memory, while other executive functions, such as inhibitory control and cognitive flexibility, are also impaired in this population and may benefit from computerized interventions.…”

Section: Discussionmentioning

confidence: 99%

“…Also, for inhibition, there were only a small number of studies investigating the ends of the gestational age range. To be able to draw robust conclusions on whether there is an effect of gestational age on executive function, more studies in children born extremely preterm (<26wks gestational age) and moderate-to-late preterm (32-37wks gestational Aarnoudse-Moens et al 63 Anderson et al 32 Brecht et al 86 Brummelte et al 86 Campbell et al 88 Crotty et al 90 de Kieviet et al 21 Farooqi et al 61 Ford et al 91 Grunewaldt et al 93 Guarini et al 94 Hodel et al 62 Lohaugen et al 97 Mulder et al 18 Ni et al 98 Potharst et al 99 Ritter et al 100 Sayeur et al 101 Wehrle et al 102 Litt et al 96 Rose et al 24 -2.00 -1.00 0.00 1.00 2.00…”

Section: Discussionmentioning

confidence: 99%

“…There is evidence that effects of a computerized executive function training programme do not generalize to other functions than the trained executive function. [102][103][104] However, this literature is based on solely training working memory, while other executive functions, such as inhibitory control and cognitive flexibility, are also impaired in this population and may benefit from computerized interventions. Given the fact that executive function remains a vulnerable area of cognitive function in the population born preterm, future studies should be conducted on which type of interventions may be effective to diminish the encountered difficulties in executive function.…”

Section: Studymentioning

confidence: 99%

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Executive function deficits in children born preterm or at low birthweight: a meta‐analysis

Houdt

Oosterlaan

Wassenaer-Leemhuis

et al. 2019

Develop Med Child Neuro

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AimTo investigate the magnitude of executive function deficits and their dependency on gestational age, sex, age at assessment, and year of birth for children born preterm and/or at low birthweight.MethodPubMed, PsychINFO, Web of Science, and ERIC were searched for studies reporting on executive functions in children born preterm/low birthweight and term controls born in 1990 and later, assessed at a mean age of 4 years or higher. Studies were included if five or more studies reported on the same executive function measures.ResultsThirty‐five studies (3360 children born preterm/low birthweight, 2812 controls) were included. Children born preterm/low birthweight performed 0.5 standardized mean difference (SMD) lower on working memory and cognitive flexibility and 0.4 SMD lower on inhibition. SMDs for these executive functions did not significantly differ from each other. Meta‐regression showed that heterogeneity in SMDs for working memory and inhibition could not be explained by study differences in gestational age, sex, age at assessment, or year of birth.InterpretationChildren born preterm/low birthweight since 1990 perform half a SMD below term‐born peers on executive function, which does not seem to improve with more recent advances in medical care or with increasing age.What this paper adds Children born preterm/low birthweight perform below term‐born children on core executive functions.Lower gestational age or male sex are not risk factors for poorer executive functions.Executive function difficulties in children born preterm/low birthweight remain stable across childhood.Executive function difficulties are similar for children born recently and children born in earlier eras.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Studymentioning

confidence: 99%

See 1 more Smart Citation

Executive function deficits in children born preterm or at low birthweight: a meta‐analysis

Houdt

Oosterlaan

Wassenaer-Leemhuis

et al. 2019

Develop Med Child Neuro

View full text Add to dashboard Cite

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“…The effectiveness of neuropsychological training in preterm-born children remains a matter of debate. Computerised working memory training interventions seem to have positive and persisting long-term effects on working memory (57) even if there is little evidence of benefits in improving academic functioning (58). Memory training induces neuroplastic changes and enhances memory performance (59).…”

Section: Clinical Implicationmentioning

confidence: 99%

Worse global intellectual and worse neuropsychological functioning in preterm‐born children at preschool age: a meta‐analysis

et al. 2019

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Aim Preterm births (<32 weeks of gestational age) are associated with cognitive problems that are difficult to diagnose in infancy but potentially detectable at preschool age. This review aimed to evaluate the extent to which total intelligence quotient (IQ) and neuropsychological functions at ages three to five years differ between children born at <32 weeks gestational age or < 1500 g birth weight and children born at term. The secondary aim was to determine whether cognitive performance differs between extremely preterm (EPT)/extremely low birth weight (ELBW) children and very preterm (VPT) or very low birth weight (VLBW) children. Methods PubMed and PsycINFO databases were searched for cohort studies comparing IQ and neuropsychological functions in term‐born and preterm‐born children born after 1994. Results At ages three to five years, preterm‐born children, compared with term‐born ones, had worse IQ mean score (d = −0.77 [95% confidence interval −0.88 to −0.66]), attention, memory, visuomotor integration skill and executive functions. No differences were found between VPT/VLBW and EPT/ELBW children. Conclusion Preterm‐born children showed poorer IQ and neuropsychological functions compared with term‐born subjects already at preschool age. The extent of differences is similar to that detected at a later age.

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“…Participants were part of a larger, doubleblind randomized controlled trial. In the main trial, we failed to identify benefits of Cogmed on working memory up to 24 months post-training compared with the placebo program (Anderson et al 2018); however, fMRI is powerful in detecting changes in hemodynamic responses even in the absence of observable effects on cognitive performance (Froudist-Walsh et al 2015;Erk et al 2011). We therefore hypothesized that training-induced changes in rsfc would be greater in the Cogmed group compared with the placebo group.…”

Section: Introductionmentioning

confidence: 97%

Working Memory Training Is Associated with Changes in Resting State Functional Connectivity in Children Who Were Born Extremely Preterm: a Randomized Controlled Trial

et al. 2019

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Children born extremely preterm (EP; < 28 weeks of gestation) or extremely low birth weight (ELBW; < 1000 g) are at increased risk of working memory deficits compared with their term-born peers and may benefit from working memory training. This study aimed to determine whether Cogmed Working Memory Training®, compared with a placebo training program, was associated with changes in resting-state functional connectivity (rsfc) and whether these changes correlated with working memory performance in EP/ELBW children. Twenty-one 7-year-old EP/ELBW children were enrolled in a double-blinded randomized controlled trial and had magnetic resonance imaging (MRI) assessments (Cogmed, n = 12; placebo (a non-adaptive version of Cogmed), n = 9). Prior to training (baseline) and 2 weeks post-training, all children received a cognitive assessment, inclusive of immediate memory and working memory measures and an MRI. The Cogmed Improvement Index was used as a measure of improvement in trained activities in the Cogmed group. Resting-state functional MRI was used to measure training-related changes in intra-and internetwork rsfc. The networks assessed include the default mode network, the left and right central executive networks, the bilateral executive network, the dorsal attention network, and the salience network. rsfc data were compared between treatment groups and investigated in relation to changes in working memory performance. There was little evidence of differences in intra-or internetwork rsfc strength changes from baseline to post-training between treatment groups. In the Cogmed group, working memory performance was associated with increased rsfc from baseline to post-training within the precuneus network, but not in the placebo group. In the Cogmed group, results that did not survive multiple comparison correction further showed that improvement in trained activities was associated with increased rsfc between the left central and bilateral executive networks, and with decreased rsfc within the right central executive network and between the right central executive and salience networks. Changes in rsfc may facilitate working memory performance following Cogmed training. Further studies are needed to investigate how changes in rsfc are associated with behavioral changes to better support working memory in vulnerable groups. Chiara Nosarti and Peter J. Anderson are joint senior authors.

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Long-Term Academic Functioning Following Cogmed Working Memory Training for Children Born Extremely Preterm: A Randomized Controlled Trial

Abstract: Australian New Zealand Clinical Trials Registry: ACTRN12612000124831.

Cited by 41 publications

References 39 publications

Executive function deficits in children born preterm or at low birthweight: a meta‐analysis

Executive function deficits in children born preterm or at low birthweight: a meta‐analysis

Worse global intellectual and worse neuropsychological functioning in preterm‐born children at preschool age: a meta‐analysis

Working Memory Training Is Associated with Changes in Resting State Functional Connectivity in Children Who Were Born Extremely Preterm: a Randomized Controlled Trial

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