Rationale and description of BrainLevel: Computerized repeated practice with strategy use instruction for children with acquired brain injury

Abstract

Objective: In this paper, we provide the rationale behind and a description of BrainLevel, a new cognitive rehabilitation intervention for children with acquired brain injury. Rationale: Children with acquired brain injury frequently report cognitive problems and consequently problems in participation, psychosocial functioning, family functioning and quality of life. Computerized repeated practice of specific cognitive tasks (so-called ‘brain training’) improves performance on those specific or highly similar tasks, but rarely leads to better daily life functioning. Adding strategy use instruction as an intervention component, with the aim to transfer task-specific effects to other contexts, may yield positive effects on cognitive and daily life functioning of children with acquired brain injury. Description of the new intervention: In BrainLevel, computerized repeated practice is offered via the online training programme BrainGymmer. For the strategy use instruction, we developed a protocol to provide and practice function-specific and metacognitive strategies. The intervention period is 6 weeks, during which children train five times per week for 30 minutes per day at home with BrainGymmer. Additionally, they attend a weekly 45-minute strategy use instruction session on the basis of our protocol with a cognitive rehabilitation specialist. Discussion: BrainLevel is innovative in combining computerized repeated practice with strategy use instruction as cognitive rehabilitation for children with acquired brain injury. Currently, we are investigating the effectiveness of BrainLevel. In this paper, possible adaptations to tailor BrainLevel to other games or contexts, or to incorporate novel scientific insights, for example regarding optimal intervention duration and intensity, are discussed.

Addressing the Interactive Effects of Maltreatment and COVID-19 Related Stressors on the Neuropsychological Functioning in Children

“…We propose to combine (home-based) paper-and pencil (e.g., mazes, trail-making) and computerized tasks (van der Oord et al, 2014 ; Corti et al, 2020 ; Resch et al, 2021 ) (optionally timed and in adapted formats), with the attention training technique (by using auditory attentional exercises; Wells, 2002 ), self-monitoring attention and self-instructional training to engage children in executive control skills (Hallahan and Sapona, 1983 ; Diamond, 2012 ), selective and divided attention, and switching (Wells and Matthews, 1996 ; Ottowitz et al, 2002 ), and to increase top-down attentional control and flexibility, also related to delay gratification (Murray et al, 2018 ). Additionally, executive functioning can be trained by planning (e.g., using checklists, day planner, routines), management of time (limits) tasks, reasoning (e.g., analogies), spell out the rationale, and decision-making (on COVID-19 issues).…”