89 A Pilot Study of a Parent-Delivered Game-Based Cognitive Intervention in Children Born Preterm

Abstract

Objective:Preterm birth (gestational age < 37 weeks) is associated with delays in the development of executive functions and their precursors, including controlling attention and retaining task-relevant information. In the current study, we aim to examine the potential therapeutic effects of a novel cognitive tablet game, Dino Island (DI), and its implementation through a parent-delivered intervention program on cognitive development in preterm children.Participants and Methods:In total, 34 participants (M = 4.99 years old) were recruited from a perinatal follow-up clinic or through the community in Calgary, AB. Participants were randomly assigned to either the DI intervention (n = 20) or tablet-based educational control games (C; n = 14). Parents completed a 2-hour training program that included information about how to support their child through the intervention using behavioural supports and metacognitive strategies. Neuropsychological assessment was done prior to beginning the intervention and after 12 weeks of intervention. Various tests were used to assess near transfer measures of sustained attention, shifting attention, executive function, verbal working memory and inhibition, and to assess far transfer measures of language skills and early numeracy. Families tracked weekly progress using journals, with the goal of 3-4 30-minute sessions per week. Multiple ANCOVA analyses were run to analyze quantitative data using the pre-test score as a covariate.Results:A total of 21 participants completed the 12 weeks of intervention (DI: n = 11 and C: n = 10). Those who did not complete the intervention withdrew from the study or were unable to make a follow-up assessment due to COVID-19 restrictions. Groups did not significantly differ in age (DI: M = 4.92, C: M = 4.61), sex (DI: Female = 6, C: Female = 6), or in weeks preterm (DI: M = 29.49 weeks, C: M = 32.7 weeks).Multiple ANCOVAs were run to determine the effect of either the DI or Control intervention on the cognitive measures after controlling for the pre-intervention score of participants. As compared to the Control group, the DI intervention group showed near transfer gains in sustained attention (F(1,7) = 5.1, p = 0.043), and executive functions (F(2,18) = 5.41, p = 0.014), as well as far transfer gains in phonetic awareness (F(2,16) = 11.63, p = 0.001), vocabulary and oral language skills (F(2,7) = 5.54, p = 0.014), and number identification fluency (F(2,17) = 11.37, p = 0.001). Detailed analyses will be discussed in the poster.Conclusions:This study provides preliminary support for the potential efficacy of the DI intervention when delivered by parents to children born preterm. Pre-post testing after 12 weeks of intervention indicated both near and far transfer gains. These results highlight the benefits of utilizing a tablet game format to facilitate collaborative parent-child interactions in cognitive intervention. This intervention provides a potential affordable and engaging alternative to existing cognitive interventions. Further investigation with a larger and more diverse sample is required.