Abstract
Children with intellectual disabilities show deficits in both reasoning ability and working memory (WM) that impact everyday functioning and academic achievement. In this study we investigated the feasibility of cognitive training for improving WM and non-verbal reasoning (NVR) ability in children with intellectual disability. Participants were randomized to a 5-week adaptive training program (intervention group) or non-adaptive version of the program (active control group). Cognitive assessments were conducted prior to and directly after training and 1 year later to examine effects of the training. Improvements during training varied largely and amount of progress during training predicted transfer to WM and comprehension of instructions, with higher training progress being associated with greater transfer improvements. The strongest predictors for training progress were found to be gender, co-morbidity, and baseline capacity on verbal WM. In particular, females without an additional diagnosis and with higher baseline performance showed greater progress. No significant effects of training were observed at the 1-year follow-up, suggesting that training should be more intense or repeated in order for effects to persist in children with intellectual disabilities. A major finding of this study is that cognitive training is feasible in this clinical sample and can help improve their cognitive performance. However, a minimum cognitive capacity or training ability seems necessary for the training to be beneficial, with some individuals showing little improvement in performance. Future studies of cognitive training should take into consideration how inter-individual differences in training progress influence transfer effects and further investigate how baseline capacities predict training outcome.
Highlights
A growing literature is showing that cognitive functions, such as working memory (WM), can be positively influenced by targeted and intensive training (Klingberg et al, 2005; Klingberg, 2010; Diamond and Lee, 2011; Morrison and Chein, 2011)
Using computerized versions of training programs has allowed for the implementation of adaptive algorithms that ensures that the level of task difficulty is always challenging for the individual, something that has been shown to be crucial for the training to be effective (Klingberg, 2010)
As reasoning ability is highly related to WM capacity, one hypothesis has been that effects of WM training will transfer to improvements in performance on reasoning tasks
Summary
A growing literature is showing that cognitive functions, such as working memory (WM), can be positively influenced by targeted and intensive training (Klingberg et al, 2005; Klingberg, 2010; Diamond and Lee, 2011; Morrison and Chein, 2011). Using computerized versions of training programs has allowed for the implementation of adaptive algorithms that ensures that the level of task difficulty is always challenging for the individual, something that has been shown to be crucial for the training to be effective (Klingberg, 2010) Such training has been shown to improve WM performance in healthy children and adults (Olesen et al, 2004; Jaeggi et al, 2008; Thorell et al, 2009; Bergman Nutley et al, 2011) and in children with attention-deficit hyperactivity disorder (ADHD) (Klingberg et al, 2002, 2005; Beck et al, 2010; Holmes et al, 2010; Mezzacappa and Buckner, 2010) children born preterm (Lohaugen et al, 2011) and adults recovering from stroke and other acquired brain injuries (Westerberg et al, 2007; Lundqvist et al, 2010). The inconsistent findings may reflect variability in the demographic characteristics of the participants, such as age and clinical status, the tasks used to evaluate reasoning ability (Klingberg, 2010), as Frontiers in Human Neuroscience www.frontiersin.org
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