Working Memory Intervention Research Articles

Computerized intervention for amelioration of cognitive late effects among childhood cancer survivors.

10034 Background: Children treated for cancer with CNS-directed therapy are at significant risk for attention and working memory (WM) problems. There is empirical support for pharmacotherapy and therapist-delivered cognitive rehabilitation; yet, the reach of these approaches is limited by medical contraindications, need for facility proximity and high resource utilization. A computer-based WM intervention has demonstrated efficacy for healthy individuals with attention disorders. We investigated this approach with childhood cancer survivors. Methods: Sixty-eight survivors of childhood acute lymphoblastic leukemia (ALL) or brain tumor (BT) with identified WM deficits were randomly assigned to a computerized WM intervention (18 males/16 females, 23 ALL/11 BT, age= 12.21±2.47) or a wait-list control group (18 males/16 females, 24 ALL/10 BT, age= 11.82±2.42). Participants in the intervention group were asked to complete 25 training sessions at home with weekly, phone-based coaching support. Cognitive assessments were completed pre- and post-intervention. Results: Among 34 participants randomized to intervention, 30 (88%) were adherent while 4 were removed from intervention because they failed to complete training in the allotted time. Survivors who completed the intervention demonstrated significantly greater improvements than controls on measures of attention (e.g., WISC-IV Spatial Span Forward 3.30±3.87 vs 1.33±2.20, p= .02, ES= .63), WM (e.g., WISC-IV Spatial Span Backward 3.13±3.19 vs 0.80±2.46, p= .002, ES= .82) and processing speed (e.g., Conners’ CPT Hit Reaction Time -2.10±8.04 vs 2.36±6.68, p= .02, ES=.60), and showed greater reductions in parent reported executive dysfunction (e.g., Conners’ Parent Rating Scale, III -6.73±8.25 vs .13±8.86, p= .003, ES= .80). No group differences in academic fluency were found (e.g., Woodcock Johnson III Math Fluency 0.90±4.59 vs 1.90±7.18, p= .52, ES= .17). Conclusions: Study results suggest computerized intervention is feasible and efficacious for childhood cancer survivors, with some evidence for generalized benefits. Computerized training may offer a safer, less time intensive and more portable alternative to existing interventions. Clinical trial information: NCT01217996.

Effectiveness of Computerized Working Memory Training Program in Chinese Community Settings for Children With Poor Working Memory

Objective: The purpose of the study is to further examine the effectiveness of computerized working memory intervention among Chinese population. Method: In comparing the performance of experimental group with those of control group, General Linear Model Analysis (repeated measures) was applied to neurological and behavioral measures obtained for working memory, response inhibition, and inattention and hyperactive symptoms. Results: For experimental group that received high-intensity training in school setting, there was a significant improvement in working memory reflected in neuropsychological measures as well as parent-rated behavioral measures as compared with the control group. Conclusion: Our results generally supported the effectiveness of group-based computerized training. It might be served as a cost-effective intervention in semistructured settings, with high-intensity training and minimal therapist involvement.

A developmental perspective on neuroeconomic mechanisms of contingency management.

This paper provides a developmental overview of relevant theory and research on delay discounting and neuroeconomics, and their implications for contingency management (CM) approaches to treatment. Recent advances in the neuroscience of decision making have the potential to inform treatment development for adolescent substance use in general, and CM treatments in particular. CM interventions may be informed by research on delay discounting, a type of decision making that reflects how individuals value immediate versus delayed rewards. Delay discounting reliably distinguishes substance abusers from nonabusers and is a significant predictor of individual differences in response to substance use treatments. Discounting may also be important in predicting response to CM, as CM attempts to directly influence this decision-making process, shifting the preference from the immediate rewards of use to delayed rewards for choosing not to use. Multiple neural processes underlie decision making, and those processes have implications for adolescent substance abuse. There are significant neurodevelopmental processes that differentiate adolescents from adults. These processes are implicated in delay discounting, suggesting that adolescence may reflect a period of plasticity in temporal decision making. Understanding the neural mechanisms of delay discounting has led to promising working memory interventions directly targeting the executive functions that underlie individual choices. These interventions may be particularly helpful in combination with CM interventions that offer immediate rewards for brief periods of abstinence, and may show particular benefit in adolescence due to the heightened neural plasticity of systems that underlie temporal discounting in adolescence.

Training working memory in kindergarten children: Effects on working memory and early numeracy

This study investigated the relationship between working memory and early numeracy. It aimed to explore the possibility of training young children’s working memory and to investigate the effects of such training both on working memory and on the specific domain of early numerical skills. Measures of working memory and numeracy were used with low-performing children in kindergarten. A total of 51 five-year-old children received one of two different versions of working memory training or no training at all. The two versions differed in the type of information the children were given to practice: non-numerical or numerical. After a pretest, 4 weeks of intervention took place, followed by a posttest. Children who participated in one of the working memory interventions significantly improved their working memory skills. Furthermore, their early numeracy skills also improved. Differences between both experimental conditions were small.

Component analysis of simple span vs. complex span adaptive working memory exercises: A randomized, controlled trial

There has been growing interest in using adaptive training interventions such as Cogmed-RM to increase the capacity of working memory (WM), but this intervention may not be optimally designed. For instance, Cogmed-RM can target the primary memory (PM) component of WM capacity, but not the secondary memory (SM) component. The present study hypothesized that Cogmed-RM does not target SM capacity because the simple span exercises it uses may not cause a sufficient amount of information to be lost from PM during training. To investigate, we randomly assigned participants to either a standard (simple span; N=31) or a modified (complex span; N=30) training condition. The main findings showed that SM capacity did not improve, even in the modified training condition. Hence, the potency of span-based WM interventions cannot be increased simply by converting simple span exercises into complex span exercises.

Working memory training improves reading processes in typically developing children

The goal of this study was to investigate whether a brief cognitive training intervention results in a specific performance increase in the trained task, and whether there are transfer effects to other nontrained measures. A computerized, adaptive working memory intervention was conducted with 9- to 11-year-old typically developing children. The children considerably improved their performance in the trained working memory task. Additionally, compared to a matched control group, the experimental group significantly enhanced their reading performance after training, providing further evidence for shared processes between working memory and reading.

Working memory intervention programs for adults: A systematic review

This systematic review aimed to identify the designs, procedures, and results of empirical studies that performed neuropsychological interventions on WM in adults.MethodsA PubMed and LILACS literature search was conducted using the keywords working memory AND (training OR rehabilitation OR intervention) AND adult.ResultsOf the seven studies found, three were randomized controlled trials, two were case reports, one was a clinical trial, and one was an evaluation study. With regard to the type of programs and samples, three studies employed global programs with healthy elderly adults and four employed specific programs for samples with neurologically-impaired adults.ConclusionsThe effectiveness of the WM intervention programs was more evident in studies that employed specific methods of rehabilitation for samples with neurological disorders than in those based on global programs with healthy adults. There is a need for more empirical studies to verify the effectiveness of WM intervention programs in order to provide adequate guidance for clinical neuropsychologists and future research.