source: The American Society of Pediatric Hematology/Oncology Conference

year: 2018

authors: Steven J. Hardy, Sarah Bills, Shane Wise, Emily R. Meier, Jeffrey C. Schatz, Kristina Hardy

Objectives:

To determine the effects of Cogmed, a home-based computerized Working Memory (WM) training intervention, in children with SCD using a randomized controlled trial design.

Results:

Ninety-one participants (M age=10.43, SD=2.93; 59% female; 69% HbSS) enrolled in the study; 52% (n=47) exhibited WM deficits and were randomized to either begin Cogmed immediately or wait 5-8 weeks before starting Cogmed. Among those that have received the intervention and reached the end of their training period (n=42), 27 participants (59%) completed at least 5 Cogmed sessions, 19 (41%) finished at least 10 sessions, and 7 finished at least 20 sessions (15%). The mean number of completed Cogmed sessions was 9.10 (SD=7.77).

Paired Samples t-tests revealed significant improvements on the Working Memory Index (t[38]=-2.44, p=0.020) and on the Digit Span (t[40]=-3.02, p=0.004), and Spatial Span-Backward (t[39]=-2.83, p=0.007) subtests. Improvements were especially pronounced for participants completing at least 10 sessions. Partial correlations controlling for respective baseline scores indicated that the number of Cogmed sessions completed was positively correlated with post-test scores on Digit Span (r=.38, p=.017) and Spatial Span-Backward (r=0.45, p=0.004) subtests. Among participants who completed at least 10 Cogmed sessions, 77% scored in the Average range or higher on the Working Memory Index at the post-intervention assessment, compared to 58% at baseline.

Conclusion:

Results support the efficacy of Cogmed in producing significant improvements in WM. A dose-effect was observed such that participants who completed more Cogmed sessions had greater improvements in WM. Home-based cognitive training programs may ameliorate SCD-related WM deficits but methods for motivating and supporting patients as they complete home-based interventions are needed to enhance adherence and effectiveness.

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