Article

Working Memory Training Improves Cognitive Function in VLBW Preschoolers

Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, 7489 Trondheim, Norway. .
PEDIATRICS (Impact Factor: 5.3). 03/2013; 131(3):e747-54. DOI: 10.1542/peds.2012-1965
Source: PubMed

ABSTRACT Preterm born children perform poorer than term peers on tests of attention and executive functions including working memory tests. Our aim was to evaluate if preterm born preschoolers with very low birth weight (VLBW) would benefit from a computerized working memory training program and if the training would have a generalizing effect on memory, learning, attention, behavior, and anxiety.
A prospective intervention study with a stepped wedge design where 20 VLBW preschoolers aged 5 to 6 years participated. The children trained with the Cogmed JM program for 10 to 15 minutes a day, 5 days a week over a 5-week period. Extensive neuropsychological assessment and parental questionnaires regarding behavior and anxiety were performed before and 4 weeks after intervention.
The children improved significantly on trained (mean Start Index 42.1 [SD 6.3]), mean Max Index 60.6 [SD 5.7]), and nontrained working memory tasks (Spatial Span backward; 2.3 [before] to 3.6 [after training] [confidence interval {CI} -2.2 to -0.4] and Spatial Span total score; 6.4-8.3 [CI -3.7 to -0.1]). A generalization effect was found on auditory attention (49.6-58.2 [CI -15.5 to -1.6]), phonological awareness (9.3-12.6 [CI -5.2 to -1.4]), visual (memory for faces 20.0-24.9 [CI -7.4 to -2.5]), as well as verbal memory (narrative memory; 12.9-17.5 [CI -7.1 to -2.0], and sentence repetition 15.7-17.7 [CI -3.3 to -0.7]).
This study shows that VLBW preschoolers benefit from a computerized working memory training program. We speculate that such training before starting school may prevent or reduce cognitive problems that impact educational achievement.

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Available from: Kristine Hermansen Grunewaldt, Dec 20, 2013
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    • "study Thorell et al., 2009 0.20 [-0.39, 0.79] mean ES 0.20 [-0.39, 0.79] Harrison et al., 2013 -0.86 [-1.45, -0.27] Dahlin et al., 2008 -0.41 [-1.19, 0.37] Takeuchi et al., 2011 -0.10 [-0.71, 0.51] Sprenger et al., 2013 2 -0.06 [-0.53, 0.41] Redick et al., 2012 -0.05 [-0.54, 0.44] Schmiedek et al., 2010 0.01 [-0.34, 0.36] Anguera et al., 2012 0.02 [-0.57, 0.61] Thompson et al., 2013 0.22 [-0.33, 0.77] Colom et al., 2013 0.24 [-0.29, 0.77] Chooi et al., 2012 0.29 [-0.20, 0.78] Von Bastian et al., 2013b 0.30 [-0.13, 0.73] Nouchi et al., 2013 0.36 [-0.35, 1.07] Martin et al., 2013 0.42 [-0.36, 1.20] Penner et al., 2012 0.46 [-0.25, 1.17] Richmond et al., 2014 0.49 [-0.16, 1.14] Salminen et al., 2012 0.54 [-0.11, 1.19] Heinzel et al., 2014 1.09 [0.31, 1.87] mean ES 0.15 [-0.03, 0.32] Zimmermann et al., 2014 -0.57 [-1.65, 0.51] Schmiedek et al., 2010 -0.10 [-0.47, 0.27] Richmond et al., 2011 0.04 [-0.59, 0.67] Theill et al., 2013 0.10 [-0.53, 0.73] Nouchi et al., 2012 0.31 [-0.43, 1.05] Borella et al., 2013 0.33 [-0.34, 1.00] Dahlin et al., 2008 0.35 [-0.39, 1.09] Heinzel et al., 2014 0.52 [-0.21, 1.25] Borella et al., 2014 2 0.78 [0.13, 1.43] Borella et al., 2014 1 0.89 [0.24, 1.54] Borella et al., 2010 1.51 [0.80, 2.22] mean ES 0.39 [0.08, 0.70] Gray et al., 2012 -0.18 [-0.75, 0.39] Egeland/Hovik et al., 2013 (combined) -0.17 [-0.66, 0.32] Dongen-Boomsma et al., 2014 -0.07 [-0.68, 0.54] Grunewaldt et al., 2013 0.06 [-0.82, 0.94] Gropper et al., 2014 0.12 [-0.39, 0.63] Söderqvist et al., 2012 0.13 [-0.50, 0.76] Klingberg et al., 2002 0.18 [-0.88, 1.24] Dunning et al., 2013 0.30 [-0.15, 0.75] mean ES 0.04 [-0.16, 0.25] Carretti et al., 2013 -0.41 [-1.29, 0.47] Vogt et al., 2009 -0.11 [-0.74, 0.52] Sohlberg et al., 2000 0.48 [-0.26, 1.22] Westerberg et al., 2007a 0.85 [-0.13, 1.83] mean ES 0.16 [-0.34, 0.67] Hardy et al., 2013 0.52 [-0.50, 1.54] Kesler et al., 2013 0.65 [0.02, 1.28] mean ES 0.61 [0.08, 1.15] overall ES for attention/processing speed 0.20 [0.08, 0.32] Richmond et al., 2014 -0.70 [-1.37, -0.03] Rudebeck et al., 2012 -0.44 [-0.97, 0.09] Dahlin et al., 2008 0.35 [-0.43, 1.13] Penner et al., 2012 0.45 [-0.26, 1.16] Schmiedek et al., 2010 0.51 [0.16, 0.86] Heinzel et al., 2014 0.57 [-0.16, 1.30] Gibson et al., 2013 0.58 [-0.16, 1.32] Harrison et al., 2013 0.91 [0.30, 1.52] mean ES 0.27 [-0.12, 0.66] Theill et al., 2013 -0.27 [-0.90, 0.36] Brehmer et al., 2012 -0.26 [-0.85, 0.33] Zimmermann et al., 2014 -0.23 [-1.29, 0.83] Dahlin et al., 2008 -0.09 [-0.82, 0.64] Buschkühl et al., 2008 0.18 [-0.53, 0.89] Richmond et al., 2011 0.25 [-0.38, 0.88] Schmiedek et al., 2010 0.27 [-0.10, 0.64] Brehmer et al., 2011 0.38 [-0.44, 1.20] McAvenue et al., 2013 0.48 [-0.19, 1.15] Heinzel et al., 2014 0.89 [0.13, 1.65] mean ES 0.17 [-0.04, 0.38] Dongen-Boomsma et al., 2014 0.04 [-0.55, 0.63] Egeland/Hovik et al., 2013 (combined) 0.12 [-0.37, 0.61] Grunewaldt et al., 2013 0.19 [-0.69, 1.07] mean ES 0.10 [-0.24, 0.45] Westerberg et al., 2007a 0.21 [-0.71, 1.13] Carretti et al., 2013 0.54 [-0.36, 1.44] mean ES 0.38 [-0.27, 1.02] Van der Molen et al., 2010 -0.12 [-0.53, 0.29] Kesler et al., 2013 -0.12 [-0.73, 0.49] Løhaugen et al., 2011 0.29 [-0.42, 1.00] mean ES -0.04 [-0.35, 0.26] overall ES for long-term memory 0.18 [0.02, 0.33] Rode et al., 2014 -0.18 [-0.42, 0.06] mean ES -0.18 [-0.42, 0.06] Onraedt et al., 2014 -0.14 [-0.65, 0.37] Brehmer et al., 2012 0.48 [-0.13, 1.09] mean ES 0.15 [-0.46, 0.75] McAvenue et al., 2013 -0.09 [-0.78, 0.60] Nouchi et al., 2012 0.04 [-0.70, 0.78] Brehmer et al., 2012 0.47 [-0.06, 1.00] mean ES 0.21 [-0.16, 0.57] Chacko et al., 2014 -0.22 [-0.65, 0.21] Dongen-Boomsma et al., 2014 -0.04 [-0.78, 0.70] Gray et al., 2012 -0.03 [-0.68, 0.62] Wong et al., 2014 0.04 [-0.57, 0.65] Klingberg et al., 2005 0.04 [-0.51, 0.59] Egeland/Hovik et al., 2013 (combined) 0.08 [-0.41, 0.57] Beck et al., 2010 0.14 [-0.41, 0.69] Gibson et al., 2011 0.29 [-0.40, 0.98] Grunewaldt et al., 2013 0.40 [-0.50, 1.30] Gropper et al., 2014 0.40 [-0.13, 0.93] Van der Oord et al., 2014 0.45 [-0.18, 1.08] Green et al., 2012 0.53 [-0.25, 1.31] Johnstone et al., 2010 0.58 [-0.16, 1.32] Klingberg et al., 2002 1.24 [0.06, 2.42] mean ES 0.17 [0.00, 0.33] Houben et al., 2011 -0.16 [-0.75, 0.43] Åkerlund et al., 2013 0.09 [-0.53, 0.71] Vogt et al., 2009 0.20 [-0.43, 0.83] Lundqvist et al., 2010 0.49 [-0.14, 1.12] Johansson et al., 2012 0.64 [-0.10, 1.38] Westerberg et al., 2007a 1.01 [0.01, 2.01] mean ES 0.29 [-0.01, 0.59] "
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    • "Our findings with lower score in the Auditory Delayed index, but not in the Auditory Recognition Delayed index in the VLBW group partly support this model. Inferior working memory function has previously been described in several VLBW groups (Skranes et al., 2009; Kulseng et al., 2006; Grunewaldt et al., 2013), and has also been related to the increased rate of Attention Deficit Hyperactivity Disorder (ADHD) and Attention Deficit Disorder (ADD) symptoms reported in preterm born subjects (Indredavik et al., 2004). We found that the VLBW group achieved lower scores on both the visual (Spatial Span) and the verbal (Letter- Number Sequencing) working memory subtests, although only the Spatial Span subtest reached statistical significance. "
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