Centre for Community Child Health, Royal Children's Hospital, Parkville, Australia.
BMC Pediatr. 2011 Jun 20;11:57. doi: 10.1186/1471-2431-11-57.
Low academic achievement is common and is associated with adverse outcomes such as grade repetition, behavioural disorders and unemployment. The ability to accurately identify these children and intervene before they experience academic failure would be a major advance over the current 'wait to fail' model. Recent research suggests that a possible modifiable factor for low academic achievement is working memory, the ability to temporarily store and manipulate information in a 'mental workspace'. Children with working memory difficulties are at high risk of academic failure. It has recently been demonstrated that working memory can be improved with adaptive training tasks that encourage improvements in working memory capacity. Our trial will determine whether the intervention is efficacious as a selective prevention strategy for young children at risk of academic difficulties and is cost-effective.
METHODS/DESIGN: This randomised controlled trial aims to recruit 440 children with low working memory after a school-based screening of 2880 children in Grade one. We will approach caregivers of all children from 48 participating primary schools in metropolitan Melbourne for consent. Children with low working memory will be randomised to usual care or the intervention. The intervention will consist of 25 computerised working memory training sessions, which take approximately 35 minutes each to complete. Follow-up of children will be conducted at 6, 12 and 24 months post-randomisation through child face-to-face assessment, parent and teacher surveys and data from government authorities. The primary outcome is academic achievement at 12 and 24 months, and other outcomes include child behaviour, attention, health-related quality of life, working memory, and health and educational service utilisation.
A successful start to formal learning in school sets the stage for future academic, psychological and economic well-being. If this preventive intervention can be shown to be efficacious, then we will have the potential to prevent academic underachievement in large numbers of at-risk children, to offer a ready-to-use intervention to the Australian school system and to build international research partnerships along the health-education interface, in order to carry our further studies of effectiveness and generalisability.
学业成绩低较为常见，与诸如留级、行为障碍和失业等不良后果相关。能够准确识别这些儿童，并在他们学业失败之前进行干预，将是对当前“等待失败”模式的重大改进。最近的研究表明，学业成绩低的一个可能的可改变因素是工作记忆，即临时在“心理工作空间”中存储和处理信息的能力。工作记忆有困难的儿童面临学业失败的高风险。最近已经证明，通过鼓励工作记忆能力提高的适应性训练任务，可以提高工作记忆。我们的试验将确定该干预措施是否作为学业困难风险儿童的选择性预防策略有效，并具有成本效益。
方法/设计：这项随机对照试验旨在在 2880 名一年级儿童的学校基础筛查后，招募 440 名工作记忆能力低的儿童。我们将联系参与墨尔本大都市 48 所小学的所有儿童的照顾者以获得同意。工作记忆能力低的儿童将被随机分配到常规护理或干预组。干预将包括 25 节计算机化工作记忆训练课程，每节课程大约需要 35 分钟完成。通过儿童面对面评估、家长和教师调查以及政府当局的数据，在随机分组后 6、12 和 24 个月对儿童进行随访。主要结局是 12 个月和 24 个月时的学业成绩，其他结局包括儿童行为、注意力、健康相关生活质量、工作记忆以及健康和教育服务的使用。
在学校中正式学习的良好开端为未来的学术、心理和经济福祉奠定了基础。如果该预防干预措施被证明有效，那么我们将有可能预防大量处于危险中的儿童的学业成绩不佳，为澳大利亚学校系统提供现成的干预措施，并在健康-教育界面建立国际研究伙伴关系，以便进一步开展有效性和推广性研究。
