de Vries Marieke, Prins Pier J M, Schmand Ben A, Geurts Hilde M
Univeristy of Amsterdam, Amsterdam, the Netherlands; Dutch Autism and ADHD Research Center, Amsterdam, the Netherlands.
J Child Psychol Psychiatry. 2015 May;56(5):566-76. doi: 10.1111/jcpp.12324. Epub 2014 Sep 26.
People with autism spectrum disorders (ASDs) experience executive function (EF) deficits. There is an urgent need for effective interventions, but in spite of the increasing research focus on computerized cognitive training, this has not been studied in ASD. Hence, we investigated two EF training conditions in children with ASD.
In a randomized controlled trial, children with ASD (n = 121, 8-12 years, IQ > 80) were randomly assigned to an adaptive working memory (WM) training, an adaptive cognitive flexibility-training, or a non-adaptive control training (mock-training). Braingame Brian, a computerized EF-training with game-elements, was used. Outcome measures (pretraining, post-training, and 6-week-follow-up) were near-transfer to trained EFs, far-transfer to other EFs (sustained attention and inhibition), and parent's ratings of daily life EFs, social behavior, attention deficit hyperactivity disorder (ADHD)-behavior, and quality of life.
Attrition-rate was 26%. Children in all conditions who completed the training improved in WM, cognitive flexibility, attention, and on parent's ratings, but not in inhibition. There were no significant differential intervention effects, although children in the WM condition showed a trend toward improvement on near-transfer WM and ADHD-behavior, and children in the cognitive flexibility condition showed a trend toward improvement on near-transfer flexibility.
Although children in the WM condition tended to improve more in WM and ADHD-behavior, the lack of differential improvement on most outcome measures, the absence of a clear effect of the adaptive training compared to the mock-training, and the high attrition rate suggest that the training in its present form is probably not suitable for children with ASD.
自闭症谱系障碍（ASD）患者存在执行功能（EF）缺陷。迫切需要有效的干预措施，尽管对计算机化认知训练的研究日益受到关注，但尚未在ASD中进行过此类研究。因此，我们对ASD儿童的两种EF训练条件进行了研究。
在一项随机对照试验中，将ASD儿童（n = 121，8 - 12岁，智商> 80）随机分配到适应性工作记忆（WM）训练、适应性认知灵活性训练或非适应性对照训练（模拟训练）组。使用了一款带有游戏元素的计算机化EF训练软件Braingame Brian。结果测量指标（训练前、训练后和6周随访）包括对训练过的EF的近迁移、对其他EF（持续注意力和抑制力）的远迁移，以及家长对日常生活中的EF、社交行为、注意力缺陷多动障碍（ADHD）行为和生活质量的评分。
损耗率为26%。所有完成训练的儿童在WM、认知灵活性、注意力以及家长评分方面均有改善，但在抑制力方面没有改善。尽管WM训练组的儿童在近迁移WM和ADHD行为方面有改善趋势，认知灵活性训练组的儿童在近迁移灵活性方面有改善趋势，但没有显著的差异干预效果。
尽管WM训练组的儿童在WM和ADHD行为方面改善趋势更明显，但大多数结果测量指标缺乏差异改善，与模拟训练相比适应性训练没有明显效果，且损耗率较高，这表明目前形式的训练可能不适用于ASD儿童。
