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极早产儿执行功能计算机化训练:一项初步研究。

Executive Function Computerized Training in Very Preterm-Born Children: A Pilot Study.

机构信息

1 Department of Pediatrics, Emma Children's Hospital, Academic Medical Centre , Amsterdam, The Netherlands .

2 Clinical Neuropsychology Section, Department of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam , Amsterdam, The Netherlands .

出版信息

Games Health J. 2018 Jun;7(3):175-181. doi: 10.1089/g4h.2017.0038. Epub 2018 Mar 13.

Abstract

OBJECTIVE

Attention problems are one of the most pronounced and documented consequences of very preterm birth (gestational age ≤32 weeks). However, up to now, there is no research published on suitable interventions at school age aimed to overcome these problems. Research in this population did show that executive functions (EFs) are strongly associated with inattention. BrainGame Brian is a newly developed computerized training, in which, in 25 training sessions, the core EFs, including working memory, impulse control, and cognitive flexibility, are trained. This pilot study aimed to examine the feasibility of studying BrainGame Brian in very preterm-born children with attention problems.

DESIGN

Pilot feasibility intervention study with one baseline and one follow-up assessment.

MATERIALS AND METHODS

Feasibility was measured by the participation rate, dropout rate, and user experiences with regard to effort, training characteristics, and recommendation to others. From a larger cohort study, 15 very preterm-born children at age 10 years with parent-reported attention problems on the Child Behavior Checklist/6-18 years were invited to participate in this pilot study. BrainGame Brian was performed for a period of 6 weeks. Training outcome measures included visual working memory, impulse control, cognitive flexibility, speed variability, and parent-rated attention, for which pre- and post-training differences were examined at the group level by the Wilcoxon signed-rank test as well as for each individual child separately by the reliable change index.

RESULTS

Twelve of 15 children and their parents agreed to participate and 11 children successfully completed BrainGame Brian in the 6-week period. Parents were positive about training characteristics and lack of interference with schooling, but scored the effort as high. We found clinically significant changes in visual working memory and speed variability in post-training assessments.

CONCLUSION

BrainGame Brian is a feasible intervention for very preterm-born children with attention problems.

摘要

目的

注意力问题是极早产儿(胎龄≤32 周)最明显和记录最多的后果之一。然而,迄今为止,针对学龄期的这些问题,还没有发表任何关于合适干预措施的研究。该人群的研究表明,执行功能(EF)与注意力不集中密切相关。BrainGame Brian 是一种新开发的计算机训练,在 25 次训练课程中,可训练核心 EF,包括工作记忆、冲动控制和认知灵活性。这项初步研究旨在检验在注意力问题的极早产儿中研究 BrainGame Brian 的可行性。

设计

一项具有一个基线和一个随访评估的初步可行性干预研究。

材料和方法

通过参与率、辍学率以及参与者对努力程度、训练特点和向他人推荐的体验来衡量可行性。从一项更大的队列研究中,邀请了 15 名年龄在 10 岁且在儿童行为检查表/6-18 岁有父母报告注意力问题的极早产儿参加这项初步研究。BrainGame Brian 持续进行了 6 周。训练结果测量包括视觉工作记忆、冲动控制、认知灵活性、速度变异性和父母评定的注意力,通过 Wilcoxon 符号秩检验在组水平上检查训练前后的差异,以及通过可靠变化指数分别对每个孩子进行检查。

结果

15 名儿童及其父母中有 12 名同意参加,11 名儿童在 6 周内成功完成了 BrainGame Brian。家长对训练特点和对学业的干扰程度表示认可,但对努力程度评价较高。我们发现,在训练后评估中,视觉工作记忆和速度变异性有临床意义上的改善。

结论

BrainGame Brian 是一种治疗极早产儿注意力问题的可行干预措施。

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