van Houdt Carolien A, Aarnoudse-Moens Cornelieke S H, van Wassenaer-Leemhuis Aleid G, Laarman A R Céleste, Koopman-Esseboom Corine, van Kaam Anton H, Oosterlaan Jaap
Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.
Emma Neuroscience Group, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.
Front Psychol. 2019 Sep 13;10:2100. doi: 10.3389/fpsyg.2019.02100. eCollection 2019.
Very preterm children have poorer attentional, behavioral and emotional functioning than term-born children. Problems on these domains have been linked to poorer executive function (EF). This study examined effects of a game-formatted, comprehensive EF training on attentional, behavioral and emotional functioning and self-perceived competence in very preterm children.
Eighty-five children participated in a multi-center, double-blind, placebo and waitlist-controlled randomized trial. Children were recruited from neonatal follow-up units of two academic medical centers in The Netherlands. Eligible for inclusion were 8-12 year old children born very preterm (<30 weeks of gestation) and/or with extremely low birthweight (<1000 g) with parent reported attention problems. Children were randomly assigned to one of three treatment arms: EF training, placebo training or waitlist. The EF and placebo training involved a 6 weeks, 25 (30-45 min) sessions training program. Attentional functioning (Attention Network Test), behavioral and emotional functioning (parent and teacher Strengths and Difficulties questionnaire) and self-perceived competence (Self-Perception Profile for Children) were assessed at baseline, at the end of the training program and 5 months after the training was finished. Data analyses involved linear mixed model analyses.
Children in the EF training arm significantly improved on all training tasks over the course of the EF training program. Despite these improvements on the EF training tasks, there were no significant differences over time on any of the outcome measures between the three treatment arms, indicating that this computerized EF training program had no beneficial effects.
Although there were significant improvements in the EF training tasks, there was no generalization of these improvements to any of the outcome measures. Thus, our findings do not support the use of computerized EF training programs. Future research should investigate effectivity of more ecologically valid, real-world like EF training programs.
极早产儿在注意力、行为和情绪功能方面比足月儿差。这些领域的问题与较差的执行功能（EF）有关。本研究考察了一种游戏形式的综合性EF训练对极早产儿注意力、行为和情绪功能以及自我感知能力的影响。
85名儿童参与了一项多中心、双盲、安慰剂和等待名单对照的随机试验。儿童从荷兰两个学术医学中心的新生儿随访单位招募。纳入标准为8至12岁的极早产儿（孕周<30周）和/或出生体重极低（<1000克）且家长报告有注意力问题的儿童。儿童被随机分配到三个治疗组之一：EF训练组、安慰剂训练组或等待名单组。EF训练和安慰剂训练包括一个为期6周、共25节（30 - 45分钟）的训练课程。在基线、训练课程结束时以及训练结束后5个月评估注意力功能（注意力网络测试）、行为和情绪功能（家长和教师的长处与困难问卷）以及自我感知能力（儿童自我感知量表）。数据分析采用线性混合模型分析。
在EF训练课程过程中，EF训练组的儿童在所有训练任务上都有显著改善。尽管在EF训练任务上有这些改善，但三个治疗组在任何一项结局指标上随时间均无显著差异，这表明这种计算机化的EF训练项目没有产生有益效果。
尽管EF训练任务有显著改善，但这些改善并未推广到任何结局指标上。因此，我们的研究结果不支持使用计算机化的EF训练项目。未来的研究应调查更具生态效度、类似现实世界的EF训练项目的有效性。
