Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia;
Clinical Sciences Theme.
Pediatrics. 2020 Dec;146(6). doi: 10.1542/peds.2019-4028. Epub 2020 Nov 6.
Subgroups of children may benefit more from working memory training than others. In this study, we aimed to examine whether response to the Cogmed Working Memory Training program differed for children with low IQ and elevated attention-deficit/hyperactivity disorder, emotional and behavioral symptoms, special health care needs, or by sex.
We used data from the Memory Maestros trial, a population-based randomized controlled trial of the Cogmed program delivered at school ( = 226) compared to usual teaching ( = 226) in grade 1 children (mean age 6.9 years; SD 0.4) with low working memory. Cogmed comprises 20 to 25 sessions of 45-minute duration over 5 to 7 weeks. Children completed subtests from the Automated Working Memory Assessment to measure change in working memory from baseline to 6 months postrandomization.
After training, improved working memory standard scores (>1 SD) from baseline to 6 months were observed for approximately one-third of the children, with more than half maintaining stable scores (within 1 SD). However, similar outcomes were observed for children receiving usual teaching. Differential effect of Cogmed versus usual teaching was evident for children with elevated hyperactivity and/or inattention, who were less likely to show improved visuospatial working memory, but not for other subgroups studied.
Children with elevated hyperactivity and/or inattention were less likely to show clinically meaningful improvement after Cogmed; however, differential effects were not evident for children with low IQ and elevated emotional and behavioral symptoms, special health care needs, or by sex. More research is needed to determine if training can improve working memory and, if so, for whom.
一些儿童亚组可能比其他儿童从工作记忆训练中获益更多。本研究旨在探讨认知加工改善训练（Cogmed Working Memory Training program）对智商较低、注意力缺陷多动障碍、情绪和行为症状、特殊医疗需求较高以及不同性别儿童的疗效是否存在差异。
我们使用了来自“记忆大师”试验的数据，该试验为基于人群的随机对照试验，在一年级儿童（平均年龄 6.9 岁，标准差 0.4）中开展，比较了在学校实施的 Cogmed 程序（共 226 名儿童）与常规教学（共 226 名儿童）。Cogmed 包括 20 至 25 次，每次 45 分钟，共 5 至 7 周。儿童在基线和随机分组后 6 个月时完成自动化工作记忆评估中的子测验，以衡量工作记忆的变化。
训练后，大约三分之一的儿童的工作记忆标准分数（>1 个标准差）从基线到 6 个月有所提高，超过一半的儿童的分数保持稳定（在 1 个标准差内）。然而，接受常规教学的儿童也观察到了类似的结果。与常规教学相比，Cogmed 的效果在多动和/或注意力不集中程度较高的儿童中存在差异，这些儿童的视空间工作记忆改善的可能性较小，但在其他研究的亚组中没有发现差异。
多动和/或注意力不集中程度较高的儿童在接受 Cogmed 后不太可能出现有临床意义的改善；然而，智商较低、情绪和行为症状、特殊医疗需求较高以及不同性别儿童的效果没有差异。需要进一步的研究来确定训练是否可以改善工作记忆，以及如果可以，哪些儿童受益。
