Gutierrez-Colina Ana M, Clifford Lisa, Wade Shari L, Modi Avani C
Division of Behavioral Medicine and Clinical Psychology.
Division of Physical Medicine and Rehabilitation Cincinnati Children's Hospital Medical Center.
Clin Pract Pediatr Psychol. 2022 Jun;10(2):150-163. doi: 10.1037/cpp0000410. Epub 2021 Sep 2.
The extent to which tailored executive functioning (EF) interventions lead to improvements in other areas of functioning in adolescents with epilepsy is unknown. The types of problems that youth select to practice EF skills during tailored interventions has not been documented. This study aimed to systematically evaluate: 1) the EF problems and strategies selected during a tailored EF intervention for youth with epilepsy, and 2) impact of a tailored intervention on specific problems for subgroups who choose to practice EF skills in those areas.
We conducted secondary data analyses of a proof-of-concept clinical trial of a tailored web-based EF intervention for youth with epilepsy. Baseline and 2-months post-intervention questionnaire data were included. A coding system was developed to identify the problem domains that adolescents targeted during treatment. Descriptive statistics and paired sample t-tests were used to examine whether adolescents who identified specific EF problems improved on specific domains.
Coding revealed eight domains: Academics, Activities of Daily Living, Family, Social, Adherence, Healthy Habits/Self-care, Sleep, and Emotion/Stress. Significant improvements were noted on "Academics," "Emotion/Stress," and "Sleep" domains for those who applied EF skills to those domains.
Tailored EF interventions such as Epilepsy Journey are related not only to improvements in broad EF skills, but also to improvements across areas of functioning that adolescents identify as important. Clinically, EF skills may be more effectively learned when adolescents directly apply EF skills to the problems they identify as most salient.
ClinicalTrials.gov: NCT02925663.
针对癫痫青少年的定制化执行功能（EF）干预措施在其他功能领域的改善程度尚不清楚。在定制化干预期间青少年选择练习EF技能的问题类型尚未有文献记载。本研究旨在系统评估：1）针对癫痫青少年的定制化EF干预中所选择的EF问题及策略；2）定制化干预对选择在这些领域练习EF技能的亚组特定问题的影响。
我们对一项针对癫痫青少年的基于网络的定制化EF干预的概念验证临床试验进行了二次数据分析。纳入了基线和干预后2个月的问卷数据。开发了一个编码系统来识别青少年在治疗期间所针对的问题领域。使用描述性统计和配对样本t检验来检查识别出特定EF问题的青少年在特定领域是否有所改善。
编码显示有八个领域：学业、日常生活活动、家庭、社交、依从性、健康习惯/自我护理、睡眠和情绪/压力。对于那些将EF技能应用于这些领域的青少年，在“学业”、“情绪/压力”和“睡眠”领域有显著改善。
诸如癫痫之旅这样的定制化EF干预不仅与广泛的EF技能改善有关，而且与青少年认为重要的功能领域的改善有关。临床上，当青少年将EF技能直接应用于他们认为最突出的问题时，可能会更有效地学习EF技能。
ClinicalTrials.gov：NCT02925663。
