A clinical trial comparing the effectiveness of psychoeducational programs and Cogmed Paying careful in Class on school performance, concentration and mnemonic ability of children with attention deficit hyperactivity disorder (ADD / ADHD).
A Dutch randomized controlled trial of Van der Donk and his collaborators, published in the journal Frontiers in Psychology in 2015, verifies the effectiveness of Cogmed psychoeducational program on school performance of children 8 to 12 years old with attention disorder with or without hyperactivity (ADD / ADHD). The results show progress in visuospatial working memory without improving educational outcomes.
The Study Rationale
The attention disorder with or without hyperactivity (ADD / ADHD) is a neurological disorder making its appearance in early childhood. It is characterized by inattention, impulsivity and / or hyperactivity.
The best results in solving these disorders were obtained by combining medication with behavioral psychotherapy. But the benefits do not persist after two years. Furthermore, Serious side effects in some children following the drug treatment.
81% of children with AD / HD have a deficit in working memory. The psychoeducational program Cogmed is a computerized cognitive remediation method of working memory. It aims to improve concentration and memory information had to use them in tasks that involve reasoning or understanding. A study was to test its effectiveness in children with AD / HD.
A psychoeducational program of working memory training would improve neurocognitive function and academic performance of students with AD / HD.
Is the Cogmed effective program to improve neurocognitive function and academic performance of children with attention deficit disorder with or without hyperactivity (ADD / ADHD)?
The controlled van der Donk and colleagues randomized trial evaluates the effectiveness of Cogmed program on measures of neurocognitive functioning and school performance of children with AD / HD. The study examined 100 children aged 8 to 12 years diagnosed with ADD / ADHD according to DSM-IV. 31 developmental psychologists and 5 coaches of Cogmed program have collaborated on this study. The group benefiting from Cogmed program is compared to a group benefiting from the program “Paying careful in Class” (CAP).
The neurocognitive assessment and school performance are the two primary endpoints. Evaluations were performed at school three different times: before the start of surgery, after surgery and six months after.
The Non-Pharmacological Intervention (NPI) assessed
The duration of the two programs was five weeks with a frequency of five times per week. Each lasted around 45 minutes.
– The Cogmed program psychoeducational this method aims to train working memory with computer software. It consists of various exercises based on the game. The difficulty level is automatically adjusted according to the working memory capacity of the child. The program includes 12 different tasks soliciting visuospatial abilities and / or verbal working memory. 8 of these tasks are carried out every day, or 90 trials in total. Children are monitored and guided by a developmental psychologist who himself was supervised by a certified coach Cogmed.
– The program “Paying careful in Class” (CAP): This program provides a method of psycho-based solicitation of executive functions related to the specific behavior of each child in the classroom. It addresses five important executive functions in a situation of learning: attention, planning, working memory, a goal-oriented behavior and metacognition. Each executive function, 5 sessions devoted to it.
The results show an improvement in visuospatial working memory for the group benefiting from Cogmed program only. The overall neurocognitive abilities are improved for both groups. However, the programs do not change educational outcomes for children.
Assessments of behavior and quality of life do not indicate significant differences between groups even if teachers and parents respectively observe an improvement in time attention problems and outsourced management problems.
The Cogmed program improves visual-spatial working memory but not in school.
What it means for General Population
The Cogmed program seems more effective than the CAP program for children 8 to 12 years with attention deficit disorder with or without hyperactivity regarding the progress of visuospatial working memory. The Cogmed and PAC programs do not improve educational outcomes for children.
What it means for Healthcare Professionals
Neurocognitive functioning of the visual-spatial working memory is enhanced for children from 8 to 12 years old with attention deficit disorder with or without hyperactivity (ADD / ADHD) by both psycho-educational programs tested. Educational outcomes are not improved differently. However, the notes reported by parents and teachers should be interpreted with caution because they are not necessarily objective and may have been influenced by what they want to hear.
What it means for Researchers
This clinical trial is the first randomized controlled trial to involve an active control group. This is its quality and default since the results differ little between groups, statistical interactions were not significant on most valued judgments criteria. This type of intervention research in educational psychology whose evaluation is mostly indirect (parents, teachers) deserve to be achieved double-blind for risk of bias. Indeed, teachers often have a general opinion on the child and can be very sensitive to the detection of positive or negative changes. The addition of a third control group without treatment would have been useful in this study.
What it means for Policymakers
The psychoeducational program Cogmed improves visual-spatial working memory in children with AD / HD compared to CAP psychoeducational program. But education outcomes do not differ between groups. Such interventional research has the advantage of objectively compare the effectiveness of psychoeducational methods and not stay on convictions.
Van der Donk M, Hiemstra-Beernink A-C, Tjeenk-Kalff A, van der Leij A, Lindauer R (2015). Cognitive training for children with ADHD: a randomized controlled trial of cogmed working memory training and paying attention in class. Frontiers in Psychology, 6, 1-13.
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To reference this Blog en Sante © article
Ninot G (2015). Comparison of psychoeducational methods for children with attention disorders. Blog en Sante, A66.
© Copyright 2015 Gregory Ninot. All rights reserved.