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Near‐transfer effects following working memory intervention (Cogmed) in children with symptomatic epilepsy: An open randomized clinical trial
Author(s) -
Kerr Elizabeth N.,
Blackwell Melissa C.
Publication year - 2015
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.13195
Subject(s) - randomized controlled trial , epilepsy , working memory , intervention (counseling) , population , psychology , psychological intervention , working memory training , medicine , physical therapy , clinical psychology , cognition , psychiatry , surgery , environmental health
Summary Objective Limited research exists regarding the effectiveness of educational and psychological interventions for improving commonly presenting cognitive impairments experienced by children with epilepsy. We evaluated the efficacy of a commercially available, computerized, working memory ( WM ) program (Cogmed) using a well‐defined population of children with epilepsy. Methods In this controlled trial, 77 children with symptomatic epilepsy (ages 6.5–15.5 years; 100% taking medication) with estimated intellectual ability greater than the 2nd percentile were randomly assigned to an intervention (n = 42) or waitlist‐control (n = 35) group. Standardized assessments of attention and WM were administered pre‐ and posttraining or waitlist interval, 7 weeks apart. Results Without intervention, participants displayed significant weaknesses in intelligence, attention, and WM compared to normative samples. After controlling for preintervention scores and intelligence, we found that significant treatment effects for the intervention group were evident for visual attention span, auditory WM , and visual‐verbal WM . Intention‐to‐treat analyses (all participants) and sensitivity analyses (n = 37 and n = 21 for the intervention and waitlist‐control groups, respectively) were highly similar, providing confidence to the results. Effect sizes for significant outcomes were large (greater than or equal to two thirds of the standard deviation of the normative‐data). The clinical/demographic and functional factors studied did not elucidate who most benefits from training. Significance This is the first study to evaluate the effectiveness of intervention to ameliorate WM deficits commonly experienced by children with symptomatic epilepsy. Results support group improvement on some untrained tasks immediately postintervention, demonstrating preliminary usefulness of Cogmed as a treatment option.