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Paying Attention in Class A classroom contextual cognitive training - - PowerPoint PPT Presentation
Paying Attention in Class A classroom contextual cognitive training - - PowerPoint PPT Presentation
Paying Attention in Class A classroom contextual cognitive training Marthe van der Donk Case of Daniel Problems that can be related to executive functions Executive functions Deficits often seen in children with ADHD (Barkley, 1997;
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- Deficits often seen in children with ADHD
(Barkley, 1997; Willcutt et al., 2005)
- Important role in academic performance
(Bull and Scerif, 2001)
- Especially working memory skills
(Aronen et al., 2005; Gathercole et al., 2000).
Executive functions
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Cognitive training
1) Processed based interventions (Sonuga-Barke et al.
2014)
2) Compensatory interventions (Dehn, 2008)
▫ Strategy training (Morrison & Chein, 2011) ▫ Modify environment (e.g. Holmes, Gathercole & Dunning,
2010)
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Previous studies of CWMT in children with ADHD
Near transfer Far transfer
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Critical notes
1) Theoretical concerns
- Near- and far transfer
2) Methodological concerns
- Inconsistent methods
- Lack of adequate control group
- Single tasks
3) Clinical implications
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Aims of our study
- Determine the effects of CWMT and compare
effects with active control group
- Extension with 6 months follow up and
academic performance measures
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102 children included
- age 8-12 years
- Diagnosed with ADHD
Pre-assessment N=52 Cogmed Working Memory Training N=50 Paying Attention in Class Post assessment Follow-up 6 months
Methods
Procedure
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Methods
Assessment
Primary outcome measures
- Neurocognitive functioning
(attention, working memory, planning and inhibition)
- Academic performance
(word reading fluency, automated math, spelling)
- The Behaviour Rating of Executive Functions (BRIEF-P/T)
Secondary outcome measures
- Behavior in class (Learning Condition questionnaire)
- Behavior problems (CBCL/TRF)
- Quality of Life (Kidscreen-27)
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Cogmed Working Memory Training - RM
- Daily sessions
- During school hours
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Paying Attention in Class
- 25 sessions of 45 minutes
- Contextual to classroom learning
- Three key ingredients
Metacognition Goal directed behavior
Working memory Planning and initation Selective attention
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Paying Attention in Class
(1) Psycho education
Pitfalls
Distraction Too fast Forgetful Emotion Repeat Take time Picture Routine
Compensatory strategies
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Paying Attention in Class
(2) Working memory training
Visual spatial span Instruction task Listening recall span task My table
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- School related tasks
- Registration card
- Active involvement
teacher
Paying Attention in Class
(3) Transfer to classroom
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Demographics
CWMT
(n=52)
Paying Attention in Class
(n=50)
Age 9.88 (1.33) 10 (1.31) boy/girl 34/15 36/13 Medication yes/no 20/25 18/29 ADHD-C/ADHD-I 55% / 43% 59% / 39% Learning Disability 22% 40% Type of education
Regular/special primary/special education
89% / 4% / 7% 86% / 14% / 0% ***
Linear Mixed Model & Bonferonni correction
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Results – post treatment
Attention Verbal WM Visual WM Inhibition Parents
- Behavior
regulation
- Metacognition
- Attention
Teacher
- Attention
CWMT
Attention Verbal WM Visual WM Inhibition Parents
- Behavior
regulation
- Metacognition
- Attention
Teacher
- Attention
PAC
d 0.87
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Results – follow up
Verbal WM Visual WM Inhibition Planning Parents
- Attention
Teacher
- Attention
- Metacognition
CWMT
Verbal WM Visual WM Inhibition Planning Parents
- Attention
Teacher
- Attention
- Metacognition
PAC
d 0.49
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Summary & discussion
1) Broad improvements in neurocognitive functioning 2) Confirmed by both parent and teacher ratings 3) CWMT outperformed only on visual spatial working memory 4) Limitedness of far transfer
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Future research (1)
Why?
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Attention
How and why?
Working memory Trained function Non-trained function
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For whom?
ADHD + WM problems
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Thanks to:
- Co authors and supervisors
▫ Anne-Claire Hiemstra, Ariane Tjeenk, Aryan van der Leij and Ramón Lindauer
- Collaborators
▫ Marieke Krop, Carola Oosterveer, Jan Geelhoed, Jehanne Vieijra, Julie Stoter, Maartje van Ballegoij and Marjolijn Glotzbach
- Funding
▫ Ministry of Education
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Questions?
- Marthe van der Donk