A Randomized Controlled Trial of Working Memory Training in Pediatric Sickle Cell Disease

Author:

Hardy Steven J12ORCID,Bills Sarah E1,Meier Emily R3,Schatz Jeffrey C4,Keridan Katie J1,Wise Shane1,Hardy Kristina K25

Affiliation:

1. Division of Hematology, Children’s National Hospital

2. Department of Psychiatry and Behavioral Sciences, George Washington University School of Medicine and Health Sciences

3. Indiana Hemophilia & Thrombosis Center, Inc

4. Department of Psychology, University of South Carolin a

5. Division of Neuropsychology, Children’s National Hospital

Abstract

Abstract Objective Youth with sickle cell disease (SCD) are at risk for neurocognitive deficits including problems with working memory (WM), but few interventions to improve functioning exist. This study sought to determine the feasibility and efficacy of home-based, digital WM training on short-term memory and WM, behavioral outcomes, and academic fluency using a parallel group randomized controlled trial design. Methods 47 children (7–16 years) with SCD and short-term memory or WM difficulties were randomized to Cogmed Working Memory Training at home on a tablet device (N = 24) or to a standard care Waitlist group (N = 23) that used Cogmed after the waiting period. Primary outcomes assessed in clinic included performance on verbal and nonverbal short-term memory and WM tasks. Secondary outcomes included parent-rated executive functioning and tests of math and reading fluency. Results In the evaluable sample, the Cogmed group (N = 21) showed greater improvement in visual WM compared with the Waitlist group (N = 22; p = .03, d = 0.70 [CI95 = 0.08, 1.31]). When examining a combined sample of participants, those who completed ≥10 training sessions exhibited significant improvements in verbal short-term memory, visual WM, and math fluency. Adherence to Cogmed was lower than expected (M = 9.07 sessions, SD = 7.77), with 19 participants (41%) completing at least 10 sessions. Conclusions: Visual WM, an ability commonly affected by SCD, is modifiable with cognitive training. Benefits extended to verbal short-term memory and math fluency when patients completed a sufficient training dose. Additional research is needed to identify ideal candidates for training and determine whether training gains are sustainable and generalize to real-world outcomes.

Funder

Doris Duke Charitable Foundation

Publisher

Oxford University Press (OUP)

Subject

Developmental and Educational Psychology,Pediatrics, Perinatology, and Child Health

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