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      Neuropsychiatric Disease and Treatment (submit here)

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      Clinician-delivered cognitive training for children with attention problems: effects on cognition and behavior from the ThinkRx randomized controlled trial

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          Abstract

          Purpose

          The impact of attention problems on academic and social functioning coupled with the large number of children failing to respond to stimulant medication or behavioral therapy makes adjunctive therapies such as cognitive training appealing for families and clinicians of children with attention difficulties or childhood attention deficit hyperactivity disorder. However, the results of cognitive training studies have failed to find far transfer effects with this population. This study examined the quantitative cognitive effects and parent-reported behavioral effects of a clinician-delivered cognitive training program with children who have attention problems.

          Patients and methods

          Using a randomized controlled study design, we examined the impact of a clinician-delivered cognitive training program on processing speed, fluid reasoning, memory, visual processing, auditory processing, attention, overall intelligence quotient score, and behavior of students (n=13) aged 8–14 years with attention problems. Participants were randomly assigned to either a waitlist control group or a treatment group for 60 hours of cognitive training with ThinkRx, a clinician-delivered intervention that targets multiple cognitive skills with game-like, but rigorous mental tasks in 60–90-minute training sessions at least 3 days per week.

          Results

          Results included greater mean pretest to posttest change scores on all variables for the treatment group versus the control group with statistically significant differences noted in working memory, long-term memory, logic and reasoning, auditory processing, and intelligence quotient score. Qualitative outcomes included parent-reported changes in confidence, cooperation, and self-discipline.

          Conclusion

          Children with attention problems who completed 60 hours of clinician-delivered ThinkRx cognitive training realized both cognitive and behavioral improvements.

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          Most cited references37

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          Understanding Power and Rules of Thumb for Determining Sample Sizes

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            CHC theory and the human cognitive abilities project: Standing on the shoulders of the giants of psychometric intelligence research

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              A meta-analysis of working memory impairments in children with attention-deficit/hyperactivity disorder.

              To determine the empirical evidence for deficits in working memory (WM) processes in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Exploratory meta-analytic procedures were used to investigate whether children with ADHD exhibit WM impairments. Twenty-six empirical research studies published from 1997 to December, 2003 (subsequent to a previous review) met our inclusion criteria. WM measures were categorized according to both modality (verbal, spatial) and type of processing required (storage versus storage/manipulation). Children with ADHD exhibited deficits in multiple components of WM that were independent of comorbidity with language learning disorders and weaknesses in general intellectual ability. Overall effect sizes for spatial storage (effect size = 0.85, CI = 0.62 - 1.08) and spatial central executive WM (effect size = 1.06, confidence interval = 0.72-1.39) were greater than those obtained for verbal storage (effect size = 0.47, confidence interval = 0.36-0.59) and verbal central executive WM (effect size = 0.43, confidence interval = 0.24-0.62). Evidence of WM impairments in children with ADHD supports recent theoretical models implicating WM processes in ADHD. Future research is needed to more clearly delineate the nature, severity, and specificity of the impairments to ADHD.
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                Author and article information

                Journal
                Neuropsychiatr Dis Treat
                Neuropsychiatr Dis Treat
                Neuropsychiatric Disease and Treatment
                Neuropsychiatric Disease and Treatment
                Dove Medical Press
                1176-6328
                1178-2021
                2018
                26 June 2018
                : 14
                : 1671-1683
                Affiliations
                [1 ]Gibson Institute of Cognitive Research, Colorado Springs, CO, USA, amoore@ 123456gibsonresearch.org , amoore@ 123456gibsonresearch.org
                [2 ]College of Education, University of Colorado, Colorado Springs, CO, USA
                [3 ]Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, LA, USA
                Author notes
                Correspondence: Amy Lawson Moore, Gibson Institute of Cognitive Research, 5085 List Drive, Suite 308, Colorado Springs, CO 80919, USA, Tel +1 719 219 0940, Fax +1 719 522 0434, Email amoore@ 123456gibsonresearch.org
                Article
                ndt-14-1671
                10.2147/NDT.S165418
                6027847
                29983567
                15f8b624-f7d2-4b65-a61a-9d7c18f9e433
                © 2018 Moore et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

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                Original Research

                Neurology
                brain training,cognitive rehabilitation,adhd,learningrx,cognitive training
                Neurology
                brain training, cognitive rehabilitation, adhd, learningrx, cognitive training

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