Telehealth Delivery of Group Format Cognitive Rehabilitation to Older Veterans With TBI

Traumatic brain injury (TBI) is common among older adults, with significant public health costs, and advanced age is a risk factor for poor outcomes after TBI. Older Veterans with TBI-related cognitive and emotional dysfunction without dementia may benefit from cognitive rehabilitation, particularly executive function training, and technology may promote optimal functioning for these patients by increasing access to such treatments. Dr. Kornblith will present pilot data on one such promising group intervention, Goal-Oriented Attentional Self-Regulation (GOALS), administered via in-home video telehealth. Themes gleaned from qualitative feedback collected throughout the intervention and post-treatment feedback questionnaires include the importance of communication and a smooth process with clear instructions for joining study sessions. Preliminary data suggest that only minor adaptions to the existing GOALS protocol are required for telehealth delivery and that delivering group-based executive function training to older TBI-exposed older Veterans with cognitive complaints via telehealth is feasible and acceptable.

Executive Functions Training and Giftedness (Capacitatión en funciones ejecutivas y superdotación)

The purpose of this article is to clarify the relationship between Executive Functions (EF) training and giftedness. In this paper we provide a literature review of condemnatory literature. Executive Functions are a set of cognitive skills considered as necessary for the cognitive control of behavior and they are important for self- regulation and adaptation. The proper functioning of the executive functions is associated with high IQ. Moreover, executive function training can be achieved by brain training programs, that aim to improve basic brain functions. Through education, various tasks are improved. Techniques that improve cognitive skills can benefit individuals with superior mental abilities and can be used as intervention techniques to improve and develop giftedness. The training of executive functions can be achieved through brain training. Brain training is a scientific field that has highly progressed over the last years and has offered extremely interesting results that lead to new developments in the field of giftedness. After analyzing what brain training is, we refer to the executive functions that can improve through brain training. Afterwards, we refer to brain training programs, which have had positive effects on the training of executive functions. Resumen: El propósito de este artículo es aclarar la relaciόn entre la formaciόn de funciones ejecutivas y la superdotación. En este artículo proporcionamos una revisión de la literatura condenatoria. Las funciones ejecutivas son un conjunto de habilidades cognitivas consideradas necesarias para el control cognitivo de la conducta y son importantes para la autorregulación y adaptación. El buen funcionamiento de las funciones ejecutivas está asociado a un alto coeficiente intelectual. Además, el entrenamiento de la función ejecutiva se puede lograr con programas de entrenamiento cerebral, que tienen como objetivo mejorar las funciones cerebrales básicas. A través de la educación, se mejoran varias tareas. Las técnicas que mejoran las habilidades cognitivas pueden beneficiar a las personas con capacidades mentales superiores y pueden utilizarse como técnicas de intervención para mejorar y desarrollar la superdotación. El entrenamiento de las funciones ejecutivas se puede lograr mediante el entrenamiento del cerebro. El Brain Training es un campo científico que ha avanzado mucho en los últimos años y ha ofrecido resultados sumamente interesantes que conducen a nuevos desarrollos en el campo de la superdotación. Tras analizar qué es el entrenamiento cerebral, nos referimos a las funciones ejecutivas que pueden mejorar mediante el entrenamiento cerebral. Posteriormente, nos referimos a los programas de entrenamiento cerebral, que han tenido efectos positivos en el entrenamiento de las funciones ejecutivas.

A preliminary randomized, controlled trial of executive function training for children with autism spectrum disorder

This randomized, controlled study examined the initial efficacy of an executive function training program for children with autism spectrum disorder. Seventy 7- to 11 year-olds with autism spectrum disorder and intelligence quotients ⩾80 were randomly assigned to receive a web-based set of executive function training games combined with in-person metacognition coaching or to a waitlist. Primary outcomes were evaluated for neural responses related to executive function, lab-based executive function behavior, and generalization of executive function skills. Secondary outcomes included measures of social function. Post-testing and analyses were conducted by staff naïve to group assignment. Children exhibited a change in neural response following training relative to the waitlist group [Formula: see text]. Training effects were not detected via lab-based tasks [Formula: see text] or generalized to caregiver-reported executive function skills outside the lab [Formula: see text]. However, the training group demonstrated reduced symptoms of repetitive behavior [Formula: see text] following training. There were no adverse events or attrition from the training group. Findings suggest that brief, targeted computer-based training program accompanied by coaching is feasible and may improve neural responses and repetitive behaviors of school-aged children with autism spectrum disorder. Lay abstract Executive function, which is a set of thinking skills that includes stopping unwanted responses, being flexible, and remembering information needed to solve problems, is a challenge for many children on the autism spectrum. This study tested whether executive function could be improved with a computerized executive function training program under the guidance of a coach who reinforced the use of executive function skills. Seventy children with autism spectrum disorder from age 7 to 11 years of age participated in the study. They were randomly assigned to receive training or to a waiting group. The tests most likely to determine whether the training may be effective were chosen from a larger battery before the study started and included one task measuring brain responses, two measures of executive function in the lab, and a parent questionnaire. Changes in social functioning and repetitive behaviors were also explored. All children assigned to training completed the program and families generally reported the experience was positive. Brain responses of the training group changed following training, but not within the waiting group during a similar time period. Children who received training did not exhibit behavioral changes during the two the lab-based tasks. Parent report on questionnaires indicated that neither group showed a significant change in their broad use of executive function in other settings. Yet, children who received training were reported to have fewer restricted and repetitive behaviors following training. These initial findings suggest that short executive function training activities are feasible and may improve some functioning of school-aged children on the autism spectrum.

Inhibitory control training in healthy and highly educated older adults

ABSTRACT. Executive function training is considered a promising tool for delaying the natural effects of aging on cognition. However, there are still few studies that propose a unimodal intervention with a focus on inhibitory control, and none of them has studied the effect of this type of intervention on older adults (OA). Objective: The aim of this study is to investigate the benefits of inhibitory control training in healthy OA by comparing the two assessment time points, namely, before and after training. Methods: Twenty-seven participants were included after interview and checking the inclusion criteria. The training was based on the stop-signal paradigm and carried out in 21 sessions. Results: Participants performed better after training by reducing the false alarm error rate (i.e., for stop-signal trials), reducing omission error rate, showing an increase in hit rate, Go response time (i.e., for go-signal trials), stop-signal response time, and showing a decrease in the level of anxiety. The executive function training had no significant impact on the scores obtained in the complementary neuropsychological tests. Conclusions: These results are consistent with previous studies that support the viability and effectiveness of cognitive intervention for executive functions in OA and suggest a positive effect of the intervention, which may be related to the learning experience of a new and challenging task.

The effects of combined cognitive training on prospective memory in older adults with mild cognitive impairment

This study aimed to assess the effects of combined cognitive training on prospective memory ability of older adults with mild cognitive impairment (MCI). A total of 113 participants were divided into a control group and three intervention groups. Over three months, the control group received only community education without any training, whereas for the first six weeks, an executive function training group received executive function training, a memory strategy training group received semantic encoding strategy training, and the combined cognitive training group received executive function training twice a week for the first six weeks, and semantic encoding strategy training twice a week for the next six weeks. The combined cognitive training group showed improvement on the objective neuropsychological testing (Montreal Cognitive Assessment scale). The memory strategy training group showed improvement on the self-evaluation scales (PRMQ-PM). Combined cognitive training improved the prospective memory and cognitive function of older adults with MCI.

sFEra APP: description and usability of a novel tablet application for executive functions training

Executive functions include functions such as planning, working memory, inhibition, mental flexibility, action monitoring and initiation, and are essential to carry out an independent everyday life. Individuals suffering from brain injury, such as a stroke, very commonly experience executive deficits that reduce the capacity to regain functional independence. In recent years, there has been a growing interest in developing tablet computer-based cognitive training programs for stroke patients. In this respect, we described and evaluated the usability of a novel tablet application (app) for executive function training, developed in the context of the MEMORI-net project, a cross-border Italy-Slovenia program for the rehabilitation of stroke patients. We conducted a pilot study with a non-clinical sample of 16 participants to obtain information about the usability of the app. Our descriptive analyses suggest that most users were satisfied with the overall experience and the app was highly usable, even with little previous experience with tablet applications. Acceptability and effectiveness will need to be evaluated in a clinical randomized controlled study.

Training Executive Functions to Improve Academic Achievement: Tackling Avenues to Far Transfer

The aim of training executive functions is usually to improve the ability to attain real-life goals such as academic achievement, that is, far transfer. Although many executive function trainings are successful in improving executive functions, far transfer is more difficult to achieve (cf. Diamond and Lee, 2011; Sala and Gobet, 2020). In this perspective article, we focus on the transfer of executive function training to academic performance. First, we disentangle possible sources of transfer problems. We argue that executive functions can facilitate academic performance via two specific pathways, namely learning-related behaviors and learning-related cognitions. Further, we discuss how domain-specific factors (e.g., task-specific demands and prior knowledge) may influence the successful application of executive functions to learning in this domain. Second, we discuss how the school setting can be used to enhance executive function training with approaches to facilitating far transfer to academic achievement. Specifically, we suggest that training executive functions as a means to improve academic performance is most promising in young students, for whom both behavioral and domain-specific cognitive demands of formal schooling are quite novel challenges. Furthermore, we outline that students could be supported in far transfer of trained executive functions by being informed of the specific relevance of these skills for learning-related behaviors and by having them practice executive functions under such authentic conditions. Moreover, we suggest that in order to promote ongoing effects of executive function training beyond short-term interventions, teachers should be equipped to consider the specific executive function components that might facilitate and support students’ acquisition of a particular subject matter.

APPLICATION OF EXECUTIVE FUNCTION TRAINING AND ITS IMPACT ON COGNITIVE INSIGHT IN PATIENTS WITH SCHIZOPHRENIA

Aim: To assess the effect of executive function re-training on cognitive insight among patients with Schizophrenia. 10 patients with Methodology: schizophrenia (diagnosed as per ICD-10 criteria) having signicant cognitive decits and compliant to intervention were assessed on Executive dysfunctions (Stroop test), and Beck's Cognitive insight Scale (BCIS). These were followed by Executive function training to the participants randomly assigned to the Experimental Group while the remaining 5 formed the control group. Both the groups went through post assessment on the same variables. In the test of executive functioning the experimental group Result: who had received executive function training had performed signicantly better than the control group of patients in the study (p<0.05), and that on BCIS the domains of self-reectiveness, self-certainty and composite index showed signicant improvement post intervention as compared to control group (p<0.01). The present study Conclusions: suggests that in patients with schizophrenia having poor cognitive exibility and executive dysfunction, the executive function retraining improves the executive functioning and signicantly impacts the cognitive insight.

Executive Function Training in Childhood Obesity: Food Choice, Quality of Life, and Brain Connectivity (TOuCH): A Randomized Control Trial Protocol

Background: Individuals with obesity are known to present cognitive deficits, especially in executive functions. Executive functions play an important role in health and success throughout the whole life and have been related to food decision-making and to the ability to maintain energy balance. It is possible to improve executive functions through targeted training. This would involve brain plasticity changes that could be studied through connectivity MRI. The general hypothesis of this study is that executive functions training in children with obesity can improve food choices and produce cognitive and neuroimaging changes (structural and functional connectivity), as well as improve emotional state and quality of life.Methods: Randomized controlled double-blind trial with 12-month follow-up. Thirty children with obesity will be randomly allocated into “executive training” (Cognifit with adaptive difficulty + Cogmed) or “control task” group (Cognifit without adaptive difficulty). Both groups will attend 30–45 min of individual gamified training (Cogmed and/or Cognifit systems) by iPad, five times per week during 6 weeks. Cogmed and Cognifit software are commercially available from Pearson and Cognifit, respectively. Participants will receive an iPad with both apps installed for a 6-week use. Participants will also receive counseling diet information via presentations sent to the iPad and will wear a Fitbit Flex 2 tracker to monitor daily activity and sleep patterns. Main outcomes will be cognitive, emotional, food decision, and quality-of-life measures, as well as neuroimaging measures. Participants are evaluated at baseline (T0), after treatment (T1), and 12 months since baseline (T2).Discussion: Longitudinal study with active control group and 3 time points: baseline, immediately after treatment, and 1 year after baseline. Threefold treatment: executive function training, psychoeducation, and feedback on activity/sleep tracking. We will evaluate the transfer effects of the intervention, including emotional and functional outcomes, as well as the effects on neural plasticity by connectivity MRI.Trial registration: This project has been registered in ClinicalTrials.gov (trial registration number NCT03615274), August 3, 2018.