This study assessed the efficacy of a 5-week, intensive working memory training program for 52 children and adolescents (ages 7-17) who had Attention-Deficit/Hyperactivity Disorder (ADHD) and other comorbid diagnoses. This study provided a treatment replication since the waitlist control group also completed training and was included in the follow-up data analyses. Parents and teachers completed paper-and-pencil measures of working memory, executive functioning, and ADHD symptoms at baseline, posttreatment, and 4-month follow-up. Parent ratings indicated that participants improved on inattention, overall number of ADHD symptoms, initiation, planning/organization, and working memory. Teacher ratings approached significance at posttreatment and at 4-month follow-up on and Initiate scale. Working memory training appears promising as an intervention in improving executive functioning and ADHD symptoms.
Type 1 diabetes (T1D) is a chronic medical condition that can negatively impact both physical and psychological health. Diabetes resilience can be protective against the physical and social/emotional consequences among children with T1D yet few studies have examined the ability to increase resiliency in the pediatric population. Forty children with T1D (Age 14.1±2.3 years, 48% female, Hba1c 12.0±1.6%) were enrolled in a 4-month multi-disciplinary intervention that included medical management, Psychology-led motivational interviewing, and frequent support from a Certified Diabetes Care and Education Specialist (CDCES). Participants completed the Diabetes Strengths and Resilience (DSTAR) measure at baseline and post-intervention. The DSTAR is a validated assessment tool aimed to assess both self and parent reported measures of general and diabetes-related child self-efficacy and level of perceived support, as well as diabetes distress. HbA1c was assessed at baseline and 4 months. At baseline, higher DSTAR scores were associated with lower HbA1c (r=-0.34, p=0.03). DSTAR scores increased significantly in response to the intervention from 43.9±6.4 to 47.2±6.9 at 4 months (p<0.001). Additionally, HbA1c significantly improved from baseline to post-intervention (12.0±1.6% to 11.0±1.9%, p<0.001). A multifaceted approach to children with diabetes can improve levels of resilience, a factor involved in improving and maintaining both physical and psychological health. Disclosure S. S. Puffenberger: None. F. Hoekstra: None. C. R. Kapadia: None. G. Q. Shaibi: None. M. Chambers: None. Funding Thomas J. Beatson Jr. Foundation
Background: Youth with poorly controlled type 1 diabetes (T1D) are at increased risk for morbidity yet very few interventions have targeted this vulnerable population. The purpose of this study was to test the feasibility, acceptability and preliminary efficacy of an intensive, team-based intervention program for youth with HbA1c ≥ 9.5%. Methods: Forty patients (age 14.1±2.3 years, 53% male) with T1D (duration 6.5±4.3 years) were enrolled in an intensive, 4-month team-based intervention that included a visit with their primary endocrinologist and a pediatric psychologist at baseline as well as up to 6 encounters (in-person visits and calls) with a Certified Diabetes Educator (CDE). The CDE encounters were designed to establish goals, support behavior changes, review glucose logs, and make interim dose adjustments as needed. Feasibility was measured by the number of patients approached and the number of patients who ultimately agreed to participate, acceptability was measured by attendance and attrition rates, and preliminary efficacy was assessed by changes in HbA1c and diabetes-related Quality of Life (QoL). Data were collected at baseline and 4 months. Results: Of the 42 patients who were approached, 40 agreed to participate, and 35 (87.5%) completed the 4-month program. CDE engagement with patients included an average of 3 phone calls and 3 in-person visits. Compared to baseline, HbA1c reduced from 12.0%±1.6 at baseline to 11.0%±1.9 at the 4 month visit (p<0.001) and QoL increased from 61.0±12.3 to 64.7±11.0 (P<0.05). Conclusion: Intensive team-based interventions in pediatric patients with poorly controlled T1D can improve glycemic control and QoL. Disclosure M. Chambers: None. G.Q. Shaibi: None. C.R. Kapadia: None. F. Hoekstra: None. S.S. Puffenberger: None. L. Touger: None. I.K. Radcliffe: None. L. Holzmeister: None. K.A. Olsen: None. Funding Thomas J. Beatson, Jr. Foundation
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