A systematic review and meta-analysis of educational interventions for children and adolescents with acquired brain injury

Linden, Mark; Glang, Ann; McKinlay, Audrey

doi:10.3233/nre-172357

Cited by 17 publications

(14 citation statements)

References 30 publications

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“…All these deficits cause a negative impact on children's adjustment in daily life [13]. Consequently, rehabilitation treatments to improve cognitive and behavioral functioning have been considered necessary for sustaining recovery and adjustment of these patients [12, 14].…”

Section: Introductionmentioning

confidence: 99%

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Remote Technology-Based Training Programs for Children with Acquired Brain Injury: A Systematic Review and a Meta-Analytic Exploration

Corti

Oldrati

Oprandi

et al. 2019

Behavioural Neurology

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Introduction. Multidisciplinary rehabilitation interventions are considered to be a need for children with acquired brain injury (ABI), in order to remediate the important sequelae and promote adjustment. Technology-based treatments represent a promising field inside the rehabilitation area, as they allow delivering interventions in ecological settings and creating amusing exercises that may favor engagement. In this work, we present an overview of remote technology-based training programs (TP) addressing cognitive and behavioral issues delivered to children with ABI and complement it with the results of a meta-analytic exploration. Evidence Acquisition. We performed the review process between January and February 2019. 32 studies were included in the review, of which 14 were further selected to be included in the meta-analysis on TP efficacy. Evidence Synthesis. Based on the review process, the majority of TP addressing cognitive issues and all TP focusing on behavioral issues were found to be effective. Two meta-analytic models examining the means of either cognitive TP outcomes or behavioral TP outcomes as input outcome yielded a nonsignificant effect size for cognitive TP and a low-moderate effect size for behavioral TP. Additional models on outcomes reflecting the greatest beneficial effects of TP yielded significant moderate effect sizes for both types of TP. Nevertheless, consistent methodological heterogeneity was observed, pointing to cautious interpretation of findings. A subgroup analysis on visuospatial skill outcomes showed a smaller yet significant effect size of cognitive TP, with low heterogeneity, providing a more reliable estimation of overall cognitive TP effects. Conclusions. Promising results on remote cognitive and behavioral TP efficacy emerged both at the review process and at the meta-analytic investigation. Nevertheless, the high heterogeneity that emerged across studies prevents us from drawing definite conclusions. Further research is needed to identify whether specific training characteristics and population subgroups are more likely to be associated with greater training efficacy.

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Section: Introductionmentioning

confidence: 99%

“…In the last two decades, numerous papers on rehabilitation treatments for pediatric ABI or reviews on the topic have been published [1, 12, 14–20]. However, it has not been yet clarified which are the most effective interventions.…”

Section: Introductionmentioning

confidence: 99%

Remote Technology-Based Training Programs for Children with Acquired Brain Injury: A Systematic Review and a Meta-Analytic Exploration

Corti

Oldrati

Oprandi

et al. 2019

Behavioural Neurology

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“…Linden, Glang, and McKinlay [7] performed a systematic review and meta-analysis, using randomized control trial (RCT) class I studies, to examine educational interventions for children with ABI. While three studies met their meta-analysis criteria, there were no significant differences between educational intervention and control conditions on academic achievement.…”

Section: Introductionmentioning

confidence: 99%

Evidence-based systematic review of cognitive rehabilitation, emotional, and family treatment studies for children with acquired brain injury literature: From 2006 to 2017

Laatsch

Dodd

Brown

et al. 2019

Neuropsychological Rehabilitation

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This paper updates guidelines of effective treatments for children with acquired brain injury (ABI) by including new evidence found in recent years and by building upon evidence presented in 2007. A systematic search was conducted for articles published from 2006-2017. Full manuscripts describing treatments of children (post-birth to 18) with acquired brain injury were included if study was published in peer-reviewed journals and written in English. Two independent reviewers and a third, if conflicts existed, evaluated the methodological quality of studies with an Individual Study Review Form and a Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Strength of study characteristics was used in development of practice guidelines. Fifty-six peer-reviewed articles, including 28 Class I studies, were included in the final analysis. Established guidelines for writing practice recommendations were used and 22 practice recommendations were written with details of potential treatment limitations. There was strong evidence for family/caregiver-focused interventions, as well as direct interventions to improve attention, memory, executive functioning, and emotional/behavioral functioning. A majority of the practice standards and guidelines provided evidence for the use of technology in delivery of interventions, representing an important trend in the field.

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“…A recent meta-analysis indicated that remote CCT programs based on the repetition of cognitive exercises (drill-based exercises) have an effect on the visual-spatial abilities of children with ABI, but no effects were documented for other cognitive abilities 26 . Nevertheless, evidence of the effects on far transfer measures of CCT programs for children with ABI has been questioned 29,30 . Overall, contrasting results on CCT efficacy have been reported in the literature and no clear indication of which training format is optimal (i.e., training performed under the guidance of a healthcare practitioner or independently; training intensity and duration; one-or multi-domain stimulation etc.)…”

mentioning

confidence: 99%

Home-based cognitive training in pediatric patients with acquired brain injury: preliminary results on efficacy of a randomized clinical trial

Corti

Urgesi

Poggi

et al. 2020

Sci Rep

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Cognitive rehabilitation may compensate for cognitive deficits of children with acquired brain injury (ABI), capitalizing on the use-dependent plasticity of a developing brain. Remote computerized cognitive training (CCT) may be delivered to patients in ecological settings, ensuring rehabilitation continuity. This work evaluated cognitive and psychological adjustment outcomes of an 8-week multidomain, home-based CCT (Lumosity Cognitive Training) in a sample of patients with ABI aged 11-16 years. Two groups of patients were engaged in five CCT sessions per week for eight weeks (40 sessions). According to a stepped-wedge research design, one group (Training-first Group) started the CCT immediately, whereas the other group (Waiting-first Group) started the CCT after a comparable time of waiting list. Changes after the training and after the waiting period were compared in the two groups. Both groups improved in visual-spatial working memory more after the training than after the waitinglist period. The Training-first group improved also in arithmetic calculation speed. Findings indicate that a multi-domain CCT can produce benefits in visual-spatial working memory, probably because, in accordance with previous research, computer games heavily tax visuo-spatial abilities. This suggests that the prolonged stimulation of the same cognitive ability may generate the greatest benefits in children with ABI.Pediatric acquired brain injuries (ABI) are among the main causes of lifelong disabilities in school age children and are often accompanied by cognitive, behavioral and affective problems 1-4 . From a cognitive point of view, impairments in global intelligence or core cognitive domains, such as attention, memory, executive functions, processing speed and visual abilities, have been reported 2,3 . These impairments may be associated with negative academic outcomes and short-and long-term functional problems at home and in general life in community 5-7 . Even those children having an intellectual quotient within the normal range often experience difficulties at school after the injury 8,9 . Tailored rehabilitation on cognitive functions has been recognized to be a key component of medical care following an ABI, as it may lead to improved functioning in everyday life [10][11][12][13][14][15][16] . Indeed, early stimulation of cognitive functions may promote use-dependent brain plasticity 17,18 and enhance the potential for the inherent brain plasticity after damage 19 . However, after hospitalization, a high number of children with ABI do not receive any help or support, experiencing a problematic return to ecological settings 20,21 .Recently, technological devices have been introduced in rehabilitation to provide treatments deliverable in ecological settings with the aim to overcome the limitations of a traditional rehabilitative approach, such as elevated costs, accessibility problems and heterogeneity in treatment practice, and to reach larger numbers of patients [22][23][24] . The majority of these programs have been dev...

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A systematic review and meta-analysis of educational interventions for children and adolescents with acquired brain injury

Cited by 17 publications

References 30 publications

Remote Technology-Based Training Programs for Children with Acquired Brain Injury: A Systematic Review and a Meta-Analytic Exploration

Remote Technology-Based Training Programs for Children with Acquired Brain Injury: A Systematic Review and a Meta-Analytic Exploration

Evidence-based systematic review of cognitive rehabilitation, emotional, and family treatment studies for children with acquired brain injury literature: From 2006 to 2017

Home-based cognitive training in pediatric patients with acquired brain injury: preliminary results on efficacy of a randomized clinical trial

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