title: Cognitive remediation for adolescents with 22q11 deletion syndrome (22q11DS): a preliminary study examining effectiveness, feasibility, and fidelity of a hybrid strategy, remote and computer-based intervention.
abstract: BACKGROUND
  22q11DS is a multiple anomaly syndrome involving intellectual and behavioral deficits, and increased risk for schizophrenia. As cognitive remediation (CR) has recently been found to improve cognition in younger patients with schizophrenia, we investigated the efficacy, feasibility, and fidelity of a remote, hybrid strategy, computerized CR program in youth with 22q11DS.
  
  
  METHODS
  A longitudinal design was implemented in which 21 participants served as their own controls. Following an eight month baseline period in which no interventions were provided, cognitive coaches met with participants remotely for CR via video conferencing three times a week over a targeted 8month timeframe and facilitated their progress through the intervention, offering task-specific strategies. A subset of strategies were examined for fidelity. Outcomes were evaluated using a neurocognitive test battery at baseline, pre-treatment and post-treatment.
  
  
  RESULTS
  All participants adhered to the intervention. The mean length of the treatment phase was 7.96months. A moderately high correlation (intraclass correlation coefficient, 0.73) was found for amount and type of strategies offered by coaches. Participants exhibited significant improvements (ES=.36-.55, p≤.009) in working memory, shifting attention and cognitive flexibility. All significant models were driven by improvements in pre to post-treatment scores.
  
  
  CONCLUSIONS
  Based on our preliminary investigation, a remote, hybrid strategy, computerized CR program can be implemented with 22q11DS youth despite geographic location, health, and cognitive deficits. It appears effective in enhancing cognitive skills during the developmental period of adolescence, making this type of CR delivery useful for youth with 22q11DS transitioning into post-school environments.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, State University of New York at Upstate Medical University, Syracuse, NY, United States.
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Mariano
authors.affiliation: Department of Psychiatry and Behavioral Sciences, State University of New York at Upstate Medical University, Syracuse, NY, United States.
authors.forename: Kerri
authors.initials: K
authors.lastname: Tang
authors.affiliation: Department of Psychology and Neuroscience and Behavior, Wesleyan University, Middletown, CT, United States.
authors.forename: Matthew
authors.initials: M
authors.lastname: Kurtz
authors.affiliation: Department of Psychiatry and Behavioral Sciences, State University of New York at Upstate Medical University, Syracuse, NY, United States. Electronic address: katesw@upstate.edu.
authors.forename: Wendy R
authors.initials: WR
authors.lastname: Kates
mesh_terms: D058165:22q11 Deletion Syndrome / Q000628:therapy*; D000293:Adolescent; D001288:Attention; D002648:Child; D003071:Cognition; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003201:Computers; D056344:Executive Function; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007361:Intelligence Tests; D008137:Longitudinal Studies; D008297:Male; D008570:Memory, Short-Term; D009483:Neuropsychological Tests; D017216:Telemedicine / Q000379:methods*; D016896:Treatment Outcome; D014741:Video Recording / Q000379:methods
keywords: Adolescents; Cognitive remediation; Remote; Schizophrenia; Velocardiofacial syndrome