title: Working memory training in children with neuropsychiatric disorders and mild to borderline intellectual functioning, the role of coaching; a double-blind randomized controlled trial.
abstract: Working memory training (WMT) has been shown to offer therapeutic benefits to both patients with Attention-Deficit Hyperactivity Disorder (ADHD) and patients with mild to borderline Intellectual Disabilities (MBID; 60 < IQ < 85). However, robust evidence for transfer effects and treatment benefits of WMT over placebo training are lacking. Owing to the nature of double-blind research designs in RCTs, children have received non-specific coaching not based on their actual training performance. Active coaching based on individual training results (such as in clinical practice) might enhance the efficacy of Cogmed WMT. Furthermore, clinical experience and the general treatment approach to these vulnerable children has shown that the intensity and duration of WMT is often too stressful. This study therefore investigated the efficacy of a less intensive, but more prolonged Cogmed WMT (including active personalized coaching and feedback) in reducing behavioral symptoms and improving neurocognitive functioning and academic achievements in children with MBID and neuropsychiatric disorders.
  
  
  
  A double-blind RCT with children (age 10.0-13.11) with neuropsychiatric disorders (ADHD and/or autism spectrum disorder (ASD)) and MBID (IQ: 60 < IQ < 85). Two groups (each n = 26) will receive Cogmed WMT (version R/M) at home or at school for 8 weeks, 4 days a week, at 30 min a day. One group will receive active personalized coaching and feedback based on their actual individual performance during Cogmed training. The other group will only receive general non-personalized coaching (i.e. no receive personalized coaching and feedback). Both groups will undergo a neurocognitive assessment (working memory, executive functioning, academic achievements) before and after training and complete several questionnaires (behavioral problems, parenting style) with a 6 months follow-up.
  
  
  
  This study will add to the literature since the role of coaching in Cogmed WMT has not been studied before. It will also provide opportunities to investigate an alternative version of WMT in a large group of vulnerable children, for whom few evidence-based treatments are available. Ultimately, this will allow us to advise mental health care professionals and special education schools about the use of this type of intervention for children with MBID and neuropsychiatric disorders.
  
  
  
  Dutch Trial Register. NTR5223 . Registration date 06-09-2015.
authors.affiliation: Karakter Child and Adolescent Psychiatry, Nijmegen, The Netherlands. s.roording@karakter.com.|Karakter Child and Adolescent Psychiatry, Utrechtseweg 320, 6862 BC, Oosterbeek, The Netherlands. s.roording@karakter.com.
authors.forename: Sammy
authors.initials: S
authors.lastname: Roording-Ragetlie
authors.affiliation: Karakter Child and Adolescent Psychiatry, Nijmegen, The Netherlands.
authors.forename: Helen
authors.initials: H
authors.lastname: Klip
authors.affiliation: Karakter Child and Adolescent Psychiatry, Nijmegen, The Netherlands.|Department of Cognitive Neuroscience, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.|Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands.
authors.forename: Jan
authors.initials: J
authors.lastname: Buitelaar
authors.affiliation: Karakter Child and Adolescent Psychiatry, Nijmegen, The Netherlands.|Department of Psychiatry, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
authors.forename: Dorine
authors.initials: D
authors.lastname: Slaats-Willemse
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000523:psychology / Q000628:therapy*; D000067877:Autism Spectrum Disorder / Q000523:psychology / Q000628:therapy*; D002648:Child; D002985:Clinical Protocols; D004311:Double-Blind Method; D056344:Executive Function; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000523:psychology / Q000628:therapy*; D007858:Learning; D008297:Male; D008570:Memory, Short-Term; D000071252:Mentoring / Q000379:methods*; D012574:Schools; D016896:Treatment Outcome
keywords: ADHD; ASD; Coaching; Mild to borderline intellectual functioning; Randomized controlled trial; Working memory training