Working Memory Training for Improving Youth Health Behaviors

Recruiting at 1 trial location

Overseen By Julia Felton, PhD

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Henry Ford Health System

Disqualifiers: Psychological disturbance, Suicidality, Substance use disorder, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 3 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 10

Duration: Approximately 5 weeks

72 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications. It is best to discuss this with the trial coordinators or your healthcare provider.

What data supports the effectiveness of the treatment Working Memory Training for improving youth health behaviors?

Research shows that Cogmed Working Memory Training can improve working memory in children and adolescents, especially those with attention-deficit/hyperactivity disorder (ADHD). However, these improvements are mostly limited to memory tasks similar to the training and do not extend to broader areas like attention or academic performance. ^{1 2 3 4 5}

Is Working Memory Training safe for humans?

The research does not report any safety concerns or adverse effects related to Working Memory Training, including Cogmed, in children or adults. ^{1 3 4 6 7}

How is Working Memory Training different from other treatments for improving youth health behaviors?

Working Memory Training, specifically Cogmed, is unique because it is a computerized program that focuses on improving working memory through adaptive tasks that increase in difficulty as performance improves. Unlike other treatments, it is designed to enhance cognitive functions like memory span, particularly in children with conditions such as ADHD, rather than directly addressing behavioral symptoms. ^{3 4 5 6 7}

What is the purpose of this trial?

The goal of this clinical trial is to deliver a computer-based working memory training program to improve delay discounting (DD) and prevent substance misuse among at-risk adolescents in a traditionally underserved area. Results from the study will inform future substance use prevention efforts targeted at youth exposed to adverse childhood experiences. Findings will also refine future models of intervention delivery in traditionally underserved communities. The main aims of the project are are: 1) To examine to examine changes in hypothesized mechanisms of substance use initiation and escalation, and 2) to assess whether changes in DD are a mechanism for reducing substance misuse during early adolescence. The investigators will evaluate whether changes in DD following active treatment predict substance use outcomes over the three-month follow-up period.

Eligibility Criteria

This trial is for English-speaking adolescents aged 11-15 who are willing to participate in a computer-based memory training program over 5-8 weeks. They must have internet access, a cell phone or email, and parental consent.

Inclusion Criteria

I am a teenager who speaks and understands English well.

Parent: Proficient in English

Parent: Access to internet services, cell phone, and/or email

Exclusion Criteria

I am a teenager struggling with thoughts of harming myself or feeling very disturbed.

Adolescent: Self-disclosure of current substance use disorder

Parent: Self-disclosure of current substance use disorder

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo a computer-based working memory training program to improve delay discounting and prevent substance misuse

Approximately 5 weeks

10 sessions (virtual)

Follow-up

Participants are monitored for changes in delay discounting and substance use outcomes

3 months

Treatment Details

Interventions

• Working Memory Training

Trial Overview The study tests if working memory training can improve decision-making and reduce the likelihood of substance misuse among at-risk youth. It will also explore how these changes might prevent substance use initiation and escalation.

Participant Groups

Group I: Working Memory Training Experimental Treatment 1 Intervention

The intervention is a computer-based training aimed at improving working memory in order to decrease delay discounting. Active training sessions include: Sequenced Recall of Digits - Auditory, Sequenced Reverse Recall of Digits - Auditory, Sequenced Recall of Digits - Visual, Sequenced Reverse Recall of Digits - Visual, Sequenced Recall of Words - Auditory, Sequenced Recall of Words - Visual, Sequenced Reverse Recall of Words - Auditory, Sequenced Reverse Recall of Words - Visual. Participants will complete at least 10 sessions with each session taking approximately 30 minutes to complete.

Group II: Working Memory Active Control 1 Intervention

The comparison control condition is a multi-session control computer training condition that is designed to not engage working memory during computer-based engagement sessions: Sequenced Recall of Digits - Auditory, Sequenced Reverse Recall of Digits - Auditory, Sequenced Recall of Digits - Visual, Sequenced Reverse Recall of Digits - Visual, Sequenced Recall of Words - Auditory, Sequenced Recall of Words - Visual, Sequenced Reverse Recall of Words - Auditory, Sequenced Reverse Recall of Words - Visual. Participants will complete at least 10 sessions with each session taking approximately 30 minutes to complete.

Working Memory Training is already approved in European Union, United States, Canada for the following indications:

Approved in European Union as Cogmed Working Memory Training for:

• Attention Deficit Hyperactivity Disorder (ADHD)
• Learning Disabilities
• Cognitive Impairment

Approved in United States as Cogmed Working Memory Training for:

• ADHD
• Learning Disabilities
• Amnestic Mild Cognitive Impairment (MCI)

Approved in Canada as Cogmed Working Memory Training for:

• ADHD
• Learning Disabilities
• Cognitive Impairment

Who Is Running the Clinical Trial?

Henry Ford Health System

Lead Sponsor

Trials

334

Recruited

2,197,000+

Wayne State University

Lead Sponsor

Trials

318

Recruited

111,000+

Findings from Research

Cogmed training significantly improved working memory in adults with ADHD, with participants showing lasting benefits in both verbal and visuospatial memory capacities even 6 months after the training ended.

Despite these improvements in working memory, the study found that the benefits did not extend to enhancing nonverbal reasoning, executive function in daily life, or reducing ADHD symptoms, questioning the overall effectiveness of the program for broader ADHD treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Working Memory Training for Adults With ADHD. Dentz, A., Guay, MC., Parent, V., et al.[2022]

The Cogmed Working Memory Training program showed significant medium-sized improvements in verbal and visuospatial working memory in school-age children immediately after the intervention, and some long-term benefits for verbal working memory at 3-6 months post-training.

However, the training did not lead to improvements in far-transfer measures like attention, executive function, or academic achievement, indicating that while working memory can be enhanced, these gains may not extend to broader cognitive skills.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of cogmed working memory training program in improving working memory in school-age children with and without neurological insults or disorders: A meta-analysis. Bharadwaj, SV., Yeatts, P., Headley, J.[2022]

Cogmed Working Memory Training (CWMT) has shown statistically significant improvements in working memory and executive functions among over 280 child and adolescent trainees based on pre- and post-training assessments.

Feedback from families indicates positive changes experienced by trainees, although the study's one-group pre-test post-test design has limitations that should be considered when interpreting the results.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Parental Perceptions of the Efficacy of Cogmed Working Memory Training. Graham, AR., Benninger, WB.[2018]

The EPIREMED study aims to assess the long-term effects of the Cogmed cognitive training program on visuospatial processing in very preterm children, involving 166 participants aged 5½ to 6 years over an 18-month period.

The study seeks to demonstrate that early cognitive training can improve working memory and overall neuropsychological development, potentially leading to better learning outcomes and reduced behavioral issues in this vulnerable population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized EPIREMED protocol study on the long-term visuo spatial effects of very preterm children with a working memory deficit. Gire, C., Beltran Anzola, A., Kaminski, M., et al.[2021]

Cogmed Working Memory Training (CWMT) significantly improved short-term memory performance in children with ADHD on tasks similar to the training activities, compared to a placebo group.

However, CWMT did not lead to improvements in broader ADHD symptoms, such as attentional problems, impulsivity, or academic performance in reading, spelling, comprehension, or mathematics.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Commentary: Working memory training and ADHD - where does its potential lie? Reflections on Chacko et al. (2014). Gathercole, SE.[2022]

In a study of 452 grade 1 children with low working memory, the Cogmed Working Memory Training program showed that about one-third of participants improved their working memory scores significantly after training, but similar improvements were also seen in children receiving usual teaching.

Children with elevated hyperactivity and/or inattention were less likely to benefit from the Cogmed training, indicating that this program may not be as effective for this subgroup, while no significant differences were found for children with low IQ or other emotional and behavioral symptoms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effectiveness of Working Memory Training for Children With Low Working Memory. Spencer-Smith, M., Quach, J., Mensah, F., et al.[2021]

In a study of 10 ADHD youth aged 8-14 undergoing a modified 30-session Cogmed working memory training, all participants adhered to the program, indicating its feasibility as an intervention.

The study found that youth with higher external motivation performed better in working memory tasks but had poorer academic outcomes and lower self-concept, suggesting that motivation type may influence the effectiveness of cognitive training in ADHD youth.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Examining the Impact of Motivation on Working Memory Training in Youth With ADHD. Sadeghi, M., McAuley, T., Sandberg, S.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

Working Memory Training for Adults With ADHD. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

Efficacy of cogmed working memory training program in improving working memory in school-age children with and without neurological insults or disorders: A meta-analysis. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Parental Perceptions of the Efficacy of Cogmed Working Memory Training. [2018]

4. England pubmed.ncbi.nlm.nih.gov

A randomized EPIREMED protocol study on the long-term visuo spatial effects of very preterm children with a working memory deficit. [2021]

5. England pubmed.ncbi.nlm.nih.gov

Commentary: Working memory training and ADHD - where does its potential lie? Reflections on Chacko et al. (2014). [2022]

6. United States pubmed.ncbi.nlm.nih.gov

The Effectiveness of Working Memory Training for Children With Low Working Memory. [2021]

7. Canada pubmed.ncbi.nlm.nih.gov

Examining the Impact of Motivation on Working Memory Training in Youth With ADHD. [2022]