Working memory training for children with cochlear implants: a pilot study

Abstract

Purpose: This study investigated the feasibility and efficacy of a working memory training program for improving memory and language skills in a sample of 9 children who are deaf (age 7-15 years) with cochlear implants (CIs).

Method: All children completed the Cogmed Working Memory Training program on a home computer over a 5-week period. Feasibility and acceptability of the program were evaluated using parent report and measures of children's performance on the training exercises. Efficacy measures of working memory and sentence repetition were obtained prior to training, immediately after training, and 1 month and 6 months after training.

Results: Children's performance improved on most training exercises, and parents reported no problems with children's hearing or understanding of the exercises. After completion of working memory training, children demonstrated significant improvement on measures of verbal and nonverbal working memory, parent-reported working memory behavior, and sentence-repetition skills. The magnitude of improvement in working memory decreased slightly at the 1-month follow-up and more substantially at 6-month follow-up. However, sentence repetition continued to show marked improvement at 6-month follow-up.

Conclusions: Working memory training may produce benefit for some memory and language skills for children with CIs, supporting the importance of conducting a large-scale, randomized clinical trial with this population.

Figure 1

Individual participant change in digit span during study periods. Panel A: Digit Span Forward standardized change scores from baseline for mean sample score (M) and by individual subject (denoted with numerals). Because baseline is Screening Visit (Visit 1) for Waiting Period and Pretraining Visit (Visit 2) for all other periods, bars for Training Period, 1-Month Follow-Up, and 6-Month Follow-Up reflect improvement over and above improvement during the Waiting Period. Panel B: Digit Span Backward standardized change scores from baseline for mean sample score (M) and by individual subject (denoted with numerals). Because baseline is Screening Visit (Visit 1) for Waiting Period and Pretraining Visit (Visit 2) for all other periods, bars for Training Period, 1-Month Follow-Up, and 6-Month Follow-Up reflect improvement over and above improvement during the Waiting Period.

Figure 2

Individual participant change in spatial span during study periods. Panel A: Spatial Span Forward standardized change scores from baseline for mean sample score (M) and by individual subject (denoted with numerals). Because baseline is Screening Visit (Visit 1) for Waiting Period and Pretraining Visit (Visit 2) for all other periods, bars for Training Period, 1-Month Follow-Up, and 6-Month Follow-Up reflect improvement over and above improvement during the Waiting Period. Panel B: Spatial Span Backward standardized change scores from baseline for mean sample score (M) and by individual subject (denoted with numerals). Because baseline is Screening Visit (Visit 1) for Waiting Period and Pretraining Visit (Visit 2) for all other periods, bars for Training Period, 1-Month Follow-Up, and 6-Month Follow-Up reflect improvement over and above improvement during the Waiting Period.

Figure 3

Individual participant change in parent-reported working memory behavior and sentence repetition during study periods. Panel A: BRIEF-WM standardized change scores from baseline for mean sample score (M) and by individual subject (denoted with numerals). Because baseline is Screening Visit (Visit 1) for Waiting Period and Pretraining Visit (Visit 2) for all other periods, bars for Training Period, 1-Month Follow-Up, and 6-Month Follow-Up reflect improvement over and above improvement during the Waiting Period. Negative standardized change scores indicate improvement in working memory behavior on the BRIEF:WM. Panel B: Sentence repetition (Wide Range Assessment of Memory and Learning—Second Edition [WRAML 2] Sentence Memory) standardized change scores from baseline for mean sample score (M) and by individual subject (denoted with numerals). Baseline is Pretraining Visit (Visit 2) for Training Period and 6-Month Follow-Up.