Evaluation of a Custom-Developed Computer Game to Improve Executive Functioning in 4- to 6-Year-Old Children Exposed to Alcohol in Utero: Protocol for a Feasibility Randomized Controlled Trial
- PMID: 31596247
- PMCID: PMC6806122
- DOI: 10.2196/14489
Evaluation of a Custom-Developed Computer Game to Improve Executive Functioning in 4- to 6-Year-Old Children Exposed to Alcohol in Utero: Protocol for a Feasibility Randomized Controlled Trial
Abstract
Background: Fetal alcohol spectrum disorder (FASD) is one of the most common causes of preventable intellectual disability, and the key associated deficits are in executive function (EF). Aspects of EF can be improved using cognitive training interventions. The highest prevalence of FASD globally (at a rate of 135.1 per 1000) has been found in a South African population in the Western Cape province. There is a shortage of specialized health service personnel, and there are limited remedial services. Computer-based cognitive training, if age and culturally appropriate, could be an effective way to provide the interventions with minimal need for skilled personnel and other resources. The Foundation for Alcohol Related Research has developed such a program for the South African context.
Objective: This protocol aimed to evaluate whether it is feasible to use computerized cognitive training in a resource-poor context to improve cognitive function in children exposed to alcohol in utero.
Methods: We are conducting a randomized controlled trial in the Saldanha Bay Municipal area, evaluating a custom-developed cognitive training program to improve the cognitive function of children aged between 4 and 6 years who were exposed to alcohol in the prenatal stage. Participants will be recruited from local Early Childhood Development centers. Community workers will interview biological mothers to identify alcohol-exposed pregnancies. Alcohol-exposed children will be randomized into an intervention or a control group of 40 participants each using block randomization. A group of 40 children not exposed to alcohol will be included in a normative group using individual randomization. The intervention group will play the game for 6 months (40 sessions). Normative and control groups will receive no intervention. Neurodevelopmental assessments will be done at baseline and upon completion of the study with all participants.
Results: The intervention has started, and all baseline assessments have been done at the time of submission.
Conclusions: This study will provide insight into whether computerized cognitive training is viable and effective in the South African context. It has the potential to provide a means of intervention globally and in other resource-poor context and expand the knowledge base regarding executive functioning and FASD. This paper presents the research protocol and intervention design of the study.
Trial registration: ISRCTN Registry ISRCTN17244156; http://www.isrctn.com/ISRCTN17244156.
International registered report identifier (irrid): DERR1-10.2196/14489.
Keywords: FASD; brain/drug effects; child development; cognitive dysfunction/prevention and control; executive function; experimental games; fetal alcohol spectrum disorders; protocol.
©Jacobus Gidion Gidion Louw, Leana Olivier, Sarah Skeen, Alastair van Heerden, Mark Tomlinson. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 08.10.2019.
Conflict of interest statement
Conflicts of Interest: Authors JGL and LO are employed by the FARR that receives additional funding from aware.org for additional projects. FARR is a nonprofit organization and the FARR game will not be monetized.
Similar articles
-
Executive Function After Prenatal Alcohol Exposure in Children in a South African Population: Cross-sectional Study.JMIR Form Res. 2021 Jul 2;5(7):e20658. doi: 10.2196/20658. JMIR Form Res. 2021. PMID: 34255647 Free PMC article.
-
Effects of a School-Based Health Intervention Program in Marginalized Communities of Port Elizabeth, South Africa (the KaziBantu Study): Protocol for a Randomized Controlled Trial.JMIR Res Protoc. 2019 Jul 11;8(7):e14097. doi: 10.2196/14097. JMIR Res Protoc. 2019. PMID: 31298224 Free PMC article.
-
Guided Internet-Based Parent Training for Challenging Behavior in Children With Fetal Alcohol Spectrum Disorder (Strongest Families FASD): Study Protocol for a Randomized Controlled Trial.JMIR Res Protoc. 2015 Oct 13;4(4):e112. doi: 10.2196/resprot.4723. JMIR Res Protoc. 2015. PMID: 26462968 Free PMC article.
-
Reducing Alcohol Consumption Among Risky Drinkers in the General Population of Sweden Using an Interactive Mobile Health Intervention: Protocol for a Randomized Controlled Trial.JMIR Res Protoc. 2019 Apr 18;8(4):e13119. doi: 10.2196/13119. JMIR Res Protoc. 2019. PMID: 30998221 Free PMC article.
-
An Individual Music Intervention for Adults With Intellectual Disabilities and Challenging Behavior: Protocol for a Randomized Controlled Trial.JMIR Res Protoc. 2024 Feb 7;13:e52497. doi: 10.2196/52497. JMIR Res Protoc. 2024. PMID: 38324357 Free PMC article.
Cited by
-
Interventions for improving executive functions in children with foetal alcohol spectrum disorder (FASD): A systematic review.Campbell Syst Rev. 2022 Nov 3;18(4):e1258. doi: 10.1002/cl2.1258. eCollection 2022 Dec. Campbell Syst Rev. 2022. PMID: 36908848 Free PMC article. Review.
-
Executive Function After Prenatal Alcohol Exposure in Children in a South African Population: Cross-sectional Study.JMIR Form Res. 2021 Jul 2;5(7):e20658. doi: 10.2196/20658. JMIR Form Res. 2021. PMID: 34255647 Free PMC article.
-
Digital Health Technologies for Maternal and Child Health in Africa and Other Low- and Middle-Income Countries: Cross-disciplinary Scoping Review With Stakeholder Consultation.J Med Internet Res. 2023 Apr 7;25:e42161. doi: 10.2196/42161. J Med Internet Res. 2023. PMID: 37027199 Free PMC article.
-
Technologies for Supporting Individuals and Caregivers Living With Fetal Alcohol Spectrum Disorder: Scoping Review.JMIR Ment Health. 2024 Jul 11;11:e51074. doi: 10.2196/51074. JMIR Ment Health. 2024. PMID: 38994826 Free PMC article.
-
Parental interaction style, child engagement, and emerging executive function in fetal alcohol spectrum disorders (FASD).Child Neuropsychol. 2022 Oct;28(7):853-877. doi: 10.1080/09297049.2021.2023122. Epub 2022 Jan 3. Child Neuropsychol. 2022. PMID: 34978272 Free PMC article.
References
-
- Clarke ME, Gibbard WB. Overview of fetal alcohol spectrum disorders for mental health professionals. Can Child Adolesc Psychiatr Rev. 2003 Aug;12(3):57–63. http://europepmc.org/abstract/MED/19030526 - PMC - PubMed
-
- Hoyme HE, Kalberg WO, Elliott AJ, Blankenship J, Buckley D, Marais AS, Manning MA, Robinson LK, Adam MP, Abdul-Rahman O, Jewett T, Coles CD, Chambers C, Jones KL, Adnams CM, Shah PE, Riley EP, Charness ME, Warren KR, May PA. Updated clinical guidelines for diagnosing fetal alcohol spectrum disorders. Pediatrics. 2016 Aug;138(2):e20154256. doi: 10.1542/peds.2015-4256. http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=2746... peds.2015-4256 - DOI - PMC - PubMed
-
- Urban MF, Chersich MF, Fourie LA, Chetty C, Olivier L, Viljoen D. Fetal alcohol syndrome among grade 1 schoolchildren in Northern Cape province: prevalence and risk factors. S Afr Med J. 2008 Nov;98(11):877–82. - PubMed
-
- May PA, Blankenship J, Marais AS, Gossage JP, Kalberg WO, Barnard R, de Vries M, Robinson LK, Adnams CM, Buckley D, Manning M, Jones KL, Parry C, Hoyme HE, Seedat S. Approaching the prevalence of the full spectrum of fetal alcohol spectrum disorders in a South African population-based study. Alcohol Clin Exp Res. 2013 May;37(5):818–30. doi: 10.1111/acer.12033. http://europepmc.org/abstract/MED/23241076 - DOI - PMC - PubMed
LinkOut - more resources
Full Text Sources