Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Oct 8;8(10):e14489.
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

Affiliations

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

Jacobus Gidion Louw et al. JMIR Res Protoc. .

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.

PubMed Disclaimer

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.

Figures

Figure 1
Figure 1
Overview of study design.

Similar articles

Cited by

References

    1. 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
    1. 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
    1. 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
    1. 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
    1. Popova S, Lange S, Probst C, Gmel G, Rehm J. Estimation of national, regional, and global prevalence of alcohol use during pregnancy and fetal alcohol syndrome: a systematic review and meta-analysis. Lancet Glob Health. 2017 Mar;5(3):e290–9. doi: 10.1016/s2214-109x(17)30021-9. - DOI - PubMed

LinkOut - more resources