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BACKGROUND: People with MS (pwMS) commonly experience a range of hidden symptoms, including cognitive impairment, anxiety and depression, fatigue, pain, and sensory difficulties. These "invisible" symptoms can significantly impact wellbeing, relationships, employment and life goals. We developed a novel bespoke online group neuropsychological intervention combining psychoeducation and cognitive rehabilitation with an Acceptance and Commitment Therapy (ACT)-informed approach for pwMS in an acute tertiary hospital. This 'Neuropsychological Intervention for Managing Invisible Symptoms' in MS (NIMIS-MS) consisted of 6 sessions, each with a psychoeducation and ACT component. The content included psychoeducation around managing cognitive difficulties, fatigue, pain, sleep and other unpleasant sensations in MS with the general approach of understanding, monitoring, and recognising patterns and potential triggers. Specific cognitive rehabilitation and fatigue management strategies were introduced. The ACT-informed component focussed on three core ACT areas of the 'Triflex' of psychological flexibility (Harris, 2019): Being Present, Opening Up, and Doing What Matters. METHODS: 118 pwMS attended the NIMIS-MS group intervention which was delivered 14 times in six-week blocks over an 18-month period. To evaluate the effectiveness and acceptability, participants completed measures of depression and anxiety (HADS), functional impairment (WSAS), Values- Progress (VQ) and Values- Obstruction (VQ), and Acceptance of MS (MSAS) pre and post NIMIs-MS group intervention. Qualitative feedback was obtained during focus groups after the final session and via online feedback questionnaires RESULTS: Pre-post analysis showed that symptoms of depression and anxiety were significantly lower and acceptance of MS was significantly higher following completion of the NIMIS-MS group. Qualitative feedback showed that participants reported that they felt more equipped to manage the "invisible" symptoms of MS following completion of the group, and benefited from using ACT-based strategies and techniques. Participants highly valued the peer support that evolved during the NIMIS-MS groups. The online format was considered more accessible than in-person groups, due to less concerns of travel time, cost, fatigue, and comfort and infection. CONCLUSION: Evaluation suggests that our novel NIMIS-MS groups is an acceptable, beneficial and feasible approach for providing neuropsychological interventions to individuals with MS.
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Esclerosis Múltiple , Humanos , Masculino , Femenino , Persona de Mediana Edad , Proyectos Piloto , Adulto , Esclerosis Múltiple/complicaciones , Esclerosis Múltiple/rehabilitación , Esclerosis Múltiple/psicología , Esclerosis Múltiple/terapia , Terapia de Aceptación y Compromiso/métodos , Psicoterapia de Grupo/métodos , Disfunción Cognitiva/etiología , Disfunción Cognitiva/rehabilitación , Disfunción Cognitiva/terapia , Terapia Cognitivo-Conductual/métodos , Educación del Paciente como Asunto , Aceptación de la Atención de Salud , Depresión/terapia , Depresión/etiologíaRESUMEN
BACKGROUND: The concept of ecological validity (EV) in neuropsychological interventions (NI) has been consistently advocated, but there is a lack of reviews focused on how EV is operationalized in NI programmes. This review aims to address this gap by exploring the outcome measures more commonly used for assessing EV and to understand the main characteristics of programmes with good EV. METHOD: A literature search was conducted to identify studies that examined the EV of NI programmes, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Cochrane Collaboration Guidelines. RESULTS: A total of twenty-seven studies were included in this review. Among these, only three studies explicitly described the procedures used to assess EV. Additionally, almost half of the studies assumed that interventions had good EV based on the characteristics of the programmes. The inconsistent assessment of EV of NI programmes prevented the identification of specific characteristics of programmes demonstrating good EV. CONCLUSION: This systematic review reveals a significant gap in the literature concerning the operationalization of EV within the field of NI. Further research is required to establish a consistent definition of EV in the context of NI and to develop criteria for its effective operationalization.
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Hormonal treatments (HT) for prostate cancer (e.g., androgen deprivation therapy) yield clinical and survival benefits, yet adverse cognitive changes may be a side effect. Since psychosocial factors are largely modifiable, interventions targeting these factors may help mitigate these adverse cognitive effects. This systematic review aimed to identify a range of psychosocial factors associated with cognitive function in individuals with prostate cancer undergoing HT and to determine whether these factors mitigate or exacerbate this effect. Applying PRISMA guidelines, a comprehensive search of relevant databases conducted in September 2023 using terms related to prostate cancer, hormone therapy, and cognitive outcomes was undertaken. The search yielded 694 unique abstracts, with 11 studies included for analysis examining the relationship between cognitive function and the following psychosocial factors: psychological distress, fatigue, insomnia, and coping processes. Findings were mixed with only two studies reporting significant associations between cognitive performance with fatigue and depression. Three studies that included measures of perceived cognitive function identified associations with depression, anxiety, fatigue, insomnia, illness threat appraisals, and coping styles. However, no studies found evidence for an association between self-reported and objective measures of cognitive functioning. Evidence regarding the association of interpersonal factors is lacking. Moreover, whether these factors mitigate or exacerbate the effect of HT on cognitive function still needs to be determined. Overall, the research exploring the association between psychosocial factors and cognitive function in prostate cancer survivors undergoing HT is still in its infancy. Further research is required to optimize the implementation of neuropsychological interventions for prostate cancer survivors.
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Objective: To delineate the unique role of clinical neuropsychologists in contemporary Australian clinical practice and present a comprehensive consensus-based set of clinical neuropsychology competencies to guide and standardize the training of clinical neuropsychologists. Method: Twenty-four national representatives of the clinical neuropsychology profession (71% female, M = 20.1, SD = 8.1 years clinical practice), including tertiary-level educators, senior practitioners and members of the executive committee of the peak national neuropsychology body, formed the Australian Neuropsychology Alliance of Training and Practice Leaders (ANATPL). Informed by a review of existing international competency frameworks and Australian Indigenous psychology education frameworks, a provisional set of competencies for clinical neuropsychology training and practice were developed, followed by 11 rounds of feedback and revisions. Results: The final set of clinical neuropsychology competencies achieved full consensus and falls into three broad categories: generic foundational (i.e. general professional psychology competencies applied to clinical neuropsychology); specific functional (i.e. specific to clinical neuropsychology areas of practice) competencies relevant to all career stages; and functional competencies relevant to advanced career stages. Competencies span a number of knowledge and skill-based domains including neuropsychological models and syndromes, neuropsychological assessment, neuropsychological intervention, consultation, teaching/supervision and management/administration. Conclusion: The competencies reflect recent advances in the field of clinical neuropsychology, including expanded intervention competencies, culturally-informed neuropsychological practice and use of emerging technologies. They will be available as a resource to guide curriculum development for clinical training, as well as providing a useful framework for professional practice and advocacy more broadly within the discipline of clinical neuropsychology.
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Neuropsicología , Competencia Profesional , Humanos , Femenino , Masculino , Neuropsicología/educación , Australia , Pruebas Neuropsicológicas , Competencia ClínicaRESUMEN
Delivery of neuropsychological interventions addressing the cognitive, psychological, and behavioural consequences of brain conditions is increasingly recognised as an important, if not essential, skill set for clinical neuropsychologists. It has the potential to add substantial value and impact to our role across clinical settings. However, there are numerous approaches to neuropsychological intervention, requiring different sets of skills, and with varying levels of supporting evidence across different diagnostic groups. This clinical guidance paper provides an overview of considerations and recommendations to help guide selection, delivery, and implementation of neuropsychological interventions for adults and older adults. We aimed to provide a useful source of information and guidance for clinicians, health service managers, policy-makers, educators, and researchers regarding the value and impact of such interventions. Considerations and recommendations were developed by an expert working group of neuropsychologists in Australia, based on relevant evidence and consensus opinion in consultation with members of a national clinical neuropsychology body. While the considerations and recommendations sit within the Australian context, many have international relevance. We include (i) principles important for neuropsychological intervention delivery (e.g. being based on biopsychosocial case formulation and person-centred goals); (ii) a description of clinical competencies important for effective intervention delivery; (iii) a summary of relevant evidence in three key cohorts: acquired brain injury, psychiatric disorders, and older adults, focusing on interventions with sound evidence for improving activity and participation outcomes; (iv) an overview of considerations for sustainable implementation of neuropsychological interventions as 'core business'; and finally, (v) a call to action.
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Williams Syndrome (WS) is a neurodevelopmental disorder with a distinctive physical, cognitive, and behavioral profile caused by a microdeletion in the q11.23 region of chromosome 7. The neuropsychological profile of WS is characterized by intellectual disability, hypersociability, and deficits, especially in attention and visuospatial skills. Our objective was to assess the effectiveness of a neuropsychological intervention program in attention and visuospatial skills in two patients with WS (aged 7 and 13 years old) with different types of deletion (1.5 and 1.8 Mb). Cognitive, behavioral, and adaptive abilities were evaluated through various neuropsychological tests and scales; the neuropsychological intervention program was subsequently applied, and we assessed its effectiveness. Both patients initially presented significant deficits in attention and visuospatial skills. After the program, we found improvements in attention and visuospatial skills. In addition, both patients had significant clinical advances and changes in adaptive behaviors (social and self-care). These findings suggest that this intervention program could improve attention processes, visuospatial skills, and some aspects of adaptive behavior in patients with WS, regardless of deletion size. Although the sample was small, limiting the generalizability of the results, we believe this program could be a helpful resource for professionals working with individuals with WS.
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Trastornos del Neurodesarrollo , Síndrome de Williams , Humanos , Niño , Adolescente , Síndrome de Williams/genética , Síndrome de Williams/psicología , Adaptación Psicológica , Atención , Pruebas NeuropsicológicasRESUMEN
Objective: Increased prevalence of mild cognitive impairment (MCI) has led to a need for new neuropsychological intervention tools in this population. This meta-analysis aimed to learn about the efficacy of virtual reality (VR)-based neuropsychological interventions in improving cognitive functioning in patients with MCI. Method: This review followed the recommendations of the PRISMA statement, and it was registered in PROSPERO. The studies examined were collected from the PsycINFO, Web of Science, Pubmed/MEDLINE, Embase, Scopus, and Cochrane Library databases. Results: The systematic search yielded 258 articles, of which 13 randomized controlled trials were selected. VR-based neuropsychological interventions had moderate effects on global cognition (g = 0.30; 95% CI = 0.05, 0.56; p = 0.02), small effects on attention (g = 0.27; 95% CI = 0.04, 0.49; p = 0.02), and large effects on executive function (g = 0.60; 95% CI = 0.38, 0.81; p < 0.0001), but non-significant effects on working memory, episodic memory, language, or visuoconstruction. When the length of the intervention was considered, VR-based interventions of 15 or more hours had moderate effects on working memory (g = 0.55; 95% CI = 0.11, 0.99; p = 0.01), and large effects on language (g = 0.60; 95% CI = 0.01, 1.20; p = 0.05) and visuoconstruction (g = 1.13; 95% CI = 0.58, 1.67; p < 0.0001). Conclusions: Results suggest that VR-based interventions are beneficial for improving cognitive functioning in patients with MCI, and allow us to make recommendations that could have implications for clinical decision-making in this population.
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Disfunción Cognitiva , Realidad Virtual , Humanos , Pruebas Neuropsicológicas , Disfunción Cognitiva/terapia , Cognición , Función EjecutivaRESUMEN
O isolamento social provocado pela pandemia de covid-19 exigiu uma intensificação no estabelecimento de parâmetros para o trabalho do neuropsicólogo com suas especificidades. Assim, o objetivo deste artigo é levantar reflexões sobre a prática neuropsicológica infantil via internet baseada na nossa experiência prática vivenciada no período, relacionando com as referências teóricas da abordagem histórico-cutural e outros trabalhos que discorrem sobre as particularidades dessa modalidade de atendimento. Para isso, foi realizada uma pesquisa bibliográfica em fontes reconhecidas, como SciELO e Google Acadêmico, utilizando-se marcadores como "neuropsicologia on-line" e "teleneuropsicologia", entre outros, em português, inglês e espanhol. Os trabalhos encontrados foram utilizados como fundamento para discutir as ideias aqui apresentadas, a partir da experiência dos autores durante esse período. Considera-se que os neuropsicólogos precisam enfrentar a possível necessidade do trabalho on-line, considerando que as situações vividas durante a pandemia tendem a aumentar a necessidade de avaliações e intervenções neuropsicológicas. Ao mesmo tempo, se prevê que essa via de trabalho deve se intensificar após o isolamento, dentro do que se tem denominado como "o novo normal". Para isso, é essencial que haja esforço por parte da comunidade neuropsicológica para mostrar como essa área de trabalho pode ser útil para crianças, seus pais e professores. Conclui-se que é preciso ter a noção de que nenhuma via ou metodologia de trabalho é absolutamente completa, sendo essencial a instrumentalização das vantagens e desvantagens de todas elas.(AU)
The social isolation caused by the COVID-19 pandemic demanded intensification in the establishment of parameters for the neuropsychologist's work with its specificities. Thus, the aim of this article is to raise reflections on child neuropsychological practice via the internet, based on our practical experience in this period, relating to the theoretical references of the cultural-historical approach and other works that discuss the particularities of this type of care. For this, a bibliographic research was carried out in recognized sources such as SciELO and Google Scholar, using markers such as "online neuropsychology" and teleneuropsychology, among others, in Portuguese, English and Spanish. The works found were used as a basis for discussing the ideas presented here which are based on the authors' experience during this period. It is considered that neuropsychologists need to face the possible need for online work, considering that situations experienced during the pandemic tend to increase the need for neuropsychological assessments and interventions. At the same time, it is expected that this work path should intensify after isolation, within of what has been called "the new normal". For this, an effort by the neuropsychological community is essential to show how this area of work can be useful for children, their parents and teachers. It is concluded that it is necessary to have the notion that no way or work methodology is absolutely complete, being essential the instrumentalization of the advantages and disadvantages of all of them.(AU)
El aislamiento social provocado por la pandemia de Covid-19 exigió una intensificación en el establecimiento de parámetros para el trabajo del neuropsicólogo con sus especificidades. Así, el objetivo de este artículo es plantear reflexiones sobre la práctica neuropsicológica infantil a través de internet, a partir de nuestra experiencia práctica en este período, en relación con los referentes teóricos del enfoque histórico-cultural y otros trabajos que discuten las particularidades de este tipo de cuidado. Para esto, se realizó una investigación bibliográfica en fuentes reconocidas como SciELO y Google Académico, utilizando marcadores como "neuropsicología en línea" y teleneuropsicología, entre otros, en portugués, inglés y español. Los trabajos encontrados sirvieron de base para discutir las ideas aquí presentadas a partir de la experiencia de los autores durante este período. Se considera que los neuropsicólogos necesitan enfrentar la posible necesidad de trabajo en línea, considerando que las situaciones vividas durante la pandemia tienden a incrementar la necesidad de evaluaciones e intervenciones neuropsicológicas. Al mismo tiempo, se espera que esta vía de trabajo se intensifique después del aislamiento, dentro de lo que se ha denominado "la nueva normalidad". Para esto, un esfuerzo de la comunidad neuropsicológica es fundamental para mostrar cómo esta área de trabajo puede ser útil para los niños, sus padres y profesores. Se concluye que es necesario tener la noción de que ninguna vía o metodología de trabajo es absolutamente completa, siendo imprescindible la instrumentalización de las ventajas y desventajas de todas ellas.(AU)
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Humanos , Masculino , Femenino , Aislamiento Social , Sistemas en Línea , Consulta Remota , Cultura , Intervención basada en la Internet , Historia , Neuropsicología , Relaciones Padres-Hijo , Pruebas de Aptitud , Práctica Psicológica , Solución de Problemas , Pruebas Psicológicas , Psicología , Calidad de Vida , Atención , Trastorno por Déficit de Atención con Hiperactividad , Escalas de Wechsler , Conducta , Integración Escolar , Adaptación Psicológica , Familia , Niño , Desarrollo Infantil , Lenguaje Infantil , Preescolar , Responsabilidad Parental , Cognición , Infecciones por Coronavirus , Comunicación , Educación Basada en Competencias , Adaptabilidad , Intervención Educativa Precoz , Manifestaciones Neuroconductuales , Reconocimiento en Psicología , Demencia , Crecimiento y Desarrollo , Comunicación por Videoconferencia , Evaluación de Programas e Instrumentos de Investigación , Cerebro , Estudios Interdisciplinarios , Memoria Espacial , Trastornos del Neurodesarrollo , Escala de Evaluación de la Conducta , Cuestionario de Salud del Paciente , Pruebas de Memoria y Aprendizaje , Pruebas de Estado Mental y Demencia , Lóbulo Frontal , Egocentrismo , Razonamiento Clínico , COVID-19 , Entrenamiento Cognitivo , Apoyo Familiar , Desarrollo Humano , Servicios de Información , Pruebas de Inteligencia , Desarrollo del Lenguaje , Memoria , Memoria a Corto Plazo , Procesos Mentales , Examen Neurológico , Plasticidad Neuronal , Pruebas NeuropsicológicasRESUMEN
Research studies show a strong influence of socioeconomic status (SES) on human development, and how the exposure to risk contexts in the earliest stages translates into dangers in the cognitive development of children and adolescents. To alleviate these consequences and favour development, different cognitive training programs have contributed to this field by identifying the criteria of efficacy. This systematic review identifies and synthesizes the evidence of cognitive intervention studies implemented with psychosocial risk groups carried out in Spain. The search strategy was adapted to different databases. Only studies published in English or Spanish and developed in Spain that included interventions applied in populations aged 5 to 18 years with a low SES were included. The analysis of the literature showed nine interventions that indicated an improvement in those cognitive functions worked with low SES children. The cognitive domains that most worked were executive functions, followed by social cognition and language. After reviewing the available literature, a clear scarcity of interventions carried out in Spain was observed. Variables such as age, cognitive functions or personal vulnerability were identified as factors to be taken into account in future lines of research due to their influence on minors. These findings indicate the relevance of this review to help decision-making in relation to the actions to be carried out by the competent bodies in Spain.
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Los pacientes con Síndrome de West y Trastorno del Espectro del Autismo (TEA) asociado presentan déficits cognitivos (i.e., alteraciones atencionales, mnésicas, visuoperceptivas, en función ejecutiva y lenguaje) que pueden afectar a su calidad de vida. Tras delimitar el perfil cognitivo de estos pacientes, este estudio pretende diseñar un protocolo de evaluación e intervención neuropsicológica específico, desde un enfoque holístico e integrativo. El programa consta de 48 sesiones planificadas en seis meses, incluyendo sesiones de evaluación neuropsicológica (antes, a mitad y al final de la intervención) y sesiones de intervención focalizadas en los dominios cognitivos afectados, los aspectos socioemocionales y la mejora de la autonomía y funcionalidad. Se espera que el programa propuesto sea eficaz para mejorar el funcionamiento cognitivo y la calidad de vida de esta población, contribuyendo a optimizar la atención sanitaria.(AU)
Patients with West Syndrome and associated Autism Spectrum Disorder (ASD) have cognitive deficits (i.e., attentional, mnestic, visuoperceptive, executive function, and language impairments) that may affect their quality of life. After delimiting the cognitive profile of these patients, this study aims to design a specific neuropsychological assessment and intervention protocol, from a holistic and integrative approach. The program consists of 48 sessions planned over six months, including neuropsychological assessment sessions (before, halfway through, and at the end of the intervention) and intervention sessions focused on the affected cognitive domains, socioemotional aspects, and the improvement of autonomy and functionality. The proposed program is expected to be effective in improving cognitive functioning and quality of life in this population, contributing to optimize health care.(AU)
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Humanos , Masculino , Femenino , Trastorno Autístico/psicología , Trastorno del Espectro Autista/psicología , Espasmos Infantiles/psicología , Espasmos Infantiles/terapia , Epilepsia/psicología , Neuropsicología , Cognición , Salud Holística , Calidad de la Atención de Salud , Psicología Social , Psicología Clínica , Psicología , Psicología Infantil , Terapia Centrada en la Emoción , Calidad de VidaRESUMEN
The inhibitory control is a component of the executive functions that allows the individual to inhibit inadequate behaviors, resist distractions and select a relevant stimulus when executing activities. In the neuropsychology field, evidences of stimulation and improvement of the inhibitory control through school interventions is sought by using computerized software, such as digital games. These research studies constitute an important investigation area within the executive functions in ecological approaches. This paper presents a systematic mapping study on inhibitory control stimulation in elementary school children with the use of digital games. The investigation encompassed an automated database search with further backward snowballing procedure with the final selection for additional publications as research strategy. The automated search considered six databases: SCOPUS, PubMed, IEEE Explore Digital Library, ACM Library, Springer Link, and Scielo. The initial database search found 641 works published between 2014 and 2019. After the exclusion and inclusion criteria were considered, three publications related to digital games or mobile applications were found and selected for analysis, which focused on inhibitory control or correlated processes stimulation in school-based interventions with elementary school children. Results indicated that investigations within the field are incipient, pointing to an emerging research area.
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Función Ejecutiva , Instituciones Académicas , Niño , HumanosRESUMEN
RESUMEN Se realizóuna revisión sobre el objeto de estudio: los métodos de modificación de la conducta de riesgo sexual y de la función reproductiva en adolescentes. A juzgar por la cantidad de publicaciones en este campo, se podría afirmar engañosamente que este tópico ha sido exhaustivamente estudiado, sin embargo, sólo hay limitada información sobre las intervenciones neuropsicológicas, por lo que los investigadores se propusieron diseñar y validar un modelo de intervención neuropsicológica para la modificación de la conducta de riesgo sexual y de la función reproductiva en adolescentes. Para ello se modeló una intervención original mediante el condicionamiento operante, que se someterá a evaluación de expertos, y luego se validará experimentalmente en el policlínico No 3 de Manzanillo, en el período comprendido desde enero del 2021 hasta enero del 2023. El universo estará formado por adolescentes entre las edades de 15 a 17años con conducta de riesgo sexual y de la función reproductiva, las unidades muestrales se seleccionarán por el método aleatorio simple. La prueba estadística a usar será el Cross over y la prueba de los signos para probar los cambios en variables relevantes de la conducta antes y después de intervenir. El método de análisis histórico lógico permitió identificar un problema científico trascendente: Existen insuficiencias en los métodos para la modificación de la conducta de riesgo sexual y la función reproductiva en adolescentes. Se expone el modelo de intervención neuropsicológica y la metodología integral de validación.
ABSTRACT A review was carried out on the object of study: The methods of modifying sexual risk behavior and reproductive function in adolescents. Judging from the number of publications in this field, it could be misleadingly stated that this topic has been extensively studied, however, there is only limited information on neuropsychological interventions. Therefore, the researchers set out to design and validate a neuropsychological intervention model for modifying sexual risk behavior and reproductive function in adolescents. For this, an original intervention was modeled through operant conditioning, which will be subject to expert evaluation, and then will be experimentally validated at the Manzanillo polyclinic No. 3, in the period from January 2021 to January 2023. The universe will be made up of adolescents between the ages of 15 to 17 years with sexual risk behavior and reproductive function, the sample units will be selected by the simple random method. The statistical test to be used will be the Cross over and the test of the signs to test the changes in relevant variables of the behavior before and after the intervention. The logical historical analysis method allowed the identification of a transcendent scientific problem: There are shortcomings in the methods for modifying sexual risk behavior and reproductive function in adolescents. The neuropsychological intervention model and the comprehensive validation methodology are exposed.
RESUMO Foi realizada uma revisão sobre o objeto de estudo: Os métodos de modificação do comportamento sexual de risco e da função reprodutiva em adolescentes. A julgar pelo número de publicações neste campo, pode ser erroneamente declarado que este tópico foi extensivamente estudado, no entanto, há apenas informações limitadas sobre intervenções neuropsicológicas. Portanto, os pesquisadores se propuseram a projetar e validar um modelo de intervenção neuropsicológica para modificar o comportamento sexual de risco e a função reprodutiva em adolescentes. Para isso, foi modelada uma intervenção original por meio de condicionamento operante, que será submetida à avaliação de especialistas, e a seguir será validada experimentalmente na policlínica de Manzanillo nº 3, no período de janeiro de 2021 a janeiro de 2023. O universo será formado por adolescentes de 15 a 17 anos com comportamento sexual de risco e função reprodutiva, as unidades amostrais serão selecionadas pelo método aleatório simples. O teste estatístico a ser utilizado será o Cross over e o teste dos sinais para testar as alterações nas variáveis relevantes do comportamento antes e depois da intervenção. O método lógico de análise histórica permitiu a identificação de um problema científico transcendente: Existem lacunas nos métodos para modificar o comportamento sexual de risco e a função reprodutiva em adolescentes. O modelo de intervenção neuropsicológica e a metodologia de validação abrangente são expostos.
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Neurobehavioral comorbidities, particularly attention-deficits, are common in children with epilepsy (CWE). Neurobehavioral problems are manifested in school performance, peer relations, and social competence. Although the high prevalence of these comorbid behavioral problems is fully recognized, there remains to be a lack of studies on the interventions targeted for CWE. A manualized neuropsychological group intervention, Rehabilitation of EXecutive Function and ATtention (EXAT) has been developed for school-aged children (aged 6-12â¯years) with executive function (EF) and attention-deficits. This study aimed to explore the effects of EXAT on parent- and teacher-rated attention and behavior problems in CWE compared with children with the diagnosis of attention-deficit hyperactivity disorder (ADHD) and children with no formal diagnosis but prominent deficits in EF and attention. Forty-two children attending in neuropsychological group rehabilitation EXAT between the years 2006 and 2017 participated in this retrospective registry study. The CWE group consisted of 11 children, the ADHD group with 16 children, and EF/attention group consisted of 15 children with EF attention and/or problems without diagnosis of ADHD. The CWE group did not differ from the other two study groups (ADHD and no formal diagnosis) before the EXAT intervention. This indicates that attention problems in CWE are similar to those with diagnosed ADHD. The results were promising for applying structured multilevel intervention for CWE and neurobehavioral comorbidities. Lack of group differences between the groups participating EXAT suggests similar intervention effects between CWE, ADHD, and those with less severe EF and attention problems. In parent ratings, intervention effects were higher in hyperactivity and oppositional behavior for children with attention problems and without epilepsy. Parents in the CWE group reported no effects except for one subscale related to hyperactivity. However, teachers reported consistently positive intervention effects for both inattention and hyperactivity-impulsivity along with anxiety and emotional lability. The results suggest that neurobehavioral comorbidities in CWE could be targeted in neuropsychological group intervention. In conclusion, CWE seem to benefit from interventions and behavior modification techniques first developed for children with ADHD.
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Trastorno por Déficit de Atención con Hiperactividad/rehabilitación , Terapia Conductista , Trastornos de la Conducta Infantil/rehabilitación , Disfunción Cognitiva/rehabilitación , Epilepsia/rehabilitación , Psicoterapia de Grupo , Sistema de Registros , Adolescente , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Niño , Trastornos de la Conducta Infantil/epidemiología , Disfunción Cognitiva/epidemiología , Remediación Cognitiva , Comorbilidad , Epilepsia/epidemiología , Femenino , Humanos , Masculino , Estudios RetrospectivosRESUMEN
We designed and evaluated the efficacy of a computer-based cognitive training program (Executive Function Enhancement Program [EFEP]) to stimulate executive functions through enhancing planning in normally-developing children. A total of 111 Colombian children participated in the study. Fifty-nine (53%) of the children were assigned to the experimental condition (application of the EFEP program) with two levels of planning performance, and fifty-two (47%) to the waiting list control condition with the same two levels of planning. The training program was applied three times a week over six weeks, with post-intervention assessment two weeks after the end of training. A follow-up assessment was carried out three months later. Results showed that the intervention program was particularly effective in the children with lower pre-intervention performance in planning, demonstrating that the program is an efficient therapeutic instrument for enhancing the executive function of planning in children between 5 and 7 years old.
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Remediación Cognitiva , Función Ejecutiva , Terapia Asistida por Computador , Niño , Preescolar , Femenino , Estudios de Seguimiento , Humanos , Masculino , Resultado del TratamientoRESUMEN
Despite the crucial role played by the executive functions (EF) to cognitive, emotional, and social development of children before and during school years, little attention has been given to construct and analyze the efficacy of programs that intend to develop them. The program of neuropsychological stimulation of cognition in students: emphasis on EF, or PENcE (an acronym from its original name in Portuguese, Programa de Estimulação Neuropsicológica da Cognição em Escolares: ênfase nas Funções Executivas), is an early and preventive intervention program for school-aged children, and implemented at school three times a week for 5 months. The PENcE was structured in four modules, each focusing on a different executive component: organization and planning, inhibitory control, working memory, and cognitive flexibility. The objectives of this study were to verify the effectiveness of the PENcE among elementary school children and to investigate whether there are transfer effects to other executive, cognitive, and academic abilities. The sample consisted of 113 children attending 3rd or 4th grade at two public elementary schools. Eight classes participated in the study, divided into two groups: an experimental group (EG) (four classes; n = 64), which received the intervention, and a control group (CG) (four classes; n = 49), which continued their regular school activities. The EF and academic skills of both participant groups were evaluated before and after the intervention. The EG showed significantly greater improvements in inhibitory control, working memory, and abstract planning relative to the CG, with a small to medium effect size. There were transfer effects to other cognitive and academic abilities. These findings suggest the PENcE may be a useful method of improving EF and could benefit both school-aged children and education professionals.
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Este artigo teve como objetivo realizar uma revisão literária sobre os estudos científicos publicados nos últimos dez anos em reabilitação/intervenção neuropsicológica com crianças e adolescentes, buscando identificar como os programas com abordagens voltadas para as dificuldades acadêmicas e executivas se articulam com as demandas familiares e escolares. As principais bases de dados utilizadas foram PubMed, SciELO e Redalyc. Dentre os 89 artigos encontrados, dez foram selecionados por englobarem métodos para o ensino de estratégias que facilitassem a aprendizagem escolar e os comportamentos adaptativos. Os resultados dos estudos sugerem que a intervenção neuropsicológica em crianças e adolescentes promove o desenvolvimento de habilidades cognitivas e dos processos de aquisição de linguagem. Entretanto, em face da distância entre o contexto clínico de intervenção e o educacional, mais estudos precisam ser promovidos em busca de um olhar mais integrado sobre esses espaços de promoção de desenvolvimento.
This article aimed to carry out a literary review of the scientific studies published in the last ten years in neuropsychological rehabilitation/ intervention with children and adolescents, seeking to identify how programs with approaches focused on academic and executive difficulties are articulated with family and school demands . The main databases used were PubMed, SciELO and Redalyc. Among the 89 articles found, ten were selected because they included methods for teaching strategies that facilitated school learning and adaptive behaviors. The results of the studies suggest that neuropsychological intervention in children and adolescents promotes the development of cognitive abilities and the processes of language acquisition. However, in view of the distance between the clinical context of intervention and the educational context, more studies need to be promoted in search of a more integrated view on these spaces for promoting development.
Este artículo tuvo como objetivo realizar una revisión literaria sobre los estudios científicos publicados en los últimos diez años en rehabilitación/ intervención neuropsicológica con niños y adolescentes, buscando identificar cómo los programas con enfoques orientados hacia las dificultades académicas y ejecutivas se articulan con las demandas familiares y escolares. Las principales bases de datos utilizadas fueron PubMed, SciELO y Redalyc. Entre los 89 artículos encontrados, diez fueron seleccionados por englobar métodos para la enseñanza de estrategias que facilitar el aprendizaje escolar y los comportamientos adaptativos. Los resultados de los estudios sugieren que la intervención neuropsicológica en niños y adolescentes promueve el desarrollo de habilidades cognitivas y de los procesos de adquisición de lenguaje. Sin embargo, en vista de la distancia entre el contexto clínico de intervención y el educativo, más estudios necesitan ser promovidos en busca de una mirada más integrada sobre estos espacios de promoción de desarrollo.
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PURPOSE: Individuals with non-central nervous system (CNS) cancers can experience cancer-related cognitive dysfunction (CRCD), negatively impacting daily functioning and quality of life. This systematic review examined cognitive rehabilitation programs aimed at improving cognitive function. METHODS: PsychInfo and PubMed were searched in February 2019. Eligible studies evaluated a cognitive rehabilitation program for adults with non-CNS cancers and included at least one objective cognitive measure. Across studies, we assessed methodological quality using relevant criteria based on published intervention-related review guidelines and examined findings from performance-based and self-reported outcome measures. RESULTS: 19 studies met inclusion criteria, totalling 1124 participants altogether. These studies included randomized controlled trials (n = 12), partial, quasi or non-randomized controlled trials (n = 3) and single-arm pilot studies (n = 4). All studies found improvements on at least one cognitive measure (performance-based or self-reported). By cognitive domain, objective improvements in memory were most commonly reported, followed by executive functions and processing speed. In terms of methodological quality, studies generally provided clear descriptions of participants and interventions. However, limitations included lack of standardized terminology for interventions, discrepancies in outcome measures, and incomplete statistical reporting. CONCLUSIONS: The available evidence supports clinical implementation of cognitive rehabilitation to improve CRCD, with further work in program development, dissemination, and feasibility recommended. We provide specific recommendations to facilitate future research and integration in this field.
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Terapia Cognitivo-Conductual/métodos , Disfunción Cognitiva/rehabilitación , Disfunción Cognitiva/terapia , Adulto , Cognición/fisiología , Función Ejecutiva/fisiología , Femenino , Humanos , Masculino , Memoria/fisiología , Persona de Mediana Edad , Neoplasias/patología , Evaluación de Resultado en la Atención de Salud , Calidad de Vida/psicologíaRESUMEN
The aim of this study was twofold: first, to obtain a neuropsychological characterization of children with language disorders, and second, to evaluate the effectiveness of an intervention program on working memory. We used a pretest-instruction-posttest design, carefully identifying a sample of 32 children with language disorders whom we then evaluated for short-term verbal and visuospatial memory, verbal and visuospatial working memory, attention, processing speed, and lexical-semantic skills. We then implemented an intervention program on working memory consisting of 72 sessions of 15 minutes each, after which we repeated the neuropsychological assessment of these functions. Children with language disorders performed worse than children in the control group in all memory tasks evaluated and in the lexical-semantic processing task. After the intervention, children with language disorders showed a significant increase over their own previous performance in all variables. Children with language disorders show significant cognitive deficits and not just linguistic impairment. We offer conclusive findings on the effectiveness of the intervention program used. Finally, we obtained partial support for the existence of a causal link between improved performance on memory tasks and performance in a lexical-semantic task.
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Remediación Cognitiva/métodos , Trastornos del Lenguaje/rehabilitación , Memoria a Corto Plazo/fisiología , Evaluación de Resultado en la Atención de Salud , Logopedia/métodos , Niño , Preescolar , Femenino , Humanos , Trastornos del Lenguaje/diagnóstico , Masculino , Pruebas NeuropsicológicasRESUMEN
This systematic review aimed to characterize empirical studies on neuropsychological interventions to stimulate executive functions in children with typical development. Searches were conducted according to the PRISMA method. Nineteen (19) studies on the analysis to evaluate the effectiveness of intervention programs in pre-school and school children were obtained. There was a predominance of studies that used computerized cognitive training, most of them involving the stimulation of working memory. Others used pen and paper forms, or hybrid tasks, and some programs used a school curriculum approach aiming to improve self-regulation. Results provide preliminary evidence on the effectiveness of such on the executive performance in children with typical development. Each executive component, as well as each type of intervention has its peculiarities. Computerized trainings and pen and paper tasks tend to improve the targeted executive functions, but transfer effects are still inconsistent. Regarding the effects of programs using school curriculum approach, they seem to be more generalizable, with functionality gains accomplishing mainly socio-emotional regulation. Multimodal approaches may be even more effective. Follow-up studies should be targeted in order to track the maintenance of direct and transfer effects regarding mainly cognitive and social development associated to school achievement.
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Desarrollo Infantil/fisiología , Terapia Cognitivo-Conductual/métodos , Función Ejecutiva/fisiología , Niño , Preescolar , Humanos , Pruebas NeuropsicológicasRESUMEN
OBJECTIVE: The goal of this study was to describe the construction process and content validity evidence of an early and preventive intervention program for stimulating executive functions (EF) in Elementary School children within the school environment. METHODS: The process has followed the recommended steps for creating neuropsychological instruments: internal phase of program organization, with literature search and analyses of available materials in the classroom; program construction; analysis by expert judges; data integration and program finalization. To determine the level of agreement among the judges, a Content Validity Index (CVI) was calculated. RESULTS: Content validity was evidenced by the agreement among the experts with regards to the program, both in general and for each activity. All steps taken were deemed necessary because they contributed to the identification of positive aspects and possible flaws in the process. CONCLUSION: The steps also helped to adapt stimuli and improve program tasks and activities. Methodological procedures implemented in this study can be adopted by other researchers to create or adapt neuropsychological stimulation and rehabilitation programs. Furthermore, the methodological approach allows the reader to understand, in detail, the technical and scientific rigor adopted in devising this program.
OBJETIVO: O objetivo desse estudo foi descrever o processo de construção e evidências de validade de conteúdo de um programa de intervenção precoce-preventiva para estimular as FE em crianças do Ensino Fundamental no ambiente escolar. MÉTODOS: O processo seguiu as etapas recomendadas para construção de instrumentos neuropsicológicos, são elas: fase interna de organização do programa, com pesquisa bibliográfica e análise dos materiais disponíveis em sala de aula; construção do programa; análise de juízes especialistas; integração dos dados e finalização do programa. Para determinar o nível de concordância entre os juízes, foi calculado o Índice de Validade de Conteúdo. RESULTADOS: Verificou-se concordância entre os especialistas tanto para o programa de forma geral, bem como em cada atividade, o que permitiu obter evidências de validade de conteúdo. Considera-se que todas as etapas foram essenciais e necessárias, pois contribuíram para identificar os pontos positivos e as possíveis falhas, assim como adequar os estímulos e aprimorar as tarefas e atividades do programa. CONCLUSÃO: Ao descrever os procedimentos metodológicos adotados nesse estudo, entende-se que outros também podem se basear para construir ou adaptar programas de estimulação e reabilitação neuropsicológica. Além disso, possibilita ao leitor uma compreensão detalhada de todo cuidado e rigor teórico e científico adotado na elaboração desse programa.