The Efficacy of Cognitive Training Programs in Children and Adolescents A Meta-analysis
The Efficacy of Cognitive Training Programs in Children and Adolescents A Meta-analysis
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DOI：
10.3238/arztebl.2013.0643
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发表时间：
2013-09-27
影响因子：
7.7
通讯作者：
von Kries, Ruediger
中科院分区：
文献类型：
--
作者：
Karch, Dieter;Albers, Lucia;von Kries, Ruediger
背景：认知疗法旨在改善基本的认知功能，无论缺陷的原因是什么。有各种认知缺陷的儿童和青少年接受行为治疗和计算机支持的培训计划。我们在这里报告了对此类计划功效的首次荟萃分析。方法：我们系统地检索了Medline、Embase、PsycINFO、PSYNDEX和ERIC数据库，以找到相关出版物，用于对儿童和青少年用于改善注意力、记忆力和执行能力的认知训练计划进行荟萃分析（主要目标）以及行为/精神病理学，智力和学校表现（次要目标）。治疗组和对照组之间的平均差异在这里给出的标准差（SD）scores.Results：1661潜在相关的出版物被发现，包括22项研究，被认为是在荟萃分析，其中17个随机对照试验。目标变量是用90多种不同的测试技术测量的。认知训练对注意力（SD 0.18，95% CI -0.11-0.47）和执行功能（SD 0.17，95% CI -0.12-0.46）的总体影响始终较小。发现对记忆性能的影响相对较强（0.65 SD，95% [-0.12-1.42]），尽管由于两项研究存在显著异质性（I-2 = 82%）。最大的影响被发现在行为和精神病理学（SD 0.58，95%CI 0.31-0.85）领域，但这最后一个数字主要是来自缺乏积极的对照group.Conclusion：认知疗法对儿童和青少年的行为普遍有利，但可能是非特异性的影响。但另一方面，具体效果总体上较弱。仅在特定适应症的某些个别类型的治疗中证明了治疗获益。
Background: Cognitive therapies are intended to improve basic cognitive functions, whatever the cause of the deficiency may be. Children and adolescents with various cognitive deficits are treated with behavioral therapeutic and computer-supported training programs. We here report the first meta-analysis of the efficacy of such programs.Methods: We systematically searched the Medline, Embase, PsycINFO, PSYNDEX, and ERIC databases to find pertinent publications for a meta-analysis of cognitive training programs that are used in children and adolescents to improve attention, memory, and executive performance (primary goals) as well as behavior/psychopathology, intelligence, and school performance (secondary goals). The mean differences between the treatment and control groups are given here as standard deviation (SD) scores.Results: 1661 potentially relevant publications were found, including 22 studies that were considered in the meta-analysis, 17 of which were randomized controlled trials. The target variables were measured with more than 90 different testing techniques. The overall effects of cognitive training on attention (SD 0.18, 95% CI -0.11-0.47) and executive function (SD 0.17, 95% CI -0.12-0.46) were consistently small. A relatively strong effect was found on memory performance (0.65 SD, 95% [-0.12-1.42), albeit with marked heterogeneity (I-2 = 82%) owing to two studies. The largest effect was found in the area of behavior and psychopathology (SD 0.58, 95% CI 0.31-0.85), but this last figure is derived mainly from studies that lacked an active control group.Conclusion: Cognitive therapies for children and adolescents have generally favorable, but probably nonspecific effects on behavior. On the other hand, the specific effects, however, were weak overall. Therapeutic benefit has been demonstrated only for certain individual types of therapy for specific indications.