Cogmed

Cogmed is a working memory and attention training program developed by Dr. Torkel Klingberg, a professor of Cognitive Neuroscience at the Karolinska Institutet of Stockholm Brain Institute.[1][2]

History

1999: Professor Klingberg come up with the research proposal of designing a training program to improve working memory and attention in children with ADHD.

2000: A group of experts in cognitive neuroscience, clinical neuro-psychology, and interactive game design put together a first prototype of the program.[3]

2001: The Cogmed company is formed after the first randomized, placebo controlled study on Cogmed training showed very promising results. The results were published in the first paper on Cogmed training.[4]

2003: The first commercial version of Cogmed program is developed. Cogmed training starts in Sweden.

2007: Cogmed is officially launched in the United States and Canada. Brad Gibson, a professor of Psychology at the University of Notre Dame conducts the first U.S. study on Cogmed, the study supports positive clinical results of Cogmed training shown by European studies.[5]

2008: Cogmed training is launched in Asia Pacific, offices open in Singapore, Japan, and Korea[6]

2009: Dr. Joni Holmes from the University of York publishes results of breakthrough study showing that working memory training yields greater benefits in working memory for children with ADHD than are provided by stimulant medication treatment.[7]

2010: Cogmed is acquired by Pearson Education and becomes part of Pearson Clinical Assessment Group.[8]

Overview

Cogmed Working Memory Training (CWMT) is a program based on the concept of neuroplasticity, the idea that the brain can reorganize itself and change in order to perform at its maximum capacity. The training consists of a specific set of working memory tasks focusing on visuo-spatial working memory, verbal short-term memory, verbal working memory, and visuo-spatial short-term memory. The training is designed as a computer program with series of video games, where the difficulty level is adjusted according to the trainee's cognitive level. Each trainee is required to complete eight exercises every day, taking about 30–45 minutes for the entire session. This is done for five days a week over five weeks. Upon completion of the five week training course, the trainees get access to Cogmed Extension Training course that consists of 100 additional computer sessions. These sessions could be taken within one year from completion of the training course and the goal of these sessions is to improve training retention over the long term. Cogmed training is semi-supervised, the trainee has weekly calls with a Cogmed coach (typically a mental health or special education professional) who leads the training and monitors the results.

Cogmed training is typically used with people who experience working memory or attention deficits, such as children and adults with ADD or ADHD, persons with learning disabilities, and victims of stroke or traumatic brain injury.

Cogmed training is available in three different modalities: Cogmed JM, QM, and RM. Cogmed JM is used with pre-school children under the age of 6, RM is used with children age 7 and up, and QM is used for training adults.

Research

What differentiates Cogmed from other brain training programs is an extensive body of academic research supporting its claims. Cogmed website lists over 45 independent, peer-reviewed research studies conducted at leading universities such as Harvard University, Johns Hopkins University, University of California – Davies, and published in most prestigious academic journals.[9] There is also 85 ongoing research studies investigating different aspects of Cogmed Working Memory Training.[10] The initial research primarily focused on using Cogmed for children with ADHD.[4][11] Later research has revealed that individuals of all ages have improved WM capacity in both the visuo-spatial and verbal domains following Cogmed training. Average improvements on non-trained tasks of WM found in Cogmed research are 26% and 23% for visuo-spatial and verbal WM respectively.[12] In some studies of children with ADHD, increased WM has also shown transfer to executive functions such as attention, inhibition, and reasoning.[4][13] Studies have investigated the impact of Cogmed Working Memory Training from the most fundamental level of genetics,[14][15][16][17] biochemical functioning,[18] neuronal activity [19][20][21] to its effect on learning [22][23][24] and everyday functioning.[13][21] In terms of attention, there are at least three randomized, controlled investigations demonstrating improved attention in everyday life [13][21][25] from three distinct research groups, meeting the Cohrane criteria for highest level of acceptance for an intervention.

Cogmed Claims

Cogmed makes the following claims based on supporting research evidence:[26]

1. Working memory (WM) is key to attention and learning

2. WM can be improved by Cogmed training

3. Training related effects have been shown on three levels of assessment: brain imaging, neuropsychological tests, and behavioral rating scales

4. Training effects have been observed in all age ranges after Cogmed

5. Improvements in WM after Cogmed have generalized to reduced cognitive failures in daily life

6. Gains in WM and behavioral outcomes are sustained over the long term

7. WM is commonly impaired in individuals with ADHD

8. Groups with ADHD have demonstrated gains in WM capacity post Cogmed training

9. Improvements in symptoms of inattention have been shown after Cogmed training in groups with ADHD and other clinical diagnoses using behavioral rating scales (e.g. the inattention subscale from DSM-5)

Criticism

Despite supporting research there is no agreement in the research community on whether all Cogmed claims can be substantiated. Some researchers question whether the benefits of training could be generalized to everyday tasks and retained over the long term. In 2012, Dr. Monica Melby-Lervag, who is a professor of Special Needs Education at the University of Oslo, published a paper with results of meta-analysis for 23 research studies on working memory training.[27] These 23 studies covered seven different commercial and non-commercial training techniques incl. Cogmed. The conclusion of the study was that "working memory training programs give only near-transfer effects, and there is no convincing evidence that even such near-transfer effects are durable."

Melby-Lervag's results were criticized by Cogmed for including only a few Cogmed-related research studies and for using inappropriate statistical methods such as pooling together the training data from different WM training programs and different test populations (e.g. combining samples with and without WM deficits, ages 10–51, etc.).[28] In her paper Dr. Melby-Lervag writes about WM training programs "The most well known is CogMed which is available in 30 countries and is widely used in schools and clinics.", yet she doesn't use any Cogmed-related studies in evaluating long term training effects on verbal working memory and uses just a single Cogmed study (each) for evaluation of training effects on visual spatial working memory and for far transfer to verbal ability, word decoding, and arithmetic.[29]

Another notable critic of Cogmed is Dr. Zach Shipstead, who is an assistant professor at the Arizona State University. In 2012, Dr. Shipstead published a paper based on review of Cogmed conducted as a part of his PhD dissertation at Georgia Institute of Technology.[30] The paper argued that many of the problem-solving or training tasks in Cogmed are not related to working memory, many of the attention tasks are unrelated to ADHD, and that there is limited transfer to real-life manifestations of attention deficits. The authors concluded: "The only unequivocal statement that can be made is that Cogmed will improve performance on tasks that resemble Cogmed training." Cogmed was quick to come up with rebuttal of Dr. Shipstead's paper[31] yet the jury is still out.

Popular media is divided when it comes to WM training. A 2014 article by Gareth Cook in the The New Yorker magazine claims that brain training games are "bogus."[32] Cook based his conclusion on a 2012 research study by Dr. Melby-Lervag.[27] The New Yorker article was later criticized for misrepresenting the study and missing the fact that the study found that WM training produces reliable short-term improvements in both verbal and visuospatial working memory skills.[33][34]

See also

References

  1. ↑ http://www.klingberglab.se/projects/torkel-klingberg/
  2. ↑ http://www.pearsonclinical.co.uk/Educationnews/TorkelKlingberg.aspx
  3. ↑ http://www.cogmed.com/history
  4. ↑ 4.0 4.1 4.2 "Training of working memory in children with ADHD". Journal of Clinical and Experimental Neuropsychology 24 (6): 781–791. 2002. doi:10.1076/jcen.24.6.781.8395.
  5. ↑ "Memory training and attention deficits".
  6. ↑ "Cogmed: International Growth".
  7. ↑ "Working memory deficits can be overcome: Impacts of training and medication on working memory in children with ADHD". Applied Cognitive Psychology 24 (6): 827–836. 2009. doi:10.1002/acp.1589.
  8. ↑ "Thousands Transform Academic, Personal and Professional Lives With Cogmed Working Memory Training".
  9. ↑ "Peer-reviewed Research Supports The Claims Made By Cogmed".
  10. ↑ "Ongoing Research".
  11. ↑ Westerberg H. "Visuo-spatial working memory: a sensitive measurement of cognitive deficits in ADHD". Child Neuropsychology 10 (3): 155–161.
  12. ↑ "Effect of working memory training on working memory, arithmetic and following instructions". Psychological Research 78 (6): 869–877. 2014. doi:10.1007/s00426-014-0614-0.
  13. ↑ 13.0 13.1 13.2 Klingberg T (2005). "Computerized Training of Working Memory in Children With ADHD — A Randomized, Controlled Trial". Journal of the American Academy of Child & Adolescent Psychiatry 44 (2): 177–186.
  14. ↑ Brehmer Y (2009). "Working memory plasticity modulated by dopamine transporter genotype". Neuroscience Letters 467 (2): 117–120. doi:10.1016/j.neulet.2009.10.018.
  15. ↑ Bellander M (2011). "Preliminary evidence that allelic variation in the LMX1A gene influences training-related working memory improvement". Neuropsychologia 49 (7): 1938–1942. doi:10.1016/j.neuropsychologia.2011.03.021.
  16. ↑ Söderqvist S (2012). "Dopamine, working memory, and training induced plasticity: implications for developmental research.". Developmental Psychology (American Psychological Association) 48 (3): 836–843. doi:10.1037/a0026179.
  17. ↑ Söderqvist S (2014). "Polymorphisms in the Dopamine Receptor 2 Gene Region Influence Improvements during Working Memory Training in Children and Adolescents". Journal of Cognitive Neuroscience (Massachusetts Institute of Technology) 26 (1): 54–62. doi:10.1162/jocn_a_00478.
  18. ↑ McNab F (2009). "Changes in Cortical Dopamine D1 Receptor Binding Associated with Cognitive Training". Science 323 (5915): 800–802. doi:10.1126/science.1166102.
  19. ↑ Olesen PJ (2003). "Increased prefrontal and parietal activity after training of working memory". Nature Neuroscience 7: 75–79. doi:10.1038/nn1165.
  20. ↑ Westerberg H (2007). "Changes in cortical activity after training of working memory – a single-subject analysis". Physiology & Behavior 10 (1-2): 186–192.
  21. ↑ 21.0 21.1 21.2 Brehmer Y (2011). "Neural correlates of training-related working-memory gains in old age". NeuroImage 58 (4): 1110–1120. doi:10.1016/j.neuroimage.2011.06.079.
  22. ↑ Holmes J (2009). "Adaptive training leads to sustained enhancement of poor working memory in children". Developmental Science 12 (4): F9–F15. doi:10.1111/j.1467-7687.2009.00848.x.
  23. ↑ Dunning D (2013). "Does working memory training lead to generalized improvements in children with low working memory? A randomized controlled trial". Developmental Science 16 (6): 915–925. doi:10.1111/desc.12068.
  24. ↑ Dahlin K (2011). "Effects of working memory training on reading in children with special needs". Reading and Writing 24 (4): 479–491. doi:10.1007/s11145-010-9238-y.
  25. ↑ Green CT (2012). "Will working memory training generalize to improve off-task behavior in children with attention-deficit/hyperactivity disorder?". Neurotherapeutics 9 (3): 639–48. doi:10.1007/s13311-012-0124-y.
  26. ↑ "Cogmed Claims and Evidence". Pearson Education.
  27. ↑ 27.0 27.1 Melby-Lervag M, Hulme C (2012). "Is Working Memory Training Effective? A Meta-Analytic Review". Developmental Psychology 49 (2): 270–291. doi:10.1037/a0028228.
  28. ↑ http://www.cogmed.com/commentary-working-memory-training-effective-metaanalytic-review
  29. ↑ Shinaver C. "Despite what negative reviews claim Cogmed Working Memory Training matters for schools".
  30. ↑ Shipstead Z, Hicks K, Engle RW (2012). "Cogmed working memory training: Does the evidence support the claims?". Journal of Applied Research in Memory and Cognition 1 (3): 185–193. doi:10.1016/j.jarmac.2012.06.003.
  31. ↑ http://www.cogmed.com/cogmed-leader-evidencebased-working-memory-training
  32. ↑ http://www.newyorker.com/tech/elements/brain-games-are-bogus
  33. ↑ Kaufman SB. "In Defense of Working Memory Training".
  34. ↑ Fernandez A. "(Some) New Yorker articles are bogus".

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