- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02759263
Improving Neurodevelopment in Adolescents With Congenital Heart Disease
October 22, 2018 updated by: Jane W. Newburger, Boston Children's Hospital
Pilot Study of Executive Function Intervention to Improve Neurodevelopmental Outcomes in Adolescents With CHD
Executive dysfunction can profoundly impact all dimensions of a child's development.
Impairments in executive function are a central component of the neurodevelopmental phenotype associated with CHD, and manifest as behavioral dysregulation and problems with attention, working memory, and organization/planning abilities.
Identifying effective treatment strategies is vital for providing optimal care for these patients.
The Cogmed executive function intervention, an evidence-based computerized neurocognitive program, improves outcomes in several pediatric populations.
The investigators propose to conduct a pilot study to evaluate its efficacy in reducing morbidities in patients with CHD.
This is a single center, single blinded 2-arm randomized controlled trial to test the immediate post-treatment and 3-month follow-up efficacy of Cogmed intervention versus standard of care in adolescents with CHD.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Actual)
60
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
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Massachusetts
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Boston, Massachusetts, United States, 02115
- Boston Children's Hospital
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
13 years to 16 years (Child)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Diagnosis of CHD requiring open-heart surgery before age 1 year.
- Ages 13-16 years old.
- ≥ 6 months post-cardiac surgery.
- Followed-up at the Cardiology clinic of Boston Children's Hospital.
- English and/or Spanish speaking.
- Home internet access and a computer on which the Cogmed program can be installed
- Informed consent of parent/guardian as well as assent of child.
Exclusion Criteria:
- Chromosomal anomalies and/or genetic syndromes.
- Severe physical and/or sensory impairments (hearing, visual, or psychomotor).
- IQ scores <85 at baseline
- Confirmed diagnosis of an autism spectrum disorder or a severe developmental disorder that would prevent successful completion of the planned study testing.
- Scheduled to undergo major cardiac interventions in the 6 months following enrollment.
- Received, receiving, or scheduled to receive Cogmed or any other computerized behavioral training program targeting executive functions or ADHD.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Experimental: Working Memory Intervention
The group randomized to the Working Memory intervention will receive Cogmed computerized training of executive function and attention skills.
The standard Cogmed RM will be used for this trial arm.
This is a child-friendly web-based software program.
The investigators will use a version of the program that contains 12 different neurocognitive tasks.
Tasks become more difficult as a function of performance on a session-by-session basis.
Each training session lasts 35-40 minutes, with one session to be completed per day 5 days each week for 5 weeks, for a total of 25 sessions.
The program yields individual session-by-session and task-by- task training results, including the adolescents' responses, time spent on each task, and evolution curves.
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Cogmed Working Memory Program will be used as a computerized home-based intervention.
Families will receive a link for downloading a web-based software program.
The program will be installed on a computer at a family's home by a research assistant.
Parents and adolescents will be actively involved, and during the installation session, adolescents will complete several practice trials.
The 25 sessions will be completed individually by the adolescent with parental supervision.
For the first 5 sessions, the participant trains on the same set of games; on the 6th session and every 5th session thereafter, a new task is introduced and replaces one of the initial tasks.
At the end of each session, the adolescent can play an age-appropriate computerized game as a reward.
After each session, results are uploaded by parents to a secure website, to keep track of the participant's progress.
Families will be contacted weekly to check program function and discuss concerns.
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No Intervention: Control group - Standard of Care
Adolescents randomly assigned to the control group will receive the standard of care recommended for patients with critical CHD.
This includes cardiac surveillance and neurodevelopmental counseling and screening at our Cardiac Neurodevelopmental Program if needed.
Once enrolled in our study, an adolescent in the control group will not receive Cogmed intervention or any other cognitive intervention that targets executive functions or ADHD symptoms until after the 3-month follow-up neurodevelopmental evaluation is performed, i.e., 5-6 months after initial enrollment.
Like adolescents assigned to the intervention group, controls can continue on treatments that are already in place for other neurodevelopmental disabilities (e.g., speech therapy, occupational services).
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change from baseline scores at the computerized Working Memory Test from the NIH Toolbox Assessment of Neurological and Behavioral Function at post-treatment assessment (up to 2 weeks after cessation of the intervention).
Time Frame: Post-treatment assessment (up to 2 weeks after the cessation of the intervention)
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This standardized measure assesses the ability to process information across a series of modalities (visual-spatial and verbal), to hold this information in a short-term buffer, and to actively manipulate it mentally.
It is considered an excellent composite indicator of adolescents' executive function skills, as it requires the simultaneous implementation of control of attention and working memory abilities on tasks of increasing complexity.
Mean scores are automatically computed and are compared to a standardization sample of US adolescents of the same age.
They are normally distributed (mean=100, SD=15).
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Post-treatment assessment (up to 2 weeks after the cessation of the intervention)
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Jane W Newburger, MD, Boston Children's Hospital
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
June 1, 2016
Primary Completion (Actual)
September 1, 2018
Study Completion (Actual)
October 1, 2018
Study Registration Dates
First Submitted
April 22, 2016
First Submitted That Met QC Criteria
April 29, 2016
First Posted (Estimate)
May 3, 2016
Study Record Updates
Last Update Posted (Actual)
October 23, 2018
Last Update Submitted That Met QC Criteria
October 22, 2018
Last Verified
October 1, 2018
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- IRB-P00022266
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Yes
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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