Computer-based cognitive remediation program for the treatment of behavioral problems in children with intellectual disability: the «COGNITUS & MOI» study protocol for a randomized controlled trial

Emilie Favre, Elodie Peyroux, Marie-Noelle Babinet, Alice Poisson, Caroline Demily, Emilie Favre, Elodie Peyroux, Marie-Noelle Babinet, Alice Poisson, Caroline Demily

Abstract

Background: Comorbid psychiatric disorders are frequent in children with intellectual disability (ID). Given the limitations of drugs treatments, cognitive remediation could be a promising tool to reduce these challenging behaviors but evidence is still scarce. Our group recently developed the «COGNITUS & MOI» program that is designed to train the attentional and visuospatial skills in children with ID. This study investigates the efficiency of the «COGNITUS & MOI» program in this condition.

Methods: Children (age: 6.00-13.11) with mild to moderate ID and behavioral problems, will benefit from a therapy during a 16 week randomized controlled trial. One group will be randomly treated with the «COGNITUS & MOI» program and the other with a motor skill and video viewing intervention. All participants will undergo a behavioral, functional and neurocognitive assessment at baseline, post-intervention, and 6-month follow-up. Primary outcome will be the change from the baseline of the score on the "hyperactivity - noncompliance" subscale of the Aberrant Behavior Checklist.

Discussion: If the results are conclusive, the «COGNITUS & MOI» program could be added to the therapeutic arsenal against challenging behavior in children with ID.

Trial registration: ClinicalTrials NCT02797418 . Date registered: 8th of June 2016.

Keywords: Challenging behaviour; Children; Cognitive remediation; Comorbid psychiatric disorder; Intellectual disability.

Conflict of interest statement

Ethics approval and consent to participate

We adhered to SPIRIT guidelines. This study was approved by the local ethic committee (decision of the Comité de Protection des Personnes SUD-EST IV of 6 April 2016; 1st amendment of 15 march 2017; 2nd amendment 27 march 2018; ID-RCB: 2015-A00858–41) and was authorized by the French National Agency for Medicines and Health Products Safety (ANSM 160096B-31). All amendments will be reported to the ethic committee. Consent to participate will be obtained from all participants and their parents.

Consent for publication

Not applicable.

Competing interests

Scientific Brain Training SA provided substantial technical support to develop computerized activities of the “COGNITUS & MOI” program. Authors declare that they have no other competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Schematic overview of the «COGNITUS & MOI» study protocol

References

    1. Einfeld SL, Ellis LA, Emerson E. Comorbidity of intellectual disability and mental disorder in children and adolescents: a systematic review. J Intellect Develop Disabil. 2011;36:137–143. doi: 10.1080/13668250.2011.572548.
    1. Linna SL, Moilanen I, Ebeling H, Piha J, Kumpulainen K, Tamminen T, et al. Psychiatric symptoms in children with intellectual disability. Eur Child Adolesc Psychiatry. 1999;8(Suppl 4):77–82. doi: 10.1007/PL00010704.
    1. Munir KM. The co-occurrence of mental disorders in children and adolescents with intellectual disability/intellectual developmental disorder. Curr Opin Psychiatry. 2016;29:95–102. doi: 10.1097/YCO.0000000000000236.
    1. de Kuijper G, Hoekstra P, Visser F, Scholte FA, Penning C, Evenhuis H. Use of antipsychotic drugs in individuals with intellectual disability (ID) in the Netherlands: prevalence and reasons for prescription. J Intellect Disabil Res JIDR. 2010;54:659–667. doi: 10.1111/j.1365-2788.2010.01275.x.
    1. McQuire C, Hassiotis A, Harrison B, Pilling S. Pharmacological interventions for challenging behaviour in children with intellectual disabilities: a systematic review and meta-analysis. BMC Psychiatry. 2015;15:303. doi: 10.1186/s12888-015-0688-2.
    1. Tsiouris JA. Pharmacotherapy for aggressive behaviours in persons with intellectual disabilities: treatment or mistreatment? J. Intellect. Disabil. Res. JIDR. 2010;54:1–16. doi: 10.1111/j.1365-2788.2009.01232.x.
    1. Ben-Yishay Y. Foreword. Neuropsychol Rehabil. 2008;18:513–521. doi: 10.1080/09602010802141525.
    1. Danielsson H, Henry L, Rönnberg J, Nilsson L-G. Executive functions in individuals with intellectual disability. Res Dev Disabil. 2010;31:1299–1304. doi: 10.1016/j.ridd.2010.07.012.
    1. Merrill EC, O’dekirk JM. Visual selective attention and mental retardation. Cogn Neuropsychol. 1994;11:117–132. doi: 10.1080/02643299408251970.
    1. Schuchardt K, Gebhardt M, Mäehler C. Working memory functions in children with different degrees of intellectual disability: working memory functions. J Intellect Disabil Res. 2010;54:346–353. doi: 10.1111/j.1365-2788.2010.01265.x.
    1. Çak HT, Çengel Kültür SE, Gökler B, Öktem F, Taşkıran C. The behavior rating inventory of executive function and continuous performance test in preschoolers with attention deficit hyperactivity disorder. Psychiatry Investig. 2017;14:260–270. doi: 10.4306/pi.2017.14.3.260.
    1. Vangkilde A, Jepsen JRM, Schmock H, Olesen C, Arnarsdóttir S, Baaré WFC, et al. Associations between social cognition, skills, and function and subclinical negative and positive symptoms in 22q11.2 deletion syndrome. J Neurodev Disord. 2016;8:42. doi: 10.1186/s11689-016-9175-4.
    1. Thakkar KN, Brugger P, Park S. Exploring empathic space: correlates of perspective transformation ability and biases in spatial attention. PLoS One. 2009;4:e5864. doi: 10.1371/journal.pone.0005864.
    1. Dodge KA, Pettit GS. A biopsychosocial model of the development of chronic conduct problems in adolescence. Dev Psychol. 2003;39:349–371. doi: 10.1037/0012-1649.39.2.349.
    1. Hetzroni O, Oren B. Effects of intelligence level and place of residence on the ability of individuals with mental retardation to identify facial expressions. Res Dev Disabil. 2002;23:369–378. doi: 10.1016/S0891-4222(02)00139-7.
    1. van Nieuwenhuijzen M, de Castro BO, Wijnroks L, Vermeer A, Matthys W. Social problem-solving and mild intellectual disabilities: relations with externalizing behavior and therapeutic context. Am J Intellect Dev Disabil. 2009;114:42–51. doi: 10.1352/2009.114:42-51.
    1. Ellis CR, Lindstrom KL, Villani TM, Singh NN, Best AM, ASW W, et al. Recognition of facial expressions of emotion by children with emotional and behavioral disorders. J Child Fam Stud. 1997;6:453–470. doi: 10.1023/A:1025097429527.
    1. Bussy G, Rigard C, des Portes V. Impact d’un entrainement de la mémoire à court-terme verbale sur le langage d’enfants ayant une déficience intellectuelle. Rev Francoph Défic Intellect. 2013;24:141–151. doi: 10.7202/1021269ar.
    1. Comblain A. Working memory in Down syndrome: training the rehearsal strategy. Syndr Res Pract. 1994;2:123–126. doi: 10.3104/reports.42.
    1. Danielsson H, Zottarel V, Palmqvist L, Lanfranchi S. The effectiveness of working memory training with individuals with intellectual disabilities - a meta-analytic review. Front Psychol. 2015;6:1230. doi: 10.3389/fpsyg.2015.01230.
    1. Hulme C, Mackenzie S. Working Memory and Severe learning difficulties. Hove: Erlbaum; 1992.
    1. Kendall C, Borkowski J, Cavanaugh J. Metamemory and the transfer of an interrogative strategy by EMR children. Intelligence. 1980;4:255–270. doi: 10.1016/0160-2896(80)90023-9.
    1. Galbiati S, Recla M, Pastore V, Liscio M, Bardoni A, Castelli E, et al. Attention remediation following traumatic brain injury in childhood and adolescence. Neuropsychology. 2009;23:40–49. doi: 10.1037/a0013409.
    1. Roording-Ragetlie S, Klip H, Buitelaar J, Slaats-Willemse D. Working memory training in children with neuropsychiatric disorders and mild to borderline intellectual functioning, the role of coaching; a double-blind randomized controlled trial. BMC Psychiatry [Internet]. 2017 [cited 2017 Jul 5];17:114. Available from:
    1. Demily C, Rigard C, Peyroux E, Chesnoy-Servanin G, Morel A, Franck N. «COGNITUS & MOI»: a computer-based cognitive remediation program for children with intellectual disability. Front Psychiatry. 2016;7:10. doi: 10.3389/fpsyt.2016.00010.
    1. Aman M, Singh N. Aberrant behavior checklist manual. East Aurora, NY: Slosson Publications; 1986.
    1. Tse J, Strulovitch J, Tagalakis V, Meng L, Fombonne E. Social skills training for adolescents with Asperger syndrome and high-functioning autism. J Autism Dev Disord. 2007;37:1960–1968. doi: 10.1007/s10803-006-0343-3.

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