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Journal of Medical Internet Research Apr 2023Learning disabilities are among the major cognitive impairments caused by aging. Among the interventions used to improve learning among older adults are serious games,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Learning disabilities are among the major cognitive impairments caused by aging. Among the interventions used to improve learning among older adults are serious games, which are participative electronic games designed for purposes other than entertainment. Although some systematic reviews have examined the effectiveness of serious games on learning, they are undermined by some limitations, such as focusing on older adults without cognitive impairments, focusing on particular types of serious games, and not considering the comparator type in the analysis.
OBJECTIVE
This review aimed to evaluate the effectiveness of serious games on verbal and nonverbal learning among older adults with cognitive impairment.
METHODS
Eight electronic databases were searched to retrieve studies relevant to this systematic review and meta-analysis. Furthermore, we went through the studies that cited the included studies and screened the reference lists of the included studies and relevant reviews. Two reviewers independently checked the eligibility of the identified studies, extracted data from the included studies, and appraised their risk of bias and the quality of the evidence. The results of the included studies were summarized using a narrative synthesis or meta-analysis, as appropriate.
RESULTS
Of the 559 citations retrieved, 11 (2%) randomized controlled trials (RCTs) ultimately met all eligibility criteria for this review. A meta-analysis of 45% (5/11) of the RCTs revealed that serious games are effective in improving verbal learning among older adults with cognitive impairment in comparison with no or sham interventions (P=.04), and serious games do not have a different effect on verbal learning between patients with mild cognitive impairment and those with Alzheimer disease (P=.89). A meta-analysis of 18% (2/11) of the RCTs revealed that serious games are as effective as conventional exercises in promoting verbal learning (P=.98). We also found that serious games outperformed no or sham interventions (4/11, 36%; P=.03) and conventional cognitive training (2/11, 18%; P<.001) in enhancing nonverbal learning.
CONCLUSIONS
Serious games have the potential to enhance verbal and nonverbal learning among older adults with cognitive impairment. However, our findings remain inconclusive because of the low quality of evidence, the small sample size in most of the meta-analyzed studies (6/8, 75%), and the paucity of studies included in the meta-analyses. Thus, until further convincing proof of their effectiveness is offered, serious games should be used to supplement current interventions for verbal and nonverbal learning rather than replace them entirely. Further studies are needed to compare serious games with conventional cognitive training and conventional exercises, as well as different types of serious games, different platforms, different intervention periods, and different follow-up periods.
TRIAL REGISTRATION
PROSPERO CRD42022348849; https://tinyurl.com/y6yewwfa.
Topics: Aged; Humans; Alzheimer Disease; Cognitive Dysfunction; Exercise; Learning; Memory, Episodic; Exergaming
PubMed: 37043277
DOI: 10.2196/43607 -
Autism : the International Journal of... Apr 2020Difficulty performing age-appropriate motor skills affects up to 83% of children with autism spectrum disorder. This systematic review examined the effect of motor and...
Difficulty performing age-appropriate motor skills affects up to 83% of children with autism spectrum disorder. This systematic review examined the effect of motor and physical activity intervention on motor outcomes of children with autism spectrum disorder and the effect of motor learning strategies on motor skill acquisition, retention, and transfer. Six databases were searched from 2000 to 2019. Forty-one studies were included: 34 intervention studies and 7 motor learning studies. The overall quality of the evidence was low. Participants included 1173 children with autism spectrum disorder ranging from 3 to 19 years. Results from level II and III intervention studies supported that participation outcomes improved with a physical education intervention; activity outcomes improved with aquatic, motor activity, motor skill, and simulated horse riding interventions; and body structure and function outcomes improved with aquatic, exergaming, motor activity, motor skill, and simulated horse riding interventions. Results from level II and III motor learning studies supported that motor skill acquisition improved with visual, versus verbal, instructions but was not influenced by differences in instructional personnel. More rigorous research on motor intervention is needed with well-controlled study designs, adequate sample sizes, and manualized protocols. In addition, research on motor learning strategies is warranted as it generalizes across motor interventions.
Topics: Animals; Autism Spectrum Disorder; Child; Exercise; Horses; Humans; Motor Skills; Physical Education and Training
PubMed: 31782658
DOI: 10.1177/1362361319885215 -
Neuropsychology Mar 2020Although there is a consensus that cannabis intoxication will have deleterious effects on a wide spectrum of cognitive skills, there is no consensus regarding the... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Although there is a consensus that cannabis intoxication will have deleterious effects on a wide spectrum of cognitive skills, there is no consensus regarding the duration of time from last use necessary to ameliorate these effects.
METHOD
A systematic review and series of meta-analyses were undertaken to assess anticipated gains in verbal learning with longer periods of cannabis abstinence. Studies assessing verbal learning performance in abstinent regular cannabis users and nonusing control participants; studies reporting length of cannabis abstinence at the time of neuropsychological assessment; and studies implementing one of three highly comparable measures of verbal learning and memory were included in the analyses. The included tasks have demonstrated some of the most robust declines associated with cannabis use and are prevalent in the clinical practice of neuropsychology. We assessed associations between cannabis abstinence and verbal learning scores via mixed effects subgroup analyses.
RESULTS
Twenty-three studies ( = 28; = 1,711) met all inclusion criteria. Cannabis users abstinent for 7 days or fewer performed worse than controls on verbal learning tasks, whereas cannabis users abstinent for longer periods showed no average significant difference in verbal learning performance compared with controls.
CONCLUSIONS
Based on available evidence, some amelioration of verbal learning limitations presumed to result from cannabis appear to resolve between 7 and 28 days of sustained abstinence. However, in the reviewed studies, years of regular use were inversely related to longer periods of abstinence and verbal learning performance, undermining a confident inference that abstinence alone has direct benefits to verbal learning and memory. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
Topics: Cognition; Humans; Marijuana Abuse; Memory; Verbal Learning
PubMed: 31886689
DOI: 10.1037/neu0000615 -
The Science of the Total Environment Feb 2023This systematic review summarises and evaluates the literature investigating associations between exposure to air pollution and general population cognition, which has... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
This systematic review summarises and evaluates the literature investigating associations between exposure to air pollution and general population cognition, which has important implications for health, social and economic inequalities, and human productivity.
METHODS
The engines MEDLINE, Embase Classic+Embase, APA PsycInfo, and SCOPUS were searched up to May 2022. Our inclusion criteria focus on the following pollutants: particulate matter, NOx, and ozone. The cognitive abilities of interest are: general/global cognition, executive function, attention, working memory, learning, memory, intelligence and IQ, reasoning, reaction times, and processing speed. The collective evidence was assessed using the NTP-OHAT framework and random-effects meta-analyses.
RESULTS
Eighty-six studies were identified, the results of which were generally supportive of associations between exposures and worsened cognition, but the literature was varied and sometimes contradictory. There was moderate certainty support for detrimental associations between PM and general cognition in adults 40+, and PM, NOx, and PM and executive function (especially working memory) in children. There was moderate certainty evidence against associations between ozone and general cognition in adults age 40+, and NOx and reasoning/IQ in children. Some associations were also supported by meta-analysis (N = 14 studies, all in adults aged 40+). A 1 μg/m increase in NO was associated with reduced performance on general cognitive batteries (β = -0.02, p < 0.05) as was a 1 μg/m increase in PM exposure (β = -0.02, p < 0.05). A 1μgm increase in PM was significantly associated with lower verbal fluency by -0.05 words (p = 0.01) and a decrease in executive function task performance of -0.02 points (p < 0.001).
DISCUSSION
Evidence was found in support of some exposure-outcome associations, however more good quality research is required, particularly with older teenagers and young adults (14-40 years), using multi-exposure modelling, incorporating mechanistic investigation, and in South America, Africa, South Asia and Australasia.
Topics: Child; Adolescent; Young Adult; Humans; Air Pollutants; Environmental Exposure; Air Pollution; Particulate Matter; Ozone; Cognition
PubMed: 36427724
DOI: 10.1016/j.scitotenv.2022.160234 -
International Journal of Environmental... Dec 2020Late preterm children born between 34 and 36 weeks' gestation account for ≈70% of prematurely born infants. There is growing concern about this population at risk of...
Late preterm children born between 34 and 36 weeks' gestation account for ≈70% of prematurely born infants. There is growing concern about this population at risk of mild neurodevelopmental problems, learning disabilities and lower academic performance. Following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement, this paper analyzes recent published evidence from 16selected studies involving late preterm children and control group assessments at preschool and/or school age, mainly focusing on cognitive functioning, language learning and academic achievement. The review identifies the assessment tools used in these studies (standardized tests, parental questionnaires and laboratory tasks) and the areas being evaluated from preschool (age 3 years) to primary school levels. Results reveal the presence of mild difficulties, pointing to suboptimal outcomes in areas such as executive function, short term verbal memory, literacy skills, attention and processing speed. Some difficulties are transient, but others persist, possibly compromising academic achievement, as suggested by the few studies reporting on higher risk for poor school performance. Given the increasing number of late preterm children in our society the review highlights the need to implement screening strategies to facilitate early risk detection and minimize the negative effects of this morbidity in childhood.
Topics: Adolescent; Child; Child, Preschool; Cognition; Cross-Sectional Studies; Gestational Age; Humans; Infant, Newborn; Infant, Premature; Premature Birth; Schools
PubMed: 33374182
DOI: 10.3390/ijerph18010074 -
The Cochrane Database of Systematic... Jun 2019Attention deficit hyperactivity disorder (ADHD) in children is associated with hyperactivity and impulsivity, attention problems, and difficulties with social...
BACKGROUND
Attention deficit hyperactivity disorder (ADHD) in children is associated with hyperactivity and impulsivity, attention problems, and difficulties with social interactions. Pharmacological treatment may alleviate the symptoms of ADHD but this rarely solves difficulties with social interactions. Children with ADHD may benefit from interventions designed to improve their social skills. We examined the benefits and harms of social skills training on social skills, emotional competencies, general behaviour, ADHD symptoms, performance in school of children with ADHD, and adverse events.
OBJECTIVES
To assess the beneficial and harmful effects of social skills training in children and adolescents with ADHD.
SEARCH METHODS
In July 2018, we searched CENTRAL, MEDLINE, Embase, PsycINFO, 4 other databases and two trials registers.We also searched online conference abstracts, and contacted experts in the field for information about unpublished or ongoing randomised clinical trials. We did not limit our searches by language, year of publication, or type or status of publication, and we sought translation of the relevant sections of non-English language articles.
SELECTION CRITERIA
Randomised clinical trials investigating social skills training versus either no intervention or waiting-list control, with or without pharmacological treatment of both comparison groups of children and adolescents with ADHD.
DATA COLLECTION AND ANALYSIS
We conducted the review in accordance with the Cochrane Handbook for Systematic Reviews of Intervention. We performed the analyses using Review Manager 5 software and Trial Sequential Analysis. We assessed bias according to domains for systematic errors. We assessed the certainty of the evidence with the GRADE approach.
MAIN RESULTS
We included 25 randomised clinical trials described in 45 reports. The trials included a total of 2690 participants aged between five and 17 years. In 17 trials, participants were also diagnosed with various comorbidities.The social skills interventions were described as: 1) social skills training, 2) cognitive behavioural therapy, 3) multimodal behavioural/psychosocial therapy, 4) child life and attention skills treatment, 5) life skills training, 6) the "challenging horizon programme", 7) verbal self-instruction, 8) meta-cognitive training, 9) behavioural therapy, 10) behavioural and social skills treatment, and 11) psychosocial treatment. The control interventions were no intervention or waiting list.The duration of the interventions ranged from five weeks to two years. We considered the content of the social skills interventions to be comparable and based on a cognitive-behavioural model. Most of the trials compared child social skills training or parent training combined with medication versus medication alone. Some of the experimental interventions also included teacher consultations.More than half of the trials were at high risk of bias for generation of the allocation sequence and allocation concealment. No trial reported on blinding of participants and personnel. Most of the trials did not report on differences between groups in medication for comorbid disorders. We used all eligible trials in the meta-analyses, but downgraded the certainty of the evidence to low or very low.We found no clinically relevant treatment effect of social skills interventions on the primary outcome measures: teacher-rated social skills at end of treatment (standardised mean difference (SMD) 0.11, 95% confidence interval (CI) 0.00 to 0.22; 11 trials, 1271 participants; I = 0%; P = 0.05); teacher-rated emotional competencies at end of treatment (SMD -0.02, 95% CI -0.72 to 0.68; two trials, 129 participants; I = 74%; P = 0.96); or on teacher-rated general behaviour (SMD -0.06 (negative value better), 95% CI -0.19 to 0.06; eight trials, 1002 participants; I = 0%; P = 0.33). The effect on the primary outcome, teacher-rated social skills at end of treatment, corresponds to a MD of 1.22 points on the social skills rating system (SSRS) scale (95% CI 0.09 to 2.36). The minimal clinical relevant difference (10%) on the SSRS is 10.0 points (range 0 to 102 points on SSRS).We found evidence in favour of social skills training on teacher-rated core ADHD symptoms at end of treatment for all eligible trials (SMD -0.26, 95% CI -0.47 to -0.05; 14 trials, 1379 participants; I= 69%; P = 0.02), but the finding is questionable due to lack of support from sensitivity analyses, high risk of bias, lack of clinical significance, high heterogeneity, and low certainty.The studies did not report any serious or non-serious adverse events.
AUTHORS' CONCLUSIONS
The review suggests that there is little evidence to support or refute social skills training for children and adolescents with ADHD. We may need more trials that are at low risk of bias and a sufficient number of participants to determine the efficacy of social skills training versus no training for ADHD. The evidence base regarding adolescents is especially weak.
Topics: Adolescent; Attention Deficit Disorder with Hyperactivity; Behavior Therapy; Child; Child, Preschool; Cognitive Behavioral Therapy; Humans; Interpersonal Relations; Social Skills
PubMed: 31222721
DOI: 10.1002/14651858.CD008223.pub3 -
The effect of sleep on novel word learning in healthy adults: A systematic review and meta-analysis.Psychonomic Bulletin & Review Dec 2021There is increasing evidence to indicate that sleep plays a role in language acquisition and consolidation; however, there has been substantial variability in... (Meta-Analysis)
Meta-Analysis Review
There is increasing evidence to indicate that sleep plays a role in language acquisition and consolidation; however, there has been substantial variability in methodological approaches used to examine this phenomenon. This systematic review and meta-analysis aimed to investigate the effect of sleep on novel word learning in adults, and explore whether these effects differed by retrieval domain (i.e., recall, recognition, and tests of lexical integration). Twenty-five unique studies met the inclusion criteria for the review, and 42 separate outcome measures were synthesized in the meta-analysis (k = 29 separate between-group comparisons, n = 1,396 participants). The results from the omnibus meta-analysis indicated that sleep was beneficial for novel word learning compared with wakefulness (g = 0.50). Effect sizes differed across the separate domain-specific meta-analyses, with moderate effects for recall (g = 0.57) and recognition memory (g = 0.52), and a small effect for tasks which measured lexical integration (g = 0.39). Overall, the results of this meta-analysis indicate that sleep generally benefits novel word acquisition and consolidation compared with wakefulness across differing retrieval domains. This systematic review highlights the potential for sleep to be used to improve second-language learning in healthy adults, and overall provides further insight into methods to facilitate language development.
Topics: Adult; Humans; Mental Recall; Recognition, Psychology; Sleep; Verbal Learning; Wakefulness
PubMed: 34549375
DOI: 10.3758/s13423-021-01980-3 -
Children (Basel, Switzerland) Nov 2022: Sex chromosome aneuploidies (SCAs) are a group of disorders characterised by an abnormal number of sex chromosomes. Collective prevalence rate of SCAs is estimated to... (Review)
Review
: Sex chromosome aneuploidies (SCAs) are a group of disorders characterised by an abnormal number of sex chromosomes. Collective prevalence rate of SCAs is estimated to be around 1 in 400-500 live births; sex chromosome trisomies (e.g., XXX, XXY, XYY) are most frequent, while tetra- and pentasomies (e.g., XXXX, XXXXX, XXXY, XXXXY) are rarer, and the most common is 48, XXYY syndrome. The presence of additional X and/or Y chromosomes is believed to cause neurodevelopmental differences, with increased risk for developmental delays, language-based learning disabilities, cognitive impairments, executive dysfunction, and behavioural and psychological disorders. : Our review has the purpose of analysing the neurocognitive, linguistical and behavioural profile of patients affected by sex chromosomes supernumerary aneuploidies (tetrasomy and pentasomy) to better understand the specific areas of weakness, in order to provide specific rehabilitation therapy. : The literature search was performed by two authors independently. We used MEDLINE, PubMed, and PsycINFO search engines to identify sources of interest, without year or language restrictions. At the end of an accurate selection, 16 articles fulfilled the inclusion and exclusion criteria. : International literature has described single aspects of the neuropsychological profile of 48, XXYY and 49, XXXXY patients. In 48, XXYY patients, various degrees of psychosocial/executive functioning issues have been reported and there is an increased frequency of behavioural problems in childhood. Developmental delay and behavioural problems are the most common presenting problems, even if anxiety, depression and oppositional defiant disorder are also reported. They also show generalized difficulties with socialization and communication. Cognitive abilities are lower in measures of verbal IQ than in measures of performance IQ. Visuospatial skills are a relative strength compared to verbal skills. In patients with 49, XXXXY, both intellectual and adaptive functioning skills fall into the disability range, with better non-verbal cognitive performance. Speech and language testing reveals more deficits in expressive language than receptive language and comprehension. Anxiety, thought problems, internalizing and externalizing problems, and deficits in social cognition and communication are reported. Behavioural symptoms lessen from school age to adolescence, with the exception of thought problems and anxiety. Individuals affected by sex chromosome aneuploidies show testosterone deficiency, microorchidism, lack of pubertal progression and infertility. Hormone replacement therapy (HRT) is usually recommended for these patients: different studies have found that testosterone-based HRT benefit a wide range of areas initiated in these disorders, affecting not only neuromotor, cognitive and behavioural profile but also structural anomalies of the brain (i.e., increase of volume of grey temporal lobe matter). In conclusion, further studies are needed to better understand the neuropsychological profile with a complete evaluation, including neurocognitive and psychosocial aspects and to establish the real impact of HRT on improving the cognitive and behavioural profile of these patients.
PubMed: 36360447
DOI: 10.3390/children9111719 -
International Journal of Telemedicine... 2022Autism spectrum disorder (ASD) is a complex neurobehavioral condition that begins in childhood and continues throughout life, affecting communication and verbal and... (Review)
Review
Diagnosis-Based Hybridization of Multimedical Tests and Sociodemographic Characteristics of Autism Spectrum Disorder Using Artificial Intelligence and Machine Learning Techniques: A Systematic Review.
Autism spectrum disorder (ASD) is a complex neurobehavioral condition that begins in childhood and continues throughout life, affecting communication and verbal and behavioral skills. It is challenging to discover autism in the early stages of life, which prompted researchers to intensify efforts to reach the best solutions to treat this challenge by introducing artificial intelligence (AI) techniques and machine learning (ML) algorithms, which played an essential role in greatly assisting the medical and healthcare staff and trying to obtain the highest predictive results for autism spectrum disorder. This study is aimed at systematically reviewing the literature related to the criteria, including multimedical tests and sociodemographic characteristics in AI techniques and ML contributions. Accordingly, this study checked the Web of Science (WoS), Science Direct (SD), IEEE Xplore digital library, and Scopus databases. A set of 944 articles from 2017 to 2021 is collected to reveal a clear picture and better understand all the academic literature through a definitive collection of 40 articles based on our inclusion and exclusion criteria. The selected articles were divided based on similarity, objective, and aim evidence across studies. They are divided into two main categories: the first category is "diagnosis of ASD based on questionnaires and sociodemographic features" ( = 39). This category contains a subsection that consists of three categories: (a) early diagnosis of ASD towards analysis, (b) diagnosis of ASD towards prediction, and (c) diagnosis of ASD based on resampling techniques. The second category consists of "diagnosis ASD based on medical and family characteristic features" ( = 1). This multidisciplinary systematic review revealed the taxonomy, motivations, recommendations, and challenges of diagnosis ASD research in utilizing AI techniques and ML algorithms that need synergistic attention. Thus, this systematic review performs a comprehensive science mapping analysis and identifies the open issues that help accomplish the recommended solution of diagnosis ASD research. Finally, this study critically reviews the literature and attempts to address the diagnosis ASD research gaps in knowledge and highlights the available ASD datasets, AI techniques and ML algorithms, and the feature selection methods that have been collected from the final set of articles.
PubMed: 35814280
DOI: 10.1155/2022/3551528 -
Journal of Clinical and Experimental... Sep 2023On some list-learning tasks, such as the California Verbal Learning Test (CVLT) or Hopkins Verbal Learning Test (HVLT), examinees have the opportunity to group words...
INTRODUCTION
On some list-learning tasks, such as the California Verbal Learning Test (CVLT) or Hopkins Verbal Learning Test (HVLT), examinees have the opportunity to group words based on semantically related categories (i.e., semantic clustering). Semantic clustering (SC) is often considered the most efficient organizational strategy and adopting SC is presumed to improve learning and memory. In addition, SC is conceptualized as reflecting higher-order executive functioning skills. Although SC measures have intuitive appeal, to date, there are no comprehensive reviews of the SC literature base that summarize its psychometric utility. In this systematic review, we synthesize the literature to judge the validity of SC scores.
METHOD
We conducted a systematic literature search for empirical articles reporting SC from the CVLT and HVLT. We qualitatively described the relationship of SC with other list-learning and cognitive test scores and clinical diagnoses, contrasting SC with serial clustering and total learning scores when possible.
RESULTS
SC was inversely correlated with serial clustering. Higher SC was strongly associated with better learning and memory performances. When compared with cognitive tests, SC tended to have the strongest relationships with other memory measures and modest relationships with tests of executive functioning. SC had negligible to small relationships with most other cognitive domains. Traditional memory scores yielded stronger relationships to cognitive test performances than did SC. SC across clinical groups varied widely, but clinical groups tended to use SC less often than healthy comparison groups.
CONCLUSION
Our comprehensive review of the literature revealed that SC is strongly related to measures of learning and memory on the CVLT and HVLT and is correlated with a wide range of cognitive functions. SC has been understudied in relevant populations and additional research is needed to test the degree to which it adds incremental validity beyond traditional measures of learning and memory.
Topics: Humans; Cluster Analysis; Cognition; Learning; Semantics; Verbal Learning; Psychometrics
PubMed: 37865967
DOI: 10.1080/13803395.2023.2270204