Feasibility and potential benefits of an attention and executive function intervention on metacognition in a mixed pediatric sample.

The term "metacognition" describes thinking about a cognitive phenomenon or, more simply put, thinking about thinking . Metacognition involves using knowledge about one's cognitive processes to change behavior, including monitoring and controlling cognition. Metacognition is vital for learning and is often more difficult for children with neurodevelopmental concerns (e.g. Attention Deficit Hyperactivity Disorder [ADHD], Fetal Alcohol Spectrum Disorder [FASD], Autism Spectrum Disorders [ASD]), possibly due to underlying deficits in attention and executive functioning (EF). The present study evaluated a 6- to 8-week cognitive intervention aimed at improving attention and EF and children's metacognitive abilities. Participants included a mixed sample of 50 children ages 6-12 years presenting with attention and/or EF deficits. Children within the active intervention group completed a game-based attention/EF intervention called Caribbean Quest (CQ), which combines process-specific and compensatory approaches to remediate attention and EF. Educational Assistants (EAs) supported children during gameplay by teaching explicit metacognitive strategies. Pre/post assessments included measures of attention and working memory (WM), metacognitive awareness (child, parent, and EA questionnaires), and metacognitive regulation (metacognitive monitoring and control). Results indicated post-intervention gains in WM, metacognitive awareness, and metacognitive regulation (self-monitoring and metacognitive control). These results provide preliminary support for CQ as potentially beneficial in improving aspects of EF and metacognition in children.

Investigating the efficacy of an attention training programme in children with foetal alcohol spectrum disorder.

OBJECTIVE: The current study investigated the efficacy of a direct intervention programme aimed at improving attention abilities in children with foetal alcohol spectrum disorder (FASD). METHODS: The Computerized Progressive Attention Training (CPAT) program is an intervention which targets proposed attention networks. CPAT task difficulty automatically adjusts based on participant performance. Ten children aged 6-15 with FASD completed an average of 16 hours of intervention over ~9 weeks at school, aided by a research assistant providing metacognitive strategies and support. RESULTS: Pre- and post-intervention assessments indicate significant improvement on several attention measures including sustained attention and selective attention. In addition, several measures of spatial working memory, math fluency, and reading fluency also significantly increased, suggesting that better attention leads to better cognitive performance. CONCLUSION: Results provide support for the use of computerized attention training materials as part of an effective intervention for cognitive performance in children with FASD.