Preliminary feasibility study of a cognitive stimulation therapy programme for older adults with an intellectual disability.

BACKGROUND: Despite the increased risk for people with an intellectual disability developing dementia, post-diagnostic psychosocial supports such as cognitive stimulation therapy (CST) are not routinely offered and there is limited research examining this intervention with people with intellectual disabilities. The aim of this study was to explore the feasibility of CST for older adults with intellectual disability to support active ageing. METHODS: Five client participants attended a 14-session CST group and four staff attended a focus group. Reflexive thematic analysis was used to investigate the client and staff narratives. RESULTS: Three key themes were generated: (1) Brain Health, (2) Connecting with others, and (3) Barriers and Enablers. CONCLUSION: Findings indicated the suitability of CST as a way of supporting active ageing for older adults with intellectual disability. This study adds to the growing knowledge about service provision for older adults and their changing needs as they age and identifies clinical implications such as staff training to support intervention adherence.

Enhancing emotional abilities in anorexia nervosa treatment: A rolling-group cognitive remediation and emotional skills training protocol.

INTRODUCTION: Anorexia nervosa (AN) is characterised by limited remission rates and emotional dimensions are often neglected. Cognitive remediation and emotional skills training (CREST) protocol aims to address cognitive and emotional factors. This study evaluates the feasibility and effectiveness of a modified rolling-group CREST protocol in an inpatient setting. METHODS: Quasi-experimental design evaluated CREST protocol in a rehabilitation programme. A total of 116 females diagnosed with AN were included, of whom 63 were included in the CREST protocol and 53 in the standard rehabilitation treatment. Various standardized measures were employed to assess psychopathology. Data collection occurred longitudinally, before and after CREST implementation. RESULTS: No significant differences emerged between groups regarding changes in specific eating psychopathology. CREST group exhibited significant improvements in emotion regulation (p = 0.002) and social skills (p = 0.014), besides a reduction in alexithymia (p < 0.001) and cognitive rigidity (p = 0.013). Empathic features remained stable. Participants reported positive perceptions of the CREST intervention. DISCUSSION: The study highlights the potential benefits of integrating emotional training within multidisciplinary intensive treatment for AN. Results emphasise the importance of treatment protocol with more affective and hot-cognition-related interventions, beyond weight-related psychopathology. Implementing a rolling-group CREST protocol in an inpatient setting showed promise in enhancing the emotional abilities of AN patients.

Preserving cognitive vitality: Value of cognitive rehabilitation in addressing cognitive deficits in the elderly.

The recent advancements in medical sciences has resulted in not only increasing life expectancy of the elderly but has also improved survival rate in elderly with neurological disorders including those with head trauma . This has resulted in an increasing number of persons with cognitive deficits. Cognitive functions such as executive functioning and memory play an important role in success of a rehabilitation programme and therefore can positively contribute to public health goals. Considering cognitive decline at present has no cure and pharmacological therapies have a limited role, efforts are usually made to delay the onset and progression of cognitive decline and improve quality of life. Literature suggests that active life style, regular exercise, actively performing activities of daily living can have a significant impact on cognitive skills. In addition different models of cognitive rehabilitation and approaches can be integrated into practice to improve cognitive reserve and cause neuroplastic changes to facilitate cognitive function by providing cognitive stimulus and training. Moreover with technological advancements, the computerized cognitive intervention field is growing. This usually integrates conventional cognitive intervention with digital smart devices to provide an engaging and cost effective alternate approach. This review aims to highlight the importance of cognitive rehabilitation and suggest a few evidence based approaches that may be considered by rehabilitation professionals to promote and improve cognitive rehabilitation in Pakistan.

Virtual reality as a method of cognitive training of processing speed, working memory, and sustained attention in persons with acquired brain injury: a protocol for a randomized controlled trial.

BACKGROUND: Acquired brain injury (ABI) often leads to persisting somatic, cognitive, and social impairments. Cognitive impairments of processing speed, sustained attention, and working memory are frequently reported and may negatively affect activities of daily living and quality of life. Rehabilitation efforts aiming to retrain these cognitive functions have often consisted of computerized training programs. However, few studies have demonstrated effects that transfer beyond the trained tasks. There is a growing optimism regarding the potential usefulness of virtual reality (VR) in cognitive rehabilitation. The research literature is sparse, and existing studies are characterized by considerable methodological weaknesses. There is also a lack of knowledge about the acceptance and tolerability of VR as an intervention method for people with ABI. The present study aims to investigate whether playing a commercially available VR game is effective in training cognitive functions after ABI and to explore if the possible effects transfer into everyday functioning. METHODS: One hundred participants (18-65 years), with a verified ABI, impairments of processing speed/attention, and/or working memory, and a minimum of 12 months post injury will be recruited. Participants with severe aphasia, apraxia, visual neglect, epilepsy, and severe mental illness will be excluded. Participants will be randomized into two parallel groups: (1) an intervention group playing a commercial VR game taxing processing speed, working memory, and sustained attention; (2) an active control group receiving psychoeducation regarding compensatory strategies, and general cognitive training tasks such as crossword puzzles or sudoku. The intervention period is 5 weeks. The VR group will be asked to train at home for 30 min 5 days per week. Each participant will be assessed at baseline with neuropsychological tests and questionnaires, after the end of the intervention (5 weeks), and 16 weeks after baseline. After the end of the intervention period, focus group interviews will be conducted with 10 of the participants in the intervention group, in order to investigate acceptance and tolerability of VR as a training method. DISCUSSION: This study will contribute to improve understanding of how VR is tolerated and experienced by the ABI population. If proven effective, the study can contribute to new rehabilitation methods that persons with ABI can utilize in a home setting, after the post-acute rehabilitation has ended.

Network meta-analysis of the effects of different cognitive trainings on the cognitive function of patients with mild cognitive impairment.

OBJECTIVE: Examining the relationship between the responses of a number of different cognitive trainings on cognitive functioning in middle-aged and elderly patients with mild cognitive impairment. METHODS: Randomized controlled experimental studies published publicly from the time of inception to October 30, 2023 were searched through Web of Science, PubMed, Embase, and Cochrane library databases. Traditional and network meta-analyses were performed using Stata 17.0 software. RESULTS: Fifty papers on 4 types of cognitive training were included. Traditional meta-analysis showed that virtual reality training (SMD = 0.53, 95%CI: [0.36,0.70], P = 0.00), neuropsychological training (SMD = 0.44, 95%CI: [0.18,0.70], P = 0.00), cognitive strategy training (SMD = 0.26, 95%CI: [0.16,0.36], P = 0.00), and cognitive behavioral therapy (SMD = 0.25, 95%CI: [0.08,0.41], P = 0.00) all had significant improvement effects on the cognitive function of middle-aged and elderly patients with mild cognitive impairment. Network meta-analysis revealed neuropsychological training as the best cognitive training, and subgroup analysis of cognitive function subdimensions showed that neuropsychological training had the best effects on working memory, lobal cognitive function, memory, and cognitive flexibility improvement. Meanwhile, virtual reality training had the best effects on processing speed, verbal ability, overall executive function, spatial cognitive ability, and attention improvement. CONCLUSION: Cognitive training can significantly improve the cognitive function of middle-aged and elderly patients with mild cognitive impairment, and neuropsychological training is the best intervention, most effective in interventions lasting more than 8 weeks.

Evaluating remote delivery of cognitive remediation in people with psychosis.

BACKGROUND: Cognitive Remediation (CR) is an evidence-based therapy targeting cognitive difficulties in people with psychosis to promote functional recovery, but it is rarely implemented routinely. To reach more individuals, CR is beginning to be delivered remotely, but there is limited evidence to support the acceptability of this method. AIMS: To evaluate the acceptability and feasibility of remote therapist-supported CR in people with psychosis and estimate its cost and potential benefits. METHODS: A case-series with all participants assessed before and after therapy with measures of personal goal attainment (main outcome), cognition, functioning and symptoms. Acceptability was assessed with post-therapy interviews. Feasibility was assessed using proportions and confidence intervals on pre-specified parameters. Indication of benefits was assessed with exploratory analyses comparing baseline and post-therapy scores on the pre-specified outcomes. The cost of providing remote CR was assessed from both healthcare and societal perspectives. RESULTS: Twenty-nine participants started therapy with two dropping out; on average participants attended 25.5 sessions. Interviews suggested that remote CR had good acceptability and led to perceived benefits. Significant and large improvements were observed on goal attainment. Cost analyses suggest that remote CR has the same health care cost as face-to-face therapy but a lower societal cost. CONCLUSIONS: Our results support the use of remote CR in psychosis services as an alternative delivery modality. This method may improve adherence, attendance and be more convenient for service users. Possible barriers such as poor digital literacy or appropriate device ownership should be addressed before starting therapy.

Rehabilitation of Executive Function in Pediatric Traumatic Brain Injury (REPeaT): Outcomes of a pilot randomized controlled trial.

OBJECTIVE: To evaluate the effectiveness of Cogmed Working Memory Training (Cogmed) in improving working memory (WM) and decision making (DM) in childhood traumatic brain injury (TBI), and any associated increases in functional outcomes such as academic achievement in mathematics, behavior, social skills, and quality of life. METHOD: A randomized controlled trial of the Cogmed (RM version) intervention for children with TBI. A total of 69 children post-TBI were screened for WM impairments, of which 31 eligible participants (Mage: 10.6 years; male n = 21) were recruited and randomized to either the treatment group (Cogmed, n = 16) or the active-control group (Lexia Reading Core5, n = 15). Both groups completed computerized training for 5 weeks with clinician support via an online video platform. Immediately posttraining and at 6 months follow-up, primary (WM and DM) and secondary functional outcomes were assessed. RESULTS: Immediately postintervention, significant improvement was found in one primary outcome (WM verbal component) for the Cogmed group, but this was not maintained at the 6 months follow-up. No immediate improvements or maintenance gains (small effect sizes) in other primary outcomes of visuospatial WM or DM were reported in the Cogmed group. No other significant group differences were detected for other functional outcomes. CONCLUSIONS: Despite the limited benefits observed in this small randomized controlled trial, it will be beneficial to investigate Cogmed's efficacy in a case-series methodology, to further determine its effectiveness in a pediatric TBI population. Furthermore, a cautious approach in clinical implementation of Cogmed is advised. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Adapting Cognitive Remediation Group Therapy Online: Focus Groups with People Aging with HIV.

Cognitive health is a significant concern for people aging with HIV/AIDS. Psychosocial group therapies may help people aging with HIV who experience cognitive challenges cope with their symptoms. The COVID-19 pandemic revealed in-person group therapies need adaptation for technology-mediated delivery. Peer-led focus groups discussed adapting cognitive remediation group therapy (CRGT) as an online intervention. CRGT combines mindfulness-based stress reduction and brain training activities. Purposive sampling recruited people aging with HIV (40+) who self-identified cognitive concerns and resided in one of two Canadian provinces. Thematic content analysis was employed on transcripts by seven independent coders. Ten, 2-hour focus groups were conducted between August and November 2022. Participants (n=45) responded favorably to CRGT's modalities. Alongside support for its continued implementation in-person, participants requested online synchronous and online asynchronous formats. Preferred intervention facilitators were peers and mental health professionals. We also discuss how to adapt psychosocial HIV therapies for technology-mediated delivery.

Changing an in-person support group about cognitive health to an online support group via focus group consultations with middle-aged and older adults living with HIV/AIDSCognitive health concerns are common for people living with HIV as they grow older. Support groups may help individuals make connections with each other and develop ways to manage symptoms of cognitive impairment. In-person support groups need to have online adaptations for many reasons, including access for rural and remote communities. We conducted ten focus groups, led by people living with HIV, to discuss how to change an in-person support group to be online. The support group uses mindfulness and brain training activities. Forty-five people over age 40+ who are living with HIV in Ontario and Saskatchewan, Canada, and concerned about cognitive health participated in these focus groups. Seven researchers analysed the focus group transcripts. Participants liked the idea of the support group, both in-person and online. They specifically requested two forms of an online support group: synchronous, where everyone attends together at the same time, and asynchronous, where people attend at different times. This paper discusses how to change other in-person counselling and support group options for HIV to online formats.

Cognitive remediation for schizophrenia: Clinician perspectives on implementation barriers and facilitators.

OBJECTIVES: Neurocognitive deficits in schizophrenia have a major impact on functioning; however, they remain poorly targeted by available treatment offerings. Cognitive remediation (CR) is effective in improving neurocognition and functioning. Despite clinical guidelines for schizophrenia recommending CR, it is still not readily available in clinical services and sizeable attrition rates are reported in clinical trials. METHOD: To elucidate the barriers and facilitators of CR access and engagement, we conducted a mixed methods qualitative-dominant study with 12 clinicians in Australia, in 2021, with 1 hr interviews and additional rating scales completed. RESULTS: Thematic analysis highlighted four themes (cognitive symptoms, CR intervention, motivation and engagement in CR, and CR implementation), and 14 subthemes. Clinicians emphasized the broad impact of cognitive deficits and outlined pros and cons of different CR approaches. Several factors were suggested as impacting engagement, including motivation assessments/techniques, neurocognitive insight, illness, and demographic factors. Lack of routine implementation in Australia was unanimously espoused and partly explained by a need for cost-effectiveness analyses, remote and flexible delivery, and increasing service resource provision and staff training in CR. CONCLUSIONS: This study offers key insights into CR access, while recommending methods for optimizing CR implementation and dissemination to improve recovery outcomes of people diagnosed with schizophrenia. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Durability of Effects of Cognitive Remediation on Cognition and Psychosocial Functioning in Schizophrenia: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

OBJECTIVE: Cognitive remediation provides substantial improvements in cognitive performance and real-world functioning for people living with schizophrenia, but the durability of these benefits needs to be reassessed and better defined. The aims of this study were to provide a comprehensive assessment of the durability of the benefits of cognitive remediation for cognition and functioning in people living with schizophrenia and evaluating potential moderators of effects. METHODS: A systematic search was conducted in PubMed, Scopus, and PsycINFO, and reference lists of included articles and Google Scholar were inspected. Eligible studies were randomized clinical trials of cognitive remediation in patients diagnosed with schizophrenia spectrum disorders in which follow-up assessments were included. Screening and data extraction were performed by at least two independent reviewers. Cohen's d was used to measure outcomes. Primary outcomes were changes in cognition and functioning from baseline to conclusion of follow-up. Moderators of the durability of effects were assessed. RESULTS: Of 2,840 identified reports, 281 full texts were assessed and 130 reports on 67 studies with 5,334 participants were included. Cognitive remediation produced statistically significant positive effects that persisted at the end of follow-up in global cognition (d=0.23) and in global functioning (d=0.26). Smaller study samples and single-center studies were associated with better cognitive outcomes; longer treatment and follow-up duration, techniques for transferring cognitive gains to the real world, integration with psychiatric rehabilitation, group format of delivery, and more female participants in the sample were associated with better functional outcomes. CONCLUSIONS: Cognitive remediation provides durable improvements in cognition and functioning in schizophrenia. This finding corroborates the notion that cognitive remediation should be implemented more widely in clinical and rehabilitation practice.

Changes in BDNF methylation patterns after cognitive remediation therapy in schizophrenia: A randomized and controlled trial.

Although cognitive remediation therapy (CRT) produces cognitive benefits in schizophrenia, we do not yet understand whether molecular changes are associated with this cognitive improvement. A gene central to synaptic plasticity, the BDNF, has been proposed as one potential route. This study assesses whether BDNF methylation changes following CRT-produced cognitive improvement are detected. A randomized and controlled trial was performed with two groups (CRT, n = 40; TAU: Treatment as Usual, n = 20) on a sample of participants with schizophrenia. CRT was delivered by trained therapists using a web-based computerized program. Mixed Models, where the interaction of treatment (CRT, TAU) by time (T0: 0 weeks, T1: 16 weeks) was the main effect were used. Then, we tested the association between the treatment and methylation changes in three CpG islands of the BDNF gene. CRT group showed significant improvements in some cognitive domains. Between-groups differential changes in 5 CpG units over time were found, 4 in island 1 (CpG1.2, CpG1.7, CpG1.10, CpG1.17) and 1 in island 3 (CpG3.2). CRT group showed increases in methylation in CpG1.2, CpG1.7 and decreases in pG1.10, CpG1.17, and CpG3.2. Differences in the degree of methylation were associated with changes in Speed of Processing, Working Memory, and Verbal Learning within the CRT group. Those findings provide new data on the relationship between cognitive improvement and changes in peripheral methylation levels of BDNF gene, a key factor involved in neuroplasticity regulation. Trial Registration: NCT04278027.

The importance of improving cognitive flexibility in adolescents with anorexia nervosa: The case for cognitive remediation therapy.

OBJECTIVE: Inefficiencies in executive functioning (EF), more specifically cognitive flexibility and an overly detailed processing style, are frequently observed in individuals with Anorexia Nervosa (AN) and have been identified as potential targets in treatment. Cognitive Remediation Therapy (CRT) is an adjunctive treatment approach specifically designed to have a positive impact on EF. Mainly evaluated in adults, CRT has been criticized for its perceived ineffectiveness in promoting weight restoration or directly reducing eating disorder symptoms. METHOD: We argue that we need to refocus our conceptual framework for using CRT as an adjunctive treatment and specifically explore its potential benefit in adolescents. RESULTS: Adolescence is a critical window for EF development during which CRT has the potential to have the most impact. While it may not specifically ameliorate eating disorder symptoms and directly improve weight gain, CRT may mitigate the impact of malnutrition on adolescent brain development, reduce attrition rates in treatment, and improve cognitive flexibility and (indirectly) other maintaining factors, thereby improving global functioning. DISCUSSION: More research needs to be done to understand the development of EF in adolescents with AN and how best to employ CRT as an adjunctive treatment to support development and target maintaining factors. The current article broadly reviews findings on executive functioning inefficiencies in adolescents with AN and discusses the purpose and role of CRT in treating AN. Finally, we highlight key critiques of using CRT and pose questions for future research. PUBLIC SIGNIFICANCE: Treatments targeting executive functioning in adolescents with AN are limited. We need to better understand how CRT can benefit adolescents in treatment. Increasing treatment options, including adjunctive treatments, is necessary to reduce the long-term impact of AN.

Evidence-based psychosocial interventions in schizophrenia: a critical review.

PURPOSE OF REVIEW: Schizophrenia Spectrum Disorders (SSD) are severe conditions that frequently produce significant impairment in cognitive performance, social skills and psychosocial functioning. As pharmacological treatment alone often provides only limited improvements on these outcomes, several psychosocial interventions are employed in psychiatric rehabilitation practice to improve of real-world outcomes of people living with SSD: the present review aims to provide a critical overview of these treatments, focusing on those that show consistent evidence of effectiveness. RECENT FINDINGS: Several recent systematic reviews and meta-analyses have investigated in detail the acceptability, the effectiveness on several specific outcomes and moderators of response of different psychosocial interventions, and several individual studies have provided novel insight on their implementation and combination in rehabilitation practice. SUMMARY: Cognitive remediation, metacognitive training, social skills training, psychoeducation, family interventions, cognitive behavioral therapy, physical exercise and lifestyle interventions, supported employment and some other interventions can be fully considered as evidence-based treatments in SSD. Psychosocial interventions could be of particular usefulness in the context of early intervention services. Future research should focus on developing newer interventions, on better understanding the barriers and the facilitators of their implementation in clinical practice, and exploring the opportunities provided by novel technologies.

Effect of immersive virtual reality-based cognitive remediation in patients with mood or psychosis spectrum disorders: study protocol for a randomized, controlled, double-blinded trial.

BACKGROUND: Cognitive impairments are prevalent across mood disorders and psychosis spectrum disorders, but there is a lack of real-life-like cognitive training programmes. Fully immersive virtual reality has the potential to ensure motivating and engaging cognitive training directly relevant to patients' daily lives. We will examine the effect of a 4-week, intensive virtual reality-based cognitive remediation programme involving daily life challenges on cognition and daily life functioning in patients with mood disorders or psychosis spectrum disorders and explore the neuronal underpinnings of potential treatment efficacy. METHODS: The trial has a randomized, controlled, double-blinded, parallel-group design. We will include 66 symptomatically stable outpatients with mood disorders or psychosis spectrum disorders aged 18-55 years with objective and subjective cognitive impairment. Assessments encompassing a virtual reality test of daily life cognitive skills, neuropsychological testing, measures of daily life functioning, symptom ratings, questionnaires on subjective cognitive complaints, and quality of life are carried out at baseline, after the end of 4 weeks of treatment and at a 3-month follow-up after treatment completion. Functional magnetic resonance imaging scans are performed at baseline and at the end of treatment. The primary outcome is a broad cognitive composite score comprising five subtasks on a novel ecologically valid virtual reality test of daily life cognitive functions. Two complete data sets for 54 patients will provide a power of 80% to detect a clinically relevant between-group difference in the primary outcome. Behavioural data will be analysed using linear mixed models in SPSS, while MRI data will be analysed with the FMRIB Expert Analysis Tool (FEAT). Treatment-related changes in neural activity from baseline to end of treatment will be investigated for the dorsal prefrontal cortex and hippocampus as the regions of interest. DISCUSSION: The results will provide insight into whether virtual reality-based cognitive remediation has beneficial effects on cognition and functioning in symptomatically stable patients with mood disorders or psychosis spectrum disorders, which can aid future treatment development. TRIAL REGISTRATION: ClinicalTrials.gov NCT06038955. Registered on September 15, 2023.

Use of conditional-discrimination training in remembering relatives in a man with Alzheimer’s Disease

In this study, a 72-year-old man with Alzheimer’s disease and a Mini-Mental Status (MMS) score of 25 participated. The participant was presented for class-formation sorting tests and conditionaldiscrimination training sequences and tests with portraits of close family members, their names, and family relationships as stimuli. The purpose of the study was to identify intact relations between stimuli, stimulus control issues and thereafter reestablish relations between stimuli. In the sorting tests, intact and weakened stimulus relations were identified. In addition, the results showed how correct stimulus control was reestablished after tailoring the conditional-discrimination training after the participant had shown systematical incorrect responding to some of the presented stimuli. Key words: conditional discrimination, matching-to-sample, dementia, sorting test, stimulus control (AU)

Revisión sistemática sobre la incidencia de los programas de actividad física en la mejora cognitiva en la infancia y adolescencia / Physical activity programs incidence in cognitive improvement of children and adolescents: A systematic review

La infancia y adolescencia son etapas importantes en el desarrollo cerebral y son la base de la vida adulta. En numerosas ocasiones se ha demostrado los efectos de la actividad física en la salud, así como en el desarrollo cognitivo y moral. No obstante, no toda actividad física llega a causar efectos en las funciones cognitivas al mismo nivel, siendo la actividad vigorosa y el aumento de actividad cardiorrespiratoria las que aportan mayores beneficios. Esta revisión pretende recoger los estudios de los diez últimos años sobre los efectos de programas de actividad física en la cognición en la infancia y adolescencia. Se busca conocer qué tipo de actividad física es más beneficiosa para qué tipo de habilidad cognitiva. Los datos mostraron que la actividad física produce beneficios en la cognición, aunque es la actividad vigorosa la que genera mayor impacto. Los juegos reducidos y las actividades aeróbicas combinadas con coordinación se han visto mejores para inhibición y flexibilidad cognitiva. Aunque parece ser más importante la intensidad de la actividad. Esto puede beneficiar la planificación de los programas de actividad física y los beneficios que conlleva. (AU)

Childhood and adolescence are important stages in brain development and are the basis for adult life. The effects of physical activity on health, as well as on cognitive and moral development, have been demonstrated on numerous occasions. However, not all physical activity can have the same level of effect on cognitive functions, with vigorous activity and increased cardiorespiratory activity providing the greatest benefits. This review aims to collect the studies of the last ten years on the effects of physical activity programs on cognition in childhood and adolescence. The aim is to know which type of physical activity is more beneficial for which type of cognitive ability. The data showed that physical activity produces benefits on cognition, although vigorous activity has the greatest impact. Reduced games and aerobic activities combined with coordination have been found to be better for cognitive inhibition and flexibility. Although the intensity of the activity seems to be more important. This may benefit the planning of physical activity programs and the benefits it brings. (AU)

The cognitive remediation of attention in HIV-associated neurocognitive disorders (HAND): A meta-analysis and systematic review.

Background: Despite medical advances in Highly Active Antiretroviral Therapy (HAART), patients living with HIV continue to be at risk for developing HIV-associated neurocognitive disorders (HAND). The optimization of non-HAART interventions, including cognitive rehabilitation therapy (CRT), shows promise in reversing the impact of HAND. No data exist indicating the efficacy of CRT in remediating attention skills following neuroHIV. This paper presents a meta-analysis of randomised and non-randomised controlled trials (RCTs) to remediate attention skills following HIV CRT. Methods: The database search included literature from Google Scholar, ERIC, Cochrane Library, ISI Web of Knowledge, PubMed, PsycINFO, and grey literature published between 2013 and 2022. Inclusion criteria included studies with participants living with HIV who had undergone CRT intervention to remediate attention skills following neuroHIV. Exclusion criteria included case studies, non-human studies, and literature reviews. To assess study quality, including, randomisation, allocation concealment, participant and personnel blinding, the Cochrane Collaboration ratings system was applied. Results: A total of 14 studies met the inclusion criteria (n = 532). There were significant pre- to post-intervention between-group benefits due to CRT in the experimental group relative to control conditions for the remediation of attention skills following HIV acquisition (Hedges g = 0.251, 95% CI = 0.005 to 0.497; p < 0.05). No significant effects (p > 0.05) were demonstrated for subgroup analysis. Conclusions: To the author's knowledge, this is the first meta-analysis that exclusively analyses the remediation of attention skills in the era of HAART and neuroHIV, where all studies included participants diagnosed with HIV. The overall meta-analysis effect indicates the efficacy of CRT in remediating attention skills in HIV and HAND. It is recommended that future cognitive rehabilitation protocols to remediate attention skills should be context and population-specific and that they be supplemented by objective biomarkers indicating the efficacy of the CRT. Registration: Protocols.io (01/03/2023).

Telepractice in Early Childhood Intervention: A Parent-Reported Social Validity Scale / Telepráctica en Atención Temprana: una Escala de Validez Social Informada por Padres

Antecedents: In recent years, telepractice has become widespread as an intervention strategy in Early Childhood Intervention (ECI) services. However, studies supporting its use in this field remain scarce. Because reliable instruments are needed to evaluate the perceived quality, satisfaction and the acceptability of telepractice from the families’ perspective, the present study aims to report the psychometric properties of an ECI-specific instrument that includes a variety of social validity indicators that are also important and consistent with a family-centered approach. Method: This study, with a sample of 738 families, introduces an instrument aimed at evaluating the social validity of telepractice. The scale includes the main indicators of social validity: Usability, Effectiveness; Feasibility, Utility, intervention with natural caregivers, and Future Intentions. The study aims to report its psychometric properties through a split-sample method, conducting both exploratory and confirmatory factor analysis with randomly assigned sub-samples. Results: We found that all seven items fit into one factor measuring social validity of telepractice, with acceptable internal consistency and sensitive enough to capture differences between the type of service delivery families received. Conclusions: In addition, the proposed instrument provides relevant information for professionals to improve the quality of service-delivery in ECI.(AU)

Antecedentes: En los últimos años, la telepráctica se ha generalizado como estrategia de intervención en los servicios de Atención Temprana. Sin embargo, los estudios que avalan su uso en este ámbito siguen siendo escasos. Además, las investigaciones muestran que es necesario disponer de instrumentos fiables para evaluar la calidad percibida, la satisfacción y la aceptabilidad de la telepráctica, tanto desde la perspectiva de los profesionales como de las familias. Método: Este estudio, realizado con una muestra de 738 familias, introduce un instrumento destinado a evaluar la validez social de la telepráctica y analiza sus propiedades psicométricas. La escala integra los principales indicadores de validez social: Usabilidad, Eficacia; Viabilidad, Utilidad, intervención con cuidadores naturales e Intenciones de futuro. Resultados: Los resultados de este estudio mostraron la fortaleza de este instrumento reportado por los padres para medir la validez social de la telepráctica en la Intervención Temprana. Conclusiones: Además, el instrumento propuesto proporciona información relevante para los profesionales que mejoran la calidad de la prestación de servicios en Atención Temprana.(AU)

Psychoeducational module on Neurocognitive impairments - Mild and Severe. Module of the neuropsychological intervention program for the elderly, REHACOG / Módulo Psicoeducativo sobre Transtornos Neurocognitivos - Leve e Maior. Módulo do programa de intervenção neuropsicológica para o idoso, REHACOG

Objective The purpose is to present a neuropsychological intervention program, aimed at the broader person, the Psychoeducation Module, directed fundamentally at one's support network, family members and even intervention agents. Method The Cognitive Rehabilitation Program, given the acronym REHACOG, can work as a remedial and/or preventive tool that is very structured but flexible and complete because it includes varied tasks that promote multiple cognitive, linguistic and socio-emotional processes. REHACOG has an active character, also having a module more oriented to information and awareness for all the themes inherent to the larger individuals, potentially more oriented to caregivers or the elderly support network. Results Emphasizing this last topic, which has not yet been disseminated, which is the main objective of this article, we present the training module and the psychoeducational module, which includes six rubrics that cover topics ranging from conceptualization(s) of dementia, neurocognitive disorders, to symptomatology, assessment, intervention, caregivers and their roles, and response resources. Conclusion Although this material has not yet been published and disseminated, we expect to use and test it very soon.We look forward to its usefulness among professionals and future professionals in the area.

Objetivo Apresentar um programa de intervenção neuropsicológica, orientado para a pessoa maior, especificamente, o módulo Psicoeducação, vocacionado, fundamentalmente, para a sua rede de suporte, familiares e mesmo agentes interventores. Método O Programa de Reabilitação Cognitiva, com acrónimo REHACOG, pode funcionar enquanto ferramenta remediativa e/ou preventiva, bastante estruturado, mas flexível, porque inclui inúmeras e variadas tarefas promotoras de múltiplos processos cognitivos, linguísticos e socio emocionais. Genericamente, o REHACOG tem caráter ativo, possuindo, também, um módulo mais orientado para a informação, divulgação e sensibilização para todas as temáticas inerentes aos indivíduos maiores, potencialmente, mais orientado para os cuidadores ou rede de suporte dos idosos. Resultados Enfatizando este último tópico, ainda não disseminado, maior objetivo do presente artigo, temos o módulo informativo/formativo, Módulo Psicoeducativo, que contempla seis rubricas que perpassam tópicos desde a concetualização(ões) de demência, os transtornos neurocognitivos, à sintomatologia, à avaliação, à intervenção, aos cuidadores e seus papéis e aos recursos de resposta. Conclusão Embora este material ainda não esteja publicado e disseminado, contamos vir a utilizá-lo e a testá-lo muito em breve. Almejamos a sua utilidade junto de profissionais e futuros profissionais da área.