Computerized Working Memory Training - Research Paper Example

Randomized Study of Computerized Working Memory Training and Effects on Functioning in Everyday Life for Patients with Brain Injury Course: Tutor: Date: Abstract Working memory can largely be defined as the innate ability for a person to keep information online for a brief time period. It is variously described as the ability to not only hold, but also manipulate information for a short delay, and to be able to subsequently make an appropriate response based on the given internal representation. This ability is essential for many cognitive tasks such as problem solving and the control of attention. Deficits in working memory and executive attention are common problems among individuals that happen to have acquired some form of brain injury. Brain injuries can trigger deficits in working memory and attention. This has been noted to usually result in impairment to social functioning and vocational performance. This paper will seek to identify the fundamental issues surrounding brain injury and the effect that brain injury has on the working memory of the affected individual. To achieve its objectives, the paper will conduct a qualitative analysis of the results of a number of research studies examining this particular subject matter. Whereas some studies suggest that computerized working memory is largely ineffective, this research paper will show that computerized working memory training is effective in improving the functioning of everyday life for individuals suffering from brain injuries. Randomized Study of Computerized Working Memory Training and Effects on Functioning in Everyday Life for Patients with Brain Injury Introduction According to Dikmen (2009), traumatic brain injury is regarded as being of major public health significance as it affects an estimated almost 1.6 million individuals across the United States each year. Of these people, about 125,000 are disabled 1 year after injury, 50,000 die and about 290,000 are hospitalized. It also estimated that more than 1.2 million are seen in emergency departments while countless others are assessed by emergency response personnel, evaluated in physician’s offices or happen to go untreated. According to the CDC, the total life time cost for the treatment of mild traumatic brain injury stood at $16.7 billion as at 1995. Cognitive problems are identified as being a common result of traumatic brain injuries and this can normally affect working memory function such as language functions as well as cause severe difficult attention difficulties. In daily life people often use their working memory to aid them in remembering instructions and plans of what they are supposed to do next. Of note is that keeping this information online is considered to be a very basic function and over time, this function has undoubtedly proven to be of central importance in the performance of a wide range of cognitive tasks. Working memory is of critical importance in the maintenance of task relevant information during the process of problem solving. Verbal working memory is indispensable for the comprehension of long sentences. Generally, working memory is identified as the most important factor in the determination of an individual’s general intellectual ability. Working memory training is primarily intended to try and improve an individual’s working memory. In a study designed to determine if working memory training is actually effective, Lervåg & Hulme (2013) point out that a number of computer-based commercial working memory training programs have been developed in recent years and perhaps the most well-know of these is CogMed which has been made widely available in an estimated over 39 countries and is popularly used in clinics and schools. This program is designed to be based on a total of eight different exercise that primarily involve verbal and visuo-spatial working memory tasks whose difficulty adaptively varies during the course of training. Other computerized working memory training programs include Cognifit Jungle Memory. A number of fundamental issues are noted to exist as pertains to the effects of computerized working memory on patient. In their review, Lervåg & Hulme (2013) challenge the effectiveness of computerized memory training by highlight the fact that the computerized working memory training programs have been noted to make a number of claims. Jungle Memory claims that it will improve working memory, IQ and grades. Similarly on its website CogMed touts itself as being the solution for individuals that happen to be held back by their working memory capacity. According to the site, improving working memory improves fluid IQ and makes individuals better able to self manage, pay attention, learn and resist distractions. Lervåg & Hulme (2013) argue that these programs seem to all be based on what might possibly be perceived as being a somewhat naïve physical energetic model that assumes that the repeated loading of a limited cognitive resource can ultimately result in causing an increase in its capacity in a process that is almost analogous to the strengthening of a muscle by its repeated use. The results of the meta-analysis conducted by Lervåg & Hulme (2013) showed that current working memory training programs have the effect yielding reliable short-term improvements on both the non-verbal and verbal working memory tasks. However, these short-term near transfer effect were found to not be sustained when they were reassessed after a delay averaging about 9 months. Conversely, the results for the visuo-spatial working memory showed a less clear pattern and there was a suggestion that a considerably modest effect may actually be present five months after training but the number of studies that this can be based on is small. It was also serious that working memory training did not realize any generalized gains to the other skills that were being investigated including arithmetic, word decoding and verbal ability, this was noted to be case when assessments took place immediately after training. On the other hand, there was an overall small but reliable improvement for non-verbal training. A number of brain injuries such as strokes can have the effect of inducing severe deficits in attention and working memory. These deficits can result in impairments to social functioning and vocational performance. In a study by Westerberg et al (2007), that sought to evaluate computerized attention training after brain injury in a total of four controlled studies. The study was conducted on a sample size of 18 participants aged between 34 and 65 years who had experienced brain damage of a time span extending between the past 12-36 months. Using a computerized training working memory approach that utilized the RoboMemo software product developed by Cogmed Cognitive Meidal systems, the researchers sought to try and evaluate the effect of adaptive, intense working memory training in a number of auditory and visuo-spatial modalities for a group of patients who had brain injuries resulting from stroke. The study results indicated that the treatment group recorded significant improvements as compared to the passive control group of the non-trained tests that was designed to measure attention and working memory. The study also recorded a significant treatment effect as was indicated by the self-rating on cognitive failures symptoms as had been measured using the CFQ. The study results also suggested that computerized memory training had the added effect of not only affective the subjective experience of cognitive functioning in daily living but also of improving cognitive functioning as measured by neuropsychological tests. The results o the study by Westerberg et al (2007) suggest that between one to three years after an individual happens to suffer from a stroke, the use of intensive training can have the effect of improving the individual’s attention and working memory performance and that the training effects can successfully be generalized to cognitive functioning in daily living. The results of this study are found to be consistent with the effect of working memory training in a number of previous studies. Following the event of brain injuries resulting from a stroke, a key reason for individuals not being able to return to work is cognitive problems. Westerberg et al (2007) note that computerized cognitive training is a rather novel field. The rationale for using working memory training after a patients experiences brain damage as a result of a stroke I that working memory supports a relatively wide range of cognitive abilities that are rather crucial for the successful accomplishment of daily living tasks and vocational performance. Some of these include reasoning, the ability to be able to effectively resist distraction from irrelevant stimuli, as well as the control of attention. In a study to examine the short and long-term transfer effects of implementing the use of a computerized working memory training program as applied to patients suffering from working memory deficits after acquired brain injury, the researcher was able to show that computerized memory training is indeed beneficial in improving the working memory of individuals affected by brain injuries. In the study, Lundgvist et al (2010) used a sample size of 21 individuals that had an average age of 43.2 years in addition to having had brain injuries over a time period averaging about 37 months. The researchers randomly divided the research participants into two groups with one groups serving as a control group. All the research study participants were trained on a daily basis using a computerized working memory task program. The participants were then followed-up and evaluated at 4 and 20 weeks after the completion o their training. The study recorded a significant improvement in the performance of the research participants in performing their trained working memory tasks. There were also considerable improvements noted in the neuropsychological worming memory test results that were conducted by the researcher at 4 and 20 weeks after training as compared to the baseline results obtained by the study control group. Although the rated quality of life for the study participants was noted to have not experienced any significant degree of change, the rated overall health is seen to have increased 20 weeks after training. From the results of the study, the researchers determined that computerized working memory training was not only of great importance in the improvement of the subjects neuropsychological working memory demanding tests but also in improving the occupational performance and well as with the general degree of satisfaction that the subjects had as a result of their performance. Conclusion While there has been a considerable degree of criticisms leveled against the effectiveness of computerized memory training and the effect of this treatment approach among individuals suffering from brain injury as has been highlighted in the review by Lervåg & Hulme (2013), there has been a number of studies that have been able to conclusively show that computerized working memory is indeed beneficial in the treatment of individuals suffering from deficits in their working memories as a result of brain injury. Some of the benefits of working memory training as highlighted in these studies include improved cognitive functioning as measured by neuropsychological tests as well as improved ability to resist distractions, better control of attention as well as better reasoning ability on the part of the individual. All these attributes greatly contribute towards the improvement of the affected individual’s functioning in everyday life. References Dikmen, S. S., Corrigan, J. D., Levin, H. S., Machamer, J., Stiers, W., & Weisskopf, M. G. (2009). Cognitive outcome following traumatic brain injury.The Journal of head trauma rehabilitation, 24(6), 430-438. Lundqvist, A., Grundström, K., Samuelsson, K., & Rönnberg, J. (2010). Computerized training of working memory in a group of patients suffering from acquired brain injury. Brain Injury, 24(10), 1173-1183. Melby-Lervåg, M., & Hulme, C. (2013). Is working memory training effective? A meta-analytic review. Developmental Psychology, 49(2), 270. Westerberg, H., Jacobaeus, H., Hirvikoski, T., Clevberger, P., Östensson, M. L., Bartfai, A., & Klingberg, T. (2007). Computerized working memory training after stroke-A pilot study. Brain Injury, 21(1), 21-29. Read More