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Table 14.17 Amsterdam Memory and Attention Training for the Rehabilitation of Attention Deficits in Children Post ABI

Author Year

Country

Study Design

Sample Size

Methods Outcome

van’t Hooft et al. (2005)

Sweden

RCT

PEDro=6

NInitial=40, NFinal=38

                             

Population: ABI: TBI=21, Brain Malignancies=14, Encephalitis=2, Anoxia=1; Amsterdam Memory and Attention Training for Children Group (AMAT-c, n=18): Mean Age=11.7yr; Gender: Male=12, Female=6; Mean Time Post Injury=2.2yr; Severity: Mild/Moderate=7, Severe=5. Control Group (n=20): Mean Age=12.6yr; Gender: Male=10, Female=10; Mean Time Post Injury=2.6yr; Severity: Mild/Moderate=6, Severe=3.

Intervention: Patients were randomly allocated to perform an interactive activity for 30 min, 6 day/wk over 17 wk using the AMAT-c program or to an interactive program chosen by the patient, teacher and parents. The AMAT-c was completed in three phases; sustained attention, selective attention, and mental tracking. Assessments were completed at baseline and at post-treatment.

Outcome Measure: Wechsler Intelligence Scales for Children (WISC-III) Coding and Digit Span tests, Visual Reaction Time (VRT), Auditory Reaction Time (ART), Gordon Diagnostic System (GDS), Stroop Tests, Trail Making Tests A and B (TMT A and B), Rivermead Behavioural Memory Test (RBMT), Rey-Osterrieth Complex Figure (ROCF), Binary Choice Test (BCT), 15 Word Test. 

1.       Post-treatment, children in the AMAT-c group had significant improvements on the GDS (p=0.01), but not on any other measure of sustained attention (ART and VRT, p=0.38 and p=0.52 respectively) compared to controls.

2.       On selective attention measures, the AMAT-c group performed significantly better post-treatment compared to baseline on both TMT A and B (p=0.002 and p=0.006 respectively), WISC-III Coding scale (p=0.002), Stroop Test 1 (p=0.020), and BCT number of correct answers (p=0.002) but not BCT reaction time (p=0.530).

3.       Performance on memory tasks significantly improved in the AMAT-c group at post-treatment compared to controls on WISC-III Digit Span (p=0.0004), ROCF (p=0.003), RBMT (p=0.00004). Immediate recall on the 15 Words Test was not significantly different between groups (p=0.390) but delayed recall on the test was significantly greater in the experimental group (p=0.020).

           

van’t Hooft et al. (2007)

*A follow-up to van’t Hooft et al. (2005)

 

Population: ABI: TBI=21, Brain Malignancies=14, Encephalitis=2, Anoxia=1; Amsterdam Memory and Attention Training for Children Group (AMAT-c, n=18): Mean Age=11.7yr; Gender: Male=12, Female=6; Mean Time Post Injury=2.2yr; Severity: Mild/Moderate=7, Severe=5. Control Group (n=20): Mean Age=12.6yr; Gender: Male=10, Female=10; Mean Time Post Injury=2.6yr; Severity: Mild/Moderate=6, Severe=3.

Intervention: A follow-up at 6 mo of children randomized to receive AMAT-c or an interactive program as described above. Outcome measures at 6 mo were compared to baseline and post-treatment.

Outcome Measure: Wechsler Intelligence Scales for Children (WISC-III) Coding and Digit Span tests, Visual Reaction Time (VRT), Auditory Reaction Time (ART), Vigilance Test of the Gordon Diagnostic System (VGDS), Stroop Tests, Trail Making Tests A and B (TMT A and B), Rivermead Behavioural Memory Test (RBMT), Rey-Osterrieth Complex Figure (ROCF), Binary Choice Test (BCT), 15 Word Test.

1.       At 6 mo follow-up, the AMAT-c group demonstrated significant attentional gains compared to the controls in VGDS correct answers (p<0.0003), VGDS commission errors (p<0.040); BCT correct answers (p<0.002) and TMT B (p=0.030) but not TMT A (p>0.050).

2.       The AMAT-c group also showed significant memory improvements on the RBMT and ROCF (all p<0.0002), 15 Word Test immediate and delayed recall (p<0.005 and p=0.012 respectively) at follow-up.

3.       No significant difference was found between groups in VRT, ART, and both WISC-III Coding and Digit Span tests. Importantly, two WISC-III factors, freedom of distractibility and verbal comprehension, were significantly greater in the AMAT-c group (p<0.050 and p<0.003 respectively) at 6 mo follow-up.

van’t Hooft et al. (2003)

Sweden

Pre-Post

N=3

Population: ABI: TBI=2, Intracerebral Bleeding=1; Mean Age=9.1yr; Gender: Male=2, Female=1; Mean Time Post Injury=3.5yr; Mean GCS=7.

Intervention: Patients participated in the Amsterdam memory and attention training for children (AMAT-c) programme with exercises lasting 30 min/d for 20 wk. The AMAT-c was completed in three phases; sustained attention, selective attention, and mental tracking. Assessments were completed at baseline and within 2 wk of treatment completion.

Outcome Measure: Deasey-Spinetta Behaviour rating scales (DSB), Trail Making Tests A and B (TMT A and B), Wechsler Intelligence Scales for Children (WISC-III) Digit Span test.

1.       According to the neuropsychological test battery, all three patients demonstrated improvements in sustained and selective attention post-treatment. Memory improved slightly in all three patients.

2.       The neuropsychological test battery revealed TMT A and B remained stable in two patients and improved one; an improvement in daily memory in all three patients; and WISC-III Digit Span improving in two patients but remaining stable in one.

3.       Parents and teachers’ DSB ratings revealed improvements on two of the patients with one patient demonstrating either no or minor improvement across the three scales (learning ability, social behaviour, emotional behaviour).