Memory training study points to possible benefits for children with Down syndrome
A study, conducted by researchers at Down Syndrome Education International and published today in the American Journal on Intellectual and Developmental Disabilities, suggests that adaptive working memory training might offer sustained benefits for young people with Down syndrome.
Cogmed JM Working Memory Training – example activities
Visuospatial short term memory scores (Automated Working Memory Assessment), initial intervention group (A) and initial waiting comparison group (B) at baseline, pre- and post-interventions and follow up for group A.
The findings from a randomized controlled trial of Cogmed Working Memory Training*, conducted by researchers at Down Syndrome Education International, are published today in the American Journal on Intellectual and Developmental Disabilities. The study was led by Dr Stephanie Bennett (now at the University of Portsmouth, UK) working in collaboration with Dr Joni Holmes (MRC Cognition and Brain Sciences Unit in Cambridge) and Professor Sue Buckley OBE, Director of Science and Research at Down Syndrome Education International. The study was funded by The Baily Thomas Charitable Fund and Down Syndrome Education International. Cogmed JM software was provided for use in the trial by Pearson Education, Inc.*
People with Down syndrome tend to be more limited in in their abilities to store and manipulate information over short periods of time (short term and working memory) than other people. Past research has found that people with Down syndrome have more limited short term memory capacity than typically developing people of the same age. Research has also found that people with Down syndrome experience relatively more difficulty storing and retrieving verbal information than they do with storing and retrieving visual information.
These memory systems impact many areas of learning, including the acquisition of vocabulary, grammar and reading skills. Improving short term and working memory function might therefore be expected to have important consequences for educational outcomes.
Past studies of memory training for young people with Down syndrome have used visual (picture) and verbal rehearsal techniques. They suggest that memory function can be improved through training, but have not provided evidence that these improvements can be sustained after training ceases.
Studies published in recent years suggest that computerised adaptive working memory training may lead to important improvements in memory function for children with relatively limited working memory skills and that these improvements may be sustained beyond the initial training period.[4,5] DSE therefore set out to explore if similar results might be achieved for children with Down syndrome.
We conducted a randomised controlled trial of Cogmed JM – the version of the software designed for typically developing pre-school children. We recruited 25 children living in South East England, aged between 7 and 12 years at the start of the study, and 21 completed the trial.
The children were randomly assigned to an initial intervention group (A) and a waiting comparison group (B). Children in group A received the intervention first while children in group B received no specific memory training intervention – providing a comparison against which the effects of the training program could be judged. Subsequently, the children in group B also received the intervention.
The Cogmed JM program includes seven computerised training activities, presented as engaging games – for example, moving bumper cars that light up one at a time, the sequence of which the child has to remember for a short time and confirm by clicking on the cars in the correct order.
The intervention was delivered in the children’s schools where the software was installed and training provided to Teaching Assistants and Special Educational Needs Coordinators. The children received the intervention over a period of 10 to 12 weeks during which they completed 25 training session, each of which generally included three of the seven activities. Every week one new activity was introduced and one previous activity removed from the three trained to maintain interest.
The children were assessed at the start of the study (t1), after the first group (A) received the intervention and the comparison group (B) waited (t2), and then again after the comparison group (B) had received the intervention and the initial intervention group had discontinued training for (t3). These assessments included computer-based tasks that were distinct from the tasks practiced during the Cogmed JM training sessions (selected from the Automated Working Memory Assessment).
The children in the initial intervention group (A) achieved important gains on the non-trained assessments of visuospatial short term memory and visuospatial working memory, while the comparison group made little or no gains on these measures. The relative improvement on the visuospatial short term memory test reached statistical significance, suggesting it is not a chance finding. Among the children in the intervention group, 60% achieved improved scores on the test of visuospatial short term memory after training and 40% made no gain or performed less well. Among children in the comparison group, 27% achieved improved scores over the same period without training, while 73% made no gain or performed less well. However, we did not find clear evidence of gains on verbal short term memory or verbal working memory measures.
When the waiting comparison group (B) subsequently received the intervention, similar gains on the test of visual short term memory were observed, though the effect on visual working memory was not as clear. Interestingly, this group made a noticeable gain on the verbal short term memory measure, but it is not clear that this was an intervention effect – the initial intervention group also made a noticeable gain on the verbal short term memory measure at this time (having discontinued the intervention).
Encouragingly, when reassessed four months after completing the training the initial intervention group maintained the gains observed on the visuospatial short term memory and visuospatial working memory assessments.
The study also explored the effects of the intervention on measures of attention and behaviour. Full details are available in the published paper.
This study suggests that adaptive working memory training could be a practical and useful intervention for children with Down syndrome. However, further research is required to confirm this. Future research is needed to explore if memory training can deliver improvements in verbal as well as visuospatial memory, and (importantly) if these gains subsequently lead to improvements in language, literacy and wider academic skills.
Larger controlled trials that examine longer term effects on wider academic outcomes will be required to assess if intensive adaptive working memory training is a useful therapy for young people with Down syndrome.
DSE is planning studies to further explore the possible benefits of adaptive working memory training and is seeking funds to continue this work.
Supporting educational research
DSE improves early intervention and education for young people with Down syndrome through original scientific research and practical, evidence-based publications, training and consulting services. Our teaching resources, guidance and information services help over 150,000 people in over 160 countries each year.
You can support DSE’s work to improve early intervention and education for young people with Down syndrome by donating to Down Syndrome Education International (a charity, based in England) or by donating to Down Syndrome Education USA (a US-based 501(c)(3) nonprofit).
- Bennett S, Holmes J and Buckley S (2013). Computerized memory training leads to sustained improvement in visuospatial short term memory skills in children with Down syndrome. American Journal on Intellectual and Developmental Disabilities, 118(3), 179-192. https://dx.doi.org/10.1352/1944-7558-118.3.179
- Jarrold C, Nadel L and Vicari S (2008) Memory and neuropsychology in Down syndrome. Down Syndrome Research and Practice. https://www.down-syndrome.org/reviews/2068/
- Connors FA, Rosenquist SJ, Arnett L, Moore MS and Hume LE (2008). Journal of Intellectual Disability Research, 52(3), 244-255. https://dx.doi.org/10.1111/j.1365-2788.2007.01015.x
- Holmes J, Gathercole SE and Dunning DL (2009). Adaptive training leads to sustained enhancement of poor working memory in children, Developmental Science, 12, F9-F15. https://dx.doi.org/10.1111/j.1467-7687.2009.00848.x
- Holmes J, Gathercole SE, Place M, Dunning DL, Hilton KA and Elliott JG (2010). Working memory deficits can be overcome: Impacts of training and medication on working memory in children with ADHD, Applied Cognitive Psychology. 24, 827-836. https://dx.doi.org/10.1002/acp.1589