Clara Chavez Arana, Marinus H van IJzendoorn, Carlos A Serrano-Juarez, Sarah S W de Pauw, Peter Prinzie
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The three-level random effects model showed a better fit than the two-level model. Almost all individual studies showed non-significant ES across outcomes but in combination interventions were effective (Cohen's d = 0.38, CI 0.16 ~ 0.61). Lower methodological quality, inclusion of participants with non-TBI, and parental participation predicted larger ES. Participants' age, time of assessment, number of sessions, and focus on hot or cold EFs were not related to ES. We found no evidence of publication bias. Interventions are effective with small to medium ES according to conventional criteria. Intervention effects do not seem to fade away with time. Parent participation in the intervention is important to improve EFs. The efficacy of interventions seems larger when non-TBI is part of the etiology of ABI. Variation between studies is relevant for tracing the effective intervention characteristics. 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引用次数: 0
摘要
研究旨在改善后天性脑损伤(ABI)儿童和青少年冷热执行功能(EFs)的干预措施的有效性,并探讨干预措施、参与者、ABI病因(创伤性脑损伤或非创伤性脑损伤)、评估时间或研究质量是否会影响干预效果。冷EF指的是纯粹的认知EF,而热EF指的是这些认知技能的情感方面。研究共纳入了来自 23 项随机对照试验研究(112 个效应量[ES])的 970 名参与者。采用了三级随机效应法(研究、ES、个体参与者)。通过元回归进行了调节分析。与两级随机效应模型相比,三级随机效应模型的拟合效果更好。几乎所有的单项研究都显示,各结果的 ES 不显著,但综合干预措施有效(Cohen's d = 0.38,CI 0.16 ~ 0.61)。方法学质量较低、纳入了非创伤性脑损伤的参与者以及家长的参与都预示着ES较大。参与者的年龄、评估时间、疗程次数以及关注冷热EF与ES无关。我们没有发现发表偏倚的证据。根据传统标准,干预对中小型ES有效。干预效果似乎不会随着时间的推移而消失。家长参与干预对提高幼儿的EF非常重要。当非创伤性脑损伤是 ABI 的部分病因时,干预效果似乎更大。不同研究之间的差异与追踪有效干预的特点有关。大多数研究都是在青少年时期进行的,因此需要对幼儿期进行研究。
[Formula: see text] Interventions to improve executive functions in children and adolescents with acquired brain injury: a systematic review and multilevel meta-analysis.
To investigate the effectiveness of interventions aiming to improve hot and cold executive functions (EFs) in children and adolescents with acquired brain injury (ABI) and to examine whether characteristics of the intervention, participants, etiology of ABI (Traumatic-brain-injury [TBI] or non-TBI), time of assessment, or study quality moderate intervention effects. Whereas cold EFs refer to purely cognitive EFs, hot EFs refer to the affective aspects of these cognitive skills. A total of 970 participants from 23 randomized-controlled-trial studies (112 effect sizes [ES]) were included. A three-level random effects approach (studies, ES, individual participants) was used. Moderation analyses were conducted through meta-regressions. The three-level random effects model showed a better fit than the two-level model. Almost all individual studies showed non-significant ES across outcomes but in combination interventions were effective (Cohen's d = 0.38, CI 0.16 ~ 0.61). Lower methodological quality, inclusion of participants with non-TBI, and parental participation predicted larger ES. Participants' age, time of assessment, number of sessions, and focus on hot or cold EFs were not related to ES. We found no evidence of publication bias. Interventions are effective with small to medium ES according to conventional criteria. Intervention effects do not seem to fade away with time. Parent participation in the intervention is important to improve EFs. The efficacy of interventions seems larger when non-TBI is part of the etiology of ABI. Variation between studies is relevant for tracing the effective intervention characteristics. Most studies are conducted in adolescence, and studies in early childhood are needed.
期刊介绍:
The purposes of Child Neuropsychology are to:
publish research on the neuropsychological effects of disorders which affect brain functioning in children and adolescents,
publish research on the neuropsychological dimensions of development in childhood and adolescence and
promote the integration of theory, method and research findings in child/developmental neuropsychology.
The primary emphasis of Child Neuropsychology is to publish original empirical research. Theoretical and methodological papers and theoretically relevant case studies are welcome. Critical reviews of topics pertinent to child/developmental neuropsychology are encouraged.
Emphases of interest include the following: information processing mechanisms; the impact of injury or disease on neuropsychological functioning; behavioral cognitive and pharmacological approaches to treatment/intervention; psychosocial correlates of neuropsychological dysfunction; definitive normative, reliability, and validity studies of psychometric and other procedures used in the neuropsychological assessment of children and adolescents. Articles on both normal and dysfunctional development that are relevant to the aforementioned dimensions are welcome. Multiple approaches (e.g., basic, applied, clinical) and multiple methodologies (e.g., cross-sectional, longitudinal, experimental, multivariate, correlational) are appropriate. Books, media, and software reviews will be published.