Parent-based training of basic number skills in children with Down syndrome using an adaptive computer game

The wide world of technological telerehabilitation for pediatric neurologic and neurodevelopmental disorders - a systematic review

Introduction

The use of Information and Communication Technology (ICT) for assessing and treating cognitive and motor disorders is promoting home-based telerehabilitation. This approach involves ongoing monitoring within a motivating context to help patients generalize their skills. It can also reduce healthcare costs and geographic barriers by minimizing hospitalization. This systematic review focuses on investigating key aspects of telerehabilitation protocols for children with neurodevelopmental or neurological disorders, including technology used, outcomes, caregiver involvement, and dosage, to guide clinical practice and future research.

Method

This systematic review adhered to PRISMA guidelines and was registered in PROSPERO. The PICO framework was followed to define the search strategy for technology-based telerehabilitation interventions targeting the pediatric population (aged 0-18) with neurological or neurodevelopmental disorders. The search encompassed Medline/PubMed, EMBASE, and Web of Science databases. Independent reviewers were responsible for selecting relevant papers and extracting data, while data harmonization and analysis were conducted centrally.

Results

A heterogeneous and evolving situation emerged from our data. Our findings reported that most of the technologies adopted for telerehabilitation are commercial devices; however, research prototypes and clinical software were also employed with a high potential for personalization and treatment efficacy. The efficacy of these protocols on health or health-related domains was also explored by categorizing the outcome measures according to the International Classification of Functioning, Disability, and Health (ICF). Most studies targeted motor and neuropsychological functions, while only a minority of papers explored language or multi-domain protocols. Finally, although caregivers were rarely the direct target of intervention, their role was diffusely highlighted as a critical element of the home-based rehabilitation setting.

Discussion

This systematic review offers insights into the integration of technological devices into telerehabilitation programs for pediatric neurologic and neurodevelopmental disorders. It highlights factors contributing to the effectiveness of these interventions and suggests the need for further development, particularly in creating dynamic and multi-domain rehabilitation protocols. Additionally, it emphasizes the importance of promoting home-based and family-centered care, which could involve caregivers more actively in the treatment, potentially leading to improved clinical outcomes for children with neurological or neurodevelopmental conditions.

Systematic review registration

PROSPERO (CRD42020210663).

Computer gaming alters resting-state brain networks, enhancing cognitive and fluid intelligence in players: evidence from brain imaging-derived phenotypes-wide Mendelian randomization

The debate on whether computer gaming enhances players' cognitive function is an ongoing and contentious issue. Aiming to delve into the potential impacts of computer gaming on the players' cognitive function, we embarked on a brain imaging-derived phenotypes (IDPs)-wide Mendelian randomization (MR) study, utilizing publicly available data from a European population. Our findings indicate that computer gaming has a positive impact on fluid intelligence (odds ratio [OR] = 6.264, P = 4.361 × 10-10, 95% confidence interval [CI] 3.520-11.147) and cognitive function (OR = 3.322, P = 0.002, 95% CI 1.563-7.062). Out of the 3062 brain IDPs analyzed, only one phenotype, IDP NET100 0378, was significantly influenced by computer gaming (OR = 4.697, P = 1.10 × 10-5, 95% CI 2.357-9.361). Further MR analysis suggested that alterations in the IDP NET100 0378 caused by computer gaming may be a potential factor affecting fluid intelligence (OR = 1.076, P = 0.041, 95% CI 1.003-1.153). Our MR study lends support to the notion that computer gaming can facilitate the development of players' fluid intelligence by enhancing the connectivity between the motor cortex in the resting-state brain and key regions such as the left dorsolateral prefrontal cortex and the language center.

Math computerized games in the classroom: A number line training in primary school children

Several studies have shown that the number line can be a useful tool to support early numeracy development. Here, we conducted a school-based training study to evaluate the effectiveness of the software "The Number Line" ("La Linea Dei Numeri"; Tressoldi and Peroni, 2013) in improving children's mathematical skills. We randomly allocated 10 classes of first, second and third graders (N=183) to one of three experimental groups: one group played with The Number Line; the second group played with Labyrinth, a computerized game designed to train attention skills; the third group had no intervention (business-as-usual). At the end of the first training phase, children in The Number Line group completed another training phase playing with Labyrinth, whereas the other two groups played with The Number Line. After playing with The Number Line, all groups displayed more accuracy when placing numbers in the number line task. However, we observed no evident improvement in other mathematical skills. These results suggest that specific training effects emerge even in the school context, although transfer to other numerical skills may be harder to achieve.

Number estimation in Down syndrome: Cognition or experience?

BACKGROUND

The ability to place numbers on a visual "number line" is a hallmark of the understanding of numerical magnitude and it is a strong predictor of mathematical achievement.

AIM

We examined whether the performance in the number line estimation task is more driven by mental age or experience with numbers in a sample of Italian children with Down syndrome (DS).

METHOD AND PROCEDURE

Sixty-three children with DS (M_months = 128.62, SD = 30.73) and sixty-three typically developing children (M_months = 54.98, SD = 6.34) matched one to one for mental age completed number line estimation tasks and other tests to assess their numerical knowledge.

OUTCOMES AND RESULTS

No significant differences emerged between the two groups in terms of accuracy of positioning numbers on the 1-10 and 1-20 interval. In addition, the accuracy on the 1-10 interval was related to the ability to recognize numbers, while the accuracy on the 1-20 line was related to the ability to compare magnitudes.

CONCLUSION AND IMPLICATION

Results suggest that in individuals with DS the linear mapping of numbers is driven by mental age, but the accuracy of positioning numbers is also shaped by the experience with symbolic numbers. Therefore, the improvement of numerical estimation abilities should be a target of intervention programs.