Testing

A-One and I have finally completed his practice and baseline tests using CogStateTM.  For him to have had sufficient sleep it usually means he's free in the afternoons, but I'm not always free then.  In my attempts to co-ordinate our schedules I'd occasionally hear faint mumblings of ... 'not important' ... but, in the end, he submitted relatively graciously.

To administer the tests I was required to read the instructions while they were also presented to him on the screen.  For the practice tests, he usually read ahead and pressed on without waiting for me to finish the instructions.  Except the working memory tests - he read and re-read them before proceeding.

For the baseline tests, because they are timed and should be done without significant breaks, I asked him if he needed a glass of water or to use the toilet before we started.  He decided he did.

An hour later (sigh) we got started.

Again I read the preparatory instructions, reminding him that the tests were the same as the practice tests, just different in the specifics so that they are still 'fresh'.

Mum: Are you ready to start?

A-One: Not yet.  I'll let you know.

A minute or so passed.

Mum: Are you ready yet?

A-One: No.  I'll let you know when I am.

A minute or so passed.

Mum: How about now?

A-One: No. Not yet.

Mum: Are you composing yourself, getting your mind ready for this?

A-One: Yes.

The first baseline test was to remember a shopping list.  As I started to read out the items, he burst out, 'Aren't these meant to be the same words as before?'  So we used up some seconds as I explained that the test is the same, but the words are different.  That's what the 'composing' time had been about - trying to remember the words from the practice test!

For most of the tests again, he pressed on without waiting for me to finish reading the instructions, except for the more challenging of the working memory tests.  We completed all the tests in about an hour and fifteen minutes. My observation, supported by the test results, showed that his working memory is quite good. When tests required that he 'work out' a rule or find a path in a maze, he performed better than when he had to remember many things short term.  But for anything that had made it into his memory, his delayed recall was then good.  This is consistent with our experience of him - it might take a while for something to get into his brain, but once it's there, it's there forever!  So it sounds to me like he would benefit from practising learning things off by heart - not so much to know many more things, but to practice the learning technique required to remember things.

Mum: Do you want to see your test results?

A-One: Nah.

Pondering the good working memory results, and recalling that his previous neuro-psyche tests indicated a weak working memory, I asked him if he was willing to do a little exercise that would take only a minute (a working memory test).

Mum: I'll give you five numbers and I want you to repeat them back to me - backwards.

A-One: OK.

Mum: 7    3     9     5     8

A-One gazed down with a look of concentration on his face.  After about 15 seconds he looked at me and giggled.  He looked down again for about another 10 seconds.  Looked up, giggling again.

Then, tumbling the numbers out in quick succession:

A-One: 85937!

The Challenge

A few days ago I was reading a SharpBrains article about whether brain training really works, and read with interest my own burning question: 'how to max­i­mize the like­li­hood of trans­fer from train­ing to daily life.'

One of the conditions is that it must target a bottleneck. 'For instance, if you need to train your exec­u­tive func­tions but use a pro­gram designed to enhance speed of pro­cess­ing, you may well con­clude that this pro­gram does not “work.” But this pro­gram may work for some­body whose bot­tle­neck is speed of pro­cess­ing ...'

Bingo.
This is the area where I have been looking lately for some professional assistance.  Where is the user's guide to online brain training, so that someone can pick the right brain training exercise for their specific area of impairment?  Even the jargon for describing cognitive capacities seems to vary between sites, or is too general, so it's not always clear which exercises match A-One's specific deficits.


To this end, I have contacted some organisations to raise the possibility of combining professional expertise with online brain training, not for general brain fitness but specifically to improve cognitive deficits, just as I am trying to do with A-One.

For example, the co-ordinator of a 'brain gym' for brain injured soldiers at Walter Reed Military Hospital in the US presented at SharpBrain's Virtual Summit last year. She described how they use readily available brain exercises based on peer reviewed neuroscience, delivered via various media - online, mobile device apps, Nintendo etc - combined with standardised neuropsych evaluations to help soldiers rehabilitate their cognitive capacities after an injury, so that it is evidence based.

It seems to me that A-One could benefit from working with others seeking to improve capacity in their areas of cognitive deficit, where each person's brain exercises are targeted to their individual bottlenecks.  I think he would benefit from the social aspects of meeting with others, as well as increased motivation to keep working at it.

I keep coming back to the initial assessment phase of the Arrowsmith program and the classroom environment for delivery, and why that has been so successful. Could there be something similar for readily available, and inexpensive, online brain training?

So I'm running a few parallel paths of activity at the moment:

• I'm contacting support organisations for people with learning disabilities or developmental or neurological deficits, with a view to joining with other parents and practitioners who have an interest in brain training to see what we could get happening for group training, especially for adults with average or above average intelligence with cognitive deficits.
• I've contacted TAFE to discuss what would be needed for TAFE to deliver the Arrowsmith program
• I have been raising awareness of the educational implications of developments in neuroscience, and the Arrowsmith program in particular.  For example, Coursera have recently announced their Continuing Professional Development program for Teachers which includes a course called The Brain-Targeted Teaching® Model for 21st Century Schools from Dr. Mariale Hardiman at John Hopkins University. I've alerted the Learning Support teacher at my daughter's school to this, and she is raising it with the school's senior admin. I also sent a link to my contact at TAFE, and the Australian Arrowsmith program as it may be a useful supplementary professional development course for teachers involved in this year's pilot in Sydney.

The penguin's still cheating Mum

A-One continues to do his daily online brain training, but in this hectic pre-Christmas season, I have not been able to add any clocks or reading exercises for a couple of days.  By including the additional logical, rather than arithmetical, problem solving game, A-One's problem solving is finally advancing beyond the 2nd percentile to 4.5th percentile.   Today he was offered a new attention game, so his attention BPI took a slight dive, but I expect he'll recover that fairly soon.  Even so, he gained 4 PBs.

His speed is now at the 59th percentile! He's still grumbling about the 'cheating' penguin which, for the level he's playing at now, travels faster than he can make his penguin move.


Faster A-One!
 

I've been visiting some of the sites listed in SharpBrains' market report.  One in particular appears to be based in Lyon, France Scientific Brain Training Rehabilitation Program which describes very well which cognitive functions are exercised by each of their 28 exercises. I'm particularly interested in the Executive Function exercises which include strategy through logical reasoning, and planning through forming mental images of which steps to execute.