COGMED WORKING MEMORY TRAINING: OVERVIEW
COGMED is a five week in home computer-based treatment intervention, for children and adults. It is designed to improve Working Memory, now known to be a key deficit in many individuals with AD/HD, learning disorders, reading comprehension & math difficulties and other organizational problems. Working Memory is a function of the brain that helps us temporarily store and manage the information required to carry out complex cognitive tasks. In daily life we use working memory for a number of things such as remembering instructions, solving problems, controlling impulses, focus and attention.
The Cogmed Program was developed in Stockholm at the prestigious Karolinska Institute, known for cutting-edge medical treatments and research. The research on the Cogmed Intervention Program, some of which has already been published in leading scientific and medical journals, shows clinically significant improvements in the functioning of individuals who complete the training program. Research is ongoing in Sweden as well as in the United States at Notre Dame, Harvard, Stanford and NYU. Information about the research is available on the Cogmed website at www.cogmed.com
Some specific examples of the difficulties faced by school aged children with Working Memory deficits include:
• Resisting tasks requiring mental effort
• Easily distracted, often impulsive
• Difficulty focusing on and completing a task
• Trouble remembering instructions or detailed information
• Problems getting information into memory and keeping it there
• Difficulty with tasks requiring organization, planning, and sequencing information
• Reading comprehension and mathematics difficulties
• Lack of a sense of time
• Poor judgment in social situations
These are some of the real world examples of Working Memory impairments that can debilitate the lives of children and adults. Obviously every individual is unique and may have some or all of these difficulties.
The actual treatment program involves at-home computer-based training for 30-45 minutes daily, 5 days a week, for 5 weeks. The exercises are similar to computer games but the computer adjusts the level of difficulty (through internet synchronization with a large data base) so the child or adult is always pushing him or herself. While some children with a strong competitive spirit are motivated simply to “beat the game,” others may find the program frustrating so the coaching and training assistance are essential to maintain motivation. The parent, or other caregiver, will be taught the necessary techniques and strategies to be a “training aide” to their child to obtain the maximum benefits from the program. Additionally your Cogmed coach will be providing weekly telephone contact to assist you and will be tracking daily progress by continuously analyzing performance data. The program requires a commitment to adhering to a consistent training schedule in order to get the optimal results. Families should think about the program like they would an exercise and fitness regimen - it needs to be consistent and intense to produce results.
There are now approximately 70 professionals in the US and Canada certified to provide Cogmed Working Memory Training. The data collected thus far by the professionals in North America and worldwide have been gratifying, with 80% of those who complete the training showing good to outstanding results. Some of the gains reported by parents include improvements in the following areas:
• Taking Initiative: including homework and chores.
• Remembering things: directions, routines, instructions, and information.
• Improved frustration tolerance: thinks before reacting; fewer “meltdowns”.
• Better able to focus, sustain attention, and can re-focus if attention starts to wander.
• Improved reading comprehension.
• Improved performance in math.
• Greater self-confidence and overall maturity, improved social interaction.
• Completing more tasks independently.
Improvement ranges from moderately good to excellent, in terms of “real world” functioning. In some cases, results are apparent as early as the third or fourth week of training. In other cases, however, results emerge slowly and begin to become apparent only after the program is completed.
There is a program available for younger children (Cogmed JM) that is currently in the research and development phase. The program for children ages seven and up is called Cogmed RM. The program is also now available for adults with working memory and attention problems (Cogmed QM). There is also published research showing benefits for stroke victims.
One of the most exciting aspects of the training is that results seem to be long-lasting: over 80% of those who improve either maintain their gains or actually continue to improve over time at one-year follow-up. For those who backslide a bit, a 3-week booster program may be helpful.
To see whether your computer would support the program, go to www.cogmed.com and run the test on your computer. There is also detailed information about the program, including information about who is most likely to benefit from working memory training, and a demonstration of some of the actual training exercises.
I have personally spent a considerable amount of time researching programs that offer a non-pharmacological addition to the treatment of ADHD and other problems with learning and development. This intervention has the evidence base and the research for me to be able to recommend it for my own clients.
Cogmed Training in Practice
The total cost of the program is $1500 which includes initial screening procedures (pre and post), demonstration of program, weekly coach calls, analysis of data, and a six month follow-up. Clinical studies have demostrated that results are long term and have been shown in actual imaging studies of the brain.
I encourage you to review the extensive materials on the Website: www.cogmed.com and contact me with any questions.
