doi: 10.1371/journal.pmed.1001756, Langbaum, J. Exp. 124, 207. doi: 10.1016/j.cger.2013.07.002, Karbach, J., and Kray, J. Stop-signal reaction time (SSRT) was calculated by sorting all correct Go-trial reaction times, taking the time corresponding to the percentage of correct stop trials, and subtracting the mean stop-signal delay (SSD) from this number (Logan et al., 1984). Benton, A., Hamsher, K. D., and Sivan, A. Benefits of using at-home computer-based training programs are evident: they require no face-to-face contact, are easy to administer, and do not require traveling, which is especially advantageous when catering to more physically impaired individuals. Multilingual Aphasia Examination. On the basis of our review of optimal study design, training efficacy, and neurocognitive profiles of successful aging (Buitenweg et al., 2012), we suggested adding the elements of flexibility, novelty (Noice and Noice, 2008) and adaptiveness (Kelly et al., 2014) to training protocols to increase the chances of finding positive effects on cognitive functioning. Tower of London Drexel University: Technical Manual. In response to the training performed, sailors augmented their ability to adjust to changing task demands (improved cognitive flexibility), which was reflected by the increased number of correct answers in unpredictable task switching and decreased task duration in predictable task switching tests. In the letter fluency task, participants produced as many words as possible starting with one of three different letters (P, G, and R on one time point, K, O, and M on the other time point, counterbalanced over participants), each in 1 min (Benton et al., 1989). As aging is associated with decreased cognitive functioning, the prevalence of age-related cognitive decline is an increasingly important issue. A., Nijboer, T. C., et al. With recent increments of the retirement age in many countries, increasing numbers of older workers are expected to contribute to the workforce, but may cognitively fall behind. Appl. J. Neural Trans. Conventional working memory training may not improve intelligence. Improvement over time was found on training tasks as well as on multiple transfer tasks covering all domains. Manual for Raven's Progressive Matrices and Vocabulary Scales—Section 3: Standard Progressive Matrices. Possibly, participants in these studies may have benefited more from the training due to this procedure, producing more conspicuous results than the home-based training method presented here. Clipboard, Search History, and several other advanced features are temporarily unavailable. In addition, we explored the question whether training efficacy is modulated by individual characteristics, such as age, baseline functioning, or education. Greenhouse-Geisser corrected degrees of freedom were used whenever sphericity was violated, though for the purpose of legibility the original degrees of freedom are reported. JB and SP analyzed the data. Per session, subjects played three games of 10 min each, thus minimizing the need for flexibility. Switch cost was calculated as the difference between reaction time on switch trials and no-switch trials in milliseconds, with higher switch cost signifying lower cognitive flexibility (Rogers and Monsell, 1995). As you learn about the nutritional food pyramid, create an ideal school lunch menu that maximizes your favorite foods and fulfills the nutritional requirements. For instance, it may prove fruitful to explore which cognitive or neural connectivity profiles are predictive of who will improve in what domain. Subsequently, we computed a mean training score for all three training groups separately and transformed these to Z-scores to be able to compare MT and experimental training groups relative to each other. PLoS ONE 7:e29676. Computer-based cognitive training for executive functions after stroke: a systematic review. Decline of cognitive control, memory, and decision-making, among other functions, leads to greater dependence on family members and society. doi: 10.3758/MC.36.4.735, Buitenweg, J. I., Murre, J. M., and Ridderinkhof, K. R. (2012). doi: 10.1080/13854040500519752. Dovis S, Van der Oord S, Wiers RW, Prins PJ. Sci. An explorative repeated-measures ANOVA was run for tasks which did exhibit a significant Time effect and had also been administered at T3. were assigned to a frequent- (FS) or infrequent switching (IS) experimental condition or to the active control group and performed 58 half-hour sessions over the course of 12 weeks. Aging Neuropsychol. Cogn. Near transfer is often reported, especially after multitasking or task-switching designs (Karbach and Kray, 2009; Wang et al., 2011; Anguera et al., 2013) though far transfer is scarcely found (Green and Bavelier, 2008; Park and Bischof, 2013). (2012). A., Boccanfuso, J., Rintoul, J. L., Al-Hashimi, O., Faraji, F., Janowich, J., et al. Results are inconsistent (Au et al., 2015; Dougherty et al., 2016) with some producing no transfer effects at all (Ackerman et al., 2010; Lee et al., 2012). Clustering and switching as two components of verbal fluency: evidence from younger and older healthy adults. Willing Ways Pakistan is the state of art facility for counseling and rehab over four decades. The assessment of fatigue: psychometric qualities and norms for the checklist individual strength. In the drag-and-drop task, participants were required to use their computer mouse to drag round or square shapes into an empty border. The Manual of the Shipley Institute of Living Scale. B., Chein, J. M., and Olson, I. R. (2011). Predicting memory training response patterns: results from ACTIVE. The stop-signal task (Logan et al., 1984) was used to measure inhibition. On the exit questionnaire, an equal number of people in each group reported having started new activities or training other than ours [χ2(2, N = 139) = 0.561, p = 0.77]. Buchler, N. G., Hoyer, W. J., and Cerella, J. Journal of Child Psychology and Psychiatry, 56 (5), 566–576. Physical activity in chronic fatigue syndrome: assessment and its role in fatigue. doi: 10.1177/1545968309353328. This three-way interaction was not significant [F(6, 360) = 0.233, p = 0.943, ηp2 = 0.004]. Front. The authors would like to thank all participants and their relatives for participating in the study; all students for assisting in recruitment, testing and coaching of participants, and Dezzel media for making Braingymmer available for our study. However, this value did not survive Bonferroni correction. Cognitive flexibility training manages responses to social conflict. To control for possible differences in fatigue and depression, we also examined baseline scores of the Checklist Individual Strength—Fatigue subscale (CIS-F) and the Hospital Anxiety Depression Scale—Depression subscale (HADS-D). Further investigation into different training methods is advised, including stimulating social interaction and the use of more variable, novel, group-based yet individual-adjusted exercises. Cognitive and neural plasticity in older adults' prospective memory following training with the virtual week computer game. Eur Child Adolesc Psychiatry. In the context of the GMAT, then, cognitive flexibility is the ability to quickly find the fastest way to solve each question and apply it. - cognitive training of executive function in the elderly. Cogn. Methods: In a randomized controlled trial, children with ASD (n = 121, 8-12 years, IQ > 80) were randomly assigned to an adaptive working memory (WM) training, an adaptive cognitive flexibility-training, or a non-adaptive control training (mock-training). 4, 734. doi: 10.4236/jbise.2011.411090, Salthouse, T. A. 139, 146–158. No Time effect was found on long term memory measured with the RAVLT-delay. Hum. This is the ability to easily switch between different tasks; to be fluid in moving from one to the other. Perspect. By the end of the intervention, the time spent on each game was similar across participants in the FS and IS groups. A battery of online tests (Neurotask BV, 2012) was devised to measure effects of the training at four points in time: at baseline (T0), after 6 weeks of training (T1), after 12 weeks of training (T2), and 4 weeks post-training (T3). We administered two versions, in which numbers were delivered at a rate of, respectively, 3.4 and 2.8 s. As an outcome measure, we calculated the mean percentage correct of both versions (Gronwall, 1977). Also, although the focus for this project was on the effectiveness of the popular home-based training tasks, some recent evidence reveals that for non-impaired older adults, individual at-home training might not be as effective as group training (Kelly et al., 2014; Lampit et al., 2014) or training sessions provided in the lab (Basak et al., 2008; Lövdén et al., 2012; Ballesteros et al., 2014). Ser. However, logistically it is difficult to encourage lower-educated, more cognitively impaired individuals to participate in research, let alone spend a sufficient amount of time on such an intervention. Rev. Clin. Whitbourne, S. K., Ellenberg, S., and Akimoto, K. (2013). FS, frequent switching; IS, infrequent switching. Our design largely lacked social interaction with other participants, which might have provided additional stimulation (Ybarra et al., 2008; Charles and Carstensen, 2010). Cognitive flexibility is usually described as one of the executive functions. Most of the secondary measures were subject to improvement with Time, as described below, but none of these effects were modulated by Group. Our cognitive flexibility training, using elements based on previously effective cognitive interventions, did not produce the expected near- and far transfer. Neuropsychol. JB, RvdV, SP, JM, and KR critically revised the article and approved this version to be published. Cyberpsychol. Behav. Despite subjects' demographic homogeneity, we noticed a large test score variability within groups, overshadowing any differences between them. Flanker tests, like the photo with the arrows, were invented in the 1970s by Eriksen and Eriksen as a way to test cognitive flexibility and are still used today (Psytoolkit, 2018). 15, 28–43. by Walter Reed Army Institute of Research . The scale consists of eight items, with scores ranging from 8 to 56. Toronto, ON: Multi-Health Systems. Performance on 2 out of 3 cognitive flexibility tasks improved over time for all three groups. Instead, the improvements in this study, appearing in all three training groups, are more likely to have been caused by retest effects. We minimized asymmetry in our three conditions using a minimization program (Minimpy; Saghaei and Saghaei, 2011) over the factors age, computer experience, TICS score, gender, and education. For the experimental conditions, domain scores were also made by averaging the three total scores within each domain, and a final score by averaging all three domain scores. Fifty-six subjects were allocated to the frequent switch training, 33 subjects to the infrequent switch training, and 50 subjects to the MT. Realistic first-person shooter games, though cognitively challenging, are perceived negatively by many older adults (Nap et al., 2009; McKay and Maki, 2010). doi: 10.1016/j.actpsy.2011.11.003, Lewis, M. S., and Miller, L. S. (2007). Among reasons given are optimization of adherence and compliance, as well as providing motivation to master more difficult training tasks. The current project studied the direct, near transfer, and far transfer effects of cognitive flexibility training in two experiments with 117 3-year-olds. Bigorra A, Garolera M, Guijarro S, Hervás A. Eur Child Adolesc Psychiatry. As specific training effects were lacking, T1 measurements were not examined. Aging 23, 743. doi: 10.1037/a0014342, Charles, S. T., and Carstensen, L. L. (2010). Therefore, our main analysis was centered around measures of these constructs. In the domain of task switching, we included the Delis-Kaplan Executive Function System—Trail Making Test (D-KEFS TMT; Condition 4), the Trail Making Test-B (TMT-B), and a separate switch condition of the semantic fluency task. HHS Front. doi: 10.1093/geronb/62.special_issue_1.19, Ballesteros, S., Prieto, A., Mayas, J., Toril, P., Pita, C., Ponce de León, L., et al. Outcome measure is the number of correct words in the switch condition, subtracted from the average number of correct words produced in the same categories without switching (Troyer et al., 1997). In our experimental design, however, we could not disentangle training effects fro… Two subcategories of cognitive flexibility are task switching and cognitive shifting, depending on whether the change happens unconsciously or consciously, … We investigated whether an online training incorporating these crucial components can lead to transfer in an elderly population. Although the scale is not validated, it serves as a necessary tool to judge participants' present and future view of the training. Scand. Devel. COVID-19 is an emerging, rapidly evolving situation. (2015). doi: 10.1016/j.jpsychores.2017.05.007, Ybarra, O., Burnstein, E., Winkielman, P., Keller, M. C., Manis, M., Chan, E., et al. by Walter Reed Army Institute of Research . Oldrati V, Corti C, Poggi G, Borgatti R, Urgesi C, Bardoni A. Neuropsychol Rev. Performance gains from directed training do not transfer to untrained tasks. Of the 14 participants whose fatigue scores exceeded the cut-off of 35, 5 were in the frequent switch condition, 5 in the active control and 4 in the infrequent switch condition. An arts intervention for older adults living in subsidized retirement homes. Credit: Pixabay/CC0 Public Domain Scientists at the … Besides this, 25 subjects (39% of IS subjects, 21% of FS subjects) scored a maximal number of points at the highest possible level on one or two of the nine games, thereby compromising adaptiveness among both experimental groups. Can training in a real-time strategy video game attenuate cognitive decline in older adults? Cogn. Training in our active control group, on the other hand, might have been too challenging. The click task required participants to click a spiral of circles of decreasing sizes using the mouse, with total time in milliseconds to complete the task signifying the outcome measure (Neurotask BV). Epub 2020 Feb 28. IBM SPSS Statistics for Windows, version 22 (IBM Corp., Armonk, N.Y., USA) was used for all statistical analyses. doi: 10.1177/1745691616635612, Milner, B. To determine whether video gaming can enhance cognitive flexibility and, if so, why these changes occur, the … Effectiveness of the training on a larger scale was assessed by using neuropsychological tests from eight cognitive domains: task switching, psychomotor speed, processing speed, planning, reasoning, working memory, long term memory, and verbal fluency. Although covariates were added only if a significant correlation with a measure occurred, on plotting the covariate data it appeared that different values of each covariate affected the various measures differently. Hence, we investigated two EF training conditions in children with ASD. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. doi: 10.1080/13506280500411111, Sullivan, J. R., Riccio, C. A., and Castillo, C. L. (2009). 11, 512–534. Neuropsychological assessments were conducted by a trained junior psychologist, who was blind to the training condition. The minimization procedure was carried out by the principal investigators only. Psychol. Psychol. (2013). First, a considerable number of participants found themselves reaching the maximum score for at least one of the games within a number of weeks before the end of the training, diminishing adaptiveness in these groups. 62, 175–184. Placebo effects in cognitive training. We and others (e.g., Buitenweg et al., 2012; Slagter, 2012; van de Ven et al., 2016) raised a number of problematic issues often encountered in the training research literature. Dev. Experimental groups differed in flexibility, novelty, and adaptiveness. doi: 10.1080/13803390490510680, Foroughi, C. K., Monfort, S. S., Paczynski, M., McKnight, P. E., and Greenwood, P. M. (2016). For the MT, we selected games that provided equal visual stimulation and feedback and put equal demands on computer ability, but that were reduced in variability, flexibility, and adaptiveness, compared with the experimental conditions (see Supplementary Material 3). However, for many participants (across groups) playing games seemed in itself to be a sufficiently novel activity to incur small cognitive effects. Culbertson, W., and Zillmer, E. (2005). The strong transfer effects to mouse ability tasks in all three groups supports this assumption. doi: 10.1111/j.1467-9280.2007.01966.x, Boot, W. R., Champion, M., Blakely, D. P., Wright, T., Souders, D. J., and Charness, N. (2013a). As a check, neuropsychological assessors were asked to guess the condition of the subject. Saghaei, M., and Saghaei, S. (2011). Soc. PASAT scores were raised to the 3rd power, a square root transformation was used on ToL data, and TMT-A and TMT-B scores were transformed using the formula 1/x0.14. Aging 33:e22. doi: 10.1080/09084280802644243. doi: 10.1002/gps.4328, Basak, C., Boot, W. R., Voss, M. W., and Kramer, A. F. (2008). Both the DKEFS TMT and the online version of the TMT-B showed decreased switching latency. 2010 Jul;14(7):317-24. doi: 10.1016/j.tics.2010.05.002. We created a program called TAPASS (Training Project Amsterdam Seniors and Stroke), a randomized controlled trial. Variability in Training. The unity and diversity of executive functions and their contributions to complex frontal lobe tasks: a latent variable analysis. Please enable it to take advantage of the complete set of features! *Correspondence: Jessika I. V. Buitenweg,, Front. ; (Delis et al., 2001). The purpose of this study was to test the hypothesis that a 12-week cognitive flexibility training would improve cognitive functions in healthy older adults. The infrequent switching (IS) group contained high novelty and adaptiveness but low flexibility, and the mock training (MT) scored low on all three features. Rev. We were especially interested in the question whether shifting attention between multiple functions during the training would transfer to decreasing switch costs. Our study entailed a randomized controlled double-blind design. B 64, 14–23. Updating performance was measured using the N-back task as used by de Vries and Geurts (2014) including 0-back, 1-back, and 2-back blocks. Here, we focus on effectiveness of this program in the healthy aging population. On tasks of working memory, both PASAT and RAVLT-direct improved over Time, whereas no change appeared on the online Corsi or the Operation Span. Successful aging through digital games: socioemotional differences between older adult gamers and non-gamers. 142, 74–86. Hum. doi: 10.1037/a0032982, Keywords: aging, cognitive training, executive functions, cognitive flexibility, videogames, Citation: Buitenweg JIV, van de Ven RM, Prinssen S, Murre JMJ and Ridderinkhof KR (2017) Cognitive Flexibility Training: A Large-Scale Multimodal Adaptive Active-Control Intervention Study in Healthy Older Adults. 17, 1–33. Pers. The D-KEFS TMT concerned the number-letter switching subtask, with the performance score calculated as the total time in seconds to complete connecting letters and numbers in alternating order (i.e., 1, A, 2, B, etc. JB interpreted the data and wrote the manuscript. Impact Factor 2.673 | CiteScore 2.96More on impact ›, Cognitive and Brain Plasticity Induced by Physical Exercise, Cognitive Training, Video Games and Combined Interventions Thus, one explanation also for the present set of findings is that of a placebo or subject-expectancy effect. When necessary, outcome measures were rescored so that a positive value indicated improvement. Cognitive flexibility and other executive function skills are crucial to success both in classroom settings and life. (1997). BMC Neurol. A sample of older, less fit individuals might be more representative in displaying the benefit for the population. Collage art inspires cognitive flexibility because components are decoupled from their literal roles and used in novel ways. doi: 10.2196/18644. Besides improvements on the training, we found significant time effects on multiple transfer tasks in all three groups that likely reflected retest effects. Aging Neuropsychol. Gerontechnology 8, 247–262. doi: 10.1016/S0010-9452(08)70878-5, de Vries, M., and Geurts, H. M. (2014). 15:144. doi: 10.1186/s12883-015-0397-y, van Muijden, J., Band, G. P., and Hommel, B. Yet, by and large, most participants experienced the tasks as aptly challenging, with the levels of variability and adaptiveness contributing to that experience. doi: 10.1037/0882-7974.7.2.242, Wang, M. Y., Chang, C. Y., and Su, S. Y. |,, Creative Commons Attribution License (CC BY). Full written informed consent was given by all subjects prior to participation. Finally, both semantic and letter fluency did not improve over Time for any of the groups. The gaming industry has conveniently caught on to this trend. Aging 23, 765. doi: 10.1037/a0013494. (2012). Perhaps the skill that we have trained, switching sorting rules, is specific for cognitive flexibility and less relevant for performance on a working memory or inhibitory control task. Processing speed was measured using the Digit Symbol Coding test (DSC; Wechsler, 2000) and an online version of this task (Neurotask BV). Front. A similar pattern was seen on the dual task, with a main effect of Time that was not modulated by Group. Neuropsychological assessors did not guess subjects' training group above chance level, both before training [39%; χ(4, N = 105)2 = 2.73, p = 0.60] and after training [33%; χ(4, N = 105)2 = 4.07, p = 0.39]. Res. Front. (2006).  |  Cognitive flexibility has been described as the cognitive ability to switch between thinking about two different concepts, and to think about multiple concepts simultaneously. The frequent switching (FS) group scored high on flexibility, novelty, and adaptiveness. Also, there was no indication that improvement was limited to specific cognitive processes, as transfer effects were not exclusive to specific domains. doi: 10.1016/j.neurobiolaging.2011.02.013, Mahncke, H. W., Connor, B. Aging Hum. A., Robertson, I. H., Walsh, C., and Brennan, S. (2014). 61, 383–409. Cognitive training games for flexibility. These were assessed with four computerized tasks. Aging 26, 813. doi: 10.1037/a0023631. Although I like diversity, I was unable to find any appropriate SlideShare presentations … I found more articles on cognitive flexibility skills than I expected. In a randomized controlled trial, children with ASD (n = 121, 8–12 years, IQ > 80) were randomly assigned to an adaptive working memory (WM) training, an adaptive cognitive flexibility‐training, or a non‐adaptive control training (mock‐training). Credit: Pixabay/CC0 Public Domain Scientists at the … Cognitive flexibility refers to our ability to disengage from one task and respond to another or think about multiple concepts at the same time. doi: 10.1016/j.neubiorev.2009.08.006, Fisk, J. E., and Sharp, C. A. Dandil Y, Smith K, Kinnaird E, Toloza C, Tchanturia K. Front Psychiatry. Iowa, IA: AJA Associates. Subjects had some extra time to finish after the time-period set aside for playing a certain game had been reached (e.g., 3 or 10 min) to prevent too abruptly ending a game. In order to ensure that older adults can live and work independently for as long as possible, research into possibilities of reducing this age-related decline of functioning is a pressing matter. Acta Psychiatr. Acquisition, recall, and forgetting of verbal information in long-term memory by young, middle-aged, and elderly individuals. doi: 10.1111/j.1467-7687.2009.00846.x, Kelly, M. E., Loughrey, D., Lawlor, B. Hum. 2020 Nov 26;11:580329. doi: 10.3389/fpsyg.2020.580329. We created a randomized controlled trial in which we evaluated the effects of an adaptive computerized cognitive flexibility training. Normality was checked using Shapiro-Wilk's test and by evaluating skewness and kurtosis. 16, 892–897. Besides this, we employed a number of measures with alternate (parallel) forms in order to minimize retest effects. Level high scores were calculated as a percentage of the maximal score on that level. Delis, D. C., Kaplan, E., and Kramer, J. KoTA is a set of training tools developed to improve cognitive flexibility in autism. An improvement for future studies is to implement more variable and novel activities tailored to individual demands to further optimize performance increases. J. Gerontol. Aging 23, 692. doi: 10.1037/a0014345, Gronwall, D. M. (1977). The D-KEFS TMT (Condition 5) concerned the motor speed condition, with the performance score calculated as the total time in seconds to complete tracing a dotted line between a number of circles (Delis et al., 2001). Video game training enhances cognitive control in older adults. This is especially evident when comparing our design to those of other studies. Exclusion criteria were a history of neuropsychiatric disorders, TIA or stroke, strongly impairing visual deficits, and colorblindness. Subjects were randomly assigned to one of three conditions, with the exception of partners/spouses, who were always assigned to the same group. 09/30/2020. Rose, N. S., Rendell, P. G., Hering, A., Kliegel, M., Bidelman, G. M., and Craik, F. I. Most importantly, however, the experimental training that capitalized on flexibility, novelty, and adaptiveness as central features did not lead to more progress than the trainings without these elements. Memory enhancement in healthy older adults using a brain plasticity-based training program: a randomized, controlled study. To explore the extent to which individual characteristics influenced training benefits, significantly correlated covariates were added to a repeated-measures ANCOVA of the primary and secondary measures. The quicker you are able to switch or 'shift' your thinking from one dimension (e.g. © 2014 Association for Child and Adolescent Mental Health. (2016). Some only use a passive control condition, or none at all. Cognitive flexibility is defined as the ability to adapt our cognitive process – that is, our thinking – to new and unexpected conditions. Would you like email updates of new search results? Epub 2010 Jun 16. van Dongen-Boomsma M, Vollebregt MA, Slaats-Willemse D, Buitelaar JK. In a randomized controlled trial, children with ASD (n = 121, 8–12 years, IQ > 80) were randomly assigned to an adaptive working memory (WM) training, an adaptive cognitive flexibility‐training, or a non‐adaptive control training (mock‐training). No use, distribution or reproduction is permitted which does not comply with these terms. Delis-Kaplan Executive Function System. Effectiveness of Computerized Cognitive Training Programs (CCTP) with Game-like Features in Children with or without Neuropsychological Disorders: a Meta-Analytic Investigation. (2008). Cognitive flexibility — the ability to adapt easily to new and unexpected conditions — is difficult for many children (and adults) with ADHD.For our kids, even the smallest changes to everyday routines can quickly become huge challenges. Hum. A separate test assessor administered four computer tasks, and introduced the training to subjects using instruction videos and a demonstration of the training platform and games. Contact us for more information. doi: 10.1073/pnas.0605194103, McKay, S. M., and Maki, B. E. (2010). Aging 25, 753. doi: 10.1037/a0019277, PubMed Abstract | CrossRef Full Text | Google Scholar, Allaire, J. C., McLaughlin, A. C., Trujillo, A., Whitlock, L. A., LaPorte, L., and Gandy, M. (2013). 10, 346–351. (1984). Brain training with non-action video games enhances aspects of cognition in older adults: a randomized controlled trial. On T0 and T2, subjects also visited the university for a series of neuropsychological tests and computer tasks, and a small set of cognitive tests was administered via a link in the email.