Our Research on Brain Training for Children with Learning Disabilities and School Struggles
Moore, A.L., Miller, T.M., Moore, J.J., Ledbetter, C. (2023). A Real-World Data Study on the Impact of the ReadRx Cognitive Training and Reading Intervention on Cognition, Basic Reading Ability, and Psychosocial Skills for 3,527 Children. Psychology Research and Behavior Management,16,1195-1220.
https://doi.org/10.2147/PRBM.S397665
We analyzed a large real-world dataset to examine cognitive, reading, and behavioral outcomes for struggling readers (n = 3527) who had completed 24 weeks (120 hours) of ReadRx, an intense cognitive training integrated with a structured literacy intervention using ReadRx in a one-on-one clinic setting. Results showed statistically significant changes on all cognitive and reading measures including attention, visual processing, processing speed, long-term memory, working memory, reasoning, phonological awareness, Work Attack, phonetic coding, spelling, comprehension, and overall IQ score with medium to very large effect sizes. The results included an average 4.1-year gain in reading skills including a 6-year gain in phonological awareness. No differences were found based on age, sex, or ADHD status, and minimal differences were found based on pre-intervention IQ score and cognitive test scores. The study also included a qualitative thematic analysis of parent-reported behavioral outcomes revealing themes of improved cognition, academic performance, and psychosocial skills including confidence and perseverance.
Carpenter, D., Ledbetter, C., & Moore, A.L. (2016). LearningRx cognitive training effects in children ages 8-14: A randomized controlled study. Applied Cognitive Psychology, 30(5), 815-826. doi: 10.1002/acp.3257
In a randomized controlled study, the effects of a one-on-one cognitive training program on IQ, memory, visual and auditory processing, processing speed, reasoning, and attention for students ages 8-14 were examined. Participants were randomly assigned to either an experimental group to complete 60 hours of cognitive training or to a wait-list control group. The purpose of the study was to examine changes in general intelligence and individual cognitive skills after completing cognitive training with ThinkRx, a LearningRx program. Results showed statistically significant differences between groups on all outcome measures except for attention. Implications, limitations, and suggestions for future research are examined. Link to article: http://onlinelibrary.wiley.com/doi/10.1002/acp.3257/full
Moore, A.L., Carpenter, D.M., Miller, T.M., & Ledbetter, C. (2019). Comparing Two Methods of Delivering ThinkRx Cognitive Training to Children Ages 8-14: A Randomized Controlled Trial of Equivalency. Journal of Cognitive Enhancement, 3(3), 261-270. doi.org/10.1007/s41465-018-0094-z
In a randomized controlled trial assessing equivalence of parallel groups of children ages 8-14, we compared cognitive outcomes between a group who received 60 hours of ThinkRx cognitive training delivered one-on-one by a clinician (n = 20) versus a group of children who received 30 hours of ThinkRx delivered by a clinician and the remaining 30 hours through supervised digital training procedures in a computer lab (n = 18). Results showed no significant differences between groups on tests of working memory, logic and reasoning, auditory processing, visual processing, processing speed, or overall IQ score. Results were significantly different on the test of long-term memory. These results suggest that both delivery models are nearly equivalent delivery methods of ThinkRx cognitive training for children. This study controlled for placebo effects because both groups attended the same number of sessions and spent the same number of hours in training (60) with an adult present. Finally, this was a single-blind study. The participants did not know there was a difference in training methods. Read the article (Link to results poster)
Jedlicka, E. (2017). LearningRx cognitive training for children and adolescents ages 5-18: Effects on academic skills, behavior, and cognition. Frontiers in Education, 2(62). doi: 10.3389/feduc.2017.00062
This study with 178 students ages 5-18 investigated whether ThinkRx and ReadRx clinician-delivered cognitive training programs reduced academic difficulties and oppositional behavior for school-age children with learning struggles compared to a control group. Results indicated there were statistically significant differences overall between the intervention groups and the control group on all measures of academic difficulties. Both intervention groups saw a reduction in academic difficulty ratings following training while the control group saw an increase in academic difficulty during a comparable time interval. Both intervention groups achieved statistically significant changes on objective cognitive test measures as well. Link to article: https://www.frontiersin.org/articles/10.3389/feduc.2017.00062/full
Hill, O.W., Zewelanji, S., & Faison, O. (2016). The Efficacy of the LearningRx Cognitive Training Program: Modality and Transfer Effects. Journal of Experimental Education: Learning, Instruction, and Cognition, 84(3), 600-620. doi: 10.1080/00220973.2015.1065218.
This article describes two trials testing the efficacy of the LearningRx one-on-one cognitive training program and its computer-based version (Brainskills) in laboratory and school settings. Study 1 tested Brainskills in a laboratory setting with 322 middle school students. Paired t-tests revealed significant gains on all cognitive measures and math performance after 3 weeks of training. Study 2, a randomized control study, included 225 high school students randomly assigned to one of three conditions: LearningRx, Brainskills, or study hall (control) in a school setting for a 15-week training period. Univariate ANCOVAs revealed significantly higher scores for the treatment groups compared with controls on working memory, logic and reasoning, and three of four math attitude measures. Funded by $3M National Science Foundation (NSF) grant. Link to abstract: http://dx.doi.org/10.1080/00220973.2015.1065218
Gibson, K., Carpenter, D.M., Moore, A.L., & Mitchell, T. (2015). Training the brain to learn: Beyond vision therapy. Vision Development and Rehabilitation, 1(2), 120-129.
The purpose of this study was to investigate the effectiveness of the comprehensive cognitive training program, ThinkRx. Sixty-one children (ages 6-18) were given pretest and post-test cognitive assessments. Thirty-one students completed a 24-week cognitive training program in a LearningRx center. A matched control group of thirty children did not receive training. Multiple regression analyses indicated that treatment group membership was a statistically significant predictor of outcomes in long-term memory, logic and reasoning, working memory, processing speed, auditory processing, and Word Attack. The treatment group realized significantly greater gains in six of seven cognitive measures. Link to study: http://www.covd.org/?page=VDR_1_2
Moore, A.L., Miller, T.M., & Ledbetter, C. (2021). Remote vs. In-Person Delivery of LearningRx One-on-One Cognitive Training During the COVID-19 Pandemic: A Non-inferiority Study. Frontiers in Psychology, 12, 749898. doi: 10.3389/fpsyg.2021.749898
The study compared remote delivery to in-person delivery of ThinkRx cognitive training during 2020. The sample included 381 child and adult clients from 18 cognitive training centers. One group (n = 178, mean age = 12.3) received traditional in-person delivery of cognitive training. The second group (n = 203, mean age = 11.7) received remote delivery of one-on-one cognitive training via Zoom. Paired samples t tests revealed significant differences from pretest to post-test across all constructs for both groups. After Bonferroni correction, MANOVA revealed no significant difference between the two intervention groups on any of the subtests. Noninferiority analyses indicated remote delivery is not inferior to in-person delivery on the primary outcome measure of overall IQ score along with processing speed, fluid reasoning, long-term memory, and visual processing. Although in-person training results were slightly higher than remote training results, the current study reveals remote delivery of cognitive training during COVID-19 was a viable alternative to in-person delivery of cognitive training.
Moore, A., & Ledbetter, C. (2020). Ethical considerations and lessons learned in a randomized controlled trial of ThinkRx cognitive training for children with learning disabilities and/or ADHD. SAGE Research Methods Cases. doi:10.4135/9781529734072
In a randomized controlled trial, we examined the efficacy of ThinkRx, a clinician-delivered cognitive training program delivered to children with learning disabilities and/or ADHD. In this case review, we discuss the ethical considerations for using a waitlist control group instead of a sham intervention in lengthy behavioral interventions with a vulnerable population. We describe the control group options we considered and why we selected waitlist controls. We report our quantitative and qualitative outcomes from two articles published on this study including statistically significant differences in eight of the nine measures, clinically significant changes in IQ score for the ADHD subset, and parent-reported improvements in self-esteem, self-discipline, cooperative behaviors, and school performance. Link to author’s copy
Moore, A.L., Carpenter, D.M., Ledbetter, C., & Miller, T.M. (2018). Clinician-delivered cognitive training for children with attention problems: Transfer effects on cognitive and behavior from the ThinkRx randomized controlled trial. Neuropsychiatric Disease and Treatment, 14, 1671-1683. doi: 10.2147/NDT.S165418
In a randomized controlled study, we examined the effects of a one-on-one cognitive training program on memory, visual and auditory processing, processing speed, reasoning, attention, overall IQ score, and behavior for students ages 8-14 with ADHD. Results included greater pretest to post-test change scores on all variables for the treatment group versus the control group with statistically significant differences noted in working memory, long-term memory, logic and reasoning, auditory processing, and IQ score. Qualitative outcomes included far transfer to cognition and behavior as reported by participants, parents, and clinicians. Read the article Link to video abstract: https://www.youtube.com/watch?v=Tso9xhKRkao
Moore, A.L., & Ledbetter, C. (2019). The Promise of Clinician-Delivered Cognitive Training for Children Diagnosed with ADHD. Journal of Mental Health and Clinical Psychology, 3(3), 3-8. doi: 10.29245/2578-2959/2019/3.1180
Mainstream approaches to treating Attention Deficit Hyperactivity Disorder in children include stimulant medication such as methylphenidate and behavior therapy that target deficits in attention as well as inappropriate behaviors but do not sufficiently address the multiple cognitive deficits associated with the disorder. Deficits beyond attention have been identified in ADHD including working memory, long-term memory, and processing speed. As key elements of cognition and intelligence that contribute to thinking and learning, these are critical deficits found in children with ADHD that must be addressed. In this review, we discuss existing research on cognitive training interventions for ADHD and evaluate their ability to target these multiple cognitive deficits as well as their ability to promote self-efficacy, social cognition, and motivation during training. We describe research on LearningRx, a clinician-delivered cognitive training intervention and suggest that human delivery enhances motivation and promotes social cognition and self-efficacy while strengthening weak cognitive skills associated with ADHD in children. Link to article.