Computer Assisted Training of Attention and Concentration with Healty Children

Ziel der Untersuchungen war es, ein im klinischen Einsatz bei Erwachsenen mit Hirnschädigungen entwickeltes computergestütztes Aufmerksamkeitstraining (System RehaCom) für den Einsatz in der Behandlung von Kindern zu erproben. Dabei wurde das Verfahren an normalgesunden Kindern verschiedener Altersgruppen evaluiert. Die gewonnenen Erfahrungen sollen helfen, die Trainingsverfahren für hirngeschädigte Kinder zu erschließen und anzupassen. In bezug auf erhobene Leistungsparameter des Trainings (erreichtes Leistungsniveau) unterscheiden sich die Altersgruppen signifikant im Verlauf. Schulkinder profitieren im Vergleich zu Kindergartenkindern in höherem Maße von dem Training. Implikationen für Veränderungen des Trainingsprogramms werden diskutiert. Weitere Leistungsparameter (Reaktionszeiten, Fehler) geben Hinweise auf die Schwierigkeitsstruktur des Programms. Fragebogenerhebungen zur Motivation vor und während des Trainings, Aufgabenverständlichkeit, Bedienerfreundlichkeit sowie bezüglich der Kindgerechtheit der verwendeten Bilder ergaben, daß eine Aufrechterhaltung der Motivation etwa durch ein leistungsadaptives Trainieren positiv beeinflusst wird: die Kinder sollten nicht durch zu leichte Aufgaben demotiviert und durch zu schwere Aufgaben frustriert werden. Insgesamt war die Akzeptanz gegenüber dem computergestützten kognitiven Training gut. Die Anwesenheit eines Therapeuten während des Trainings ist bei Kindern unter sechs Jahren unbedingt erforderlich.(DIPF/Orig.)The intention of this study was to analyze in how far a computer assisted training for brain damaged adults can be used for the practice with children. Healthy children of different ages were trained with this attention and concentration programme. The results should help to adapt the training programme for the use in brain damaged children. Age-groups differed significantly in level of performance. Data showed that in comparison to Kindergarten-children, first-grade children showed a higher benefit from the training. Implications for modifications of the training-programme are discussed. Other parameter of performance (reactiontime, errors) in relation to school age provide clues to the distribution of structure of difficulty in the programmes. A questionnaire assessing motivation before and during the training, intelligibility of the task, feasibility of the computer and adequacy of the test in children showed that sustained motivation can be achieved provided the training is used in an adaptive way. Thereby demotivating with too easy tasks as well as frustration caused by difficult tasks can be avoided. In general, there was good acceptance of the computerised cognitive training. The presence of a therapist during every training session proved to be necessary in children under the age of 6 years.(DIPF/Orig.

Practical implementation of the partial ordering continual reassessment method in a Phase I combination-schedule dose-finding trial.

Funder: Merck; Id: http://dx.doi.org/10.13039/100009945There is a growing medical interest in combining several agents and optimizing their dosing schedules in a single trial in order to optimize the treatment for patients. Evaluating at doses of several drugs and their scheduling in a single Phase I trial simultaneously possess a number of statistical challenges, and specialized methods to tackle these have been proposed in the literature. However, the uptake of these methods is slow and implementation examples of such advanced methods are still sparse to date. In this work, we share our experience of proposing a model-based partial ordering continual reassessment method (POCRM) design for three-dimensional dose-finding in an oncology trial. In the trial, doses of two agents and the dosing schedule of one of them can be escalated/de-escalated. We provide a step-by-step summary on how the POCRM design was implemented and communicated to the trial team. We proposed an approach to specify toxicity orderings and their a-priori probabilities, and developed a number of visualization tools to communicate the statistical properties of the design. The design evaluation included both a comprehensive simulation study and considerations of the individual trial behavior. The study is now enrolling patients. We hope that sharing our experience of the successful implementation of an advanced design in practice that went through evaluations of several health authorities will facilitate a better uptake of more efficient methods in practice