Abstract
Background
Adaptive computerized interventions may help improve preterm children’s academic success, but randomized trials are rare. We tested whether a math training (XtraMath®) versus an active control condition (Cogmed®; working memory) improved school performance. Training feasibility was also evaluated.
Methods
Preterm born first graders, N = 65 (28–35 + 6 weeks gestation) were recruited into a prospective randomized controlled multicenter trial and received one of two computerized trainings at home for 5 weeks. Teachers rated academic performance in math, reading/writing, and attention compared to classmates before (baseline), directly after (post), and 12 months after the intervention (follow-up). Total academic performance growth was calculated as change from baseline (hierarchically ordered—post test first, follow-up second).
Results
Bootstrapped linear regressions showed that academic growth to post test was significantly higher in the math intervention group (B = 0.25 [95% confidence interval: 0.04–0.50], p = 0.039), but this difference was not sustained at the 12-month follow-up (B = 0.00 [−0.31 to 0.34], p = 0.996). Parents in the XtraMath group reported higher acceptance compared with the Cogmed group (mean difference: −0.49, [−0.90 to −0.08], p = 0.037).
Conclusions
Our findings do not show a sustained difference in efficacy between both trainings. Studies of math intervention effectiveness for preterm school-aged children are warranted.
Impact
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Adaptive computerized math training may help improve preterm children’s short-term school performance.
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Computerized math training provides a novel avenue towards intervention after preterm birth.
-
Well-powered randomized controlled studies of math intervention effectiveness for preterm school-aged children are warranted.
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Acknowledgements
This study was funded by Stiftung Mercator (grant number PR-2014-0039). We thank all cooperating hospitals, Katholisches Klinikum Bochum, Klinikum Duisburg, Elisabeth Hospital Essen, Vest Children’s Hospital Datteln, University Hospital Duesseldorf, University Hospital Essen, and Helios Klinikum Niederberg in Velbert, for supporting this project. Special thanks to Frauke Dransfeld, Eva Weishaupt, and Gisela Axmacher-Bopp for assistance with recruitment, intervention implementation, data collection and management, and to the study participants, their families, and teachers.
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Substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data: all authors. Drafting the article or revising it critically for important intellectual content: J.J., K.M.H., B.H., A.Z., P.B., and D.W. Final approval of the version to be published: all authors.
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Jaekel, J., Heuser, K.M., Zapf, A. et al. Preterm children’s long-term academic performance after adaptive computerized training: an efficacy and process analysis of a randomized controlled trial. Pediatr Res 89, 1492–1499 (2021). https://doi.org/10.1038/s41390-020-01114-w
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DOI: https://doi.org/10.1038/s41390-020-01114-w
