Preterm children’s long-term academic performance after adaptive computerized training: an efficacy and process analysis of a randomized controlled trial

• Published in: Pediatric research 2021-05, Vol.89 (6), p.1492-1499
• Main Authors: Jaekel, Julia, Heuser, Katharina M., Zapf, Antonia, Roll, Claudia, Nuñez, Francisco Brevis, Bartmann, Peter, Wolke, Dieter, Felderhoff-Mueser, Ursula, Huening, Britta
• Format: Article
• Language: English
• Subjects: Academic achievement; Academic Performance; Child; Child, Preschool; Clinical; Clinical Research Article; Computer-Assisted Instruction; Humans; Infant, Newborn; Infant, Premature; Intervention; Mathematics - education; Medicine; Medicine & Public Health; Pediatric Surgery; Pediatrics; Prospective Studies
• ISSN: 0031-3998; 1530-0447
• DOI: 10.1038/s41390-020-01114-w

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 Adaptive computerized math training may help improve preterm children’s short-term school performance. 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.