The Cogmed Program was developed by Torkel Klingberg, a Swedish Neuroscientist at the prestigious Karolinska Institute, known for cutting-edge medical treatments, research, and the Nobel Prize in Medicine. Dr. Klingberg and his team discovered that working memory deficits underlie many difficulties children and adults experience with focused attention and learning. They also discovered that these WM deficits can be improved with computer based brain training.
This is the Cogmed Story – the unique and research supported data that training working memory can help children and adults overcome problems with working memory function. The aim of Cogmed Working Memory Training is to increase the ability to stay focused, ignore distractions, plan and sequence, remember instructions, and start and finish tasks. Those skills are crucial for both school and professional performance as well as for everyday living skills (e.g. cleaning one’s room). Some specific examples of the difficulties faced by children and adults with Working Memory deficits include:
- Resisting tasks requiring mental effort
- Easily distracted, often impulsive
- Difficulty focusing on and completing a task
- Trouble remembering instructions or detailed information
- Problems getting information into memory and keeping it there
- Difficulty with tasks requiring organization, planning, and sequencing information
- Reading comprehension and mathematics difficulties
- Lack of a sense of time
- Poor judgment in social situations
- Weak conversational skills – turn taking, listening, commenting
- Organizational skills
These are some of the real world examples of Working Memory impairments that can debilitate the lives of children and adults. Obviously every individual is unique and may have some or all of these difficulties.
The actual intensive portion of the treatment program (the first 25 days) involves at-home computer-based training. The amount of time varies it can be anywhere from 15-60 min per session. You need to finish all of the exercises on your screen each session. For the first 25 days the goal is – 5 days a week, for 5 weeks or 3 days a week for 8-9 weeks. The exercises are similar to computer games but the computer adjusts the level of difficulty (through Internet synchronization with a large data base) so the child or adult is always pushing him or herself. While some children with a strong competitive spirit are motivated simply to “beat the game,” others may find the program frustrating so the coaching and training assistance are essential to maintain motivation. The parent, or other caregiver, will be taught the necessary techniques and strategies to be a “training aide” to their child to obtain the maximum benefits from the program.
I will be providing weekly coaching tips via email based on analysis of your or your child’s performance data. The program requires a commitment to adhering to a consistent training schedule in order to get the optimal results. Families should think about the program like they would an exercise and fitness regimen – it needs to be consistent and intense to produce results.
There is now a select group of professionals in the US and Canada certified to provide Cogmed Working Memory Training. The data collected thus far by the professionals in North America and worldwide have been gratifying, with 80% of those who complete the training showing good to outstanding results. Some of the gains reported by parents include improvements in the following areas:
- Taking Initiative: including homework and chores.
- Remembering things: directions, routines, instructions, and information.
- Improved frustration tolerance: thinks before reacting; fewer “meltdowns”.
- Better able to focus, sustain attention, and can re-focus if attention starts to wander.
- Improved reading comprehension.
- Improved performance in math.
- Greater self-confidence and overall maturity, improved social interaction.
- Completing more tasks independently.
- Notebooks, materials, and planners more organized
- Reduced impulsivity and hyperactivity
- Better social skills, more connected to others
- Cognitive decline due to: stroke, aging, or traumatic brain injury
Improvement ranges from moderately good to excellent, in terms of “real world” functioning. In some cases, results are apparent as early as the third or fourth week of training. In other cases, however, results emerge slowly and begin to become apparent only after training is completed.
There are three programs available: JM, RM and QM. Cogmed JM for younger children ages 4-9 is of shorter duration. Training session time is variable pending on how quickly and efficiently a child/teen/adult can complete the exercises presented each day. A typical range is anywhere from 15-30 min for JM and 30-90 min for RM and QM versions. After the initial 25 day intensive training the optional but included extension training is roughly 1/3-1/2 the time. The program is designed with exercises of maximal intensity so the training can be condensed in a manner that is more developmentally appropriate for younger children.
It is critical to demo the cogmed program with the person doing it to pick which one is right for you and or your child. In general JM is for 4-7 yrs, RM is 7 and up and QM is for teens or adults.
One of the most exciting aspects of the training is that results are long-lasting: over 80% of those who improve either maintain their gains or actually continue to improve over time at one-year follow-up. The program now includes a year long extension training program which is abbreviated training at your own pace-one hundred additional sessions available for a year from when you start the training. The extension training is optional but it is included as part of the training when you enroll.
I have personally spent a considerable amount of time researching programs that offer a non-pharmacological addition to the treatment of ADHD and other problems with learning and development. This intervention has the evidence base and the research for me to be able to recommend it for my own patients.