Review Article

Remote Technology-Based Training Programs for Children with Acquired Brain Injury: A Systematic Review and a Meta-Analytic Exploration

Table 1

Overview of the studies on Cognitive Training Programs.

StudyResearch designSampleTreatment characteristicsTreatment domain(s)Outcome measuresMain findings

Bangirana et al., [36]Pre/posttest design.
Control group: passive control group.

(E: 32, C: 33).
Age: E: years ( years); C: years ().
Diagnosis: cerebral malaria, at approximatively 45 months since injury.
Training: Captain’s Log.
Description: Captain’s Log is a cognitive training aimed at stimulating attention, memory, visuomotor skills, and reason abilities. Fifteen of the 35 possible brain-training exercises of the program were chosen for this study.
Training adaptation: the difficulty of exercises automatically increased based on the child’s performance.
Setting: clinic, home, or school.
Duration: 16 sessions in 8 weeks.
Frequency: twice a week.
Therapist monitoring: not required.
(i) Working memory
(ii) Psychomotor speed
(iii) Visual attention
(iv) Visual learning and memory
(v) Spatial working memory and learning
(vi) Visuomotor processing speed
Cognitive functioning:
(i) “CogState” battery: working memory, detection, identification, card learning, maze learning, and maze chasing
Behavioral, social, and emotional functioning:
(i) CBCL (internalizing, externalizing, total problems)
Improvement in
(i) Visuomotor processing speed
(ii) Working memory
(iii) Learning
(iv) Internalizing problems (CBCL)

Bangirana et al., [35]Pre/posttest design.
Control group: passive control group.

(E: 28, C: 33).
Age: 5-12 years.
Diagnosis: severe malaria at 3 months since injury.
Training: Captain’s Log.
Description: Captain’s Log is a cognitive training aimed at stimulating attention, memory, visuomotor skills, and reason abilities. Fifteen of the 35 possible brain-training exercises of the program were chosen for this study.
Training adaptation: the difficulty of exercises automatically increased based on the child’s performance.
Setting: clinic, home, or school.
Duration: 16 sessions in 8 weeks.
Frequency: twice a week.
Therapist monitoring: not required.
(i) Working memory
(ii) Psychomotor speed
(iii) Visual attention
(iv) Visual learning and memory
(v) Spatial working memory and learning
(vi) Visuomotor processing speed
Cognitive functioning:
(i) KABC-II: working memory, visual spatial ability, reasoning, learning, and planning
(ii) TOVA
Academic functioning:
(i) WRAT-3: arithmetic, reading, and spelling
Behavioral, social, and emotional functioning:
(i) CBCL (internalizing, externalizing, total problems)
Improvement in
(i) Learning mean score

Hardy et al., [65]Pre/posttest pilot design.
Follow-up: at 3 months.
Control group: no control group.
.
Age: 10-17 years.
Diagnosis: 6 BT, 3 ALL at 1-10 years since surgery and/or adjuvant therapies.
Inclusion criteria based on cognitive functioning:
(i) Presence of attention problems based on CPRS and WMI of WISC 4
Training: Captain’s Log.
Description: Captain’s Log is a cognitive training aimed at stimulating attention, memory, visuomotor skills, and reason abilities.
Training adaptation: the difficulty of exercises automatically increased based on the child’s performance.
Setting: home.
Duration: 12 weeks.
Frequency: at least 50 minutes of training per week.
Therapist monitoring: weekly contact provided by a researcher for motivation and troubleshooting.
(i) Attention
(ii) Concentration
(iii) Memory
(iv) Listening skills
(v) Processing speed
(vi) Self-control
(vii) Hand-eyecoordination
(viii) Fundamental numerical concepts
(ix) Basic problem solving/reasoning skills
Cognitive functioning:
(i) WMI of WISC IV (digit-span, letter-numbersequencing)
Behavioral, social, and emotional functioning:
(i) CPRS
Improvement in
(i) WMI from baseline to 3-monthfollow-up
(ii) Digit-spanforward at post training
(iii) Parent-reported attention across the 3 time points

Kesler et al., [21]One-arm open trial pilot study.
Pre/posttest design.
Control group: no control group.
.
Age: 7-19 years.
Diagnosis: 14 ALL, 9 posterior fossa BT, at 6 months since surgery and/or adjuvant therapies.
Inclusion criteria based on cognitive functioning:
(i) Deficit in EF: two or more EF test scores > 1 SD under the normative mean or the FSIQ score
Training: Lumosity Cognitive Training.
Description: Lumosity Cognitive Training is a brain training consisting of different games, each targeting one of the following cognitive domains: speed of processing, attention, memory, flexibility, and problem solving.
Only those exercises addressing cognitive flexibility, attention, and working memory (available in 2007 at the beginning of the study) were chosen for the training used in this study.
Training adaptation: the difficulty of exercises was automatically and in real time adjusted by the program, based on the child’s performance.
Setting: home.
Duration: 40 sessions in 8 weeks.
Frequency: 5 sessions/week, 20 minutes/session, 6 tasks/session.
Therapist monitoring: weekly monitoring by research staff.
(i) Cognitive flexibility
(ii) Attention
(iii) Working memory
Cognitive functioning:
(i) WISC-IV or WAIS-III
(ii) WRAML2 (list memory, picture memory)
(iii) NEPSY II (animal sort for children of 7–16 years)
(iv) D-KEFS (sorting test for children of 17–19 years)
(v) WJ-III(cancellation test)
(vi) MVPT-3
Other measures:
(i) Neuroimaging data
Improvement in
(i) Processing speed
(ii) Cognitive flexibility
(iii) Verbal and visual declarative memory
(iv) Prefrontal cortex activation at post training, compared to baseline

de Kloet et al., [34]Multicenter pre/posttest design.
Control group: no control group.
.
Age: 6-29 years.
Diagnosis: 27 TBI, 23 ABI non-TBI, at 0-2 years since injury.
Training: TherapWii Protocol.
Description: this program consists of different Nintendo Wii games, each one composed of several subgames.
Training adaptation: the difficulty of the majority of games was automatically adjusted by the program, based on child performance.
Setting: home, school, or clinic during an individual rehabilitation session.
Duration: 12 weeks.
Frequency: at least 20 minutes per week, for a maximum of 2 hours per week.
Therapist monitoring: weekly contact provided by a therapist for motivation and troubleshooting.
(i) Working memory
(ii) Attention
(iii) Information processing
(iv) Executive functioning
(v) Visuospatial perception
Cognitive functioning:
(i) ANT
Physical and/or behavioral, social, and emotional functioning:
(i) Time spent on physical activity: ad hoc Likert questionnaire
(ii) Social participation: children’s assessment of participation and enjoyment
Quality of life:
(i) Peds-QL
Improvement in
(i) Alertness
(ii) Attentional flexibility
(iii) Visuospatial WM
(iv) Motor tracking
(v) Time on physical activities
(vi) Quality of life regarding school and social participation

Hardy et al. [47]Randomized study.
Pre/posttest design.
Follow-up: at 3 months
Control group: active control group performing the MegaMemo, a computer-based program that consists of the same exercises as CogmedRM, but the level of difficulty does not increase.
(9 BT; 11 ALL); (E: 13, C: 7).
Age: 8-16 years.
Diagnosis: BT and ALL, at 1 year since surgery and/or adjuvant therapies.
Inclusion criteria based on cognitive functioning:
(i)
(ii) Difficulties with attention and working memory, according to at least one of the following criteria:
(1) T-score of inattention subscale of the CPRS-3 ≥ 75th percentile
(2) Attention/concentration subscale or working memory indices of the WRAML2 > 1 DS below the mean
(3) Attention/concentration subscale or working memory indices of the WRAML2 > 1 DS below the estimated IQ
Training: Cogmed Working Memory Training.
Description: this program consists of exercises targeting verbal and visuospatial working memory.
Training adaptation: the difficulty of exercises was automatically and in real time adjusted by the program, based on the child’s performance.
Setting: home.
Duration: 25 sessions in 5-8 weeks.
Frequency: approximatively 3-5 sessions/week.
Monitoring: weekly phone-based contact with a coach.
(i) Visuospatial and verbal working memoryCognitive functioning:
(i) WRAML2 (attention/concentration and working memory)
Everyday cognitive functioning:
(i) CPRS (inattention and learning problems scales)
Improvement in
(i) Visuospatial working memory
(i) Parent-ratedlearning problems

Sohlberg et al., [66]Pilot study.
Pre/posttest design.
Control group: no control group.
.
Age: 13-16 years.
Diagnosis: TBI at >12 months since injury.
Inclusion criteria based on cognitive functioning:
(i) Attention problems as defined by a frequency score of 2 or 3 on at least 4 out of the 9 items from the Attention Subscale of the Vanderbilt ADHD Diagnostic Parent Rating Scale
Training: Attention Improvement Management (AIM) training.
Description: this training is a cognitive intervention aimed at improving attention and executive functions. The program combines computerized drill-based tasks and metacognitive strategy instruction.
Training adaptation: difficulty of exercises was weekly adjusted by a therapist.
Setting: home.
Duration: 10 weeks; the treatment was extended by 1 week for each week that the child failed to complete at least 2 home practices.
Frequency: 2-4 sessions/week, 20 minutes/session.
Therapist monitoring: home practice sessions were tracked and monitored by a clinician via a USB drive. Weekly face-to-face meetings between the child and the research clinician were scheduled to review home practice and adjust exercise difficulty.
(i) Working memory
(ii) Attention (inhibition, sustained, selective/focused attention)
(iii) Executive functions (flexibility of thinking, inhibition, problem solving, planning, impulse control, concept formation, abstract thinking, and creativity in both verbal and spatial modalities)
Cognitive functioning:
(i) TEA-Ch (the Score!, Walk/Do not Walk, Code Transmission, Sky Search)
(ii) D-KEFS (Trail Making Test, Color-word Interference Test, and Tower Test)
Everyday cognitive functioning:
(i) BRIEF (GEC)
Other measures:
(i) GAS
Improvement in
(i) Attention
(ii) Parent reported executive functioning
(iii) GAS

Conklin et al., [46]Single-blind randomized controlled trial.
Pre/posttest design.
Control group: passive control group.
(E: 34, C: 34).
Age: 8-16 years.
Diagnosis: ALL or BT (E: 34, 23 ALL +11 BT; C: 34, 24 ALL +10 BT), at least 1 year since surgery and/or adjuvant therapies.
Exclusion criteria based on cognitive functioning:
(i)
Training: Cogmed Working Memory Training.
Description: this program consists of exercises targeting verbal and visuospatial working memory.
Training adaptation: the difficulty of exercises was automatically and in real time adjusted by the program, based on the child’s performance.
Setting: home.
Duration: 25 sessions in 5-9 weeks.
Frequency: approximatively 3-5 sessions/week, 30-45 minutes/session.
Therapist monitoring: weekly phone-based contact with a coach.
(i) Verbal and visuospatial working memoryCognitive functioning:
(i) Abbreviated IQ of WASI (vocabulary, matrix reasoning)
(ii) WISC IV (working memory, digit span forward, digit span backward, letter number sequencing, working memory index, spatial span forward, spatial span backward)
(iii) CPT-II (omissions, hit reaction time)
Academic functioning:
(i) WJ-III (math fluency, reading fluency)
Everyday cognitive functioning:
(i) CPRS-3 (inattention, executive function)
(ii) BRIEF (working memory scale, metacognitive index)
Other measures:
(i) Neuroimaging data
Improvement in
(i) Working memory (spatial span backward)
(ii) Attention (WISC-IV spatial span forward)
(iii) Processing speed (CPT-II hit reaction time)
(iv) Executive function (CPRS-3)
(v) Functional magnetic resonance imaging revealed reduction in activation of left lateral prefrontal and bilateral medial frontal areas.

Eve et al., [64]Pre/post-test design.
Follow-up: at 12 months.
Control group: no control group.
children (5 at follow-up).
Age: 10-16 years.
Diagnosis: arterial ischemic stroke, at 4-10 years since injury.
Inclusion criteria based on cognitive functioning:
(i) IQ scores within 2 SDs of the mean, as measured by the WASI or WISC 4
Training: Cogmed Working Memory Training.
Description: this program consists of exercises targeting verbal and visuospatial working memory.
Training adaptation: the difficulty of exercises was automatically and in real time adjusted by the program, based on the child’s performance.
Setting: home.
Duration: 25 sessions.
Frequency: 5 sessions/week, about 30-40 minutes per day.
Therapist monitoring: weekly phone-based contact with the coach.
(i) Verbal and visuospatial working memoryCognitive functioning:
(i) WMTB-C (digit recall, word list matching, word list recall and non-word list recall, block recall, listening recall, backward digit recall)
(ii) Tea-Ch: (Sky Search, Score!, Score! Dual Task, Sky Search Dual Task, Walk/Do not Walk)
Academic functioning:
(i) WRAT-4 (mathematics)
Improvement in
(i) Verbal working memory (not maintained at follow-up)

Phillips et al., [50]Double-blind, randomized, placebo-controlledtrial.
Pre/posttest design.
Follow-up: at 3 months.
Control group: control group performing non-adaptive tasks of a less demanding version of the Cogmed Working Memory Training.

(E: 13, C: 14).
Age: 8-15 years.
Diagnosis: moderate to severe TBI, at >12 months since injury.
Inclusion criteria based on cognitive functioning:
(i)
Training: Cogmed Working Memory Training.
Description: this program consists of exercises targeting verbal and visuospatial working memory.
Training adaptation: the difficulty of exercises was automatically and in real time adjusted by the program, based on the child’s performance.
Setting: home.
Duration: 25 sessions.
Frequency: 5 sessions/week, about 30-40 minutes per day.
Therapist monitoring: weekly phone-based contact with a coach.
(i) Visuospatial and verbal working memoryCognitive functioning:
(i) AWMA (digit recall, dot matrix)
(ii) TEA-Ch (Sky Search Score, Sky Search DT, Creature Counting, Walk/Do not Walk)
Academic functioning:
(i) WIAT-II (word reading, reading comprehension, numerical operations)
Improvement in:
(i) WM tasks (at post-trainingand follow-up)
(ii) Reading comprehension (at post-training)
(iii) Reading accuracy (at follow-up)

Sakzewski et al., [52]Randomized controlled trial.
Pre/posttest design.
Control group: control group undergoing usual care program.

(E: 29, C: 29).
Age: 8-16 years.
Diagnosis: stroke (; E: 10, C: 12), TBI (, E: 11, C: 8), nontraumatic ABI (; E: 8, C: 9), at least 12 months since injury.
Training: “Move it to improve it” (Mitii™).
Description: this training is a multimodal web-based rehabilitation intervention to improve occupational performance, visual perception, and upper limb speed.
Training adaptation: the therapist weekly adjusted the exercise complexity based on child’s performance and feedback from the child and family.
Setting: home.
Duration: 20 weeks.
Frequency: 6 days/week, 30 minutes/day.
Therapist monitoring: weekly remote monitoring provided by a therapist for motivation and troubleshooting.
(i) Physical domain (i.e., upper limb and gross motor abilities)
(ii) Visuospatial perception (visual discrimination, spatial relations, visual memory, form constancy, sequential memory, figure ground, and visual closure)
Motor functioning:
(i) AMPS (processing, motor skills)
(ii) Jebsen-Taylor Test of Hand Function
(iii) COPM (performance, satisfaction)
(iv) AHA (school kids version)
Cognitive functioning:
(i) TVPS (overall standard score, discrimination, memory, spatial relations, sequential memory, figure ground, and closure)
Improvement: negligible changes

Treble-Barna et al., [33]Open-label pilot study.
Pre/posttest design.
Control group: healthy control group () receiving the same treatment.
(E: 13, C: 11).
Age: 9-15 years.
Diagnosis: mild to severe TBI, at least 1 year since injury.
Inclusion criteria based on cognitive functioning:
(i) Evidence of behavioral attention problems (Vanderbilt ADHD Diagnostic Parent Rating Scale, Attention Subscale: at least 4 items with a frequency score of 2 or 3)
Training: Attention Improvement and Management (AIM).
Description: this training is a cognitive intervention aimed at improving attention and executive functions. The program combines computerized drill-based tasks and metacognitive strategy instruction.
Training adaptation: the difficulty of exercises was weekly adjusted by a therapist.
Setting: home.
Duration: 12 weeks.
Frequency: 2-4 sessions/week.
Therapist monitoring: weekly face-to-face meetings between the child and the research clinician were scheduled to review home practice and adjust exercise difficulty.
Weekly face-to-face meetings between the child and the research clinician were scheduled to review home practice and adjust exercise difficulty.
(i) Working memory
(ii) Attention (inhibition, sustained, selective/focused attention)
(iii) Executive functions (flexibility of thinking, inhibition, problem solving, planning, impulse control, concept formation, abstract thinking, and creativity in both verbal and spatial modalities)
Cognitive functioning:
(i) TEA-Ch (the Score!, Walk/Do not Walk, Code Transmission, Sky Search)
(ii) D-KEFS (Number-Letter Switching score from TMT, Inhibition/Switching score from CWIT, Total Achievement Score from the Tower Test)
Everyday cognitive functioning:
(i) BRIEF (BRI, GEC, MI)
Other measures:
(i) GAS
Improvement in
(i) Sustained attention
(ii) Parent-reportedEFs
(iii) The majority of families also reported expected or more-than-expectedpersonalized goal attainment

Carlson-Green et al., [44]Pre/posttest design.
Follow-up: at 6 months.
Control group: no control group.
.
Age: 8-18 years.
Diagnosis: BT, at least 1 year since surgery and/or adjuvant therapies.
Inclusion criteria based on cognitive functioning:
(i) Working memory deficits ( on the attention scale of CBCL or percentile on the parent-rated working memory scale of BRIEF or WMI SD below the mean)
(ii)
Training: Cogmed Working Memory Training.
Description: this program consists of exercises addressing verbal and visuospatial working memory.
Training adaptation: the difficulty of exercises was automatically and in real time adjusted by the program, based on the child’s performance.
Setting: home.
Duration: 35 sessions, in 8-12 weeks.
Frequency: not reported.
Therapist monitoring: intermittent emails from coaches.
(i) Visuospatial and verbal working memoryCognitive functioning:
(i) AWMA (at the baseline and immediately after training: digit recall, nonword recall, listening recall, backwards digit recall, dot matrix, mister X, mazes memory, and odd one out; at the baseline and at 6-month follow-up: word recall, digit recall, backwards digit recall, counting recall, dot matrix, mister X, and spatial recall)
Academic functioning:
(i) WJ-III (applied problems and passage, comprehension subtests)
Behavioral, social, and emotional functioning:
(i) CBCL (internalizing scale, externalizing scale, total problems scale)
Everyday cognitive functioning:
(i) BRIEF, at baseline and 6-month assessment
Social functioning:
(i) ABAS-II, at baseline and 6-month follow-up
Other measures:
(i) NPS: index of a child’s exposure to neurocognitive risk factors during cancer treatment
Improvement in
(i) Working memory at post training and at follow-up
(i) Math achievement at follow-up
(i) Executive functioning at follow-up

Conklin et al., [45] (extension of Conklin et al., [46])Single-blind randomized controlled trial.
Pre/posttest design.
Follow-up: at 6 months.
Control group: passive control group.

(E: 34, 23 ALL +11 BT; C: 34, 24 ALL +10 BT).
Age: 8-16 years.
Diagnosis: ALL or BT, at least 1 year since surgery and/or adjuvant therapies, without recurrence.
Inclusion criteria based on cognitive functioning:
(i) Digit span, letter-number sequencing, or spatial span performance (WISC-IV) > 1 SD below the normative mean
(ii) (WASI)
Training: Cogmed Working Memory Training.
Description: this program consists of exercises targeting verbal and visuospatial working memory.
Training adaptation: the difficulty of exercises was automatically and in real time adjusted by the program, based on the child’s performance.
Setting: home.
Duration: 25 sessions, in 5-9 weeks, 30-45 minutes/session.
Frequency: not reported.
Therapist monitoring: weekly phone-based contact with a coach.
(i) Verbal and visuospatial working memoryCognitive functioning:
(i) Abbreviated IQ of WASI (vocabulary+matrix reasoning)
(ii) WISC IV (working memory, digit span forward, digit span backward, letter number sequencing, working memory index, spatial span forward, spatial span backward)
(iii) CPT-II (omissions, hit reaction time)
Academic functioning:
(i) WJ-III (math fluency, reading fluency)
Everyday cognitive functioning:
(i) CPRS-3 (inattention, executive function)
(ii) BRIEF (working memory, metacognitive index)
Other measures:
(i) Neuroimaging data
Improvement:
(i) Working memory and processing speed were unchanged from posttest to 6 month follow-up, indicating maintenance of training improvement.

Piovesana et al., [51]Randomized waitlist controlled trial.
Control group: waiting-list control group.

(E: 30, C: 30).
Age: 8-16 years.
Diagnosis: mild, moderate, or severe ABI, at least 12 months since injury.
Training: “Move it to improve it” (Mitii™).
Description: Internet-based, multimodal program aimed at exercising cognitive, visual perceptual, and physical (i.e., upper limb and gross motor) function areas.
Training adaptation: weekly remote monitoring of a therapist to control performance and update the program difficulty.
Setting: home.
Duration: 20 weeks.
Frequency: 6 days/week for 30 minutes.
Therapist monitoring: regular contact via phone or email with participants and families by the therapist to provide feedback and support.
(i) Cognitive functions
(ii) Visual-perceptualfunctions
(iii) Physical functions (i.e., upper limb and gross motor abilities)
Cognitive functioning:
(i) WISC 4 (digit span backward, symbol search, coding)
(ii) CTMT (trail 2, 3, 4, 5)
(iii) D-KEFS: color naming, word reading, inhibition scores from CWI
(iv) TOL
(v) TEA-Ch (Sky Search, Sky Search Dt Score)
Everyday cognitive functioning:
(i) BRIEF (BRI, MI, GEC)
Improvement: none

Verhelst et al., [68]Pre/posttest design.
Feasibility study with preliminary data on efficacy.
Follow-up: at 6 months.
Control group: no control group.
.
Age: 16-17 years.
Diagnosis: TBI, at least 1 year, but no more than 5 years since injury.
Training: Brain Games Program.
Description: entertaining games aimed at stimulating working memory/executive functioning and attention.
Training adaptation: the difficulty of exercises was automatically and in real time adjusted by the program, based on the child’s performance.
Setting: home.
Duration: 8 weeks.
Frequency: 5 sessions/week.
Therapist monitoring: none.
Participants received a calendar and a training schedule to self-monitor their own adherence and performance.
(i) Attention
(ii) Working memory
(iii) Processing speed
Cognitive functioning:
(i) CPT III
(ii) Flanker task
(III) WISC III: digit span-forward, digit-span backward, digit symbol coding
(iv) CANTAB: spatial span-forward and backward, stockings, intra-extradimensionalset shift
Everyday cognitive functioning:
(i) BRIEF (BRI, MI, GEC)
Improvement:
(i) Positive effect sizes were found for all measures, except the BRIEF (BRI).

Corti et al., [29]Pre/posttest design.
Feasibility study with preliminary data on efficacy.
The main study on efficacy is a randomized controlled study, with a stepped-wedge design.
Control group (in the main study): waiting-list group, performing the same cognitive training of the experimental group at a different time point.
.
Age: 11-16 years.
Diagnosis: 28 ABI (traumatic or nontraumatic) + 4 congenital brain damage, at least 1 year since injury.
Training: Lumosity Cognitive Training.
Description: Lumosity Cognitive Training is a brain training consisting of different games, each targeting one of the following cognitive domains: speed of processing, attention, memory, cognitive flexibility, and problem solving.
Five of the possible brain-training exercises of the program were chosen for this study.
Training adaptation: the difficulty of exercises was automatically and in real time adjusted by the program, based on the child’s performance.
Setting: home.
Duration: 8 weeks.
Frequency: 20 minutes/day, 5 days/week.
Therapist monitoring: weekly remote monitoring provided by a researcher for motivation and troubleshooting.
(i) Memory
(ii) Attention
(iii) Executive functioning
(iv) Processing speed
(v) Arithmetic operations
Cognitive functioning:
(i) Lumosity Performance Index (LPI): average performance across the different games
Improvement:
(i) Increase in mean LPI between the first day and the last day of the training (Cohen’s )

Vander Linden et al., [67] (extension of Verhelst et al., [68])Pre/posttest design.
Control group: passive control group.
(E: 16, C: 16).
Age: 11-17 years (mean: 15.8 years).
Diagnosis: moderate to severe TBI (mean age at injury: 13.4 years, mean time since injury: 2.4 years).
Training: Brain Games Program.
Description: entertaining games aimed at stimulating working memory/executive functioning and attention.
Training adaptation: the difficulty of exercises was automatically and in real time adjusted by the program, based on the child’s performance.
Setting: home.
Duration: 8 weeks.
Frequency: 40 minutes/session, 5 days/week.
Therapist monitoring: none.
Participants received a calendar and a training schedule to self-monitor their own adherence and performance.
(i) Memory (verbal memory, visuospatial memory, and working memory)
(ii) Attention (selective attention, sustained attention, and inhibition)
(iii) Processing speed
(iv) Nonverbal learning
(v) Problem-solving and planning
Cognitive functioning:
(i) Digit span (forward and backward) of WISC IV
(ii) Spatial span (forward and backward) of WISC IV
(iii) Flanker task (conflict cost)
(iv) CPT III (reaction time)
(v) Digit Symbol Substitution Test
(vi) Stockings of Cambridge
Everyday cognitive functioning:
(i) BRIEF (GEC)
Improvement in
(i) Digit span forward, Flanker test, CPT III, digit symbol substitution, stockings of Cambridge, and GEC at posttraining and at 6-month follow-up
(ii) Digit span backwards at 6-monthfollow-up
(iii) Executive functions in daily living (BRIEF) for patients without diffuse-axonal-injuriesin deep brain nuclei

Note: study included in the meta-analytic exploration. Inclusion criteria indicated in the table only refers to those reported in the studies with respect to cognitive functioning. Other inclusion criteria based on demographic factors were omitted. ABAS-II: Adaptive Behavior Assessment System, 2nd Edition; ABI: acquired brain injury; AHA: The Assisting Hand Assessment; AIS: arterial ischemic stroke; ALL: acute lymphoblastic leukemia; AMPS: Assessment of Motor and Process Skills; ANT: Amsterdamse Neuropsychologische Taken Programme; AWMA: Automated WM Assessment; BRI: Behavioral Regulation Index; BT: brain tumor; C: control group; CANTAB: Cambridge Automated Neuropsychological Test Battery; CBCL: Child Behavioral Checklist; COPM: Canadian Occupational Performance Measure; CPRS: Conners’ Parent Rating Scale; CPT: Continuous Performance Test; CTMT: Comprehensive Trail Making Test; CWIT: Color-Word Interference Test; DKEFS: Delis Kaplan Executive System; DSM-IV: Diagnostic and Statistical manual, 4th edition; E: experimental group; EF: executive functions; FSIQ: Full Scale Intelligence Quotient; GAS: Goal Attainment Scale; GCS: Glasgow Coma Scale; GEC: Global Executive Composite; KABC-II: Kaufman Assessment Battery for Children, 2nd edition; GMFCS: Gross Motor Function Classification Scale; MI: Metacognitive Index; MVPT-3: Motor Free Test of Visual Perception, 3rd Edition; NPS: Neurological Predictor Scale; NEPSY II: Developmental NEuroPSYchological Assessment; PRI: Perceptual Reasoning Index; PSI: Processing Speed Index; SD: standard deviation; TEA-Ch: Test of Everyday Attention for Children; TMT: The Trail Making Test; TOVA: Test of Variables of Attention; TT: Tower Test; TVPS: Test of Visual Perceptual Skills; WAIS-III: Wechsler Intelligence Scale, 3rd edition; WASI: Wechsler Abbreviated Scale of Intelligence; WISC IV: Wechsler Intelligence Scale for Children, 4th edition; VCI: Verbal Comprehension Index; WIAT-II: Wechsler Individual Achievement Tests, 2nd Edition; WJ-III: Woodcock-Johnson 3rd Edition; WM: working memory; WMI: Working Memory Index; WMTB-C: Working Memory Test Battery for Children; WRAML2: Wide Range Assessment of Learning and Memory, 2nd Edition; WRAT-3: Wide Range Achievement Test, 3rd edition; WRAT-4: Wide Ranging Achievement Test, 4th edition.