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

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.
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).
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).
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.
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.Fig. 1RANDOMIZATION FLOW CHART.: Note. HIE hypoxic-ischemic encephalopathy, PVL periventricular leukomalacia, IVH intraventricular hemorrhage, ODD oppositional defiant disorder.Fig. 2TEACHER-RATED ACADEMIC ATTAINMENT SCORES (TAAS) BY INTERVENTION GROUP (XTRAMATH (N = 29, BOLDED) VERSUS COGMED (N = 27)) AT BASELINE, POST TEST, AND 12 MONTHS FOLLOW-UP.: Note: Bolded bars represent the XtraMath intervention group.Fig. 3MATH TEST SCORES (DEMAT) BY INTERVENTION GROUP (XTRAMATH (N = 28, BOLDED) VERSUS COGMED (N = 25)) AT BASELINE, POST TEST, AND 12 MONTHS FOLLOW-UP.: Note: Bolded bars represent the XtraMath intervention group.