Cognitive Remediation Therapy in Autism Spectrum Disorder: Effects on Working Memory

Background:  Cognitive impairment, especially executive dysfunction has been linked to a number of developmental disorders, including Autism Spectrum Disorder (ASD). Cognitive Remediation Therapy (CRT) is a novel rehabilitation method that aims to produce improvement in cognitive processes. CRT has been used in patients with schizophrenia. 

Objectives:  

we aimed in this study to examine the effectiveness of CRT for improving working memory and clinical symptoms in children with ASD.

Methods:  Children meeting the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) criteria for ASD were recruited from clinical population at the Child and Adolescent Psychiatry Department in Razi University Hospital – Manouba - Tunisia. The CRT program was conducted at the rate of one session per week of 45 minutes each.  The main outcomes measures are working memory, assessed by forward and backward digit span, and clinical symptoms assessed by Childhood Autism Rating Scale (CARS). These outcomes were measured at baseline and one week after completion of the treatment.

Results:  

Of the 25 patients included, 16 achieved assessments tests after CRT, thus constituting our final sample. Their average age was 10.87 years. The mean number of sessions performed was 22.38. After completion of CRT, patients showed significant improvement (p=0.001) on forward digit span which score was 3.38 before CRT and 4 after completion of the program.  Concerning backward digit-span, the mean score increased from 2.21 before CRT to 3.09 after it. This improvement was significant (p=0.006). As for clinical symptoms, lower scores (26.81) were found after CRT in comparison with baseline mean scores (27.87).  This improvement was also significant (p=0.001).

Conclusions:  

Our study showed evidence that CRT can yield positive effects in cognitive performance and clinical symptoms, but it is not known whether these effects are sustainable. The durability of cognitive and clinical benefits obtained from neurocognitive treatment should be investigated in further studies.