Eye-tracking working memory intervention in young people with severe dyskinetic cerebral palsy: an exploratory pilot study

Background/ObjectivesWorking memory (WM) is a core component of cognition, supporting learning, reasoning, and daily functioning. In severe dyskinetic cerebral palsy (CP), profound motor impairments and involuntary movements make reliable cognitive assessment and access to cognitive interventions difficult. Eye-tracking technology offers an optimal computer interface for administering computerized cognitive assessments and training programs. This study explored the feasibility and efficacy of an adaptive, eye-tracking WM training in young people with severe dyskinetic CP. MethodsFour individuals with severe dyskinetic CP (age range 10-20 years old, 4 female) completed a 5-week intensive Cogmed WM training (five 30-45-minute sessions per week). Primary outcome was the Cogmed Improvement Index, reflecting near-transfer on trained WM tasks. Secondary outcomes included tests from the Wechsler Intelligence Scale for Children-Fifth Edition (WISC-V) to assess near-transfer on untrained WM tasks (Picture Span) and far-transfer to fluid reasoning (Matrix Reasoning, Figure Weights) and visual-spatial reasoning and planning (Visual Puzzles). Language comprehension was evaluated using the Computer-Based instrument for Low motor Language Testing (C-BiLLT), and executive functions behaviour using the Behavior Rating Inventory of Executive Function-2 (BRIEF-2). Descriptive statistics were used. ResultsParticipants completed 23-25 sessions (100% adherence). Cogmed Improvement Index increased by +10.5 to +27, and Picture Span by +12 to +21 post-intervention, mostly retained at 3-month follow-up. Far-transfer effects were variable, except language comprehension which improved consistently and remained stable. ConclusionsThese preliminary findings suggest the feasibility and potential cognitive benefits of adaptive eye-tracking WM training in severe dyskinetic CP. Randomized controlled trials are needed to confirm efficacy and generalisation effects.