Cognitive Intervention at the End of Therapy for Survivors of Childhood ALL Treated on TOTXVI

Participants enrolled on the TOTXVI protocol at SJCRH will be randomized to either complete the Cogmed intervention at the end of their therapy, or to a standard-of-care condition.

Cogmed is a computer-based cognitive training program that consists of rotating exercises that train attention and working memory. The exercises are presented in a child-friendly, game-like format. Training is completed at home in 25 sessions for 15-45 minutes each weekday for 5-9 weeks. A research team member serves as a coach who monitors progress and provides support through weekly phone calls with study participants and their parents/guardians. Information regarding compliance and performance is tracked over the internet and used to tailor feedback during weekly telephone coaching.

Neurocognitive assessments will be conducted at baseline, immediate-post (3-4 months after baseline), and 8 month follow-up (12 months after baseline).

Inclusion criteria

• Currently enrolled and receiving treatment for acute lymphoblastic leukemia (ALL) on the TOTXVI therapy protocol at St. Jude Children's Research Hospital
• At least 4 years of age at the time of randomization
• Primary language is English
• Parent/legal guardian/caregiver that speaks English available to assist in participant's training

Exclusion criteria

• Significant cognitive impairment as determined by either an IQ of ≤ 70 or by clinician judgment
• Major sensory or motor impairment that would preclude valid cognitive testing
• Major psychological condition that would preclude completion of the intervention
• History of significant CNS injury or disease predating or unrelated to cancer diagnosis
• Documented ADHD predating cancer diagnosis