When Brain Training Works – Points of Controversy, by Betsy Hill and Roger Stark

Pre-publication publicity for a new book on the value of brain training claims that there are 5 conditions that make it effective.  While it surfaces some important considerations, it is likely to disappoint anyone who adheres strictly to the five conditions.

Here’s where the advice falls short:

  1. It must engage and exercise a core brain-based capacity or neural circuit identified to be relevant to real-life outcomes.

Response:  First of all, if there is a brain-based capacity or neural circuit that hasn’t been identified as relevant to real-life outcomes, then it probably doesn’t exist.  The purpose of our brain is survival, so all mental capacities are arguably relevant to real-life outcomes.  But more importantly, it is insufficient to say that training must target a mental process shown in research to be relevant to real-life performance.  The training should actually be able to demonstrate improvement in whatever that real-life performance is.   This is actually where much brain training falls down.  It’s not that the training doesn’t connect the exercise to a specific neural process, but that it can’t demonstrate actual change in real life application.

2.  It must target a performance bottleneck.

Response: The issue here is the model of brain functioning that underlies the statement.  A bottleneck is relevant for a linear process.  If step 2 of 10 in a manufacturing plant is slow, then that produces a “bottleneck.”  Speeding up step 2 will speed up the whole manufacturing process.  But our brains are not manufacturing processes.  Rather, they are complex systems with multiple processes occurring simultaneously (and hopefully in coordination).  In fact, recent research supports the idea that multiple mental processes are involved in just about everything we do and they have to work together.  While there is some truth to targeting weaker functions, it is at least as true that brain training, to be effective, is about integrating multiple systems.

3.  It requires a minimum “dose” of 15 hours total per targeted brain function performed over 8 weeks or less.

Response:  It’s refreshing, actually, to see a consensus emerging that a few minutes or hours of training here and there won’t do much for cognitive fitness.  But there is a fundamental flaw in the implication that each brain function must be trained independently.  If that were the case, then a training regimen of 150 hours would be required to address 10 targeted brain functions.  In our research, we have found that a dramatic impact on multiple brain functions is achieved in 35 to 50 hours of training multiple cognitive skill areas in an integrated fashion (using BrainWare SAFARI 3 to 5 times per week, in 30-45 minutes sessions over about 12 weeks).  We can agree that noticeable differences start to appear at the 6-8 week mark, but much more can be accomplished than this description of the book suggests.

4.  Training must adapt to performance, require effortful attention, and increase in difficulty.

Response:  This is all true, but it neglects what we know about what actually motivates effortful attention and persistence in training.  Parents and clinicians we talk to tell us, over and over, that most other brain training programs they have experienced are BORING.  Even when they are adaptive, increase in difficulty, and require focus (effortful attention).  Human beings don’t expend effortful attention when things are not engaging.  Students don’t care how much you know until they know how much you care.  The design of the training program needs to be motivational, engaging and reward, not just demand, persistence.

5.  Continued practice is required for continued benefits.

Response:  This condition suggests that one needs to continue training essentially forever.  First, we want to say, “Wrong,” but then we want to relent and acknowledge that, “It depends.”  It also requires that we consider what “practice” means.

When children complete a brain training program (which we think is better termed cognitive training), they bring their improved attention skills, working memory, or visual-spatial processing to an educational environment that, in most cases, continues to put demands on those very cognitive skills.  In other words, they are using and practicing those enhanced cognitive skills every day.

If you are an adult in the workplace, the same would be true, by and large.  You are in an environment where you “practice” your improved skills constantly.  After all, if they haven’t transferred to real life, what’s the point?  If your goal, as an adult, is not to perform better, but to be a “high functioning couch potato,” then that is another story altogether.

One situation where continued benefits may require ongoing training is for those who want to build cognitive reserve and/or mitigate the effects of the declining demands of everyday life as they age.  For many individuals who are not as active as they used to be in intellectually demanding activities, ongoing training makes sense.

The idea behind brain training is that getting skills to the level of automaticity so that they are used in real life, means that real life becomes the practice.  While continued training may be useful for some, the better the training, the better the transfer, the better the individual applies their stronger cognitive functions in everyday life, the more challenges they take on, the more problems they solve … and the less need they will have for ongoing training.

We welcome the opportunity to explore the fascinating topic of brain training – and everything we know and don’t know – with you.  Please comment or feel free to email us at bhill@mybrainware.com or rstark@mybrainware.com.

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One Response to When Brain Training Works – Points of Controversy, by Betsy Hill and Roger Stark

  1. Jean-Claude Dutes says:

    It must engage and exercise a core brain-based capacity or neural circuit identified to be relevant to real-life outcomes.
    I am basically in agreement with your position. This criterion is met by most if not all of brain training program that I am familiar with in that they usually address attention, including processing speed, working memory, executive skills and memory, whether this is explicitly stated in their program description or not. Some programs may focus exclusively on the visual or verbal modality or a combination of both, with some programs also addressing fine motor abilities. The issue for me here is the depth or the extent to which program exercises present sufficient levels of challenge for its targeted population.
    It must target a performance bottleneck.
    I agree.
    It requires a minimum “dose” of 15 hours total per targeted brain function performed over 8 weeks or less.
    I am not sure what they mean here by targeted function. In my experience with brain injured persons, attention retraining appears to leads to improvement not only in basic attentional processes such as encoding, inhibitory control (selective attention) and speed of processing but also to changes in learning, memory recall and executive abilities as measured by pre and post psychological testing and self and others’ reports of behavioral control. I don’t know if the same holds true for non-injured brains where the issue is optimization instead recovery. The 15 hours is consistent with my experience. In a two segment program of 15 hrs each, we saw significant changes after 15 hrs of consecutive work within a five-week period. For me what is important is not only the duration but the intensity of the therapeutic period. There must be caveat here: progress can be expected as long as the brain integrity is stable. This is particularly the case for middle age persons with many undiagnosed medical conditions such as sleep apnea, vascular problems and medication regimen.
    Training must adapt to performance, require effortful attention, and increase in difficulty.
    Agree. We usually tell our patients that “we will stretch your brain but will not break it” and that they can expect to be challenged. Basically no sweat, no gain. It seems to me that many good training programs don’t work because they fade into disuse when the user expecting quick and easy progress does experience any changes after a few tryouts. In our experience having a coach during the first training segment was critical in facilitating continued use of computer programs during the life training phase of our therapeutic program. It’s like having a body building equipment. If you don’t use it, you will not see any gains.
    5. Continued practice is required for continued benefits
    Agree. But the intensity can decrease. If one wants to maintain “good brain tone” or having an edge over the competition, in the case of optimization of functioning, doing systematic exercises at least once a week, I believe, would be helpful. If anything because of aging effects and the continual need to guide the brain’s development and counteract the potential effects of genetics, in the case of a neurodevelopmental disorder such as ADHD. The patients we worked with, a heterogeneous group of brain injured individuals, showed evidence of continued gains over time but with some regression from where they were right after training. Of importance, they did not go back to where they were at onset of treatment. Unfortunately, we did not have time before I left to start systematically tracking this trajectory and this impression is based on about five patients.
    GENERAL COMMENT
    I agree that automaticity is the goal. Without evidence of it, it cannot be assumed that the neural networks had actually changed. Automaticity is evidence of mastery, with automaticity being itself a function of intense practice.

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