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Head injuries: investigating the benefits of memory training

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What did the project achieve?

“We’ve now completed what we believe is the largest randomised controlled trial evaluating working memory training in children with acquired brain injury (ABI) in the world – and the only one reported in the UK,” says Dr Anna Adlam of the University of Exeter.

Around 70,000 children in the UK are admitted to hospital each year because of a head injury, with at least 350 classified as severe.1,2 They can have many causes, including road traffic accidents, falls, (traumatic brain injury) or injuries caused by non-traumatic events such as brain tumours, stroke or infections – and some can leave a child with devastating, lifelong consequences.                                                                                                                     

One lasting effect can be problems with working memory, which means that children can struggle to hold information in their minds while they are busy with other activities.

The team were initially investigating whether a commercially-available computerised training programme (Cogmed Working Memory Training - CWMT) could help to improve the working memory of children who are recovering from traumatic brain injuries – and they also expanded their research to include children with non-traumatic brain injury.

“Although we did not see an effect straight after training, when we reassessed children six months later, we found that children who had undergone the adaptive training performed better on our memory measures than those who had not – suggesting they may need time to consolidate their skills,” says Dr Adlam.

However, there were no differences in either maths or reading performance between the groups – either immediately after training or six months later.

“Despite the current interest in working memory training, there has so far been limited research investigating its potential for children with brain injuries,” says Dr Adlam. “So our preliminary results provide new insight to help inform future clinical decision-making around how best to use CWMT to help children with ABI.”


  1. The Brain Injury Group https://www.braininjurygroup.co.uk/living-with-brain-injury/children-brain-injury/ [website accessed 27 February 2018]
  2. Hayes, L et al. Requirement for and current provision of rehabilitation services for children after severe acquired brain injury in the UK: a population-based study. Arch. Dis. Child. 2017 Sep;102(9) 813-820.

This research was completed on

Each year in the UK, around three children in every 1,000 suffer a head injury that is so bad they have to be hospitalised for at least 24 hours.1 Sadly, these injuries, known as traumatic brain injuries, are a major cause of disability and can limit children’s future prospects. Dr Anna Adlam, from the University of East Anglia, is investigating whether a computerised training programme, which is designed to boost working memory, can help improve these children’s lives.

What is the problem and who does it affect?

Head injuries are a major cause of disability in children. Children under five and young people between the ages of 15 and 24 are particularly at risk. Road accidents and falls are common causes of these injuries, which are known by medics as traumatic brain injuries and result from force to the head.

“Advances in emergency care mean that most children now survive a traumatic brain injury,” explains Dr Anna Adlam. “However, children can go on to suffer long-term, even life-long difficulties – their social skills, emotions, behaviour and performance at school can all be affected. When they grow up, they can even be at increased risk of substance misuse, mental health difficulties, unemployment and criminal behaviour.”

It can also impact the children’s families too. Caring for a child who has survived a head injury can be difficult. Siblings and parents are at increased risk of mental health difficulties and marital breakdown.

Unfortunately, it is far from clear how best to help. “We lack good evidence and guidance on appropriate treatments for children who have suffered head injuries,” says Dr Adlam. “There is an urgent need to identify effective ways to improve the outlook for this vulnerable group of children.”

What is the project trying to achieve?

Dr Adlam is investigating whether a computerised training programme, which is designed to boost working memory, benefits children who have survived a head injury. Problems with working memory are common in these children. (Our working memory enables us to hold information in our mind when doing things like trying to solve a problem or learn something new.)

Around 45 children aged 8 to 16 who have survived a head injury are using the training programme in their homes for around 25 days. Their progress is being compared with another 45 children who are receiving training with activities that do not tax working memory.

“We aim to answer several important questions,” explains Dr Adlam. “Does this computerised training improve children’s working memory and their academic ability – their performance in maths and English? How does training affect children’s behaviour, their emotional wellbeing and the whole family’s quality of life? And could training save money for the NHS?”

What are the researchers’ credentials?


The interdisciplinary research group includes psychologists with expertise in human memory, gained both during research and while working with children who have suffered head injuries, a medical statistician and a health economist. The team has all the knowledge, skills and resources needed to make this investigation a success.


  1. Hawley CA et al. Prevalence of traumatic brain injury amongst children admitted to hospital in one health district: a population-based study. Brain Injury 2003; 34: 256-60.


Project Leader Dr A Adlam
Project Team Professor L Shepstone Joint PIMr E WilsonProfessor S GathercoleDr J HolmesDr F GraceyDr J Limond
Project Location Faculty of Medicine and Health Sciences, University of East Anglia, Norwich
Project Location Other MRC Cognition and Brain Sciences Unit, CambridgeCambridge Centre for Paediatric Neuropsychological Rehabilitation, Ida Darwin Hospital, Cambridge Washington Singer Laboratories, School of Psychology, College of Life Environmental Sciences, University of Exeter
Project duration 3 years
Date awarded 22 August 2011
Project start date 1 July 2012
Project end date 31 March 2017
Grant amount £130,818
Grant code SP4649, GN1833
Acknowledgements This project is supported by a generous grant from The Henry Smith Charity.


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