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Visual Sustained Attention Auditory Sustained Attention Divided Attention Visual Memory Figural Memory
Pattern Memory Visual Verbal Memory Letters-Syllables-Words Reading-Decoding Pictograms
Spelling Anagrams Classification Series Completion Analogies
Visual Tracking Hand-Eye Coordination Perceptual Speed Field Independence Shape Recognition
Puzzles Spatial Orientation Labyrinths Spatial Relations Spatial Visualisation
Visual Perspective Arithmetic Strategies    

Equipment required          Cost of programs

Cognitive training programs: CO-SKILLS is a comprehensive cognitive program for training many cognitive skills such as attention, memory, language, reasonning, hand-eye coordination, visuo-patial abilities and problem solving. The tasks are ordered in difficulty to situate the client within his/her zone of development and to offer challenges appropriate to his/her level. It is within the context of sustained practice that learning conditions are maximized. The CO-SKILLS programs thus target different skills that can be subject to training. However, the tasks often call upon several skills simultaneously. For example, attention is omni present in all tasks. Table 1 presents the twenty-eight programs of the version 5.0 in association with the principal cognitive variable categories. Within each category, the programs generally involving easier exercises precede those that are more demanding. For example, the Reading-Decoding program presents a content that is easier than that of Anagrams. The Spatial Visualisation exercises are more difficult than the exercises from the Spatial Orientation program. In Table 1, the programs appear according to their level of difficulty within the principal cognitive skill categories. This order is based on the first levels of each program. This means that the final level of a program that is considered to be easier than the next program may be more difficult than the final level of a program that is considered to be easier. This table is only a guideline. For certain clients, the order may slightly vary.

Table 1. CO-SKILLS programs according to their principal associated cognitive skills

Cognitive Skills CO-SKILLS programs
Attention Visual Sustained Attention
Auditory Sustained Attention
Divided Attention
Memory Visual Memory
Figural Memory
Pattern Memory
Visual Verbal Memory
Language Letters-Syllables-Words
Reasoning Classification
Series Completion
Hand-Eye Coordination Visual Tracking
Hand-Eye Coordination
Visuo-Spatial Skills Perceptual Speed
Field Independence
Shape Recognition
Spatial Orientation
Spatial Relations
Spatial Visualisation
Visual Perspective
Mathematics and

Characteristics common to CO-SKILLS programs

Training according to the client’s rhythm

Since the beginning, CO-SKILLS programs have been interactive and have functioned according to an « adaptive » mode that enables the client to progress at his/her own rhythm. Each program automatically manages or adjusts the training’s progress according to the client’s performance.

Gradual Training

Each CO-SKILLS program has several levels of difficulty; certain programs are also subdivided into classes within which there are variable levels of difficulty. During a training session, one’s progress depends upon successes or failures. Accordingly, when the client accumulates a certain number of consecutive successes, the program automatically increases the difficulty level. However, if the client does not manifest mastery over the content, the program continues to offer exercises from the same difficulty level.

Data Recording

The CO-SKILLS programs record the client’s performance during each training session. This means that at a later session with the program, the client continues his/her exercises at the level he/she previously reached. The supervisor/clinician may use the CO-SKILLS manager environment to easily monitor the client’s progress.

The Exams

The exams included in most CO-SKILLS programs assess the client’s mastery of the program’s contents. They are not normative tests, but assessment tools that may be used for two main purposes: 1) assess the relevance of exercising on this program; 2) assess a client’s progress following training (pre- et post-tests).

Each exam is generally constructed from a sample of items representative of the tasks involved in each program. The result is expressed as a percentage of mastery of the program’s content.

The exams were thus solely created according to the CO-SKILLS programs’ contents. The result obtained by a client has no other signification than an indicator of his or her level of performance in regards to the program’s contents. The result cannot be interpreted as a general measure of skills, nor be used for purposes other than training with CO-SKILLS programs. As the programs have different difficulty levels, each result is independent from the other and cannot be compared directly. Therefore, a score of 50% on Spatial Visualisation and a score of 50% on Spatial Orientation does not mean that the clients performances are equivalent with regards to the cognitive skills that these programs share; it means that master of each program’s contents is 50 %.

Table 2 presents the program classes and number of levels.

Table 2. Program classes and difficulty levels

Program Class Levels Program Class Levels
Visual Sustained Attention 1. Increasing 14 Anagrams 1 11
2. Decreasing 14   Classification 1. Images-Items 9
3. Series 8   2. Images-Categories 38
Auditory Sustained Attention 1. Increasing 14 3. Words-Items 10
2. Decreasing 14   4. Words-Categories 48
3. Series 8 Series Completion 1. Letters 18
Divided Attention 1 16   2. Numbers 20
Visual Memory 1. Numbers 21 3. Symbols 14
2. Letters 24 Analogies 1 26
3. Figures 24 Visual Tracking 1 27
4. Symbols 24 Hand-Eye Coordination 1 21
Figural Memory 1. Themes 6 Perceptual Speed 1. Letters 35
2. Categories 6 2. Symbols 33
3. Related Themes 6 Field Independence 1 20
Pattern Memory 1 29   Shape Recognition 1 18
Visual Verbal Memory 1. Text 4 Puzzles 1. With Model 20
2. Categories 6 2. Without Model 20
3. Themes 6 3. Identification 20
4. Incomplete Sentences 6   Spatial Orientation 1 20
5. Related Themes 6 Labyrinths 1 6
Letters-Syllables-Words 1 48   Spatial Relations 1 22
Reading-Decoding 1 24   Spatial Visualisation 1 23
Pictograms 1. Images 61 Visual Perspective 1 14
2. Words 61 Arithmetic 1 114
Spelling 1 85 Strategies 1 5

Assessment of cognitive skills for monitoring and measuring the intervention’s effectiveness

Cognitive skill assessment is essential before applying a cognitive training program (Gontkovsky et al., 2002). The administration of cognitive skill tests or any other neuropsychological tests in pre- and post-treatment enable one to establish the client’s base-line performance, a rigorous monitoring of progress, as well as evaluation of the cognitive training’s effectiveness. It is important that the evaluator respects the following criteria to guide his/her choice of exercises: 1) do not use evaluation material to conduct cognitive training; 2) favour measurement instruments that target the same cognitive variables already targeted by the CO-SKILLS programs being used; 3) use evaluation tools for which good psychometric properties have been demonstrated; 4) use evaluation tools for which the evaluator is qualified to administer and interpret.

Equipment required: A PC or PC compatible microcomputer with a Pentium III processor, 128 M octets of live memory, a graphics card with at least 8 M octets of memory, a colour screen, a standard CD ROM drive, a hard drive with at least 150 M octets of free space, Windows software (2000 or more recent), a computer mouse  or joystick, a sound card and two speakers (or earphones), and a printer.